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

  1. 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
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  2. 79 Comments

  3. by   RNperdiem
    Yes, the CNA's are supposed to be the ones doing the check sheet, but it seems like the nurse will still be responsible for overseeing it should the CNA duck out of this new trend. The unit manager will probably come to you and not to the CNA if the sheet is not filled out.
    If the issue is about CNA interaction and hourly rounding, then I would want the inservice for the CNA's only with it made clear that the new "official" hourly rounding is now one of their responsibilities, as is filling out the sheet.
  4. by   SuesquatchRN
    And if you shove a broom up my butt I'll sweep the floor when I walk.
  5. by   pie123
    Quote from jlsRN
    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

    My hospital actually instituted this 'hourly rounding' about 9 months ago. I guess the goal is to improve patient satisfaction. There is a dry erase board in each pt's room. The board has areas for date, nurse's name, doctor, plan for the day, questions for the doctor, pain medication, what's important, and there are numbers for every hour that we are to initial, showing that we have been in the patient's room at least once an hour. The what's important section is not for things like pain control, for example. It's for what extracurricular activities the pt enjoys. Seriously. We're told it will help us to get to know our patient's better. One patient said he liked fly-fishing, and that's what the powers that be said needed to be written in that area. We were also told that it is not acceptable to ask the patient before leaving the room, "Is there anything I can do for you before I leave?" We have to be more specific, and address the 3 P's: pain, potty, and positioning. Come on. At the bottom of the board, there's some ridiculous blurb at the bottom of the board, about us being there to serve the patient, and striving for patient satisfaction. To my knowledge, we are supposed to be reciting this blurb to the patients.
    I've only seen one MD actually read (aloud) the section on questions for the doctor, and actually addressed them.
    We've also started discharge call backs, to see how the patient liked/disliked their stay.
    Last edit by pie123 on Nov 6, '07
  6. by   FireStarterRN
    Quote from Suesquatch
    And if you shove a broom up my butt I'll sweep the floor when I walk.
    :roll
  7. by   mr.ahp
    I don't know how much more interaction I can take.
  8. by   FireStarterRN
    Yes pie123, I like the idea of getting people to be more skillful in making the patients feel safe and addressing their needs efficiently and kindly. I always ask the patient if they need anything else before I exit. It seems like common sense to me. It sounds like my facitlity doesn't want us to actually sound like robots, just generally make sure we give the patient a chance to ask for things.
  9. by   rn undisclosed name
    I don't agree with this whole hourly rounding thing. Some patients just don't like being bothered all that much. What about respecting that?

    Quite frankly these people are in the hospital because they are not feeling well. When I don't feel good the last thing I want is people coming and making small talk with me. I just want to get well so I can get back to my daily activities.

    They keep on adding more and more things for the nurses to do while taking on more patients. It's beyond ridiculous!!! I am there to do nursing care and I love to talk to my patients and try to help them, BUT, when they keep on adding all this extra stuff in when am I supposed to be doing nursing care (which is what I went to school for). I know I sound bitter about the whole hourly rounding thing but that is because I am.

    I am so tired of hearing how the hourly rounding is not being done appropriately. I try to do it the best I can and I would say I do it 98% of the time. There are some nurses who never do it. They look at these sheets and if there is 1 hour that is not done even if the pt was there for 5 days the sheet is considered incomplete which affects our compliance with the hourly rounding. I think that is completely unfair. They need to start going after the nurses who NEVER complete the hourly rounding sheets instead of complaining that everyone is not being compliant when it is a handful of people who don't do it. Also, when patients are sleeping at night we should be letting them sleep and not going in hourly to see if they need something to drink, need to go potty, etc.

    I would love to get rid of all the hourly rounding!!!!!!!!!
  10. by   FireStarterRN
    I generally dislike a formula approach to customer service. People are individuals, I wish management would help educate caregivers as to the different personality types, rather than trying to have a one size fits all approach. Aren't there some programs and seminars that address personality and tempermant types? I'm talking something along the lines of what we get on cultural diversity, only dealing with human diversity. I'd like a program to help some of the nursing staff have more finesse, not a formula to treat every person alike.
  11. by   cmo421
    Quote from Suesquatch
    And if you shove a broom up my butt I'll sweep the floor when I walk.


    You just made my day,lmao,,,,
  12. by   Mulan
    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.
  13. by   alkaleidi
    LOL. HOURLY rounding? We have a little 2-3 second thing that goes overhead in the ENTIRE hospital that sounds like a little musical "chime" sequence... every 30 MINUTES... reminding us to check on our patients. Yee-haw!

    This appropriately represents how we are now expected to treat our patients: . If I wanted to be this heavily involved in customer service and satisfaction, I'd be working somewhere like Lone Star or Outback Steakhouse and at least getting good tips. Press Ganey makes me .
  14. by   EmmaG
    We have a little 2-3 second thing that goes overhead in the ENTIRE hospital that sounds like a little musical "chime" sequence... every 30 MINUTES... reminding us to check on our patients.
    You have GOT to be kidding me...

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