Wednesday, October 1, 2008

Our Friends...JCAHO

It was the middle of the afternoon that I thought I saw my whole nursing career flash before my eyes. Every hospital person knows what JCAHO is. Well they usually come at a time when I'm not working, and in school you don't have to deal with them. Guess that all changes now! The "mock" JCAHO people came around (we found out later they weren't so "fake" afterall...) and of course want to see all the units.

By the time they get to L&D we're on C/S #5 of the day, we have a bunch of triages and look, one labor patient on the board. Guess who's patient she is?! Someone sends me to go get J and have her talk to the group of 15 people standing around the nurses station in their business suits. J comes out to the desk and tells our manager, "I haven't touched that chart. Beckie's had that patient on her own 'cuz I've had my own two triages!" So now guess who gets to talk to Joint Commission?! Thank all the higher powers that be that I had just closed the chart after finishing it and all my computer charting. Pt had been here for 2 hours already, but of course Ms. Natural isn't just a put in the room and chart type of patient. Besides, the patient always comes first, so it had taken me 2 hours to even look at her chart.

I thought talking to doctors was bad? That's a joke after a JCAHO interview! And it's not just one or two people, we're sitting in the middle of the nurses station, with 3-4 JCAHO people, my manager, the M/B manager, the NICU manager, the chair of the department, the educator for the department, and about 5 other people, all looking at me, all expecting me to know that answers for everything! Good grief! When the interview person found out I was a new nurse she said "Oh good, my favorite!" I got drilled about boards, passing boards, how long I've been on orientation, what to do in a fire, patient identifiers, JCAHO safety standards, she made me give her 3 NURSING DIAGNOSES and PLAN OF CARE!!! I thought I was done with "related evidenced by..." guess not! The lady wanted to know all about my patient, how may kids, who was with her at the hospital, who was taking care of her other kids? My goodness. She looked at all my charting and asked how I "personalized it to the patient." I thought personalization of charting was kinda the whole point. Then she goes "show me the urine machine and the standardization log." First of all, that's the charge nurses' job, it's in her job description! But I was able to find what she wanted, thank goodness the log was on a bright blue clipboard!

After a good 25 minutes of drilling, she kinda smiled and said "I'm very impressed. This unit has stood out above all the rest. Congratulations, keep up the great work!" I have never breathed such a big sigh of relief. That was more intense than I don't know what. Poor J just kinda had to sit there, they weren't too interested in talking to her. After the big group left, both the manger and the "head manager" came over to me and gave me great big hugs and told me that I did a good job and they were impressed. I thought JCAHO was scary before, next year I'm telling them it's someone else's turn!

I should of known that things couldn't keep going perfectly when I sliced my thumb open snapping the top off of the darn lidocaine ampule before starting the IV at 0710...


  1. Wow, that sounds really stressful. Good for you for doing such a great job. I didn't know you needed to know personal details about a patient.

    I'm sorry you hurt your thumb :(

  2. Congratualtions! That sounded very rigorous-but you held up well. In the next few years when Joint Commission comes in again maybe the nurse supervisor will tell the charge nurse to direct all questions from "the suits" to you! That's what happened to my sister who is an ICU nurse when the Joint Commission "suits" came into the ICU. That's what 16 years of nursing will get you - a tough grilling by Joint Commission.I love your blog!

  3. Great job! You handled everything extremely well, and under a big amount of pressure!! Personally, I try to not schedule myself to work on the days when we know JCAHO is coming. Or, if they happen to show up on my day of work, I hide out in my patient's room all day! Giggles.....