I work on a very busy med/surg/tele/pediatric/ortho floor. .we have a little bit of everything we see on our floor...Now i know one hour rounding and bedside reporting is nothing new for hospitals in the area and has become quite popular, and i do agree that it does appear to really improve patient satisfaction. The problem that i am having is that on a busy floor as ours it is almost impossible to hourly round every 1 hour on 6 patients. I do understand that many other hospitals have higher ratios and this may be a good ratio, but truth is we usually only have 2-3 aides with 42 patients on the floor and nurses are doing alot of nurse and aide duties. when medication pass with assessments takes 2 hours in the am or longer; simple discharges take 30 minutes, LTAC and nursing home discharges take at least an hour; admissions take an hour, well you can see how 100% of the time we can't hourly round even though we really try to make it 100%. . also to mention codes, family or patient outburst and disruptions, interruptions, needy or demanding patients...Our hospital solution at the time is administrative rounding, where the CEO's and administrators are rounding on patients daily to make sure we are rounding EVERY HOUR without a miss...If a patient says we didn't round one hour, it is immediately reported to the charge nurse and we can get into trouble. . in special instances and we have many of them, it is impossible..i had a conversation with one of the CEO's today and he told me plain and simple if a nurse is found to not have hourly rounded even one hour, they will be fired. . .it has been really hard to meet this goal for me and basically every nurse on the floor. . also we get in trouble if we stay past 7:15 because we are charting (unable to do with acuity and demands of floor and continue hourly rounding). ..I'm wondering if any other hospitals are doing administrative rounding or having increased micromanagement that they are seeing on their floors, or if this is just my hospital..has anybody had increased pressure on rounding and disciplinary actions?? Should i find another job or are all hospitals implementing this .. . very stressed and used to really enjoy this job and hospital despite the acuity and busy workload. . :/
Feb 24, '12
Is there anyway that you and a CNA can switch off? That way you get some longer periods of time inbetween to get things done.
How can the management prove you did not round? Do you have to chart you did so? People are confused, people sleep, and they could not even know you are there.
We don't have hourly rounding yet, but it's coming, I think.
Feb 26, '12
I work a small rural hospital in GA. We aren't "required" to do hourly rounding, but they are suggesting it. Our manager is fairly happy with us doing 2hour rounds. They like us to chart every time we enter a room...even for small things like turning a light on/off. They haven't gotten so strict as to say they will fire us if we don't do this.
Feb 26, '12
Where I work, we switch off. We communicate and say "I'll round odds, you round even hours" or something along those lines. Basically, as long as SOMEONE, CNA or RN was in the room every hour we are covered.
Feb 26, '12
Where I work there is hourly rounding but the techs do the even hours and nurses the odd hours. I find myself in every patient's room within half an hour either way of when I'm due and sign off on it then. Our director does round at least once a day and asks the patients if we have been taking good care of them, answering their bells promptly, etc.