What is the dumbest most degrading, most unprofessional thing...

[Chico David]

that you have heard of a hospital requiring nurses to do?

I was in a meeting with a group of nurses yesterday - most of us with more than 25 years as RNs - and was hearing about the lovely new practice of "scripting". What is that? It means giving you - a professional nurse with all of your experience and skills and knowledge - a cute little "customer relations script" that you are supposed to say to patients when in various patient interaction situations.

For example: before leaving the room at one hospital, you are supposed to say " Is there anything else you need? I have the time." (whether you have time or not)

I understand basic sense about being pleasant to patients. I understand courtesy. I even know that a few nurses can use a little work in these areas. but the indignity of giving a professional RN a script to use when we talk to our patients? All because some consultant has told them it will improve the patient satisfaction scores. Cartain of our chains seem to be stars at this sort of thing - part of the corporate mind set I guess.

Anyway, I wanted hear how wide spread is this and what other stupid ways of degrading our practice are you seeing out there?

[sissiesmama, ASN, RN]

As the person who started this thread, this feels like a good place to jump back in. I've thoroughly enjoyed reading the comments in response. The righteous anger of good professional nurses asked to participate in these silly schemes matches mine.

Now here's another question: Do you think maybe the motivation for these ideas is more than just management stupidity? Might it be a conscious effort to degrade our professional status? One more way, along with computer charting, scripting, hourly rounding, etc to keep us from exercising independent nursing judgement and really acting like professionals? Curious to hear your thoughts on the bigger picture.

Chico - Good point with your last posting regarding the motivation. It does seem to me that some of their hairbrained schemes may start off as having some potential for not being totally ridiculous.

My dh and I worked together at my last job, and it was the same company that he had worked with for approx. 15 years, so he was more used to their "good ideas". While I was still there, he would come home home and tell me some tidbits of new things to come. A good bit of the time, they did sound good when h talked about some possibilities, but by the time it when from the planning to the implementation stage, the once good sounding ideas get so warped, it is almost a different concept completely. I know the powers that be have the patients and staff interests at heart, and they don't sit around at night thinking "What kind of stupid crap should we make them do now?!" It just seems like it sometimes!

Anne, RNC

[rph3664]

Here's another demeaning thing that happened to me, although not in health care.

When I was a teenager, I worked at Target and it was a pretty good job until we got this assistant manager who was a.....never mind, I can't use those words here. Anyway, this was before scanners and we had to key a 6-digit code into the cash register for inventory purposes, and were not supposed to look at our hands. To ensure we didn't, every register was covered with a piece of felt.

Customers would ask me about it, and I always ignored them. If they asked me a second time, they got the stink eye from me. After a few days of this, the first thing I would do when I came to work was remove the felt and throw it in the garbage. I got in trouble for doing that. So what.

[RN1982]

I used to work at a Little caesar's pizza playland and I swear the parents were worse than the kids. Talk about cruel, rude and demeaning. They sure gave it to the 15/16 yo kids that worked with me. It was ridiculous.

[Cindy-san]

As the person who started this thread, this feels like a good place to jump back in. I've thoroughly enjoyed reading the comments in response. The righteous anger of good professional nurses asked to participate in these silly schemes matches mine.

Now here's another question: Do you think maybe the motivation for these ideas is more than just management stupidity? Might it be a conscious effort to degrade our professional status? One more way, along with computer charting, scripting, hourly rounding, etc to keep us from exercising independent nursing judgement and really acting like professionals? Curious to hear your thoughts on the bigger picture.

Honestly, I think the problem centers on, the almighty dollar. Everyone is out to make a buck today. I can understand on some level, most hospitals are deeply in the red, insurance and medicare doesn't pay for x-y-and-z.

I remember the old PA my MD had telling me how they had to fight to get paid half the time and they were rarely victorious. It ****** me off because at the time, I was still in school and under my mom's insurance and I had to fight those losers over at Cigna to pay for anything and everything. Everytime I had an appointment or a test, my school documents were suddenly lost and I was no longer covered by them. And my mom was paying through the nose for that horrific insurance.

