Lots of paperwork. I spend more time with papers than people. Every interaction with a patient has to be kept as brief as possible in anticipation of all the paperwork created by even the slightest encounter.
They have invented another form. Like most other new forms, this form is IN ADDITION TO and not IN REPLACEMENT OF other forms. This new form also requires an additional signature- that of the Medical Director- who is not on the grounds 24/7 and is not readily findable when his car is in his parking spot. [Can you tell that I am already sharpening my medical director locator skills?] What is the new procedure? We must get his signature for all narcotic refills "to keep track of where these drugs are going," my supervisor explained to me. For those of you who are not medication nurses, let me clarify for you: every narcotic is already signed for by the nurse removing the pill; the date, time, and patient are also recorded on this existing form. So there is already an uncriticized system in place for tracking the dispension of lorazepam, zolpidem, and assorted other controlled goodies. Now I have to get coverage for my patients and leave the floor every day to track down the medical director so he can sign that I am reordering the medications just as I always have been.