Don't be an Autobot

Nurses General Nursing

Published

Specializes in ER.

When I'm a patient, nothing makes me feel more like I, the patient, am on an assembly line, than when my nurse comes across as an Autobot.

You know, you send a portal message to the office nurse, and the reply sounds like it's composed of drop down box choices. "I'm so sorry that you are having this problem, the doctor will be back in the office on Thursday to address your concerns". "We care about our patients, your pain is important to us". They may as well label the message 'donotreply'.

You're an inpatient and Autobot RN enters the room with a fake smile with a scripted speech "What can I do for you, I have the time. On a scale from 1-10, 1 being barely any pain, and 10 being the worst pain imaginable, how would you rate your pain?".

At least try to be a little real, genuine, creative, HUMAN! Our modern approach to medicine, and many other fields, has taken the human touch out of so many of our interactions. No wonder we often feel empty and uncared for.

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Specializes in PICU, Sedation/Radiology, PACU.

That's why I hate scripting. If every single nurse enters the room saying, What can I do for you? I have the time.” it takes the patients all of two hours to figure out they are saying it because they have to, not because it's true. Unfortunately in some places, the scripts are the standard, and nurses that are observed not using scripted language are subject to counseling or even a talk with the manager. Honestly and authenticity are far more effective, in my opinion.

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Specializes in CVICU, MICU, Burn ICU.

I honestly didn't know this was a thing. Where is this? This is common? You have a script?

My mind is blown. Please clarify.

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Specializes in ER.
I honestly didn't know this was a thing. Where is this? This is common? You have a script?

My mind is blown. Please clarify.

I was specifically referring to being the recipient of these artificial interactions, not a initiator. As a nurse, I make an effort to treat people as individuals. As a patient, I've been negatively affected by one size fits all, impersonal scripting.

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Specializes in Critical care.
I honestly didn't know this was a thing. Where is this? This is common? You have a script?

My mind is blown. Please clarify.

Yes, it is a thing. I've not first-hand seen it in full-blown use at the bedside in any hospital setting, but have directly seen its strong encouragement by my own leadership. We are directed to use specific keywords in our speech that directly mirror keywords in the surveys given to pts post-discharge. One example, for use bedside report, nurse A is to manage up nurse B by using "This is blah blah, she's been a nurse for 10 years, and blah blah...I know she will *give you very good care*" where the same phrase will show up later when the patient comples the Press-Ganey survey.

:***:

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Specializes in CVICU, MICU, Burn ICU.
I was specifically referring to being the recipient of these artificial interactions, not a initiator. As a nurse, I make an effort to treat people as individuals. As a patient, I've been negatively affected by one size fits all, impersonal scripting.

Well according to a couple other posters that kind of automation is being encouraged in some settings. Which, like you, I find sad, impersonal and frankly unprofessional. What you and others are describing is not an RN practicing at the top of his/her licensure -- even if we only look at the therapeutic relationship.

Wow. I'm sorry you've had that response. I think you should fill out a patient satisfaction survey about it -- and I only mean that half joking. Looks like the bright ideas of upper management are backfiring.

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Specializes in CVICU, MICU, Burn ICU.
Yes, it is a thing. I've not first-hand seen it in full-blown use at the bedside in any hospital setting, but have directly seen its strong encouragement by my own leadership. We are directed to use specific keywords in our speech that directly mirror keywords in the surveys given to pts post-discharge. One example, for use bedside report, nurse A is to manage up nurse B by using "This is blah blah, she's been a nurse for 10 years, and blah blah...I know she will *give you very good care*" where the same phrase will show up later when the patient comples the Press-Ganey survey.

:***:

wow. Just wow. Wonder what patients would think if they knew this kind of stuff. So much for informed consumers.

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Specializes in allergy and asthma, urgent care.
Well according to a couple other posters that kind of automation is being encouraged in some settings. Which, like you, I find sad, impersonal and frankly unprofessional. What you and others are describing is not an RN practicing at the top of his/her licensure -- even if we only look at the therapeutic relationship.

Wow. I'm sorry you've had that response. I think you should fill out a patient satisfaction survey about it -- and I only mean that half joking. Looks like the bright ideas of upper management are backfiring.

