Discussion

for adminstrators

Dec 18, 200817 yr

As it is right now, a nurse's day is full. What that means is if you add something, something else will not be done. Maybe I could demonstrate this: I will put a glass on your desk. This represent's a nurse's day. Then I will fill it to the brim with water. This represents the tasks that a nurse does. Now this pitcher of water I am handing you represents any extra tasks you might like to add, including new flowsheets, assessments, reports, etc... Now: watch what happens when you add water to this full glass- See how water comes out? The water on your desk represents something the nurse used to do, but now can't.

It's a simple concept. Developmentally, children get this concept at about age 4. Why do administrators not get this? If you give me something new to do, I will have to cut something else out. The worst part is, it will probably be some part of patient care which is important, but that I am not evaluated on.

I realize that a study you read somewhere showed that using this new skin assessment matrix (or whatever) reduced bedsores by 12% That's great. But at what cost?

I propose a new rule: Anything new task you introduce must be accompanied by a reduction somewhere else. Since that is a mathematical reality, let's choose what will not be done. Think of my time like a budget- a real budget, not the government kind. This budget needs to be balanced. For example, if you already spend your entire paycheck, but get a car with a higher payment, you will have to cut back on something else.

So- thanks for the new flowsheet. What do you want me to cut out to allow me time to do it?

hherrn

Dec 18, 200817 yr

....it will probably be some part of patient care which is important, but that I am not evaluated on.

....like simply talking to your patient possibly helping one that is lonely/scared of surroundings/fearful of a diagnosis/need further teaching etc.

Dec 18, 200817 yr

We are told this

Active listening is the most important factor in determining a patient's overall evaluation of an inpatient hospital experience. Patients rate highly clinicians who listen to them carefully. In a nationwide survey conducted by NRC Picker, patients identified good communication skills as one of the most desirable characteristics of a caregiver.

Active listening involves focusing on the patient's or family members' words, tone, body language, emotion and behavior. There are also other factors that directly help in the development of a healing and nurturing relationship with a patient and their family.

Caring, respect, and empathy are vital aspects of relationship building. Active and non-judgmental listening shows respect.

There are certain research-based listening techniques that are proven to work in clinical situations: Positioning oneself at an eye level that is lower than the patient's, sitting down, and the use of silence to allow time for the patient to express their thoughts thoroughly.

My thing is WHEN DO WE HAVE TIME TOO.

Yes I would love to sit and talk with my patients, find out what I could do to make them feel better. Or to help my patients learn to breastfeed, but with four to five babies, and with four BFeeders who all need help at the same time, you just can't do it. You are rushed, you have other patients to see and check on. So you rush in get the child latched on the best you can say "see that's how you do it, if you need any help call me." and then rush back out of the room to the next mom. And I love since it is night shift that the nurse to patient ratio is so much higher. So at times we have even less time to sit and actively listen to our patients.

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