My employer has experienced falling Press Ganey scores and has decided putting nurses through Press Ganey's C3 program is just the way to fix it!
So, today I learned:
There is an easy way to cut off a patient's conversation - Connect, Summarize, Close.
It looks like this:
1. Connect - Make a connection with the patient
2. Summarize - Confirm listening
3. Close - End the conversation
If Ms. Smith in bed 4 is rambling about her flower garden, here's what you can do about it:
1. Connect - "Oh, I love flowers!"
2. Summarize - "It's great that you're able to grow roses and lilies! That sounds like a beautiful combination!"
3. Close - "You're going to have to tell me more about your garden when I come back next hour."
See, it only takes about a minute and a half to learn about the patient, parrot back what they told you, and tell them how interested you are in talking about it again when you come back for hourly rounding!
I also learned that whenever someone is upset, you can come up with an Empathy Statement with a simple formula:
1. Lead in - I hear/I see/It sounds like/It seems like...
2. Acknowledgement of the other person - You/Your family
3. Description of feelings - Anxious/frustrated/nervous....
4. Situation - This part is optional.
So, if Mr. Doe in room 3 is angry because it took a while for someone to come after he pressed the call bell, you can always say: "Mr. Doe, it seems like you are upset that it took a while for your nurse to arrive after you pressed the call bell." This will make you look empathetic and responsive to his problem. Don't forget to use silence therapeutically after you make this statement so he has time to express his feelings.
So, what customer service things have you all had forced down your throats recently? Inquiring minds want to know.
I know we've all had a lot of patients/families who are, shall we say, a few fries short of a Happy Meal. But we also know that a lot of our patients and their loved ones are pretty savvy - and *we* look like we're coocoo for cocoa puffs in front of these people when we spout off this nonsense. Surely they don't believe we all happen to say the same things extemporaneously.
How can these inane ideas possibly increase their confidence in us if it appears as if we can't speak without a script?
Then the roommate's nurse comes in and says to her patient, "Hi, I'm Nelda Newbie, and I've been a registered nurse for four months..."
Oh, that's when you get around it by being sneaky. I have heard coworkers involve their nursing school experience as well. "Yes, Ms. Smith, I have been in the hospital setting for two years now," isn't lying if you're being super technical with the meaning of your words. Students do have clinicals in hospitals in their junior year of nursing school, after all.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Oh, that's when you get around it by being sneaky. I have heard coworkers involve their nursing school experience as well. "Yes, Ms. Smith, I have been in the hospital setting for two years now," isn't lying if you're being super technical with the meaning of your words. Students do have clinicals in hospitals in their junior year of nursing school, after all.
"This is Nate the Newbie, and he went to a very good school. Although he IS on probation from his graduate program for practicing medicine without a license . . . ."
"And your night nurse will be Agatha here. She hasn't killed anyone in at least a month!"
No, I wouldn't say that. Really. I wouldn't. Although it's a nice fantasy.
When I was on the floor, there was a sign in the nutrition area that warned us (the nurses) that we were not to tell the patient that the medication they've been waiting for has not yet arrived because pharmacy or lab is behind or lab results needed before dosing, etcetera.
Of course these are the actual and legitimate reasons the meds have yet to arrive, but apparently Upper Management thinks it's better if the patient thinks the med is available and we (the nurse) are an incompetent buffoon who has just chosen not to administer it yet.
Good grief.
That annoys me so much I'm not sure I made sense explaining it. Grrr.
I know we've all had a lot of patients/families who are, shall we say, a few fries short of a Happy Meal. But we also know that a lot of our patients and their loved ones are pretty savvy - and *we* look like we're coocoo for cocoa puffs in front of these people when we spout off this nonsense. Surely they don't believe we all happen to say the same things extemporaneously.
How can these inane ideas possibly increase their confidence in us if it appears as if we can't speak without a script?
And if you work in a small community hospital, where you actually know 99% of your patients, they look at you like you have 3 heads.
My employer has experienced falling Press Ganey scores and has decided putting nurses through Press Ganey's C3 program is just the way to fix it!
So, today I learned:
There is an easy way to cut off a patient's conversation - Connect, Summarize, Close.
It looks like this:
1. Connect - Make a connection with the patient
2. Summarize - Confirm listening
3. Close - End the conversation
If Ms. Smith in bed 4 is rambling about her flower garden, here's what you can do about it:
1. Connect - "Oh, I love flowers!"
2. Summarize - "It's great that you're able to grow roses and lilies! That sounds like a beautiful combination!"
3. Close - "You're going to have to tell me more about your garden when I come back next hour."
See, it only takes about a minute and a half to learn about the patient, parrot back what they told you, and tell them how interested you are in talking about it again when you come back for hourly rounding!
