So this is why They called a “code triage external” at change of shift. This is why there was no cuddle or lean board meeting or any of the daily partial communication that occurs before we start our shift.

My facility is trying to go “lean.”

A fundamental aspect of “lean” is that front-line workers have a say in operations. So now we have to have a pre-shift “meeting” around the “lean board” which captures nothing related to actual patient care or outcomes, only what has been charted (because that is what is audited). After I rather loudly complained that outcomes were not part of this “huddle” (which we euphemistically call a “cuddle”) they started reporting the number of days we have been without a fall, pressure ulcer, CAUTI, CLABSI, etc.

Like the good old days at the plant. “this is the number of days we have not had a Silkwood event thanks to y’all keeping your mouths shut and not reporting anything!!!

Does anyone with a LSS cert think it’s a good idea to *withhold* information from front-line workers who have to respond to a mass casualty event?

Really? No I am not trying to get fired. I am trying to understand how the one time we need info it is not given, but every other day we have to be 15 minutes late to shift report so we can hear the managers whine about our missed punches.

However, this could get me fired. Even though though it is not political, it is not a HIPAA violation (this is a news report, no patients are identified, my facility is not identified, etc etc), and I am not saying any untoward events happened as a result and thus I am not opening my unidentified facility up to legal scrutiny, I could get fired for this post.

Like when I suggested to the rep for our monitors that maybe the vitals could be integrated into the EHR so that I would not have to spend my entire day doing data entry –fired.

Like when I suggested that simulation does not adequately capture the intricacies of a real life emergency and that strict adherence to unnecessary rules could compromise efficacy in an emergency –fired

Like when I suggested that allowing a patient to die due to inadequate treatment for their MI was not preferable to transferring them to a higher level of care — fired (well I quit on the phone but was reported to the BRN for a fabricated incident anyway).

I still have my license, because I either quit or get fired from every place that is a risk for my license (usually I get fired) .


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