When nurses are told, “Our management consultant has determined that no more bar code scanners are needed for X nurses or Y beds, so make it work,” or, “The scanners are under warranty only if we send them to ABC for repairs, and we can't get them back any faster, so we'll still hold you responsible for scanning 95% of the time,” or, “There is no more linen, so do the best you can,” then we will continue to do what we've always done—the best we can to provide safe care (“Workarounds Are Routinely Used by Nurses—But Are They Ethical?” Question of Practice, October).
We've always dealt with linen shortages—I can remember having state-of-the-art blood gas kits in the ICU but “no washcloths until Monday.” And oddly, nurses gave meds safely without bar code scanners for years by following the five rights, and could do so again if they had less blind reliance on technology and if there were more RN staff with more time to think about more than completing task checklists. But then… see above: “No more linen.” There will be no more staff, will there? And so, workarounds.
Wendie H., via ajnoffthecharts.com