So, w/ hospitals closing and CEO's wanting to justify their overblown paychecks, they're all out to show they can make a buck. And, in deference to Generation Me, they'll do whatever they can to schmooze these people, while pulling the curtain over their eyes as to how this impacts the level of care.

There was a post somewhere here recently about an "undercover pt" (I believe it was), this woman was judging and picking her dentist based on various amenties available in his office. Me? I don't care if a doc gives away first class plane tickets on every visit, I'm not going to any GI doc nicknamed "the perfer" (yes, I know a doc like that).

I don't really think that docs who run hospitals get together and say "those stupid nurses! How can we degrade them even more today?" My old hospital was run by a business man. His concern was the pts. Mainly, their money and satisfaction scores. He wanted to make them happy w/ stupid things, so they would come back and bring their friends. Nothing about actual nursing care for pts. Believe me, I was on the nurse advisory comittee for my old job. Once a month, we met w/ the Nursing VP, various other people, occassionally that moron CEO. It was all about P-G. No one gave a damn about any of my unit's concerns.

And the docs were on our side with many issues, particularly staffing. I caught a bunch of snide remarks about how "I'm not sending my pt to the floor, they'll die there." It doesn't take a genius to realize that a 1:12 ratio is unsafe.

But rather than spend their money improving staff ratios, so pts could get the level of care they deserve and staff wouldn't get so burned out with crazy loads and leave in droves and more money wouldn't be spent on hiring new people to replace them, money was spent on other things. Making the hospital name bigger over the front door. I don't want to think about how many millions were spent on a food service program that came with a garantee to "improve your PG scores by x-number of points!"

And then, there was the staff. "Patients are scared, how can we make them feel more at ease so they'll like us? I know! White uniforms, that's their image of a nurse! Familiar sayings! Pillow fluffing! Computer scanning to make people see how high-tech we are! Hourly rounding so they feel like there are more than 2 nurses on the floor for 24 patients! It's not like those nurses do anything anyway. We'll give the nurses stupid badges and the pts silly booklets to make them feel more involved, and cha-ching!"

I don't think they want to degrade our professional status, it's more like they don't give a damn about it. [/incoherant rant]

[rph3664]

Honestly, I think the problem centers on, the almighty dollar. Everyone is out to make a buck today. I can understand on some level, most hospitals are deeply in the red, insurance and medicare doesn't pay for x-y-and-z.

I remember the old PA my MD had telling me how they had to fight to get paid half the time and they were rarely victorious. It ****** me off because at the time, I was still in school and under my mom's insurance and I had to fight those losers over at Cigna to pay for anything and everything. Everytime I had an appointment or a test, my school documents were suddenly lost and I was no longer covered by them. And my mom was paying through the nose for that horrific insurance.

So, w/ hospitals closing and CEO's wanting to justify their overblown paychecks, they're all out to show they can make a buck. And, in deference to Generation Me, they'll do whatever they can to schmooze these people, while pulling the curtain over their eyes as to how this impacts the level of care.

There was a post somewhere here recently about an "undercover pt" (I believe it was), this woman was judging and picking her dentist based on various amenties available in his office. Me? I don't care if a doc gives away first class plane tickets on every visit, I'm not going to any GI doc nicknamed "the perfer" (yes, I know a doc like that).

I don't really think that docs who run hospitals get together and say "those stupid nurses! How can we degrade them even more today?" My old hospital was run by a business man. His concern was the pts. Mainly, their money and satisfaction scores. He wanted to make them happy w/ stupid things, so they would come back and bring their friends. Nothing about actual nursing care for pts. Believe me, I was on the nurse advisory comittee for my old job. Once a month, we met w/ the Nursing VP, various other people, occassionally that moron CEO. It was all about P-G. No one gave a damn about any of my unit's concerns.

