Oh what they've done now!

  1. Apparently our powers that be have decided on a new and improved way to increase ED patient satisfaction. Meeting after meeting, meetings about the meetings and they give us "Scripting". HA! But wait, it gets better. We also have new surveys in which we are expected to "script" and hand out to patients as they enter triage (and return to the lobby for up to a 5 hour wait) or upon entering the exam room.

    Maybe it's a lack of sleep, but this is quite possibly the stupidest idea I have ever heard of. This whole survey promotion is not about increasing patient (or staff) satisfaction, but rather increasing patient satisfaction SCORES on a meaningless piece of paper. And in my sometimes irrational opinion, I have to think that someone at the height of rage for being made to wait an extended period of time to be seen and treated, is going to be less kind with that survey in their hands than someone who has had a chance to step away from the situation and see that perhaps there were extenuating circumstances delaying their care?

    I want to scream!!!
    We've asked for different triage protocols to keep wait times down
    We've asked for an increase in staff during peak hours
    We've asked for help getting patient's admitted to keep down our over flow status
    We've asked for longer orientation times for our new nurses

    And what do we get???
    Scripting and Homecoming decorations through-out the department!
    I'm telling you, some days the job as the Walmart greeter looks pretty swell
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  2. 25 Comments

  3. by   traumaRUs
    In the ER where I worked, we did the scripting thing too but I could barely get the words out. My favorite was "I have the time." Us ER nurses are pretty hardcore and none of us liked this. What we would do (and yes, I know its juvenile), when we would have a full arrest come in, as we were hustling to the trauma bay, we would be saying to each other, "Oh don't worry, we have the time." Or...when there were 10 patients waiting at triage, we would snidely say to each other "we have the time." It got to be idiotic.

    And...like you, we couldn't get extra staff, we couldn't get expanded protocols, they wouldn't hire mid-levels, etc...nothing to really help the situations. My own personal gripe was the consultants (in their 3 piece suits and 3 inch high heels) who would come in and tell us what needed to be done.
  4. by   gam3rchic
    Quote from traumaRUs
    In the ER where I worked, we did the scripting thing too but I could barely get the words out. My favorite was "I have the time." Us ER nurses are pretty hardcore and none of us liked this. What we would do (and yes, I know its juvenile), when we would have a full arrest come in, as we were hustling to the trauma bay, we would be saying to each other, "Oh don't worry, we have the time." Or...when there were 10 patients waiting at triage, we would snidely say to each other "we have the time." It got to be idiotic.

    And...like you, we couldn't get extra staff, we couldn't get expanded protocols, they wouldn't hire mid-levels, etc...nothing to really help the situations. My own personal gripe was the consultants (in their 3 piece suits and 3 inch high heels) who would come in and tell us what needed to be done.
    Amen!!! I would give anything to have them walk a mile in OUR shoes!
  5. by   drmorton2b
    Once again is the Suits with the MBA, MPH, KPH, RLH, ADD, and whatever capacity that have never done anything but sit behind a desk in a health care facility making decisions about patient care, the RNs aren't busy. How about have Registration do all that crap. Or give them an 800 number to call. One local hospital Metrowest in Natick, MA has come up with a card system that will store the patient's frequently asked Data (Name, DOB, PCP, etc.). Ideas like the should be stressed. When I'm an ER patient I don't want to fill out some survey. Screw that. I would start writing PT refused or something, or use some firm reasoning on not to fill them out. Bah stupid management
  6. by   littleRNthatcould
    Thank you! And here's one of my biggest pet peeves with the whole administration, I call it the 50/50 rule. 50% of them haven't done my job in upwards of 25 years if ever. So when they make the grand screw up, it's almost a little bit forgivable. They simply do not know any better. I consider them to be like little children who don't know that the stove is hot!

    However, the other 50% of our management team has not only done my job within the last 1-5 years (some of them within six months) but they did so with the same complaints as the rest of us! And yet, they return to us with this "Golden Ticket" aka survey paper that is supposed to cure all the ills within the department???????

    What goes on in all these meetings that allow these people to reach such a zen level of enlightment to think "all can be fixed if you just smile pretty and say please and thank you!!!"

