Are you providing great patient care?
This article points out the difference between good and great patient care. I use an example from my experience with my recent orientee. Also, it shows what appears to be great time management is not always indicative of quality patient care.
I thought about this question as I reflected on my day with my new orientee who has been with me for almost two weeks now. She is a new grad but does have previous military experience as a medic. She has far exceeded my expectations so far during this orientation. We were extremely busy the other day but still able to provide great care for our patients.
These are patients with new head and neck cancer with flaps that have new tracheostomies and require a lot of teaching. We were successful in ambulating all of these patients and teaching them to the best of our ability.
Now, I know what you are going to say. These are just part of basic nursing care.
That is true, but some nurses will avoid those tasks since they can get through the day without actually having to do them. What I mean by that is these are often things that need to be initiated by the nurse since the patient does not know they need to be done or is not motivated.
The point is, I have been a nurse for a while now and have noticed through the years that some nurses seem to always have their work done and this is not always indicative of a job well done.
The nurses that seem to have it all figured out from a time management perspective do not always provide a high level of patient care. I will see these same nurses talking about personal issues or navigating the internet when there are things that can be done to raise the quality of care they provide to their patients. This does not surprise me and I am sure it happens in every profession, but I think some nurses label themselves as slow when they are actually just providing great care.
My orientee and I did not have to ambulate and teach these patients as much as we did and we did not have to think critically or keep their rooms as clean as we did. We did it, because it is the best thing for the patient, and it will allow them to recover faster and have a more successful transition back into their normal life with a decreased chance of re-admittance.
That day my orientee seemed to be a little worried about her time management as she observed other nurses having an easier day. I pointed out to her that she has only been on orientation for two weeks and she is providing a very high level of care which she should be proud of. I told her it takes more time to provide high level care and others may not be doing the same.
Almost always there is something that can be done to improve your patient's level of care. If you have time after providing great care for your patients then be a team player by helping another nurse who is struggling. This will help her bring up her level of patient care. In the end we all want what is best for our patients. What is one example of where you have gone the extra mile to provide better patient care when you did not have to?Last edit by Joe V on Jan 9, '15
About Surg-OncRN, BSN
Hi, my name is Brian Knight and I have been an RN for seven years now. I specialize in Surgical Oncology and am working on my BSN.
Surg-OncRN has '11' year(s) of experience and specializes in 'Med-Surg., Oncology, Observational Units'. From 'South Carolina'; Joined Jun '13; Posts: 103; Likes: 185.Nov 1, '13I agree with you point of view 100%. When I worked as an aide, I worked evenings, so I would overlap with the nurses that worked all different shifts. There were quite a few nurses on days that worked until 7pm that were the laziest nurses I have ever worked with. I would tell them about patient pain, and they would say "okay" and then sit on the computer for another half hour (not charting, but on yahoo or facebook) and then get up and make a personal call and then never medicate the patient. These nurses were idolized by management since they got out on time. However, there were 2 nurses on evenings that helped with baths, made sure patients ambulated, medicated ATC and went above and beyond with teaching and they were always labeled as "slow" and criticized for staying a little late to chart. One of the MANY reasons I chose not to work their once I graduated.Nov 1, '13The nurses that seem to have it all figured out from a time management perspective do not always provide a high level of patient care. .Nov 1, '13I like to think I'm both efficient and proficient, but who knows, I may be biased. Warm fuzzies have never been my thing, but I'm good at making sure my patients are clean, lotioned, ambulating, learning, incentive spirometering, and turned and positioned if applicable. I also help out other nurses whenever I'm caught up. Interestingly, I always find I'm helping the same people.Nov 1, '13I understand what OP is saying, first of all it isn't all nurses that she is speaking of. There are a few nurses like this where I work. Since I am the charge nurse (I also take a lighter patient load) when I see these nurses sitting around chatting away, I redirect them by asking them to help so and so.
I often wonder how somebody can assess 4 patients and have their charting done in a half an hours time? I agree with OP, these are the nurses that probably didn't do teaching and all the little things that make a difference to the patient. Maybe they go back to do these things later.
The_Optimist, I'm not saying they are incompetent nor am I labeling nurses that have great time management skills, all I am saying is I can see where the OP is coming from.Nov 1, '13I'd like to consider myself as being competent, caring, while having excellent time management skills. Being a nurse requires one to chew and walk at the same time. You have to manage your time correctly in order to meet the needs of all your patients. I go far and beyond every day at work. However, I leave work on time. If I do leave late it is because I'm helping out another nurse. Bottom line: You can be competent and efficient at this same time.Nov 1, '13Maybe you were able to do all of those things so well because you had an orientee (extra pair of hands) with you? Nowadays, floor nurses are so over-worked, that they are often lucky to get the bare minimum done. Present day floor nursing does not usually allow us to provide the type of care we'd all like to give. That's why I got out...
