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

Nurses General Nursing

Published

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

Specializes in Critical Care.

It's part of some program called A.I.D.E.T. We went throught the training a couple of years ago. Most of it is a duh. I always ask my pts if I can help them in any way before I leave the room, it might save me an early trip back to their room. I never say "I have the time", quite frankly they would all know it's a lie. Thankfully, we don't have check off sheets. If you want to see how often I am in there, look at my charting rather than make me chart in yet another place.

Studies have shown that rounding does increase pt satisfaction but rather at the 2 hour period than every hour. Every hour is just obnoxious. Besides, I can't tell you how many times I have had to put a Do Not Disturb sign on a door because a pt is c/o no sleep d/t constant interruptions during the night. Gotta love Gallup polls.

Specializes in cardiac.

our hospital wants us to do the same. I tried it once. I went in, assessed the pt, administered meds, gave ACS, CHF, Medication instructions etc., then got ready to leave. I then asked if they needed anything, "I HAVE TIME." My pt looked at me as if I had 3 eyes instead of two. Since then, I do things my way. I make my rounds, ask how they feel they are doing, answer questions, and ask if they need anything. It seems to work much better for me.

Specializes in Case Management, Home Health, UM.
And if you shove a broom up my butt I'll sweep the floor when I walk.

BWWWAAAAHAAAAA!! :rotfl::lol2::lol_hitti

You all might get a kick out of this...

http://donurseshavethetime.blogspot.com/

Specializes in ER, IICU, PCU, PACU, EMS.
You all might get a kick out of this...

http://donurseshavethetime.blogspot.com/

I think that hit the nail on the head!

Specializes in Med-Surg, Psych.
You all might get a kick out of this...

http://donurseshavethetime.blogspot.com/

One of the best articles I've read about the ridiculous situation in hospitals these days. Thanks!

You all might get a kick out of this...

http://donurseshavethetime.blogspot.com/

There is a place for comments at the bottom. Imagine what impact that would have on the public and the idiots that started that whole concept.

I have learned that the people that make decisions are the biggest most clueless FLAKES on the earth.

I say we get a petition to forbid such idiots to have any kind of management positions. Do away with Masters of business and more.....my MASTER.....is life and reality. Why can I do the job? Cuz I have a real clue and a real solution. What is my qualification...REAL EXPERIENCE. Most of those managers couldn't SURVIVE as nurses! They couldn't DO THE JOB that they are forcing us to do.

Reality. I have no respect for any manager that manages under those conditions any more.

I found a place that actually allows us to get our work done without running around behind 20-50 tasks at every given minute. I can actually be in my patients rooms, do everything they need before I leave and get all their mandated paperwork done too. Do we get busy? YES.....crazy........rarely.

I have actually said those words to my patients and it did NOT come from a script. It comes from ME and my heart because the employer has given me the resources to do it. They have offered me a job but I have a waiting period because I went in through agency.

Through agency....I have not been to ONE sane place yet besides this one. This whole thing has gotten out of hand and by the looks of things it is going to continue to get way worse.

Reality.........I don't care who is brown-nosing the boss.....it is rare that they are friends. Brown-noses are desperate to save themselves from being victims.

The only way anything will ever be done is to act. Nurses are afraid to act because they are afraid to be black-balled. Once they do get burned, they DO speak up.

I have received a couple emails from other support groups for this cause. I have given up to the reality that there are too many organizations asking for the same thing and each of them with only a small number of followers. I decided to sign them all. The politicians and the people that CAN make changes already know this is a problem. Like Pres. Bush behind his own profits in OIL, all these decision makers probably have shares of stocks in every chain of the medical field that they could possibly get and that is why they don't want to see this change. Since each organization wants to have their OWN logo and their OWN day on stage, I say SIGN THEM ALL....because then I am going to start asking JCAHO and all my politicians over and over......why they ignoring so many outcries for the same thing?

Also......if JCAHO can scare the pants off of your managers with compliance with pain assessments and charting.....then THEY can mandate safe patient care ratios. That should be more important than charting every half hour to an hour and causing ADDICTS.

Target JCAHO.....forget POLITICIANS. Push JCAHO to answer why they push such stupid issues and IGNORE the most important. Everything JCAHO pushes can be done with the right ratios. The reason why hospitals are not compliant.........too many patient ratios.

It's a no-brainer.

I have been sent these links lately. I am signing everything that addresses safe patient handling and whistleblowing.

http://leapforpatientsafety.org/ (doctor oriented but these people get out and GET signatures)

Another blog

http://medteam.wordpress.com/

Comment on the blogs. The more the comments, the more popular they become on searches.

Specializes in Case Management, Home Health, UM.

This is one of the BEST posts I have ever read on this website.

I have learned that the people that make decisions are the biggest most clueless FLAKES on the earth.

And what irks the crap out of me is the fact that they are NOT making these decisions based on what is "best" for their customers....whether they be internal or external. They make them based on the business model of the "organization", which is not always in favor of those customers they are targeting....or the people who work for them. If they honestly had their best interests at heart, then we wouldn't have to be talking about why the health care industry in this country is at Death's Door.

Push JCAHO to answer why they push such stupid issues and IGNORE the most important.

JCAHO pushes stupid issues because they have become yet another pathetic example of another mindless bureaucracy which has lost sight (and heart) as to their purpose for existence. Read this excerpt from Thomas Cromwell's article "Accreditation and Other Fantasies", and you'll see exactly what I am talking about:

"Hospitals divert egregious amounts of staff time and money from badly needed improvements to prepare for reviews, hire armies of former nurses/administrators-turned-"consultants" and perform endless mock surveys. Review teams are infested with rogue reviewers who are free to interpret regulations as they see fit, a task in which they are given significant latitude considering Medicare regulations now comprise, believe it or not, 350,000 pages - four times larger than the Internal Revenue Service code. Hospitals seek the latest buzzwords that seem to be in vogue for reviewing teams, and hospital administrators, in their zeal to placate reviewers, accept interpretations without challenge, no matter how irrational or bizarre. Worst of all, the public assumes that the seal of approval by the regulatory agency is a guarantee of optimal medical care, but studies indicate there is no relationship whatsoever. Despite extensive efforts by ASA, a number of state components, the American Medical Association and others to interject some rational thought into this process, it is getting worse".

http://www.asahq.org/Newsletters/2002/7_02/admin702.htm

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