I also learned that whenever someone is upset, you can come up with an Empathy Statement with a simple formula:
1. Lead in - I hear/I see/It sounds like/It seems like...
2. Acknowledgement of the other person - You/Your family
3. Description of feelings - Anxious/frustrated/nervous....
4. Situation - This part is optional.
So, if Mr. Doe in room 3 is angry because it took a while for someone to come after he pressed the call bell, you can always say: "Mr. Doe, it seems like you are upset that it took a while for your nurse to arrive after you pressed the call bell." This will make you look empathetic and responsive to his problem. Don't forget to use silence therapeutically after you make this statement so he has time to express his feelings.
So, what customer service things have you all had forced down your throats recently? Inquiring minds want to know.
Ummm isnt this what they used to call therapeutic communication? or am I that old?
Wonder how much money that "consulting company " got for that one.
You know, for the amount of money they paid for that consult, they probably could have hire an aide for a year!!
I guess I was taught all of this in nursing school. My husbands grandfather (the last of his family that he actually talked to or cared for) died last week. He was a champ in public and was polite and kind to his family that he probably doesn't like at all. But when we got back to the hotel; I didn't know what to say to validate his feelings, angry, worried, upset, frustrated. So.. I used therapeutic silence, which further infuriated him. I still think it's better than saying the wrong thing :)
Our last customer service seminar included not only the hated "I HAVE the time!" script (there was no mention of whether or not they would be hiring more staff to actually GIVE us the time) but a prescription for the exact distances at which we must smile, make eye contact, and greet people, and the news that we are now expected to strike up conversations with visitors on the elevator.
The most maddening thing about it is that the people who administer these seminars administer customer service seminars for a living. Of course they're chipper and eager to talk to strangers. If I happen to be lucky enough to get thirty seconds to myself in an elevator in the middle of a day of trauma and mayhem in the ER, I'm going to use it to regroup and breathe for a change. I AM NOT GOING TO STRIKE UP A MEANINGLESS CHAT with a visitor (who might very well be there for a tragic or stressful reason and not want to shoot the s*** with a stranger, either).
My description of that seminar was "Our Ten Point Plan For Making This Facility Unbearable For Introverts."
I know we've all had a lot of patients/families who are, shall we say, a few fries short of a Happy Meal. But we also know that a lot of our patients and their loved ones are pretty savvy - and *we* look like we're coocoo for cocoa puffs in front of these people when we spout off this nonsense. Surely they don't believe we all happen to say the same things extemporaneously.
How can these inane ideas possibly increase their confidence in us if it appears as if we can't speak without a script?
This is exactly what I meant by my first comment. If people truly believe the script that comes out of nurses' mouths, then they're idiots. I'd much rather have an RN with an actual personality and individual brain/opinion. Those are the nurses that aren't afraid to go toe-to-toe with a physician to have their patients' needs met. One who is content with scripting and having their patient interactions prepared for them are likely to accept anything that's said by a physician or anyone "higher up" as law. Of course, this is just my opinion ...
I don't believe patients want to feel pacified. Or maybe they do and I'm giving the patient too much credit. But I know I wouldn't want to feel poo-poo'd and a lot of this scripting certainly sends that message.
Ummm isnt this what they used to call therapeutic communication? or am I that old?
Wonder how much money that "consulting company " got for that one.
You know, for the amount of money they paid for that consult, they probably could have hire an aide for a year!!
I think the intention is to expand upon the therapeutic communication model, but let's be honest: how much of therapeutic communication is actually effective? I reach for therapeutic communication when I'm actually out of options and I have exhausted all of my own people skills. And what I find, 9/10, is that it actually makes the patient angrier because it feels insincere on the part of the nurse.
Patient: "I'M SO ANGRY RIGHT NOW!"
Nurse: "I'm hearing you say that you're very angry right now. Tell me more about that."
"This is Nate the Newbie, and he went to a very good school. Although he IS on probation from his graduate program for practicing medicine without a license . . . ."
"And your night nurse will be Agatha here. She hasn't killed anyone in at least a month!"
No, I wouldn't say that. Really. I wouldn't. Although it's a nice fantasy.
Exactly. Which presents an interesting conundrum: lie and instill a false sense of confidence or tell the truth and completely scare the pants off the patient?
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Nurse Leigh
1,149 Posts
I know we've all had a lot of patients/families who are, shall we say, a few fries short of a Happy Meal. But we also know that a lot of our patients and their loved ones are pretty savvy - and *we* look like we're coocoo for cocoa puffs in front of these people when we spout off this nonsense. Surely they don't believe we all happen to say the same things extemporaneously.
How can these inane ideas possibly increase their confidence in us if it appears as if we can't speak without a script?