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.
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.
Sooooooo, what was the "approved" explanation if the patient asked about meds?
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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?
Ugh.
There's got to be something nice you can say about every one of your co-workers. I remember saying "This is Jade -- she just finished the Boston Marathon and did her personal best. We're very proud of her."
Or "This is Kevin. He's the brain behind all those cute handwashing posters you're seeing all over the place."
You've introduced your colleague, you haven't said anything bad, you haven't lied by saying they're the best nurse since Florence and you've given the patient a handle to start a conversation if they like. "Oh, I used to run but since my knees got so bad it's difficult to even walk." Or "The doctor says not washing my hands before I did my dressing change might be why my wound got infected."
There's got to be something nice you can say about every one of your co-workers. I remember saying "This is Jade -- she just finished the Boston Marathon and did her personal best. We're very proud of her."
Or "This is Kevin. He's the brain behind all those cute handwashing posters you're seeing all over the place."
You've introduced your colleague, you haven't said anything bad, you haven't lied by saying they're the best nurse since Florence and you've given the patient a handle to start a conversation if they like. "Oh, I used to run but since my knees got so bad it's difficult to even walk." Or "The doctor says not washing my hands before I did my dressing change might be why my wound got infected."
It's a nice sentiment. The "talking up" concept is supposed to reinforce the nurses' ability to care for the patient in front of them, per our in-service. I skip that part. I introduce the nurse and state how long they've specifically been with our hospital, and make note they'll be caring for the patient until 'x' amount of hours. Then I leave.
I honestly don't know enough personally about my co-workers to include a fun factoid.
Lol we're supposed to do that "talking up" thing even as a tech. I always just say this is Blank and he/she is going to be with you tonight...but I'll be back tomorrow! And when every so often the occasional patient asks "Are they good?" (and it someone who is horrible) I just say "Of course, not as good as me obviously..." then they laugh, I laugh, and I leave.
We do bedside report, but I don't 'talk up' a nurse unless I genuinely believe what I am saying. And if I do, it's usually before the next nurse gets there anyway. I might tell the patient at 0630, "It's almost shift change, but is going to be your nurse and she is a wonderful nurse." or at one point I (honestly) told a patient, " is going to be your nurse today once I leave, and truthfully, she is the nurse I would want if I were hospitalized here." During bedside report, I usually just say "This is and she's going to be your nurse today." as a courtesy to the other nurse.
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.
Oh, but that's why there's a script for talking to physicians! Our magic phrase is "I have a concern." Physicians are taught to stop and listen to any nurse who says that. So you don't have to have any balls at all to talk to a physician. You just have to use the magic words.
Specializes in med-surg, IMC, school nursing, NICU.
"Is there anything I can get for you? I have the time!" (lying to patients is encouraged now. I don't even have time to pee)
"Thank you for calling Med-Surg floor! How can I make your day better?" (how we were told to answer the phone)
"This is a thank you card signed by your care team expressing our gratitude for you choosing us to help with your wellness needs" (what a waste of paper and load of BS. I never signed one)
This is making me physically ill and so mad. I do NOT miss that nonsense from bedside nursing!!!!!
Oh, but that's why there's a script for talking to physicians! Our magic phrase is "I have a concern." Physicians are taught to stop and listen to any nurse who says that. So you don't have to have any balls at all to talk to a physician. You just have to use the magic words.
Oh, man. If I used that phrase with any of our hospitalists, they'd eat me with a fork, knife, and spoon.
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.
I agree! When someone uses "therapeutic conversation" script on me I feel rage. :-/
So called "therapeutic communication" scripts when I'm a patient or any type of client make my head spin in pure, seeing red, cursing a blue streak, pea soup spitting rage. I've actually ended conversations rather.... Ahem...Abruptly....when customer service people or care providers try that with me. It feels like a patronizing BS way to insincerely dismiss my (legitimate or at least *feels* legitimate) concern or complaint.
I can't stand artifice. Just be real with me for pete's sake! Oh, and with regard to "magic words" with physicians? I would like to see a circulator or cvicu nurse try that with some of our CV surgeons. Wow. Give them the bullet, spit it out before it gags you, whatever.... Be cognizant of their time, give 'em the facts they need and things usually roll okay. At 0300 there are occasional explosions, but damn, some of those are gonna happen no matter what you do. It's 0300.
Luckily our hospitalists seem to, as a whole, have patience, good sense, and sincerity to spare. At least the ones I deal with on my current unit at night. Good group of docs who go out of their way to be kind and appreciative of our work and "concerns".
dudette10, MSN, RN
3,530 Posts
Sooooooo, what was the "approved" explanation if the patient asked about meds?