Coming soon to YOUR healthcare system (shudder)

Brita01 · Jul 5, 2003

If I was the patient hearing the exact same greeting from every nurse, I would laugh at the fakeness of it all. Someone made a reference on another thread to the "Stepford Nurses". I picture this robotic nurse shorting out from stress. My...name...is...Jane. I'm...your nurse. I...have...time. I thought we were friends....I thought we were friends..... :chuckle

rebel_red · Jul 5, 2003

Oh Brita,

The visuals! Do you remember in one of the Stepford movies, a bell would ring, and all the women would reach in their purses, and pull out their "keeping you compliant" pills? Gee makes you wonder if that would be the next step.

Tres

BadBird, BSN, RN · Jul 6, 2003

Although customer satisfaction is important to all business, medicine is unique, many patients and families would rather go to other facilities but are limited by where their insurance mandates them to go. Now what would the script be for that?

RyanRN · Jul 6, 2003

Here's the ticket - listen politely, don't make a big deal and DO THE HELL WHAT YOU DARNED WELL PLEASE!!

No way would I fall for this crap. It'll disapear as soon as everyone 'forgets' to follow through.

And people get PAID to dream up this stuff!!!!!!!!

VickyRN, MSN, DNP, RN · Jul 6, 2003

Ah yes... a little passive aggressiveness goes a loooong way

Home Health Columnist / Guide · Jul 6, 2003

Our program is "Values in Practice" developed by Quint Studer-- a journey to implementing a culture of excellence.

"Quint Studer is reinventing health care to make it a better place for employees to work, patients to receive care, and physicians to practice medicine" --part of presentation and FOCUS of his program.

Scripting is only one part of it. I use the phrase "I have the time, how can I help you?" when dealing with our department staff and managers while trouble shooting their concerns and "Sorry we did not exceed your expectations" when dealing with irate patients/families who missed a homecare visit. I am amazed how both of these statements calm people who are upset about department missed communication or perceived missed care.

Saying a similar heartfelt sentament is what its all about: showing that you are taking the time to LISTEN, problem solve,appolize when you are wrong (owning your mistakes) or pointing the person in the direction to someone who can help them.

When working in the hospitals or during a home visit I'd say "Is there anything else I can do for you today before I leave your room/home?" allowing the patient to voice a last minute concern and giving THEM a chance to speak. It really decreased the number of call bells I had to answer because I took the patients desires, just not what I thought they needed into consideration. Yet this is a scripted message being taught today because it is a proven satisfaction "win-win" for patient and nurse. I was amazed at the number of staff who never thought of saying something similar along these lines to their patients.

I know I'm lucky for having such great mentors both nurses and aides who taught me how to truely CARE for people in the late 70's. That's what a lot of the focus is: returning caring into instututions for both staff and patients. It's not about numbers.

Here are his Pillars and Principles:

http://www.studergroup.com/$spindb.query.flywheel.studview#9

Must Haves:

http://www.studergroup.com/$spindb.query.musthaves.studview

None of these things are unatanable or that difficult to do.

I have a pile of thank you notes from Health System CEO, agency CEO, VIP of Nursing, other staff and today received one at home from CFO! When I did annual perforance reviews this week with all my staff, I wrote them a note which included their pay raise in it. I know it's made me feel warm and fuzzy inside to receive such a note and want them to feel appreciated too.

Go into the session with an open mind. I see my organization focussing much more on it's staff and the little things we can change. Our patient satisfaction scores are moving upwards too so we must be doing something right. Morale is up and we are working together much more as a TEAM.

caroladybelle, BSN, RN · Jul 6, 2003

Originally posted by NRSKarenRN
"Quint Studer is reinventing health care to make it a better place for employees to work, patients to receive care, and physicians to practice medicine"

Scripting is only one part of it. I use the phrase "I have the time, how can I help you?"

Saying a similar heartfelt sentament is what its all about: showing that you are taking the time to LISTEN, problem solve,appolize when you are wrong (owning your mistakes) or pointing the person in the direction to someone who can help them.

When working in the hospitals or during a home visit I'd say "Is there anything else I can do for you today before I leave your room/home?" allowing the patient to voice a last minute concern and giving THEM a chance to speak. It really decreased the number of call bells I had to answer because I took the patients desires, just not what I thought they needed into consideration. Yet this is a scripted message being taught today because it is a proven satisfaction "win-win" for patient and nurse. I was amazed at the number of staff who never thought of saying something similar along these lines to their patients.

Karen,

That is a lovely sentiment but not how it works for many of us in the hospitals that I have been to.

As far as MDs are involved, I have yet to have known any of them to go to these "scripting" meetings. Most of them would laugh in your face at the idea. It is almost impossible to get them to learn computerized ordering or paging without the force of law behind it. And if they don't go, how are they to uphold their end of the bargain.

Many of us fill our pitchers on rounds and already ask if there is anything else needed. That is called intelligence and common courtesy, and yes, they were still teaching it in the 1990's. It is sad that people don't know it, but perhaps that is something that should be screened for in the hiring process.

"I have time, how can I assist you?", expresses such a lovely idea - unfortunately my religion and ethics have prohibitions against LYING. And at 8-12 patients, that it what it comes down to. If management is so concerned about excellence, they would provide us with the personnel to provide it.

"Scripting" tends to alienate good nurses and does little to improve bad nurses. Perhaps a good old fashioned course in communication would be a bit more approppo.

