Re: Physician Notification Guidelines

[Delores234]

Pay close attention to what Marie is recommending.  The old 'cliche' documentation will do nothing by cause problems.  Nurses must start documenting exactly what happened.

And another problem I had today.  What is it about documenting the SHIFT instead of the exact time of day?  Where did this start?  If you document 3am I know you work the night shift, really I can figure it out all by myself, you don't need to help me.  DOCUMENT EXACT TIME OF DAY ON ALL NOTES.

Delores

In a message dated 2/17/2004 7:49:58 AM Pacific Standard Time, [EMAIL PROTECTED] writes:

DITTO!  Why you are doing what you are doing and the resident's response to what was done are the missing pieces to most legal puzzles whether survey, quality of care investigation or litigation.  Please just remember "BECAUSE"...For example, , I called the physician BECAUSE ______________; The doctor ordered (or did not order) ____________ BECAUSE ______________, The resident did or did not respond BECAUSE_____________________. 

Delores L. Galias, RN, RHIT

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