Kugel, may I have your permission to quote this repeatedly?
I've got another idea. How about we disband JCAHO entirely? They make up regulations just so they can be seen to be 'doing something'. Screw them. Screw them all.
But, of course, it's not just Joint Commission. CMS (formerly HCFA) has a ton of regs in place that mean nothing, and each state has its own. Then you get the bureaucrats and lawyers interpreting all those regs/rules in ways that even the rule-makers never intended (because most of them haven't bothered to READ the rules).
Almost daily, I have to contend with someone saying, "It's a Joint Commission (or other rule-maker) rule that we have to do it this way," when, in fact, it is NOT. When I show them in b/w that they are wrong, all I get back is, "Well, one of the lawyers said that it is," but no one will tell me which supposed lawyer said that. We have such rampant fear of non-compliance with the rules that our "policies" (most of which have never been written into actual policy) are based on myth and rumor. As a result, the nurses are so scared to do anything that they feel they have to ask a supervisor about almost everything.
Seriously, they will not discharge a patient home w/o supervisor approval because he lives alone and, "It's our policy to contact someone who lives with the patient before discharge, so I can't discharge him home because there's no one else who lives there." Nothing about the patients' safety or ability to care for himself - just fear of violating a "policy" that has never been written into policy. After waiting hours for "approval", and the buses have stopped running, and its cruel to discharge him without a way home, so he's still on the unit the next morning - screaming to be let out since the doc discharged him over 12 hours ago. Then the nurse is scared to discharge him because "he's so agitated."
And these are not stupid nurses. This is the system they're forced into and they WILL be disciplined if they don't adhere to these non-policies.
