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?

[FireStarterRN, BSN, RN]

i have seen these scripted sayings posted in the staff restroom- directly across from the toilet.

talk about a new spin on subliminal messages.

an appropriate venue for them in my opinion, since they are are nothing but a pile of *vulgarity for solid waste product of elimination preemptively edited*...

[Witiku]

I've been a manager of nurses and other HCWs for years, This pre-aranged phrases stuff is a form of people control that I'd be embarrassed to implement.

Maybe I just don't get it but it sounds unprofessional and it's demeaning to make a registered professional do this.

JMHO

Back to my cell.

[FireStarterRN, BSN, RN]

What irritates me about this stuff is that there ARE some people who DO need help or guidance in how to come across better at the bedside in their interactions with patients, but instead of dealing directly with them, management comes of with a one size fits all solution such as scripting.

I think it's a lazy way to manage human beings.

[llg, PhD, RN]

What irritates me about this stuff is that there ARE some people who DO need help or guidance in how to come across better at the bedside in their interactions with patients, but instead of dealing directly with them, management comes of with a one size fits all solution such as scripting.

I think it's a lazy way to manage human beings.

I agree. I dread the day my hospital goes to scripting -- and I think it is coming soon. I have people in leadership positions discussing it. It appalls me that some of my colleagues think it is a good idea.

I'm OK with the idea of discussing cussing and suggesting a few phrases that RN's might use in certain situations. Some nurses NEED to improve their customer service skills and need help thinking of something to say. But the nurse should always have the freedom to use her judgment and choose what to say, modify the suggestions to suit the situation, etc.

Suggesting a few possibilities is one thing ... but strict scripting is another.

The sad thing is ... that telling staff to insert the word "excellent" into as many sentences as possible has been shown by research to have an effect on patient satisfaction scores. The repetition of the word seems to have a subliminal effect on the patient, who then checks the "excellent" score on the survey. Pathetic!

[sissiesmama, ASN, RN]

No Sharrie its more like this...

Nurse calls doc: "Hey Doc, I need something for my patient"

Doctor (very irritated): "What do you want? Do you realize what time of the day you are calling me? It's 1:30am."

Michigan - My thoughts exactly!! And most of the time when we have to call the MD for a patient, The call usually goes like you described and added to it will be ...*@X "*%^&%#".

Anne, RNC

[RN1982]

And then I'll say to the doc: "Thats not my problem. If you don't like being paged at all hours of the night/day, get a new job"

[sissiesmama, ASN, RN]

OMG! Great minds. I had this same image run through my head, but only a little robot nurse with arms and legs pumping to the I have the time...I have the time...I have the time.... While she bounces off the wall after each phrase. (Oh in the old operator nasal voice, no less)

I have the time...Bop.....I have the time....Bop

Sheesh, did I mention it is 6:30 am here and I haven't been to bed yet, ROLF.

Oh that is too funny!!! I love the robot or a windup doll, or that type of thing!!! I can hear it now, her little speil, and bumps the wall, back up, and over and over and over...

My last hospital, notice the phrase "my LAST hospital" started that ____ not long before I left, and well, I'm just not very good at the smoozing, and ignorance, while providing patient care and doing all I do every day for my patients, and administration, and families, and physicians, and staff at other hospitals that call and need something, and ...

I decided to leave my last job not too long after all this got started at our facility. I never really learned how to just keep my big mouth shut, and grin and bear it, and on and on.

They were SO into this scripting that when you went into a patient's room the manager would sometimes stand outside or turn the call bell on in that room to eavesdrop, to make sure that we saying just the right things, then later trying to find out if WE HAD A FREAKING SMILE ON OUR FACES when we said it, or if we just said it and didn't "mean it". Please!!! And, hopefully many of our patients weren't ignorant enough that when we were in a patient's room and the whole time we were providing care and then saying our little speil, the ward clerk buzzes into the room with, "Hey Anne...the patient in room xxx needs you to come look at the IV. They think it is out." and "Hey Anne ... the dialysis nurse is calling back to talk to you about something and she said she doesn't have time to wait." Hey Anne ... the patient in room xxx is having (insert your rhythym of choice here) and they want you to come check on them." Oh, and always, "Hey Anne... Dr. zzzz is on the phone to give orders on another patient and I can't find her and the doc won't wait."