I don't mean to be snarky at all. It sounds like you had a great shift!Nov 1, '13Quote from crazy&cuteRN^THIS...Thank YOU!!!I'd like to consider myself as being competent, caring, while having excellent time management skills. Being a nurse requires one to chew and walk at the same time. You have to manage your time correctly in order to meet the needs of all your patients. I go far and beyond every day at work. However, I leave work on time. If I do leave late it is because I'm helping out another nurse. Bottom line: You can be competent and efficient at this same time.Nov 1, '13I agree with you surg-oncRN. And I gotta say....I work with some nurses who have their cell phones out and are on them almost the whole shift. Mine stays in my locker. I also see a lot of nurses surfing the web for a large part of their shift.
There are some nurses that are very organized and get everything done pretty quickly and there are some that provide great care but aren't as organized. There all all types of people in nursing and I for one am thankful for that. I am very detailed oriented and take my time with everything. I provide great care within the limits of what we are provided with. Not every patient gets everything I hope to do, all the time, but I try.Nov 1, '13I arrived to work with an assignment of primary care for 6 pts. No CNA on the unit.
One pt was neuros q 2hr.
Two were getting blood. Hrly vitals.
Two were total care and needed turned q 2hrs. One was incontinent with complete bed changes. Both were confused and high fall risks.
One was stable, younger, and needed nothing from me but meds.
How was I supposed to even give basic care to those pts? Forget great care.
I was thrilled nobody died.Nov 1, '13I ask myself this question all the time. Unfortunately there are times when I can only give good enough care and don't have the time or resources to go the extra mile. Some of my happiest nursing moments are when I can take the time to shave a patients' face for them, or hoyer lift them out of bed into the chair for the first time. The not so life threateningly necessary things that make the pt happy make me feel like a good nurse. Sigh.Nov 2, '13Quote from The_OptimistOh, knock it off. He said "do not always" not "never."Way to label a bunch of nurses with great time management skills incompetent! Good going.
Having been the hospital aide stuck with the lazy-ass nurses texting, facebooking and surfing travel sites for their next vacation while complaining that I don't have vitals done on all FIFTEEN of my patients on time for their med pass when I've literally been up to my elbows in poop for a solid hour...... I feel complete comfort with saying some nurses deserve to be called crappy because they ARE. (And especially the cowardly charge, who told me, a brand new CNA three months out of school and in my first job, that *I* should speak to those nurses about this recurring problem when I brought it to her. Honestly, if you're afraid to discipline people, you have no business being in any management position.)
Nothing that was said in the article states that all nurses who get out on time do so because they are skimping on patient care. If you're having unwarranted defensive reactions to this, you need to figure out why that is.Last edit by duskyjewel on Nov 2, '13Nov 2, '13In the rural setting I work in several of us routinely provide great care. That includes bathing/showering them, cutting their hair if need be (on the men) and setting the old ladies hair in curlers and painting their fingernails. I also go around when I have a moment and trim off the whiskers on the old ladies. I also routinely shave them men who shave. No lady wants chin hairs regardless of how sick they are. A lot of time if a patient looks good, they feel better. Especially the older ladies who are used to always having their hair done. It's a small thing in the big scheme of nursing but I like to think they spend less time on the call bell when we can pay a little extra attention to them.Their families also like to see their people cared for. Sure I have a million other things I could be doing, but sometimes we need to remember patients are still people with families that love them. I would rather spend some time with them and listen to them than answer 40 call bells because they are lonely. Plus bathing or showering your people lets you get a good look at their skin condition, see any bruises, potential bed sores etc. A warm bath can sooth old bones and aches and pains. After a bath they get lotion, Which always includes a good back rub, warm blankets and are far more settled for the evening. It is also a chance for mobilizing them on the walk to the tub room. I have brought in treats for patients who need cheering up and routinely buy the curlers, hair gels, hair spray and deodorant we use for people. This doesn't always get to happen, based on the acuity of all the patients, but it's nice to get back to looking after the whole person at times. Not all shifts can go that way depending on meds, treatments and things like running blood. Time management is important but I figure I am being paid to work while I am there so I may as well get to it. I am fortunate in that most of the people I work with are not lazy and have developed excellent time management skills.Last edit by MelissaC71 on Nov 2, '13
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