what a challenge. if it has been decided by the hospital that there is not a problem with the situation mabye it is just up to you to tollerate it for a while transitions are never easy. I do agree with your concerns compleetly and if this is just a decision that the manager has made on thier own mabye it could be brought up to a person over patient rights. but if these areas have been envolved and have approved then tollerance seems to be the best answer. good luck and good topic. J

Makes me glad I don't work there. We have computer charting but we get computer generated kardexes with the latest dx, labs and test results on them. Which we fold over and make notes on the back of for the things that aren't on the kardex. (yes spelled that way). They are great, but they took a while to learn to use. They also list all consulting docs and give their phone numbers. As for including family members in report we don't. Nor do we do bedside. Family members are a large part of the problem, and responsiable for much illness. As an example I had a pt some weeks ago who was on multable phsyc meds. His brother, decided he just had a learning disability and through out a whole bag of his meds. Thus he was admited with altered mental status. The pt is a clasic skitzo, like the ones you see on the 6 oclock news when they go on a killing spree. How could you give an honest report infront of the brother, who does not belive the truth because it disagrees with his world view? He thinks that if his brother would stop being lazy, get right with god and get a job he would be ok. (Parts of that I could agree with, but the job thing just isn't going to happen, no perception of reality most of the time) Another example I could give is the one time I had a wife slowly killing her husband for his money. The story is long, but eventually between the staff and the Dr. she was banned from the hospital, but too late he died. (Sounds like a movie I know, but it happened.) How could I tell the truth to an oncoming nurse with her standing there? I could go on with other examples. I really feel for you. What a burden. I don't feel like I am missing anything not being at the bedside. If there is something I feel I need to see, we get up and go look. On occation some pts have had complictated surguries with drains and other things in od places and I just say "show me". I do a really good assessment of people when I go to see them, and most of the time I feel that I got an accurate picture from report. Just take it from head to toe, going through all the systems and then fill in the details that don't fit anywhere else. Works great. What happens when you have a pt with medastaic CA who's family doesn't want them to know? How could you give a bedside report in that instance? Or you have a pt who is up for placement in a nursing home and the family and the pt are fighting about it ? The system you discrib has multable problems and hippa is just the minor point. Do you realise that from what you say the family must be looking at specific test results, which by law are only supposed to be disclosed by a doctor? This is because the general public is not educated to understand the results which often results in an incorrect interpretation of the results. Sounds as if what you really need is new administrators with some nursing experience. Do you guys really stand over a pt and tell the oncoming nurse that "yes I think he will be dead in a couple of hours"? There are so many things wrong with that idea I could go on for hours. Anyway as for computer charting I tried going back the other way for a few weeks and once you get used to it you will love it. Good luck and let me know the answers sounds ammazing.

computer charting.
We have computer charting but the computers are not in the hallway!! Nor do family members have any rights to view the records unless proper authorization was obtained (hippa) and certainly NOT listen to shift report!! I value my license too much for that crap. I have noticed that hospitals that are "middle management heavy" come up with really wierd stuff, like they are trying to validate their jobs. The nurses actually INVOLVED in patient care should make a lot of those decisions, esp. how to give a shift report. I think a family member who knows nothing about medicine would misunderstand what is being said, and create more problems.