Is there anything else I can do for you? I have the time. (new hourly rounding sheet)

[FireStarterRN]

We had an inservice yesterday. Now, they've instituted a new fall prevention policy that they basically expect every inpatient to be on. You have to reassess every 12 hours, plus reassess with every change such as a new narcotic or BP med, or transfer to another unit. They want the nursing staff to do hourly rounding, and have a sheet up in each room to check off that this was done, along with what the pt was doing at the time. They expect the nursing staff to ask "Is there anything else I can do for you? I have the time."

I told the woman that I wasn't going to say any canned comments like that, that it would seriously annoy many patients to be repetitivly asked the same question. I also told her that I basically already do this, but I don't want to follow a formula. She replied that many people, especially the CNAs aren't doing this, that probably most nursing staff was, and that this was more to get the CNAs to interact better, and that they would be the ones to do the check sheet. She said that they don't expect you to say the same thing each time, just use that as a guideline.

Well, since I already do this I don't have a big problem, except that the charting will be totally obnoxious and meaningless because I'll most likely hurry through it. Since I work in the ICU, it won't be to bad, but when I float to Med/Surg it will be a PITA to complete all this extra charting. The check off sheet will not be a part of the permanant chart, but will be collected each day and reviewed by the unit managers. I feel sorry for them, that sounds like a dreary task.

Honestly, there are nurses on our Med/Surg unit who sit at the nurse's station quite a bit, so I do think there is a problem that this is trying to rectify. But it's making a lot more charting for everyone. :angryfire

[EmmaG, RN]

I agree Goldstein. They like it when you sit for a few minutes. It makes them feel more secure and less needy.

Goldstein

I have no idea how to find it now, but I remember reading some research to that effect.... when sitting vs standing to talk to someone, their perception is that you spent something like twice the time you actually did... or something like that lol.

Been a loooong day.

[ASSEDO]

sounds like hospitals are trying to make the 5 star hotel list. "i have the time" was started at my hospital over a year ago. guess what, the pg satisfaction surveys are lower than ever.

i vote for taking all tv's and telephones out of the room. patients don't have time to do things for themselves or heal because they are watching their "program." god help you if you work during college football season in the south. you can't get a patient to respond to you, they are so focused the "big game". noise, indirect, slows the healing process. what about the direct noise (telephones and tv)?

i truly believe we have treated patients like "guest" instead of "patients" far too long, and they actually believe their in a resort, at my hospital, usually on tax-payer expense. "i have the time, my foot, how about pick a number and wait until your number is called? hospital admins don't have a freaking clue.

[General E. Speaking, RN, RN]

We had an inservice yesterday. Now, they've instituted a new fall prevention policy that they basically expect every inpatient to be on. You have to reassess every 12 hours, plus reassess with every change such as a new narcotic or BP med, or transfer to another unit. They want the nursing staff to do hourly rounding, and have a sheet up in each room to check off that this was done, along with what the pt was doing at the time. They expect the nursing staff to ask "Is there anything else I can do for you? I have the time."

I told the woman that I wasn't going to say any canned comments like that, that it would seriously annoy many patients to be repetitivly asked the same question. I also told her that I basically already do this, but I don't want to follow a formula. She replied that many people, especially the CNAs aren't doing this, that probably most nursing staff was, and that this was more to get the CNAs to interact better, and that they would be the ones to do the check sheet. She said that they don't expect you to say the same thing each time, just use that as a guideline.

Well, since I already do this I don't have a big problem, except that the charting will be totally obnoxious and meaningless because I'll most likely hurry through it. Since I work in the ICU, it won't be to bad, but when I float to Med/Surg it will be a PITA to complete all this extra charting. The check off sheet will not be a part of the permanant chart, but will be collected each day and reviewed by the unit managers. I feel sorry for them, that sounds like a dreary task.

