Wednesday, August 22, 2012


I was trying to write a simple nursing note on a patient.

Quality Assurance Manager walks in.  He is not a nurse.

Asks me for a chart on a specific patient.

The desired chart is sitting on a shelf in front of his face.  With all of the other charts.

His interruption causes me to write the wrong word.

"The chart is somewhere on the shelf.  Go ahead and look," I say calmly and return to my writing.

He stands there silently and then says, "I don't see it."

I start to write the wrong word.  Again.  This is in ink.  I have to cross off, date and initial.

"Keep looking," I try to sound encouraging yet firm.  He is 100% capable of locating a chart all by himself and I am the nurse, not the file retrieval girl.

He finds it.  He opens it and starts talking again.  "I'm investigating an error," he says, as if this is enticing information that will draw me in.  Little does he know that I cover up more errors in a day than he'll see in a year.  He also does not know that his constant interruptions have caused me to err in writing a third time.

In the background are ringing phones that nobody else can answer because they didn't go to nursing school.  (You answer phones and don't have a nursing degree?  You are quite talented!)  Patients screaming, "Nurse!"  Alarms beeping.

"You want to know the number one cause of all of those errors you examine?" I ask him.  He looks intrigued.  "Interruptions.  You interrupt the nurse and she loses focus on what she was doing."  He didn't seem to understand.  I pointed to the paper I was writing my note upon.  "You see these three cross-outs?"  He nodded his head.  "They were the three times that you interrupted me."  Recognition flashed into his eyes.  "Nursing requires focus and concentration to deliver quality care.  You cannot pay attention and properly complete a task when you are incessantly interrupted, which is the norm around here."

"I didn't realize this," he stammered.

"Now you just saw how your seemingly innocent interruptions caused errors in documentation.  Keep that in mind as you look for the causes of omissions and errors."

I walked away.  Idiot.

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