![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
whitewriterI'm sure I've ranted about this before on multiple occasions but the mood strikes once more.
Well, strictly, that's not the real terminology. They're called forms and they're titled "Midwifery nursing handover checks" or something. like that (honestly, couldn't tell you).
Everyone who actually uses the damn forms (not the people who created them-- and that's if they get used) -- calls them tickey boxes.
If you ask someone have you "done the tickey boxes" they will immediately know what you mean.
Because that is literally what the form is all about.
Boxes you tick.
Do you check what your actually ticking off?
If you have time.
How many tickey box checklists do you have to do a shift ?
Good question.
So if your on a ward, and you have 10 patients, you have 10 fucking tickey box forms to do.
How many boxes are on a tickey box form you ask, intrepidly.
About 20 items per page per patient.
Now. In birth unit, given that we typically only have one woman per midwife (maybe 2 -3 if they're postnates) -- this sorta makes sense. And ICU has something similar : There's 10 questions your supposed to tick off at the start of a shift post the checks:
- is the suction working
- is the correct diet ordered
- do you have spare oxygen at the bedspace
- have you set your alarms appropriately
- have you done the falls and waterlow?
- etc.
The ICU one is on the computer, you have 1 or 2 patients to do it for, it takes like 1 min per patient. The checks itself probably take about 10 mins, and you do it once and your sorted.
Now when you have 10 forms to do. and 10 checks to do, to ensure that each woman
-has the correct arm band
-has working suction (this one is important though I must admit)
-has oxygen tubing at the bedside
-whatever else is on that damnned list-- that literally if I do complete it, probably (definatly) do it like everyone else :
With great disdain
With speed.
Most of the time without actually checking what the hell I'm ticking off.
(And this was at MSH)
Since I've come to SSH I've stared at countless empty tickey box forms in countless women's files.
All empty.
Not completed.
Sticker at the top of the page (and then what, to be thrown out by administration staff because its fully empty, or will they scan that too like everything else? -- but bloody empty).
At MSH - management was on our backs about tickey boxes. They audited them, we pretty much actually did them (not in birth unit though, but on postnatal we did, 90% of the time probably, begrungingly).
They increase the workload due to probably, I assume one bad incident that happened when something wasn't how it was supposed to be - so they introduce this tickey box to supposedly, spur us into ensuring and double checking everything.
But does it actually increase compliance?!
At MSH when they actually whipped us into doing the forms, I'd say yes.
Whilst the staff at SSH feel unsupported and told to do a billion other things (there's been a few lectures about CTGs in the last few days that I managed somehow to skip) -- there just isn't enough time to add in tickey boxes.
So these dumb boxes go unticked.
Unlooked at. Unappreciated for the time and effort someone must have spent creating the form.
Only to be added to the files by administration staff on admission and then disregarded for the entirety of a woman's stay.
I want to meet this person! Do they know that it's not being used. Do they care that no one is using their form? Do they want to think about ways to ensure these checks are being done?
....
Trees are crying.
And one day, hell is going to come on SSH because something happened and a damned tickey box wasn't filled out.
No, you wouldn't say it's due to staffing.
Or due to inexperienced staff not having enough support.
Or senior staff being stressed by the increased workload a junior staff requires in order to not make mistakes.
Or the fact that SSH is in one of the most booming and expanding areas of the state; due to a large boom of young families moving into the area looking for cheap land and house , 30km from Sydney city with a good train station and services (large hospital; but funded like its a much smaller hospital, and staffed like a much smaller hospital- so they're building for the future, I suppose but it has such an "empty vibe" due to this) -- low socioeconomics with drugs, housos on social security, plus new migrants with poor english (a lot of them are from India: we had 5 x Kaur's birth one night. 5!) or poor health literacy...
Do they fund us on these factors - rather than say, a public hospital in a more affluent area, with people using their private health insurance to pay for using a public hospital --
Where people are wealthy enough to donate to the local hospital.
Where people have high education and literacy.