    A doctor once told me that you can only work within the "illness' of your facility and that trying to "cure" it can make you crazy. My facility has gone past "illness" I'm pretty sure at some point it contracted the Ebola virus:trout:
  7. by   RN1989
    It sounds like they are trying to increase patient satisfaction not nursing satisfaction. So with that in mind - hand out all those surveys. Once admin gets a truckload of surveys with nasty comments written on them by the patients, they will no longer be able to say that the nurses were wrong. Because chances are, the patients are going to comment on the lack of supplies, staff, etc. - the very thing you guys have been trying to tell them!
  8. by   Dixielee
    The outright stupid stuff they have us do in our very busy level 1, 50+ bed trauma center is way past rediculous. In additon to the 4 consents patients have to sign to get past the admissions people, they now have to sign and consent and we do a "timeout" for every invasive procedure. I am not talking about surgery or chest tube insertion, but dental blocks, I&D's of fingernails, wound closures, etc.

    Last week they took all of the cleaners we clean the stretchers with, removed them from baskets outside the rooms, and placed 2, only 2 by the Pyxis...no, we don't have to count and sign them out yet, but that is probably next.

    The final blow came yesterday, when they said we could no longer keep blood collection tubes in patient rooms or in the ER! When we need to draw blood, and we do on almost every patient, usually quickly, we have to go to the main stock room, enter with our name badge, sign into the supply Pyxis, take out tubes, don't forget to scan them and then hike back to our patient room to draw blood. Why the change?? Who knows. Did someone drink the anti-coagulant in the purple top tubes?

    Non medical people are making it impossible to do our jobs.

    Now, don't let me get started on the computer, or Medicare reimbursement cuts......ERGGGGG

    Thanks for starting this thread so I can vent!:angryfire
  9. by   ebear
    I agree totally with Dixielee! The situation has gotten WAY past ridiculous! Bright ideas by the higher ups make it impossible to simply do our jobs. Everything you go to do is such a pain! I believe that the major gripe with nurses is not the patients but the bureaucratic bull hockey that ties our hands!:angryfire
  10. by   loricatus
    They may be able to tell you what to say; but, remember they cannot control HOW you say it. Tone of voice, lack of inflection (robotic sounding) & body language, if properly used, can eliminate the scripting very quickly. And, it can all be done with a smile on your face (they can't control that your smile might look like a sneer or make look like a horse ) I no longer have to follow the script because it nauseated those that had to see me follow it. Behind closed doors I told the patients what I was doing and most had a good laugh. The most fun you can have with it is on those patients (excuse me, customers) that are A&O X2 or less...
    Last edit by loricatus on Sep 20, '07 : Reason: added illustration w/a smiley
  11. by   carachel2
    And...like you, we couldn't get extra staff, we couldn't get expanded protocols, they wouldn't hire mid-levels, etc...nothing to really help the situations. My own personal gripe was the consultants (in their 3 piece suits and 3 inch high heels) who would come in and tell us what needed to be done.
    If they would only take the $$ they pay out the wazooo for those consultants every few years and just oh, maybe, hmmm...........invest in RETAINING the good nurses that are already on staff then they might see the satisfaction scores (of patients, fellow staff and the medical staff) shoot out the roof.
  12. by   edprincess
    Ok, I have to ask a dumb question...what is scripting? From what it sounds like, it's a stupid questionaire. If it is, I had to do that at my last job, Press Ganeys they were called. I gotta say, on a slow night, we would read them and laugh. Unfortunately that's all they were good for. Admin did nothing to improve that situations or the complaints.

    And Dixielee, I am so sorry to hear about your hospital! I remember taking out the surgilube from the rooms when JAHCO came around. Oh and the NS in the liter bottles because someone might drink them! As for your tubes...that's ridiculous.:angryfire Here's what I do, though it's a pain. At the beginning of my shift, I make up IV start kits. I put everything I need to start and IV in a biohazard bag. And I make several of them. Try that and hide your extras in a drawn near your desk. Just remember to remove them at the end of your shift. They're great if a code comes in, no fumbling.

    Wow! I thought where I worked was bad. I am so sorry guys!
  13. by   nuangel1
    i don't do scripting .i have heard of places that want you to do that but fortunately i have never worked at one that did it.cuz i wouldn't do it.
  14. by   dspring
    On of my classics was I was at a meeting, and one of the administrators actually asked us what we could do to increase patient satisfacion, without spending any money. Give me a break. I left management shortly after that.

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