PS. When I was in school for my first degree, all engineering students were required to take a course in technical communication. It had been found, that while engineering students were smart with technology, they were a bit...lacking.. in social/writing/presented themselves type skills. This class helped with writing resumes, cover letters, and nuances of speech - skills that would help them in the real life work/social world. Perhaps, nursing may need to institute the same thing.

Edward,IL · Jul 6, 2003

cheerfuldoer is right. Scripting is for actresses. The Donna Reed Show was cancelled about 40 years ago! She played the obedient middle-class housewife to her MD husbsnd. She was paid a lot of money to recite those lines. So was Beulah the Maid!

Neither of these characters were nurses!

Further, the nursing profession does not need outsiders to "re-invent" nursing: our education, practice, research belongs to US.

We have our own scholars, scientists, academicians, theorists and practioners who function quite well to provide a vision of what we are becoming as a profession and science.

Many of those outside of the nursing profession apparently think that nurses are so lame that they will fall for their public relations crap!

I encourage anyone interested to read what has already been published by the legimate authorities on nursing:

Notes on Nursing, Florence Nightingale

Toward a Theory of Nursing, Martha Rogers

Other noted theorists and authors: Imogene King

Dorthey Orem

Marjory Gordon

Virginia Henderson

Joanne McCloskey

Gloria Bulechek

Meridean Maas

Martha Craft-Rosenberg

Linda Carpenito

(And all the other scholars, healers, artisans that have contributed to our understanding of nursing.

Are there any nurses stupid enough to fall for thoses slick lines from those public relations people?

I pray to the Virgin Mother every day for the repose of the poor souls of those of such intellectual impoverishment!

Just my humble opinion, Edward, IL

Tephra · Jul 7, 2003

Thanks again for everyone's response. :)

NRSKaren, appreciate your response too, as someone with a positive experience (and I did check out your links). Just a thought (NOT an attack!) :) : If someone said, "Sorry we did not EXCEED your expectations" when they hadn't even MET them (as in that missed visit), I'd be even more annoyed. My best bet, from reading your posts now and in the past, is that your commendations are a reflection on YOUR personal excellence, not the system's. :)

My concern is that admin is seeking to "overlay" a customer service system/philosophy without actually giving the meat-'n-potatoes backing to it. It's nice to say, this is how we'll all do things, but you can't get employee satisfaction with big smiles and forced

scripts. For example, at my hospital major concerns are pay issues, retention, staffing and perceived admin indifference (LOL! I know, I know, that's everyone out there too). I fear that a happy new customer service plan will just be plastered over the underlying

problems with no attempt to raise salaries, retain long-term employees, or hear the problems from below. I'm sure those who promote these service systems (and who are paid to do so, let's don't forget) would say that's not what they intend, but it's the individual

systems' IMPLEMENTATION that I fear.

Also, per your response, "Saying a similar heartfelt sentiment is what it's all about" -- that's what most of us are already doing, lol! But a canned response is never heartfelt, IMHO. I've already heard one too many knotheads mumbling out a greeting by rote without feeling or concern and I'd rather a personalized response ANYTIME.

I agree, there are folks out there with minimal customer service and/or social skills. I'm super-frustrated that I have to go sit with them! This just sounds like it could be a lowest-common-denominator scheme... because some are lacking, all will have to be standardized. Again, how any one system IMPLEMENTS it can be at issue. If the plan allows for individual variation and personality, then I'm more

willing to listen. If I get a card with printed scripts to attach to my ID badge for easy reference, well, let's just say Tephra's gonna have a few giggles at admin's expense. :)

BBFRN, BSN, PhD · Jul 7, 2003

Ya know, we have a post up in our staff restroom that says, "Remember to be polite. YOUR PATIENTS WILL REMEMBER YOUR ATTITUDE MORE THAN YOUR TECHNICAL SKILL when dealing with them." The irony of this is that half of our patients are drunk DT'ers- I doubt they will remember anything about us :) The other irony is that it's in the restroom where crap belongs.

DeniseLDRN · Jul 7, 2003

I realize that not everyone likes the idea of scripting, however I feel that it is helpful in it's own right. The very first hospital that I worked at began using scripting, and I thought it was a very good way for a nurse to explain some thing that may seem intrusive, to patients in a different way. Like:

"Here, I am going to put your bed rails up for your safety" Rather than just pulling them up.

"Can you please wait one second before you get up, I would like to clean this blood off the floor so you don't slip in it and injure yourself"

" Hello I am Denise and I will be your Nurse today, if there is anything I can get for you, please let me know" Rather than walking into the room and writing your name on a board for the patient. Or not even telling the patient your name.

I realize that most Nurses use their own way to convey their message to the patients, but not everyone has finess and tactfulness in their messages.

I agree that Housekeeping, Lab, X-ray and Food services, should be made to attend the scripting meetings. What is fair for one should be fair for all! I can't think of how many times housekeeping walked in at very inappropriate times, and never even asked if it was ok.

Just my 2 cents

Deniseldrn

vaughanmk · Jul 8, 2003

Where does administration think we are going to find the time for all this extra "customer satisifation" stuff. We are already working our butts off trying to give the best care possible to our patients. Seriously, what else can we do? There is only so much time in a day. As pointed out before, it's housekeeping, medical records, admission, dietary...etc that needs to keep working on this. Our focus needs to remain with the patient, We will always have to do things they don't like. Come on now, how likes getting an enema?

Coming soon to YOUR healthcare system (**shudder**)

Coming soon to YOUR healthcare system (shudder)