Jump to content

Bedside reporting as a management tool of humiliation

Posted

Specializes in Oncology. Has 13 years experience.

I am just sitting here with my mouth hanging open. On Day One of go live with our bedside reporting, our big boss(not an assistant manager) was following nurses to "coach" them. A nurse who has been here for 30+ years and is probably one of the most stoic people I've ever met was apparently dressed down in front of the patient, to the point of the nurse crying so hard she couldn't speak.

Let me repeat, day one. The nurse receiving report attempted to redirect and prompt and she had the micromanaging ire turned on her. They are insisting we do everything just so(like: offgoing nurse must do x, y, and z and oncoming must do a, b, c when really either could do them, and you'd best get your scripts perfect.) Any plus sides to this are being drowned by management control and humiliation. Half the floor is looking for a new job. It's the height of inappropriate behavior.

Edited by sistrmoon

Altra, BSN, RN

Specializes in Emergency & Trauma/Adult ICU.

A 30-year nurse, described by peers as "stoic" ... suddenly had a tearful breakdown in front of a patient?

Dramatic, indeed.

Emergent, RN

Has 27 years experience.

Whoever thought that a one size fits all, scripted bedside report, is a blithering idiot. It shows an utter lack of awareness of human nature and individuality. It treats Healthcare as nothing more than a visit to McDonald's; come up with a formula that works and you'll sell billions and billions of burgers.

meanmaryjean, DNP, RN

Specializes in NICU, ICU, PICU, Academia. Has 40 years experience.

Don't even get me started on this........ entering a room with sleeping toddler and sleeping parents at 0700 for bedside report when all parties involved have only been asleep for a couple of hours......

imintrouble, BSN, RN

Specializes in LTC Rehab Med/Surg. Has 16 years experience.

For some nurses it seems more like a schmoozing session, than an information trade. With a lot of chit chat with the patient and family. As long as most of us kiss the pt's butt while we're bedside rounding, management is happy. The info shared is secondary.

We're supposed to end the bedside report with "thank you so much for letting me take care of you today", but I simply can't get that garbage past my lips.

If they want me to read a script, if my job depends on reading that script, I'll read the script. But I'll literally read from a piece of paper when I round.

There are pieces of paper taped everywhere in our nursing station. Scripts at the ward clerks chair with what to say to people who approach. Scripts taped to the telephones with how to answer. Scripts taped in the employee bathroom. I hope we won't have to share with the customers, but who knows?

.

imintrouble, BSN, RN

Specializes in LTC Rehab Med/Surg. Has 16 years experience.

Don't even get me started on this........ entering a room with sleeping toddler and sleeping parents at 0700 for bedside report when all parties involved have only been asleep for a couple of hours......

At least they allow us the discretion of whether to wake a sleeping patient or not.

That's probably the next thing they'll take away from the robots.

sistrmoon

Specializes in Oncology. Has 13 years experience.

For some nurses it seems more like a schmoozing session, than an information trade. With a lot of chit chat with the patient and family. As long as most of us kiss the pt's butt while we're bedside rounding, management is happy. The info shared is secondary.

We're supposed to end the bedside report with "thank you so much for letting me take care of you today", but I simply can't get that garbage past my lips.

If they want me to read a script, if my job depends on reading that script, I'll read the script. But I'll literally read from a piece of paper when I round.

There are pieces of paper taped everywhere in our nursing station. Scripts at the ward clerks chair with what to say to people who approach. Scripts taped to the telephones with how to answer. Scripts taped in the employee bathroom. I hope we won't have to share with the customers, but who knows?

.

Yeah. The "thank you for allowing me to care for you" is rich. Who exactly had a choice in the matter? Oh I guess the "customer" has their choice of nurse, which is not so subtly implied in that subjugating phrase.

sistrmoon

Specializes in Oncology. Has 13 years experience.

At least they allow us the discretion of whether to wake a sleeping patient or not.

That's probably the next thing they'll take away from the robots.

In the training materials, it says we are to ask the patient while they are awake if they want to be woken for report. But management says "they don't have a choice." Waking someone who hasn't slept all night due to pain is not going to increase the hallowed satisfaction scores.

sistrmoon

Specializes in Oncology. Has 13 years experience.

To think I was worried about my coworkers hounding me in front of the patients. Manager clapped the crying nurse on the arm and told her to "buck up." Manager also physically and roughly moved the nurses into their prescribed places.

I don't take kindly to being touched without permission. I just...wow.

Altra, BSN, RN

Specializes in Emergency & Trauma/Adult ICU.

