Hourly Rounding

[Erianne1074]

our hospital recently implemented hourly rounding. but before that we have to go through a one on one teaching session with our manager so we can go through a script on how we will address our patient every time we make rounds (a script...sounds like a play!)

"is there anything else i can do for you? i have time."- this should be the exact words we are required to use before we leave patients room.

(i could bring a recorder with me and play it everytime i check on my patient...hehe! ) of course, our patient are expected to be informed of this hourly rounding. and if we don't show up in their rooms or missed the due time for rounding..patient and family can write us up and complain.

take note , we are to document this rounding in a piece of paper. if not our attention will be called for not documenting it. so my guess would be unrealistic documentation. why? most of the time you can be stuck in one patient for 45 mins to an hour esp when you have a needy patient. and they rarely provide us with nurse aide or techs.

(can i just clone myself..! maybe clone a secretary so somebody can enter doctor's order while i do my hourly rounding).

well the reason for this because they want a high score on patient satisfaction..oh yes to be recognize!

how about nurses satisfaction? nah..they don't care!

anybody care to react?

[PostOpPrincess, BSN, RN]

Ah. AIDET.

Did you tell them you have 1,000 years of experience? Don't forget that.

[dscrn]

Forgive me if I'm wrong, but "back in the day" patients weren't as demanding. That generation is about gone. Now patients want things and they want it NOW!

I think that you are correct...Back in the day, there were no pt satisfaction scores...we helped pts as needed, gave meds, did teaching, etc. I think that since the shift has been made, and pts are now guests, they are given neg reinforcement by hsp managers. ?How is your stay? is best left to hotels...

[dscrn]

What happens during an emergency situation? Any slack cut if one of your assignment happens to code??

[Riseupandnurse]

It is just totally unrealistic. And no, there is no "slack" for emergencies, as management feels that staffing is GREAT and so if we can't get to a room we could just delegate this to the nonexistent smiling, break-taking laid-back other staff on the floor. Who in the heck is THAT???? See the problem? It's like third degree heart block. No communication between the S Administration node and the over-working ventricles.

[OldnurseRN]

We implemented the hourly rouding in our facility and it's a joke. The nurses who don't do it keep their "Sorry I Missed You" card by their computer, write the times in and drop the card off in the room before they end shift. Personally, I chart every hour on my patients because I DO round. My main objective is patient care and fulfilling the law of my licensure and I feel I achieve both. It's charted .... it's done!

This is so reminscent of the old days when hospitals switched to "team nursing" under the premise that 3 people to a team, RN, LPN and CNA could be assigned more patients and the patient would feel they were getting better care because they saw more faces.

[morte, LPN, LVN]

Sorry if I missed it, but what do you do when the pt is asleep? I work nights, and try to "bundle" care so that the pt's get a least at couple of uninterrupted hours of sleep whenever possible. (Whicn is a good thing according to EBP). So, is it better for the pt to get through all of the stages of sleep, or be wakened every hour to see if they need anything? Can you let a sleeping pt lay? (or is it lie?)

i think it is lie.......lay is the passive....miranda will know, lol

[RheatherN, ASN, RN, EMT-P]

I am absolutly ticked about all of this. we are supposed to be doing this as well. we have these little clocks that are wipe off things in each pt room on the boards we are supposed to inital each time we are in there. you know what, AINT GONNA HAPPEN. as for the script, SAME DANG THING!!! no way in heck. this angers me to no end. every time we try to tak to managers about it, they tell us they are keeping track of times and calls from rooms since this things has started to prove that calls have lessened, i call bs. they didnt keep track before, so what are they going to do? show me numbers now? great for them! dont care. they are not the ones on the floor, we are! besides the fact, if i am charting or if i am on the floor with pt walking or something- i am not going to MAKE SURE that i am signing my name on the little clock. like i have time. grr. this is just such a sore spot. even when i do have an aid, they dont even help, they dont sign anything! even when i have talked to them to explain that tey are supposed to be helping as well, they dont, whatever. i am not going ot keep explaining ya know? its bs, bs bs bs.

not even gonna sign my name i am so annoyed!

[MurfRN]

WOW. It is amazing the extremes and the passionate responses this topic has elicited. I too am subject to hourly roundings till 2200 then q2hrs (I am a night shift owl). It certainly is depressing to know that you are entrusted with the lives of patient's but not empowered by trust that you can do your job. The signing of the logs to PROVE you rounded? please. As most of you have said we are professionals. Give me the job, the job descriptions, the requirements, then empower me to get it done. Have faith in me and I will raise your Press Ganey Scores but keep in mind that people at times think they are at the Ritz. ie I had a patient with family at the bedside who called for me to adjust a blanket, hummm, Jane Doe down the hall was in pain so I prioritize. That didn't make the family and the blanket patient happy that I did not meet their immediate needs right now. What now do we right UOR's for every nit picky petty event. Oh well role with the punches, I still love bedside care.

[MedSurgeMess]

I think, if I'm ever given a script, I will enter the patient's room, pull out my laminated card, hold it right in front of my face, and read it verbatim in a very monotone voice. After reading it, I will say that I'm required to do this once every hour, and I will continue to do so in the same exact way (laminated card, script, monotone) unless they tell / ask me otherwise. I can only imagine they'd find it just as irritating as I and would tell me I don't have to -- and I would make sure to document that!

When my DH had surgery last year, he got the same script, and when the NM came around and asked how his stay was going and all that satisfaction stuff, he said "if one more employee comes in here with that phoney sh*t, I will write the biggest complaint letter you have ever seen." Needless to say, staff was informed and no one said anything about having the time anymore. And before this, he never believed me when I told him about our wonderful scripts. We openly joke about our scripts anymore. Also, I think so much of the customer service stuff has changed since the economy started to tank. Good care of patients never goes out of style though..

[PostOpPrincess, BSN, RN]

Forgive me if I'm wrong, but "back in the day" patients weren't as demanding. That generation is about gone. Now patients want things and they want it NOW!

I am a "back in the day" nurse. and Yes, I totally agree with this poster.

People are me, me, me, me, and ONLY ME.

[brandy1017, ASN, RN]

We too have hourly rounding and have to sign a pledge promising our commitment and to use the phrase, "Is there anything you need, I have the time". Well I can tell you I don't have the time, we work on a stepdown unit and can have crashing patients that are keeping you busy and the admission or transfer that was supposed to go to ICU but they have no beds or not enough nurses so play ICU nurse with 7 patients!

Secondly, the first thing they'll want is to get out of bed and they can't stand and will be 200, 300, 400 even 500 pounds that you are supposed to magically be able to lift them as if you were a superhuman machine. It is physically impossible and lift equipment is nowhere to be found.

Isn't there some agency to complain to about worker safety? We have a very alarmingly high injury rate at our hospital. I've sent letters to the Congress and even Gov but so far no response. I know there was a Safety Act in Congress this year but nothing ever became of it. I used to be afraid of making a mistake and being stressed out, now I'm just afraid of being injured. I dread going to work and feel fear when I see the mega patients I'm caring for and then when you tell them you can't lift them they start crying! I feel terrible, but if I don't protect myself who will.

Our employee health person just logs injuries, there is no back prevention injury program and when you speak up the comment we have no money for lift equipment! It is sickening!

[dscrn]

OSHA!