And the docs were on our side with many issues, particularly staffing. I caught a bunch of snide remarks about how "I'm not sending my pt to the floor, they'll die there." It doesn't take a genius to realize that a 1:12 ratio is unsafe.

But rather than spend their money improving staff ratios, so pts could get the level of care they deserve and staff wouldn't get so burned out with crazy loads and leave in droves and more money wouldn't be spent on hiring new people to replace them, money was spent on other things. Making the hospital name bigger over the front door. I don't want to think about how many millions were spent on a food service program that came with a garantee to "improve your PG scores by x-number of points!"

And then, there was the staff. "Patients are scared, how can we make them feel more at ease so they'll like us? I know! White uniforms, that's their image of a nurse! Familiar sayings! Pillow fluffing! Computer scanning to make people see how high-tech we are! Hourly rounding so they feel like there are more than 2 nurses on the floor for 24 patients! It's not like those nurses do anything anyway. We'll give the nurses stupid badges and the pts silly booklets to make them feel more involved, and cha-ching!"

I don't think they want to degrade our professional status, it's more like they don't give a damn about it. [/incoherant rant]

I've heard that Cigna and Aetna are two of the worst companies when it comes to paying. They reel in employers, and private pay people, with these great rates and low deductible, and then find ways to get out of paying.

As for the 5th paragraph, good heavens, what does this CEO think people are doing? "Hey, I'm not doing anything today, I think I'll go to the hospital!" Don't think so.

I do have a distant relative whose got divorced and her ex-husband had to pay the kids' medical bills, which 90% of the time is a very legitimate way to support your children, but in her case, she found ways to take the kids to the doctor several times a week, and would even go to the ER on the weekends with the kids, even if they weren't sick, so he would get a bill.

Thing is, they adore her and want nothing to do with their father. Go figure.

[wooh, BSN, RN]

Now here's another question: Do you think maybe the motivation for these ideas is more than just management stupidity? Might it be a conscious effort to degrade our professional status? One more way, along with computer charting, scripting, hourly rounding, etc to keep us from exercising independent nursing judgement and really acting like professionals? Curious to hear your thoughts on the bigger picture.

I don't think it's to degrade our professional status, I think it's more because our professional status has already been degraded.

[VivaLasViejas, ASN, RN]

Honestly, I think the problem centers on, the almighty dollar. Everyone is out to make a buck today. I can understand on some level, most hospitals are deeply in the red, insurance and medicare doesn't pay for x-y-and-z.

I remember the old PA my MD had telling me how they had to fight to get paid half the time and they were rarely victorious. It ****** me off because at the time, I was still in school and under my mom's insurance and I had to fight those losers over at Cigna to pay for anything and everything. Everytime I had an appointment or a test, my school documents were suddenly lost and I was no longer covered by them. And my mom was paying through the nose for that horrific insurance.

So, w/ hospitals closing and CEO's wanting to justify their overblown paychecks, they're all out to show they can make a buck. And, in deference to Generation Me, they'll do whatever they can to schmooze these people, while pulling the curtain over their eyes as to how this impacts the level of care.

There was a post somewhere here recently about an "undercover pt" (I believe it was), this woman was judging and picking her dentist based on various amenties available in his office. Me? I don't care if a doc gives away first class plane tickets on every visit, I'm not going to any GI doc nicknamed "the perfer" (yes, I know a doc like that).

I don't really think that docs who run hospitals get together and say "those stupid nurses! How can we degrade them even more today?" My old hospital was run by a business man. His concern was the pts. Mainly, their money and satisfaction scores. He wanted to make them happy w/ stupid things, so they would come back and bring their friends. Nothing about actual nursing care for pts. Believe me, I was on the nurse advisory comittee for my old job. Once a month, we met w/ the Nursing VP, various other people, occassionally that moron CEO. It was all about P-G. No one gave a damn about any of my unit's concerns.

And the docs were on our side with many issues, particularly staffing. I caught a bunch of snide remarks about how "I'm not sending my pt to the floor, they'll die there." It doesn't take a genius to realize that a 1:12 ratio is unsafe.