To think I was worried about my coworkers hounding me in front of the patients. Manager clapped the crying nurse on the arm and told her to "buck up." Manager also physically and roughly moved the nurses into their prescribed places.

I don't take kindly to being touched without permission. I just...wow.

From the picture painted here, the relationship between staff and manager was straight out of a Dickens novel ... way before the bedside report initiative came along.

And yet, professionals have remained on this unit.

Fascinating story.

The whole thing is hard to imagine, from the managers disrespecting the nurses in front of patients to senior nurse responding with uncontrollable tears instead of dragging the manager into break room and laying into him/her.

Aside de from it being phony, did they not even have some mock reports beforehand?

I have to say though, we have staff who years later even with a bullet point guide, still won't start off with John Smith 72 yr old patient s/p..etc. they will still jump into talking about a patient without providing the preliminary info. (Team conf, not report). Even when it's relevant there is a resistance to follow a format.

I would imagine for those that are disorganized in regular report would really struggle under the negative spotlight. It's a terrible way to teach and enforce a new style of report. Not to mention perpetuating patient anxiety.

Altra, BSN, RN

Specializes in Emergency & Trauma/Adult ICU.

The whole thing is hard to imagine, from the managers disrespecting the nurses in front of patients to senior nurse responding with uncontrollable tears instead of dragging the manager into break room and laying into him/her.

Aside de from it being phony, did they not even have some mock reports beforehand.

I think you've hit the nail on the head here.

A manager so concerned with sticking to the script (presumably to benefit patient satisfaction scores) that she lays hands on a crying nurse in front of said patient? Come on now.

And yet, people determined to feed into the nurse-as-victim mentality just eat up farces like this.

Rose_Queen, BSN, MSN, RN

Specializes in OR, education. Has 15 years experience.

There are pieces of paper taped everywhere in our nursing station. Scripts at the ward clerks chair with what to say to people who approach. Scripts taped to the telephones with how to answer. Scripts taped in the employee bathroom. I hope we won't have to share with the customers, but who knows?

Scripting is just ridiculous. If they think patients don't pick up on the fact that we are told what to say, then they are seriously underestimating the intelligence of our patients. We are educated professionals; those who can't figure out how to speak with patients/visitors will reveal themselves at some point and be addressed accordingly. There is no reason to try to turn nursing professionals into robots.

nynursey_

Specializes in Med/Surg/ICU/Stepdown. Has 3 years experience.

I knew this was coming. Believe me, I called it from Day 1.

When we had our "Go Live" launch, I was horrified. I was forced to wake sleeping patients in spite of my strong wishes not to. These are medical/surgical patients, multiple comorbidities, some with admissions as early as 0300 that morning, who I was forced to wake with a cheesy grin for the excuse of "it's for YOUR safety."

On Day 2, I inadvertently revealed information about a patient to a family member she would have preferred not been mentioned. I did this, even with asking if the patient would like her family member to leave (she stated she did not), and the patient was mortified. Not only was she turned off to the idea of my being her nurse for the duration of the shift, but she complained to management. The result? We're sorry, but bedside report is not an option. This will turn patients off to the HOSPITAL as an entity entirely.

I, too, will NOT have my interactions with patients scripted. I'm also looking for a new RN position.

hppygr8ful, ASN, RN, EMT-I

Specializes in Psych, Addictions, SOL (Student of Life). Has 18 years experience.

I once worked in a hopsital where we all shared duty of answering phones if the ward secretary was busy. We were requested to answer the phone "Thank you for calling---------, this is -------------, how may I exceed your expectations today" -)

NurseSpeedy, ADN, LPN, RN

Has 18 years experience.

Don't even get me started on this........ entering a room with sleeping toddler and sleeping parents at 0700 for bedside report when all parties involved have only been asleep for a couple of hours......
Oh, any facility that doesn't all for some flexibility with this one is bound to have several unhappy pediatric parents. Nothing like a stupid policy to get the patients to op for a different facility. They would not want me to be that parent. I'm a pitbull when it come to my child

NurseSpeedy, ADN, LPN, RN

Has 18 years experience.

To think I was worried about my coworkers hounding me in front of the patients. Manager clapped the crying nurse on the arm and told her to "buck up." Manager also physically and roughly moved the nurses into their prescribed places.

I don't take kindly to being touched without permission. I just...wow.

Great, now the poor patient is a witness to battery!

Should the nurses actually start departing, while there may be talk in the community about this idiocy, the departing nurses should expect no understanding from prospective employers. I was one of several nurses who departed a hellhole within weeks of each other. Each was blacklisted for a very long time and some had to leave the area altogether to get work. It seems the responsible idiots never pay the price.