I have filled out a patient satisfaction survey to that end. I said I wanted competent professionals who used their nursing experience and judgement to care for my medical needs, not overworked automatons who were forced to follow a script to make management look good. I never got a response...

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Yes, it is a thing. I've not first-hand seen it in full-blown use at the bedside in any hospital setting, but have directly seen its strong encouragement by my own leadership. We are directed to use specific keywords in our speech that directly mirror keywords in the surveys given to pts post-discharge. One example, for use bedside report, nurse A is to manage up nurse B by using "This is blah blah, she's been a nurse for 10 years, and blah blah...I know she will *give you very good care*" where the same phrase will show up later when the patient comples the Press-Ganey survey.

:***:

One of the questions is about controlling pain, so we're supposed to make comments to the patient like, "Good! Your pain is at a 7 instead of an 8. We're controlling your pain."

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That's why I hate scripting. If every single nurse enters the room saying, What can I do for you? I have the time.” it takes the patients all of two hours to figure out they are saying it because they have to, not because it's true. Unfortunately in some places, the scripts are the standard, and nurses that are observed not using scripted language are subject to counseling or even a talk with the manager. Honestly and authenticity are far more effective, in my opinion.

Unfortunately, I think most people don't figure it out!! I guess I'm not sure though, because I've always ignored the requirement (when it was one). I didn't even have time to tell the patient, "I have time."

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Specializes in ICU, LTACH, Internal Medicine.
wow. Just wow. Wonder what patients would think if they knew this kind of stuff. So much for informed consumers.

Trust me, they know. Where I am (LTACH) scripting is not existing but in our "host" facility (with which we share most of the services, so patients constantly being exposed to both) it is hammered in nurses' heads with red-hot nails. The patients and families, at the most part, do not seem to like it after a while. At first, they enjoy everyone being nice and oh-so-polite but, unless they are booted out in 24 hours, they start to notice repetitions and associated lack of real information. If a patient is transfered to LTAC, one of the first thing we hear is "wow, guys, here you speak as humans!" In many cases, this is the first time when family comes to understanding that they were, for the most part, blatantly lied to by everyone, day after day, about The Mother Dear doing "awesome" and "wonderful", and that right now the poor old lady is having a long, hard road ahead to whatever degree of recovery she actually can make. I inquired, out of curiosity, why they never asked anyone about all that, and got answers mostly along this line: we thought that nurses/CNAs are required/paid for/just want to be nice with everyone/to stay out of trouble, and they were ever so polite that we were not comfortable to confront them. In other words, these people felt correctly that they were, to put it mildly, misinformed about something that was, and is, VERY important for them, but since other side was so polite, they were not comfortable to confront the situation. Of course, it all happened with liberal addition of denial and all other negative coping reactions, and adds a lot to their effects.

It reminded me how, after my family was exposed to identity theft, we stopped to give out any personal information. Like, if a cute shop assistant asks me for email/phone/area code, I politely answer "sorry, I do not want to give it out". I was told many times by aggrieved fellow shoppers that it was rude thing to do because poor girl was "just doing her job" and I was somehow preventing her from doing so. They did not ever think that this information can be easily misused and that credit card info + area code = access to attached bank account for a kid with entrance level experience in programming/coding.

I found since that being ever-so-polite seems to decrease number of hard, confronting questions patients and families tend to ask. But I feel that I would do disservice for these people if I continue to smother them with scripting. They went through pure hell, and they deserve to be spoken with like adults and be told the truth, hard as it could be.

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You're an inpatient and Autobot RN enters the room with a fake smile with a scripted speech "What can I do for you, I have the time. On a scale from 1-10, 1 being barely any pain, and 10 being the worst pain imaginable, how would you rate your pain?".

At least try to be a little real, genuine, creative, HUMAN!

Well EXCUUUUUSE me! Next time I ask you if you need anything, I will utilize interpretive dance and/or haiku. When I chart your pain scale, I will use a code of my own devising based upon your astrological sign (sun sign only, duh). On days of the month that are prime numbers, I will use hand puppets and hand puppets ONLY.

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