But rather than spend their money improving staff ratios, so pts could get the level of care they deserve and staff wouldn't get so burned out with crazy loads and leave in droves and more money wouldn't be spent on hiring new people to replace them, money was spent on other things. Making the hospital name bigger over the front door. I don't want to think about how many millions were spent on a food service program that came with a garantee to "improve your PG scores by x-number of points!"

And then, there was the staff. "Patients are scared, how can we make them feel more at ease so they'll like us? I know! White uniforms, that's their image of a nurse! Familiar sayings! Pillow fluffing! Computer scanning to make people see how high-tech we are! Hourly rounding so they feel like there are more than 2 nurses on the floor for 24 patients! It's not like those nurses do anything anyway. We'll give the nurses stupid badges and the pts silly booklets to make them feel more involved, and cha-ching!"

I don't think they want to degrade our professional status, it's more like they don't give a damn about it. [/incoherant rant]

Some profound truths about health care today, expressed in words anyone---even those CEOs who sit up nights thinking up new ways to justify their phoney-baloney jobs and fat paychecks---can understand. BRAVO!!!!!!

[sissiesmama, ASN, RN]

Here's another demeaning thing that happened to me, although not in health care.

When I was a teenager, I worked at Target and it was a pretty good job until we got this assistant manager who was a.....never mind, I can't use those words here. Anyway, this was before scanners and we had to key a 6-digit code into the cash register for inventory purposes, and were not supposed to look at our hands. To ensure we didn't, every register was covered with a piece of felt.

Customers would ask me about it, and I always ignored them. If they asked me a second time, they got the stink eye from me. After a few days of this, the first thing I would do when I came to work was remove the felt and throw it in the garbage. I got in trouble for doing that. So what.

rph - Don't you just love the stink eye?!! My sons get it from me a lot of the time, I think I was the first one to ever give it to them. I gave it to my dh by accident one time, meant to give it to him, just didn't mean to get caught

[RN4MERCY]

When the hospital where I worked started hourly rounding, I was so tempted to say to each patient, "I'm here to do rounds. Do you have any needs regarding pain, positioning, and POTTYING?"

The "pumps and pearls" set is at it again. POTTYING? During our hospital's annual "skills lab" this year, they actually had a "skill validation" station with candy kisses and little souvenir laminated cards with bullet points for "commode chair etiquette." -"insure privacy", "place call light within patient's reach", "stay with unsteady patients," "use proper body mechanics when transferring patient from bed to commode."

What an insult! Yeah, it's going right in my pocket next to my ACLS algorithms. NOT!

Where do they get these consultants from? I'd venture a guess and say they're not licensed RNs, so why are we letting them get away with insulting our practice as professionals. Our so-called nurse leaders and change agents and champions ought to be ashamed of themselves for not being able to stop administration from cramming this STEPFORD PR garbage down our throats.

[RN4MERCY]

Oh, I almost forgot...here the administrators go again, trying to chip away at the nurse's credibility as patient advocates. Anyone else feel insulted by this poster/button campaign?

"It's O.K. to ask if I've WASHED MY HANDS."

[wooh, BSN, RN]

Oh, I almost forgot...here the administrators go again, trying to chip away at the nurse's credibility as patient advocates. Anyone else feel insulted by this poster/button campaign?

"It's O.K. to ask if I've WASHED MY HANDS."

Considering study after study has shown that physicians are worse about this than nurses, there's no way I'd agree to wear them unless the MDs had to wear them too.

[princess_chaos]

well im still a student nurse and a newbie here in this forum. anyweiz, yeah, i agree thats stupid. i never thought that theres such thing as SCRIPTS that nurses use in the hospital. its plastic. and truly degrading.

but actually in some country, (i wont mention the name) instead of being caring to the patients, they actually never care. student nurses often see that to staff nurses. they dont make rounds, dont even give the medicaions on time and violates the principles of sterile/clean technique. poor patients.