This is my 13th year as a Nurse, I currently work in the ICU and have been at this hospital for nearly 7 years. I AM a good nurse, I am trusted by my physicians, a resource for other nurses, and I TAKE CARE OF MY PATIENTS.  We have been SLOWLY incorporating computerized charting (yes we STILL do most of our charting on paper..) Our meds are scanned with bar codes (what a pain), and within the past 9 months we have been doing care plans on the computer. Now this has been a work in progress, MULTIPLE changes, updates, and nothing ever definitive with directions. Our latest "change" occuring 2 weeks ago. Now lets face it..care plans?  As if they really have any true effect upon patient care and in the past have not been highly emphasized, nor was it ever a part of the medical record. Anyway we are to chart on this twice daily within the first 4 hours of our shift then at the end to assess if our nursing interventions were effective in caring for the patient during our shift....I don't know about anyone who may be reading this but I chalk it up to a win-win if my patient is stable and I'm out on time.  Anyway I had two very busy patients and I failed to chart on my computerized record for my whole shift..OH NO!!  I still didn't get out on time because I had to catch up on a full day of charting at 5pm, the VERY last thing I thought about was my careplans.  The next day I was off, I did speak to my supervisor that afternoon about working extra, she commended my flowsheet (paper charting) documentation and the way I lets face it sucked up to this difficult family member and patient.  YEAH...positive feedback!!!!  Later that afternoon early eve I rec'd a call at 5:10pm (I had plans that nite and was very excited to head out so 510 was a poor time, I needed to leave by 530pm). Anyway a random audit of the computerized documentation was performed and I was grossly non-compliant. I was told that my documentation was incomplete, and how could I have left my shift without documenting completely.  It seemed that everything I stated was WRONG. I forgot..not sufficient..then the kiss of death.." I  didn't realize that the care plans were a vital part of the documentation process, and with all the updates, changes etc I was finding it very difficult to stay on top of these mandates." Not to mention I never thought of it as part of the medical record.   I was told (in a 3 way conference call) that "how could a nurse of my experience forget this? "  addl "your care plans direct your care", and the prize.."maybe i'm not a good fit in this dept".  This went on for 40 min. At the end of the conversation my manager told me that she needed to terminate the call  "because she feels as if they were beating me up".  I was in tears nearly hysterical.  Not once during the call did any of the participants, My nurse manager, and 2 assistant managers, offer any amount of support, or comfort, and I was obviously distraught, in fear of losing my job, or even being reported to the state for documentation issues. Not once was I told that my job was safe, nor when I asked that question was this even answered.  Needless to say my event I had planned to attend of course I didn't, I was inconsolable, and crying most of the nite.  I made myself sick and out of fear, and true illness (probably brought on by stress) I ended up calling in my next two shifts.  Last nite I went in finally, the anticipation of repercussions was getting the better of me so I went in (I'm a day nite rotater).  I wasn't terminated yet was concerned about  what to expect this morning when management showed.  This morning one of assistant managers saw me, patted me on the shoulder and said she was glad I was feeling better..that was it.  Now tomorrow will be the true test when I am there on days subjected to my nurse manager and the other asst mgr who happens to be a bit well two faced.  Yet it would seem to me that if I was going to be term'd then they would have just called me in the office this morning and been done with it.

During my time at this organization I have been written up once for attendance, yet I have been reprimanded for speaking my mind too many times this being chalked up to a poor attitude.  It is my feeling that yes ok I am not perfect I failed to document on the computerized portion, now that I KNOW obviously how important this is to "my care", this will no longer be an issue.  I will make a point of doing this as well as completing my other tasks for the day, yet during our impromptu conference call this was not a sufficient response.  I felt backed into a corner, fearing that my job was on the line, and completely 100% bullied to a quivering mess of goo.  I do not know what to do, I always fear management and their critiques, not that I can't handle constructive criticism, our managerial staff seems so punitive, "DO THIS OR YOUR OUT".  I am interested on what other nurses think about this situation and any advice.  Part of me wants to go to HR, another part wants to seek out an attorney, yet I realize that both options will put my job on the line. I am a good nurse, a born bedside nurse in an era where most new nurses want to go on to be NP's or CRNA's. Is this what we are reduced too? and if bullying in managers is commenplace where will the bedside nurses be when WE are in the hospital?

Hiya, Are they having any inservices about the changes in progress? Pehaps that could be recommended. However, if you think that the end is near, it may be best to jump the gun and give in your resignation.. That may  prevent you from having trouble in the future for other positions... Best of luck to you... God Bless you and please keep us posted....Hugs, Teresa.