Honestly, there are nurses on our Med/Surg unit who sit at the nurse's station quite a bit, so I do think there is a problem that this is trying to rectify. But it's making a lot more charting for everyone. :angryfire

I think we are twins separated at birth...I could have written this! oops- except for the "nurses on our Med Surg unit who sit at the nurse's station" part. THAT rarely happens on our MS unit

[Mulan]

yeah, sit down in that chair with the MRSA and God knows what else is all over it

[tddowney]

I don't have time to do hourly rounding (I don't even have time to write my name on the board, particularly since there is no pen there to write it with) since I am too busy doing everything else I have to do for the patient, meds. etc.

Hourly rounding would make sense if the nursing staff were just sitting at the desk and had to get up every hour and go make rounds.

That's not the reality. Who comes up with this crap? It sounds like it is all over.

In this case, it was nurses who came up with the hourly rounding. The idea is that it cuts down on call light use, and thereby saves nursing time.

But, no doubt the researchers forgot to take into account all the documenting time.

[tddowney]

The rule on my floor was CNA's round on the even hours and nurses round on the odd hours. Starting today nurses round every hour. At the start of the shift we write our name and number, the CNA's name and number, the date, a mutual goal and room number on the dry erase board.

We are also supposed to sit down in our each room to talk to our patients. The thought being that we stand and talk to them so why not sit? The NM, assistant NM and team lead will round with all the patients daily to make sure we are rounding hourly and sitting down.

So, if you're sitting down, that must mean you're on a break, and don't need a real one, right?

[leslie :-D]

Sitting down and talking as opposed to standing over someone actually increases their perception that you have spent more time with them and were focused on what they were saying. I try to make a point of doing this with all my patients at least once during the shift (getting off my feet for a few minutes is just an added bonus).

i don't sit down, as some sort of strategic intervention.

my feet hurt, i'm cranky and tired.

and dang it, i need to sit.

so i nudge my pt's feet/legs over, and make myself comfy.

they seem to love it, and i probably love it more.

a couple of times, i've walked out w/o my clogs on. :)

leslie

[Ayvah, RN]

It's on trial on my floor... and it sucks. And the "is there anything else I can get for you? I have time" is pure BS. I DON'T have time

Exactly! When this was introduced at my hospital, admin even admitted that they knew they were asking us to lie to our patients!!!

[psalm, RN]

Sitting down and talking as opposed to standing over someone actually increases their perception that you have spent more time with them and were focused on what they were saying. I try to make a point of doing this with all my patients at least once during the shift (getting off my feet for a few minutes is just an added bonus).

So many of my patients don't have room for me to sit down if I wanted to! Every space is covered with their "stuff" or a visitor who is staying the night. I usually will hold their hand and look directly at them instead of rearranging everything so I can sit.

And I rarely have the time...

[BonzoRN]

We have been instucted by administration to initiate hourly rounding on our unit. The premise is wholeheartedly accepted and embraced, however, I'm curious about the staffing ratios in those facilities that have had positive results. would anyone be willing to share with me their number of beds and staffing ratios (professional and non professional), I would be very appreciative.:innerconf

[nursemaa]

Hourly rounding is not really a new concept- it was considered standard practice when I entered nursing in the late 70's. If a patient is sick enough to be in the hospital, someone should be checking on him/her hourly. And, it is just good patient care to see if they are comfortable, need to go to the bathroom or use the bedpan, or see if they need help to reposition every hour or so. So I don't see why nurses are fighting this idea- if we are sitting around instead of checking our patients, we are not making sure their needs are met and that they are safe.

Just my opinion.

[Ruby Vee, BSN]

hourly rounding is not really a new concept- it was considered standard practice when i entered nursing in the late 70's. if a patient is sick enough to be in the hospital, someone should be checking on him/her hourly. and, it is just good patient care to see if they are comfortable, need to go to the bathroom or use the bedpan, or see if they need help to reposition every hour or so. so i don't see why nurses are fighting this idea- if we are sitting around instead of checking our patients, we are not making sure their needs are met and that they are safe.

just my opinion.

i don't think nurses are fighting the idea of rounding on their patients. i think what they're fighting is the idea of filling out a checklist on each of their hourly checks and uttering the canned spiel: "is there anything i can do for you? i have the time," when most of the time we've got all we can do to keep our heads above water. the "i have the time" part of that canned spiel is a damned lie, and i think nurses are fighting that.