Bedside reporting as a management tool of humiliation

NYbabyRN, BSN, RN · Mar 14, 2015

Wow, we just started bedside reporting last week and although we haven't been treated so roughly, management continues to grill us that we need to be saying key phrases over and over again, including "Is there anything else I can do for you today, I have the time?" "I have the time" is not always the truth, when there is charting to catch up on, a dressing change that needs to be done right at change of shift, or report to get about other patients. I am already tired of being told I have to say things exactly a certain way. I have left continually late since bedside reporting started, because some patients are keeping nurses a long time at the bedside while they are giving bedside report.

I am so sorry for the experience your fellow nurse went throughâ€¦sigh.

brandy1017, ASN, RN · Mar 14, 2015

Bedside report is sweeping the nation because management believes it will improve press ganey scores and I believe one of the questions on the survey mentions bedside report. So it will be hard to run to another place that doesn't do this. I agree it turns into a schmoozing session with the patient which is what management wants and true report gets swept to the side because we know there are times when we can't give a full report in front of the patient for any number of reasons such as a bad test result/diagnosis the patient hasn't been told yet or language barriers or confusion. It makes no sense to talk in front of a confused patient or someone who doesn't understand what we are saying! There aren't enough interpretation phones to communicate to the many patients we have that don't speak english. That's another subject, but why don't people make the effort to learn english when they live in America?

Management has watched us several times and some people were insulted, but they at least kept their distance and listened outside the room. Still it is insulting to treat experienced professional nurses as if they were auditioning for a play! We haven't been subjected to the scripting at least. They have offered ideas possible scripts I suppose of what to say to a patient, but at least it was a suggestion not a demand.

One patient mentioned liking bedside report so that was the justification that it was really great! They are blaming the older nurses for bedside report not being done all the time. It really iust because they won't compromise with the nurses and let them get the main report at the station and then meet and greet the patients and give them a brief update of their treatment plan. They are simply not being reasonable because we all know we can't say everything in front of the patients, plus we have to dumb down the report for them to understand. If they would compromise and work with us I think everyone could be happy. Good luck with that! It is sad what nursing has become between the computers and the press ganey scores!

SmilingBluEyes · Mar 14, 2015

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" -)

where is the "vomiting" smiley when I need one???? Ew.

tokmom, BSN, RN · Mar 15, 2015

I personally like bedside report. If a slacker nurse fails to hang an IV bag, or leave in infiltrated IV, I can ask them to fix it before they leave.

The scripting however is crazy. I don't need someone putting words in my mouth.

Emergent, RN · Mar 15, 2015

There's nothing inherently wrong with bedside report. There's everything wrong with how the OP's unit is instituting it. The ridiculous, disrespectful, inflexible behavior of her manager is beyond the pale.

5 years ago, when I was working the floor, my hospital started it. It's been approached much more realistically where I work. There are too many variables to take an over the top, rigid approach.

whofan, ADN, BSN, RN · Mar 15, 2015

I have been doing bedside report for over a year on my unit. It is usually a good thing, we don't have scripts (yet) though I am sure the powers that be are contemplating that. After I am done, I usually ask the family or if the patient is alert and somewhat oriented I ask them if I missed anything they think might be important. OUr management watches and makes sure we actually do bedside, but they never go in with us. (please don't give them that idea)!

**canoehead, BSN, RN** · Mar 15, 2015

If the patient is HARD OF HEARING do you HOLLER THE WHOLE REPORT?

Mr. Murse · Mar 15, 2015

wow.......and here we were at my job just complaining about having to go into the room for report. All these stories of abusive management and micromanaging makes me a lot more grateful for my situation.

Really though, who is coming up with all this utter bull **** (sorry, I have to use that word because it's the most appropriate word for it)? Must be the same group of morons that came up with referring to patients as "clients".

Gooselady, BSN, RN · Mar 15, 2015

We did bedside report the last two and a half years of my previous job. It was seriously NO BIG DEAL.

What insensitive, angry, micromanaging idiot thinks it is improving patient care to wake patients up during nursing report?? Isn't this the PURPOSE of nursing report? Improving patient care and nurse's jobs with communication improvements? Funny me, I always thought our managers got those kinds of jobs because they had leadership skills LOL (NOT!)

It's not bedside report that is so bad. It's really not. It's the scripting and 'acting' and other insane (not to mention sadistic) power-drunk managers OR nurses that screw this stuff up. There is no issue! There is no problem! But they can make up a drama out of nothing

Anna S, RN · Mar 15, 2015

This is just awful, awful.

Here.I.Stand, BSN, RN · Mar 15, 2015

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.

OH. HECK. NO.

Time for a visit to HR.

jadelpn, LPN, EMT-B · Mar 15, 2015

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.

First off, I am so sorry that this happened to your co-worker. It really, really stinks.

With that being said, what is an ongoing theme in facilities is that it is a business. Period. Therefore, in order for the business to run successfully and make money, it is a "customer is always right" mentality. It is large theme park-esque in the "service" that nurses are expected to provide.

Topped with the fact that your 30 yr vet nurse, whose practice and nursing character was always defined by the CARE that was given to patients, the TRUST that the plan of care was based on what would make a patient function at the highest level, has been switched up to only include illusions and patient "delight".

Not to mention this nurse's hefty salary, which they could hire 2, (or with 30 years in 3) nurses for what they are paying her.

So begins the "she doesn't usually make errors, so lets just humiliate her into submission and resigning!! She has a PENSION, she needs to RETIRE"....."we don't give a little rat's behind that she has been nursing longer than we have been ALIVE....heck, we don't necessarily care that the PATIENT stays alive.....just make sure it happens someplace else and get the patient out of here.....and don't forget---use the script only"

For nurses with even 7-8 years in, this whole scripting concept seems (and I argue is) a dumbing down of what nurses have always done. Insisting that one has a BSN to be customer service rep. and an improv star were not even remote thoughts in a great deal of seasoned nurse's heads. And this concept is not only foreign, but borders on ridiculous.

Nurses are now being encouraged to get a master's degree is business. And I believe most will find that they use that degree more than a BSN. Patient's are units, and each unit needs to bring in money. If the reps are not making the facility money, they are a liability and need to be let go. But it is not easy when you have a stellar nurse with multi years in a facility and a union or policy regarding progressive discipline. So it begins.....and unfortunately it had to happen at bedside.

The goal IS to humiliate, degrade, make one question......IF the nurse's goal is to provide CARE that works for a patient. If said nurse gets with the program and stops cowboying and taking it upon herself to actually tailor a plan of care that is going to work for a patient as opposed to the facility, her days are numbered. Sigh.

So everyone needs to get on the fake smile, sing-song voice of "managing up" your oncoming nurse, be absolutely sure you "have the time" be a mind reader and anticipate if your patient (or their visitors) wants a blankie or a diet coke, keep the unit quiet....(except for the shrill of your voice as you are "delighting" the patients) Oh, and that pesky nursing care thing---you have to do that too, only do it quick---as insurance only pays for 2 days to be in-house--so get to it.

Sad state of affairs.