Hourly Rounding

You should do a search in these forums on scripts and hourly rounding, I think you will find alot of info

Good grief...........I am SO glad I left acute carel!!! I'd get fired in a New York minute if I were working in a facility that treated professionals like Wal-Mart greeters. I can just see myself telling administration, "Right---I went through four years of college and $20K in debt so I could learn how to act like a #@*! parrot!!!"

I can't believe this trend toward "scripts"........as if nurses are too stupid even to know how to talk to people. And that silly phrase "I have the time"---what happens when you DON'T have the time, do they just take you out to the town square and execute you?

I'm not usually one to agitate for a revolt, but I really think it's time for nurses to rise up and REFUSE to put up with this. There are a lot of jobs out there that don't require one to surrender all dignity or be treated like a first-grader. We should vote with our feet and refuse to work anywhere that nurses are regarded as glorified waitresses. I mean, can you imagine anyone making a physician or a physical therapist do hourly rounds and act like a Stepford wife?? Sheesh!

We are supposed to say that very same thing. Is there anything else I can do for you? But before you answer that I want you to know that since I came on shift I have been in here at least twice an hour, helped you order your breakfast and lunch, put you on the bedpan about 10 times and given you all of your prn meds that you can have right now(not all at once, but one at a time like water torture). Now I absolutely do not have time to sit down, go to the restroom or actually eat something myself. What did you need?

At the risk of sounding like a relic. In the days before IV pumps and vital sign monitors we did hourly rounds and without the benefits of a unit secretary or respiratory therapy or computers and if you worked nightshift or weekends no pharmacist. It can be done and done well you need to be organized and think ahead about what your patients may need. I do my meds and assessments on my most critical patients first then prioritize the rest of the group. I don't use a canned phrase but I always end with "is there anything I can get for you before I leave?", or something to that effect. I encourage the patient to call if they need something before I get back, otherwise I will see them soon. I also do my charting in the room with the portable computer. Hourly rounding is more critical thinking than task oriented and you don't have to disturb a patient with a long conversation each time you enter. Think about how you can make it work for you. I think you will be surprised.

See, that's just it. Most nurses are 'people persons', and we know instinctively that we can save ourselves a lot of time and give the best care by anticipating our patients' needs. It's so much easier to invest a few minutes of time at the beginning of the shift to learn who your patients are and what they need, and assure them that you will do your best to meet those needs. No one has to tell us how to do this; it comes naturally.

It's the idea of the "script" that sticks in my craw. Nurses are professionals; it's insulting to all concerned to demand that we utter a canned, pat phrase like "Is-there-anything-else-I-can-do-for-you-I-have-the-time" It sounds insincere and forced, and most patients know it.

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!

Yes, we were supposed to end each visit to the patient's room with those exact words. "Is there anything I can do for you? I have the time." As far as I know, we're still supposed to be doing it, but administration has not been trying to enforce it lately. Very disturbing to realize there is some management/consultant group somewhere that is getting paid big bucks to feed administrators this nonsense. We fought it; I never had any time at all. Once you give up all breaks and meals and STILL are staying an hour or two overshift, where is this time that I'm supposed to have? Finally one evening I tried it on 3 patients. One wanted me to play cards with him, one wanted me to pop along to the kitchen and rustle up some soup and sandwiches, and one said he wished he had a job as easy as mine because he never had extra time at HIS work. I cannot bring myself to say it. If I have the time, then where in the world have I been all shift? That is what I would think if a nurse said that to me. When will hospitals stop trying to script their nurses? We went through many classes in school that helped us learn to relate genuinely and to care about our patients. These rote phrases are phony to the hilt and PREVENT an honest and meaningful nurse-patient encounter, something that is worth much more than any customer service ploy.

I've read about this stuff before and can't see myself dealing with it adequately. I have enough trouble actually attempting to do my job the way I believe it should be done, in spite of the impediments placed in front of me, as it is. If I were ever to work in a facility that started down the PG route, I think I would seriously consider a new place to work. It's hard enough as it is. But, funny as it may seem, I go for the script idea. Why? Because, my little brain, for various reasons, is just fried enough to look for such crutches. But to have them shoved down my throat by mgmt, no, I don't agree.

The acute care units in my facility have implemented the hourly round idea and on the unit that I work in we have boycotted the idea to the point where my manager just gave up.

The day shift staff never or rarely signed the rounding book, and there were lapses in the records so my manager just told us to be on the lookout for patients more often.

It is such a relief to not have to round every hour. I have vital signs, blood sugars, and patients to clean up, not to mention assisting the RN with her duties.