Wednesday, June 11, 2008

JCAHO Is Here

How do you know? Well, for one, all the administrators and supervisors that you hardly see or that rarely call you by name are frantic and just a plain nuisance. When will they get it? If they ever thought about safe staffing, not only would patients receive quality care but, also, all that work that doesn’t get done on a daily basis would be in a more “compliant” status. Supervisors that never “supervise” will show up with dust rags and cleansers and stress the housekeepers out trying to fix in hours what has been ignored for months and years. Things that have never been wiped down will now be polished by a “supervisor.” Managers will have their fingers on the pages of the charts and so graciously ask you to fix this or update that. Of course every manager will be their staff’s best friend as they point fingers to the “other” departments that do not comply. On the surface, it’s time to convince JCAHO that IV tubing always has the appropriate stickers and dates on them and are never left uncapped and open to air. Medications are never left on the cart and the med book is always kept closed. We have nothing more to do but assess and chart pain and all the required specific details about it every hour and every half hour. The frinzy is entertaining. It brings the department window dressed administration staff back down to reality and the rest of us get to see how much they fear that they will get busted for NOT managing or NOT supervising. I guess we can be thankful that we don’t have to deal with them every day in our job. The relief is in knowing that once JCAHO has left the building, we will hardly ever see the managers again unless, of course, you need to be reprimanded or fired. They worry about JCAHO and we worry about getting our work done by the end of our shift, making sure our patients are breathing or haven’t fallen because we can’t be there for them, praying that your patient won’t be lying in a wet diaper or on their tail bone so long that they get break down, hoping that we can actually control their pain rather than chart about it, wishing important medications will get to you faster so you can stabilize a crisis. You know when you leave at the end of the day that you might have felt crazy trying to do your job but you weren’t the one that “was” crazy. You shake your head as you head to your vehicle to go home but you chuckle at the stupidity that entertained you as you got to see that phoney side of management that you knew existed but had forgotten about in your day to day actual concerns for the patients.

Thanks, JCAHO, for entertaining us periodically. I think if you really cared you would be investigating hospitals on a daily basis. We all know this is a money game. You have to know that with the present nurse to patient staffing rations there is no way all your rules will be followed. Do you really care? WHEN will you enforce safe staffing numbers? Seems with all your power you could be making sure that hospitals comply with appropriate and safe nurse to patient staff ratios, then your pain assessments would be timely and efficient. For now, we all just play the game. You make money and the hospital makes money but quality patient care is non-existent.

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