Do those hospitals have tickey boxes to do - and do they do them?
Well, strictly, that's not the real terminology. They're called forms and they're titled "Midwifery nursing handover checks" or something. like that (honestly, couldn't tell you).
Everyone who actually uses the damn forms (not the people who created them-- and that's if they get used) -- calls them tickey boxes.
If you ask someone have you "done the tickey boxes" they will immediately know what you mean.
Because that is literally what the form is all about.
Boxes you tick.
Do you check what your actually ticking off?
If you have time.
How many tickey box checklists do you have to do a shift ?
Good question.
So if your on a ward, and you have 10 patients, you have 10 fucking tickey box forms to do.
How many boxes are on a tickey box form you ask, intrepidly.
About 20 items per page per patient.
Now. In birth unit, given that we typically only have one woman per midwife (maybe 2 -3 if they're postnates) -- this sorta makes sense. And ICU has something similar : There's 10 questions your supposed to tick off at the start of a shift post the checks:
- is the suction working
- is the correct diet ordered
- do you have spare oxygen at the bedspace
- have you set your alarms appropriately
- have you done the falls and waterlow?
- etc.
The ICU one is on the computer, you have 1 or 2 patients to do it for, it takes like 1 min per patient. The checks itself probably take about 10 mins, and you do it once and your sorted.
Now when you have 10 forms to do. and 10 checks to do, to ensure that each woman
-has the correct arm band
-has working suction (this one is important though I must admit)
-has oxygen tubing at the bedside
-whatever else is on that damnned list-- that literally if I do complete it, probably (definatly) do it like everyone else :
With great disdain
With speed.
Most of the time without actually checking what the hell I'm ticking off.
(And this was at MSH)
Since I've come to SSH I've stared at countless empty tickey box forms in countless women's files.
All empty.
Not completed.
Sticker at the top of the page (and then what, to be thrown out by administration staff because its fully empty, or will they scan that too like everything else? -- but bloody empty).
At MSH - management was on our backs about tickey boxes. They audited them, we pretty much actually did them (not in birth unit though, but on postnatal we did, 90% of the time probably, begrungingly).
They increase the workload due to probably, I assume one bad incident that happened when something wasn't how it was supposed to be - so they introduce this tickey box to supposedly, spur us into ensuring and double checking everything.
But does it actually increase compliance?!
At MSH when they actually whipped us into doing the forms, I'd say yes.
Whilst the staff at SSH feel unsupported and told to do a billion other things (there's been a few lectures about CTGs in the last few days that I managed somehow to skip) -- there just isn't enough time to add in tickey boxes.
So these dumb boxes go unticked.
Unlooked at. Unappreciated for the time and effort someone must have spent creating the form.
Only to be added to the files by administration staff on admission and then disregarded for the entirety of a woman's stay.
I want to meet this person! Do they know that it's not being used. Do they care that no one is using their form? Do they want to think about ways to ensure these checks are being done?
....
Trees are crying.
And one day, hell is going to come on SSH because something happened and a damned tickey box wasn't filled out.
No, you wouldn't say it's due to staffing.
Or due to inexperienced staff not having enough support.
Or senior staff being stressed by the increased workload a junior staff requires in order to not make mistakes.
Or the fact that SSH is in one of the most booming and expanding areas of the state; due to a large boom of young families moving into the area looking for cheap land and house , 30km from Sydney city with a good train station and services (large hospital; but funded like its a much smaller hospital, and staffed like a much smaller hospital- so they're building for the future, I suppose but it has such an "empty vibe" due to this) -- low socioeconomics with drugs, housos on social security, plus new migrants with poor english (a lot of them are from India: we had 5 x Kaur's birth one night. 5!) or poor health literacy...
Do they fund us on these factors - rather than say, a public hospital in a more affluent area, with people using their private health insurance to pay for using a public hospital --
Where people are wealthy enough to donate to the local hospital.
Where people have high education and literacy.
Do those hospitals have tickey boxes to do - and do they do them?
