What is Killing your Front Line Healthcare Workers? It’s not what you think…….
Read on to learn about the
Current PANDEMIC:
“Working in the healthcare field is Fu*@king insane”.
A quote from a fellow Hospice nurse. Why did she say this? Because healthcare workers are required to take care of two patients now. The glorified cash register called the computer (ZDogg MD, Stop calling it Burnout) (watch video) and you. Notice I put the computer before you in the sentence? That is where you have ended up in this chaos of healthcare. If you haven’t noticed, the computer is winning.
I’m sure you have heard on the news, “Our healthcare system is broken.” Newsflash!! It has been for years. Front line healthcare workers struggle every moment of every shift to try and be present with you, but the tasks that pile up on our list and in our brains are a tough contender against our attention to you.
No one has been paying attention to the other Pandemic started 15 years ago, the computer system virus of healthcare. The glorified cash register of insurance companies and private hospitals.
Why has the computer become so important? Besides the few good reasons it exists, like having your information accessible to different caregivers in different places , it is because this is what administration prioritizes. Not because they are cruel, uncaring, or don’t give a shit, (well, most anyway), it is because healthcare has become a business, an enterprise, and the computer is one of the best ways to obtain the ‘numbers’. (Medical Records and Data Driven Healthcare) (info Link) This is widespread, it has been a stealthy steadily growing pandemic, and it started way ahead of the Covid pandemic. Covid only exacerbated the insanity that was already present. The more numbers that can be gathered, the more numbers are wanted. The powers that be; the insurance companies, drug companies, and our government won’t easily give up the power so it continues in exponentially scary ways. The victim in this is you, the patient, the healthcare consumer. It is rampant but it is not worldwide, it is nationwide.
I am a nurse who entered this career in 1988. We were actually trained and videoed on how to talk with and be present with our patients. We had TIME to be with those in our care. When computer charting started invading our jobs 15 years ago I begged the person training us to stop this before it started. I said with tears in my eyes, “Please do whatever you can to help us not have to do this because I can guarantee at some point you or someone you love is going to be a patient and you will see the damage this will bring.” Her response? ” That is something you will need to bring up with your manager.”
Fast forward: Today’s nurse training’s main focus is how to handle the equipment and how to chart correctly for the right numbers for the facility and to help cover their ass against lawsuits. As you can see and as predicted, this is a horrendous change and has had an enormous effect on patient ‘care’ (defined below).
Patient Care Definition: The services rendered by members of the health profession and non-professionals under their supervision for the benefit of the patient. (From Dorland, 28th ed, p269)
“For the benefit of the patient.” Do you feel that is happening? Correct! It’s not. You the patient are NOT at the top of the food chain. In fact, you are at the bottom, along with the nurses, medical assistants, physicians and all the other front line workers. You are not being benefited. You are not imagining the inattentiveness of your hospital staff, or the seeming preoccupation with things other than you. What you are feeling is real, it is scary, it is out of control, and it needs to stop.
The Equipment alone in any nurse’s day is extraordinary, then add the computer charting.
We are asked to be tech experts with the most minimal of tech training. Click here, they say, fill out this box, go to this screen, do these 10 extra steps because the systems ‘don’t talk to each other’. It is insane for so many reasons, and your care suffers.
The last time I checked, we are nurses, not tech experts, not robots. And yet we are told, “If you didn’t chart it, you didn’t do it,”, and “You must chart it when it happens or it is a ‘Late entry’ and subject to litigation”. So even in emergent situations, we must do it. We do ALL the extra unnecessary charting on a totally screwed up computer system for totally screwed up reasons. But we are now suffering for it along with you. Along with the moral injury (watch video) and environmental toxins and stress, cancers along with other mental and physical afflictions are on the rise in the healthcare profession.
Do you think this is not your problem? Think again. In the last few years I have seen my comrades either die, retire early, or quit their positions for self preservation. If this trend continues there will be no one but robots (article) figuratively or not, taking care of you when you are your most vulnerable.
So you see, it is not because we don’t CARE about you that you are seeing a lack of presence when taking care of you, it is because WE DON’T HAVE THE TIME or are FEARFUL OF LOSING OUR JOBS! We can’t tell you this however, for moral reasons as well as the threat of losing our jobs if we do speak the truth. Besides, how would that make you feel at one of the most vulnerable times of your life?
Instead, we carry on, being your best advocate because it is the right thing to do. Internally, however the stress mounts.
Below are just a FEW things in a nurses’ day that are done to help take care of you, the Human BEing in the room :
We listen to what you, the patient are saying. If you are unable to speak we observe and decipher what your body is communicating
( and then chart this on the computer)
We talk to your family about your status and assess how they are dealing with your illness
( and then chart this on the computer)
We talk succinctly to the Healthcare team in a timely and approved manner. (minute by minute in a crisis)
( and then chart this on the computer)
If you are a laboring mother we assess the status of you and your unborn or newly born child constantly.
( and then chart this on the computer)
We are continuously assessing the status of your brain, heart, lungs, stomach, bowel and bladder, skin, etc.
( and then chart this on the computer.)
If the computer or equipment isn’t working we have to take the time to find a work around or fix the computer, or find someone to fix the computer, or whatever else works in the moment to do all the right things while taking ‘Care’ of you
1. We are told we must chart all of your care in a ‘timely manner’, which is then audited on a regular basis. Threats of disciplinary or corrective action are discussed if we don’t comply with charting requirements.
Take a look at the amount of equipment in the picture on the left. That alone requires one person!!! A hired ‘Scribe’, charting the information for us would help but that ‘costs too much money’ for a nurse to have.