When they started this at our hospital, it was bad enough that if the patient was on a bowel prep or something and housekeeping had been in their room on a routine basis by the patient didn't think it was quite clean enough they had a hotline they could call and then the hotline person would call our station and tell us. Then we were to find housekeeping to come up and remedy the problem. We were given a max of 5 minutes to do all this along with our routine daily nursing stuff and our little robot song and dance 'I have the time...I have the time..."

So, I guess our little nurse robot needs to come equipped with a holster and waist belt so we can carry our toilet brush, Windex, our cable equipment to gandle the call that a tv isn't working, and some clean linen, because the patient in room ccc doesn't like the color pattern on her hospital gown. I could also see it having a type of shock collar that we wear and we get a little shock or jolt when the powers that be use to gently remind us to smile big when we say our lines ...

Anne, RNC :paw::paw::paw::saint:

"I have the time ... (jolt!) I have the time ...(jolt!) I have the time ...

[sissiesmama, ASN, RN]

and tell me that mr. rogers was the administrator?

leslie

Leslie - great minds think alike!! My first thought was "...Is it still a great day in the neighborhood?!" Wondering what color sweater he was wearing!

Anne, RNC:paw::paw::paw::saint:

[medsurgrnco, BSN, RN]

If administrators want patients to think we have the time, they need to stop making us carry spectralink phones that ring all the time showing patients just how busy we actually are.

The last hospital I worked in wanted us to explain to patients that we were washing our hands or using the hand sanitizer, and also say we were there to do "rounds", so that they would know we did those things when filling our their surveys. Guess they don't ask on the surveys if the nurses treated them like they were mentally deficient!

[imanedrn]

There are a few other threads about this.

If my hospital ever starts doing this, I decided this is my plan: At the start of my shift, when I walk into my patients' rooms to check on them, I will read the script from a piece of paper verbatim in the most monotone voice possible. I will then tell them I'm required to say this every time I enter their room -- and ask if they would like me to continue doing this or speak to them like a "normal" human being, deserving of individualy respect and dignity. If they choose the latter, I will encourage them to fill out a comment card which indicates how stupid!...I mean insulting and demeaning, these scripts are.

[gnu2thezu]

Thankfully, my facility has not tried to script us ..... yet. Sounds like HR's next "big idea" tho. Gawd, I hope not. But... my hospital has given us some pretty crazy stuff to do.

Administration cut our housekeeping staff in 1/2 to preserve the almightly dollar. Then, of course, we have our "mawk joint commision survey" where we get dinged because there is spots on the floor and full linen carts and equipment in the hall and the keyboard on the clerks computer was messy. So what happens??? The suits get in a big way and decide to make a "chore list" for the nurse staff.

Clean the nurse station counter qshift.

Dust the stock room (and all the little shelfs and buckets) twice weekly.

Mop (yes, mop) behind the nurses station twice weekly.

Clean the doctors dictation room and remove any HIPPA violations qshift.

Bag the dirty linen and take it to the bins qshift.

Sanitize ice machine daily.

The list goes on and on and on with all this crap.

I mean, don't get me wrong. #1 I reconize the necessity of cleanliness in a hospital environment. #2 I don't by any means consider myself "above" cleaning.

But does anyone else agree that a nurse is supposed to take care of her patients, not be running around with a mop and bucket or a dustrag making sure everything is all tidy? But oh, the almighty dollar.... Lets cut jobs and squeeze all the work we can out of our nurse staff!! Hows that look on your patient satisfaction score, buddy?

I am wondering how all these chores are supposed to get done in the middle of taking care of patients? I'm in critical care and more than sometimes there is just time to get the important stuff done. I think administration feels the important stuff is tidy rooms and public relations. I, on the other hand, am thinking the important stuff is meds, procedures, titrating drips to keep the patient alive--could be wrong though! If the patient dies, you can bet administration is going to blame...ahem, the nurse...because then the patient really won't be satisfied

[annmariern]

we had to wear huge yellow badges that read "are you very satisfied" lost mine to first day, do you know how many crude comments we had to put up with?