WhiteCoat

Fall Back

It is that time of year when most of the country sets its clocks back one hour in order to provide more daylight for itself during working hours.

It is also that time of the year when those who with clipboards who audit hospitals are on heightened alert for those practicing clinicians who dare not make clear their orders during said time change.

You see, it is possible that a patient could be registered at 1:45 AM on November 7, 2010, but that the same patient’s orders could be timed at 1:05 AM on November 7, 2010 and that the patient could be discharged at 1:30 AM on November 7, 2010, which, on paper, appears as if the patient was discharged before the patient arrived.

Because such notations could make the heads of clipboard auditors explode, this trickery must represent a de facto patient safety issue and would require the involved clinician and/or hospital to create an action plan on how to prevent such unsafe practices in the future.

Document carefully, dear friends. Document carefully.

Hospitals in Arizona and Hawaii are lucky enough to have dodged this bullet since those two states do not follow Daylight Savings Time.

13 Responses to “Fall Back”

  1. throckmorton says:

    Does the time change mean I can really admit someone for 23 hours but keep them 24 if I do it right or will CMS flip out?

  2. Steve says:

    About to head in for my night shift with an additional hour…and as a resident I won’t see one more dime for it…I guess its payback for working the spring ahead shift last year…

  3. Mark the times 1:45 EDT and 1:30 EST (assuming east coast).

    Or lie.

  4. Doc99 says:

    I support Daylight Savings Time. I have issues with Standard Time, however.

  5. Dr. J says:

    Do you really work in a department where a patient could be seen evaluated and discharged within one hour of registration? If so impressive!! If not please set the heads of the bean counters to explode by signing off some nonsensical times on your reports this eve…

  6. ER Murse says:

    I once ended up having to write an incident report, describing how I’d been injured when the stepstool I was standing on to change the department clocks collapsed. It made for some odd timing, and looked a lot like I’d been injured before I’d been injured. Now I work in a place where the clocks change automatically, and if they don’t, it’s a problem for maintanance, not nursing to fix.

  7. BinkRN says:

    ER Murse- in 2 different hospitals where I worked, if you got busted changing the clocks, or the clock’s battery, you would get in trouble with the union whose responsibility it was to do it!!
    Nevermind that there were a couple years where certain clocks didn’t get changed for a couple days. (We knew which clocks to use and which to avoid, so things were safe.).

    Now it is a joke- “Guard the doors, I gotta change the clocks!”

    • ER Murse says:

      This was at a previous job. At my current one, I’ve been telling patients for two days ‘That time isn’t right. Maintainance will be around to change the clock.’ One of the other nurses finally just put a big sheet of cardboard over the main clock, with a message to ask us what time it is.

  8. Anonymous says:

    God bless Arizona, the one state sane enough to get rid of a stupid time change that doesn’t do anything but annoy.

    If it were me I would just put an asterisk next to the time if it doesn’t make sense (like checking in at 1:30 and out at 1:15. That’s a good indicator that it is not a mistake.

  9. SeaSpray says:

    “Because such notations could make the heads of clipboard auditors explode, this trickery must represent a de facto patient safety issue and would require the involved clinician and/or hospital to create an action plan on how to prevent such unsafe practices in the future.”

    Funny! :)

    I love it when it gets dark early.

    I forgot all about it this year. You were the first to remind me.

  10. NurseBeth says:

    “the union whose responsibility it was to do it”….changed the clocks back at my son’s HS LAST WEEK, then couldn’t figure out how to change them back (and then back again this week), so they’ve been off for a week. And I guess everybody thought the kids were all late for school….

  11. ER Murse says:

    The fun for me has always been arguing with patients about how the time change affects medication times, especially PRN narcotics. Yes, I see your point that it has in fact been four hours, regardless of the clock indicating three…

  12. ChuckInMI says:

    I am SO glad I didn’t go into medicine. Several of my family members have, but they don’t work at hospitals.

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