It is this pressure, the unrealistic expectations, and the resulting self protection that forces many to finally choose the computer over being present with you, the most important person in the room. It breaks our heart, strains our morality, and keeps us from doing the very thing we went into the healthcare profession to do in the first place: take good care of YOU.
2. A clinic practitioner is expected to see up to 4 patients per hour depending on the type of visit. The quicker the better they say. This is @15 to 30 minutes to read your chart before they come in the room, talk with you in the room, do a full assessment, order all the necessary tests or referrals, chart it all on the computer, then quickly move on to the next patient. They are told they can’t create overtime or chart ‘off the clock’, so there is no other time for them to chart! This is why so many providers say to you when they come in the room, “So what are we seeing you for today?” Honestly, it is because they only had very few minutes to prepare for your visit and probably only ‘skimmed’ your chart. Here is an article by Wendy Dean, MD about Clinician Distress.
ARE YOU GETTING THE IDEA? WE NEED HELP!!!!!!
Despite all of those tasks we have to do, we are still trying our damnedest to be in the moment with you. While you are being born, while you are living your life, while you are dying. We choose to try and listen. To care. Even though we are overloaded with two full time jobs: Taking care of the computer and all it’s equipment, and taking care of you.
YOU, the person for whom the healthcare system is there for in the first place.
We, the healthcare providers are struggling to hold on to you and keep you from getting sucked into that capitalistic void. But we are losing. More and more workers are getting sick, depressed, or suicidal because of it. Or worse yet, becoming apathetic robots or retiring early because they don’t want to continue to have the moral struggle every moment of every day, trying to do what is right for you, trying to be present with you while shouldering the other (literally) thousands of tasks we do in a single shift. While working in Labor and Delivery, I asked my manager often whenever we were asked to do yet another protocol’d task in our day, “When are we going to have a task taken away from our list? All we have are add-ons.” In the seven years we had this conversation, ONLY ONCE did she sit in a staff meeting and tell us, “Guess what? Finally a take away!” She understood and was stuck in the madness as well. And this was all BEFORE Covid-19 hit! Think of what they are going through now!
THIS IS THE REASON THE FRONT LINE HEALTHCARE WORKERS ARE HEROES!!!
So the next time you want to get upset with your healthcare provider for not being present or listening to you, take a closer look before judging them, they are trying their asses off to juggle two jobs. And if they are able to look at you versus the computer for the duration of your visit, thank them and acknowledge that this act alone will put them behind in charting, and subsequently into a risky situation for their own job stability because of audits and demands that they incur no overtime. It has become increasingly impossible for us to Float Sideways (website link) with you and it continues to tear at our moral fabric.
Until we all help cure this other intertwined pandemic, this will continue to manifest in horrible, ugly ways.. Why?
Because you the patient, and all of the different levels of administrators making the rules don’t really know what is going on ‘behind the scenes’. You are not at fault for this. Administrators are partially at fault for not paying closer attention and then acting in the absolute best interests of their patients and staff. It is ultimately the allowance of this insane unchecked system at the highest levels of healthcare (article on the history of Insurance companies) that is at fault.
You, the patient, the healthcare consumer are losing the race. It is now between the tech world and hospitals as they struggle to appease all of the federal, state and local rules and regulations along with the insurance companies’ rules and regulations while also taking care of their own pocketbooks. You have been left in the dust.
How can you help?
Here are a few ideas (Please comment to this article with any other ideas you have, we need everyone’s brains involved in this change!!)
Have patience with your provider, they are doing the best they can. Are there personnel that really DON’T give a shit? Of course. But try asking them what’s going on before you assume this is the case. Most of the time, it’s not.
Ask your hospital or clinic administrators about getting scribes for their front line workers to help document (article on scribes) the care they give you. THIS ALONE WOULD HELP IMMENSELY.
Talk regularly to your friends and neighbors and ask them what healthcare is like for them. Share these and other ways they can help make a difference.
Fill out those comment cards and surveys after your visit. Administrations respond to these because patient ratings affect their nationwide status and ultimately their income. Please know the facts surrounding any incident with your front line worker if you are dissatisfied before writing a comment, then offer a solution on the comment card as well. (Tell administration to hire scribes, or get more staffing, etc.) And please be sure to say any positive interactions you have as well, using individual’s names if possible.
Get and keep copies of your medical records. Because of the way the computer charting is organized, it is insane for nurses and physicians to try and wade through all of the information and then chart succinctly and with detail all the information needed in just 15 minutes. Resultingly there are now many mistakes that go unnoticed on your medical record. This can cause insurance companies to reject your claims, leaving you with that ‘pre existing condition’ or an extraordinary bill.
Think twice about filing a lawsuit against your provider. Lawsuits only make our job harder and give us even more tasks to do in our shift. Things are rarely really fixed from a lawsuit against the hospital or healthcare worker. If you want to sue, go higher on the food chain
Get involved politically (https://www.usa.gov/elected-officials) and in your communities (www.nextdoor.com ) working for solutions to the problem at hand
With the current Covid crisis, wear a mask, wash your hands often, and social distance when possible. Healthcare workers don’t need the extra stress of a massive Covid patient influx because people don’t want to follow these 3 simple guidelines
Wear a Mask
Spread the Word
IF YOU WANT MORE PRESENCE FROM YOUR HEALTHCARE PROVIDER, BE MORE PRESENT WITH THEM, get to know the issues at hand, then push to make a change.
YOUR HEALTH ALONG WITH YOUR LIFE’S MOMENTS DEPEND ON IT
