Improving patient satisfaction in OB

kirsnikity · Feb 6, 2013

Several years ago our surveys were showing that many patients claimed the worst part of their labor and delivery experience was the IV start (I'd say we were doing pretty well if that was the biggest complaint!). So we started using 1% lidocaine for our IV starts. The patients really appreciate this and now it's second nature for me to use local for IV starts.

caringfornurses · Mar 9, 2013

I have been asking myself that same question.I would imagine that if someone were in labor, you could teach side effects all you want before giving the medication, who would hear it? I have been racking my brain over this question for years now. The conclusion is that I feel this is on there to set us up for failure. Doctors prescribing and nurses administering these medications have gone to school for years to learn how these medications work in the body. Now, we are expected to "explain the side effects in a way you can understand" before handing them the pill. I work on an orthopedic unit. Giving 6 patients coumadin and doing coumadin teaching in an hour (without appearing rushed) is pretty tricky. Especially when you enter the room and the patient suddenly has to go to the bathroom, etc it is especially interesting that the question is worded before it is given and not before you went home. Yes, failure is going to happen.

And what's up with the call light help "as soon as you wanted" Again, almost impossible. I would love to survey the public on the politicians and see if they are happy. I have no idea how to teach patients to become nurses and doctors in the brief periods they are in the hospital (our average stay is 2 days). I think longer stays would help.

M/B-RN · Mar 11, 2013

Our manager is always trying to get us to improve our scores, however it is very hard to make people happy when we do not have the means. Patients want help right away, well only two nurses each with 5 couplets each makes it very hard. Patients want help with breastfeeding, well there's only so much I can do the rest is up to you, I will NOT stand there holding your boob the whole 30 minutes. Also, patients complain about our rooms being dirty, food is not good, rooms are too small, about having a roommate and all of those things are not even in the nurse's control.

I think things that would help would be proper staffing, updating/renovating the unit, and better housekeepers.

Elvish, BSN, DNP, RN, NP · Mar 11, 2013

Staffing by AWHONN standards....good start.

PinkNBlue, BSN, RN · Mar 12, 2013

Staffing by AWHONN standards....good start.

Ideally.

Elvish, BSN, DNP, RN, NP · Mar 12, 2013

Ideally.

I know. It is always an uphill battle - but I hear over and over on my unit (and have said it myself) that if the nurses are happy, the patients will be too. If the nurses aren't overextended doing and being everything for 5 couplets/10 patients, they will have the time to help with breastfeeding, to address pain within a reasonable time frame, to spend more time with patients helping them learn how to care for their babies. As it is, we give minimal care, and that is frustrating.

PinkNBlue, BSN, RN · Mar 12, 2013

I know. It is always an uphill battle - but I hear over and over on my unit (and have said it myself) that if the nurses are happy, the patients will be too. If the nurses aren't overextended doing and being everything for 5 couplets/10 patients, they will have the time to help with breastfeeding, to address pain within a reasonable time frame, to spend more time with patients helping them learn how to care for their babies. As it is, we give minimal care, and that is frustrating.

So frustrating. I feel like I'm running like a chicken with my head cut off between rooms with breast feeding help, meds on time, getting patients up for the first time etc that the time actually SPENT with my patients is not always what I strive for it to be. Unfortunately AWHONN staffing guidelines and unit budget are two different things :-/

dariah · Mar 12, 2013

So we started using 1% lidocaine for our IV starts. The patients really appreciate this and now it's second nature for me to use local for IV starts.

In an injection or cream?

RNinLDRP620 · Mar 13, 2013

kirsnikity - when you say local are you injecting lidocaine or using a cream/gel? This is interesting, have you noticed a huge difference in survey scores?

cayenne06, MSN, CNM · Mar 13, 2013

I would suggest taking a look at your protocols and ensuring they are evidence based and mom/baby friendly. Instituting intermittent ausc as standard for low risk moms, performing all newborn care at the bedside, providing a comfy sleeping space for the partner, having rooming in be default, and allowing a normal diet during labor are things that come to mind. Of course hopefully your unit already does all or most of these things! Oh, and maybe have saline locks instead of IVs for low risk moms, tele for those who require continuous monitoring. another complaint i here sometimes is the transition to PP if you dont have LDRP rooms. No particular suggestions for that. Pls excuse typos, on my phone

klone, MSN, RN · Mar 13, 2013

I think she's referring to a local anesthetic. IME, the injection of the local hurts about as much as the IV start itself (assuming the person starting the IV is skilled at it, and not digging around).

During the day will have massage therapists come around and offer massages to the new moms. We also have "tea time" on T, Th and Sat at 2pm, where the room service staff come around with a cart with all kinds of fancy teas, as well as cookies, brownies, and little cups of mousse.