Going "Above and Beyond" UGH

Nurses Relations

Published

At my hospital, there has recently been a push for nurses to "go above and beyond" when providing patient care. They send out emails, put up little signs and posters, and will occasionally show up in the unit and ask people how we have gone above and beyond today. It has really rubbed me the wrong way. First, because it's ridiculous to set such an ambiguous standard. But mainly, it's because I think it is probably impossible for a nurse to actually do something that would be considered "above and beyond." Let me explain.

As nurses, we have an incredible amount of responsibility for our patients. We are responsible for providing infinite aspects of bedside care. We are responsible for providing emotional support for both patients and their families. We are responsible for providing education to each patient about his or her medical condition, medications, any necessary procedures, and instructions for after discharge. We are responsible for keeping them both safe and comfortable simultaneously. And, we are responsible for communicating with each patient's specialists, surgeon, nutritionist, respiratory therapist, PT/OT and whoever else, and coordinating care between all of these people. And of course there's more.

These responsibilities are all part of a standard nurse's job description. We are expected to do each and every one of these things for all of our patient's every shift, and if we leave just one of them out, we have fallen short, and can even get written up. This isn't me complaining about being too busy or having too much responsibility. I love my job, and enjoy the patient population I get to work with. But with all the different hats nurses wear, it seems to me like anything I do for my patients, no matter how difficult it is to accomplish, or how much time it takes, is just me doing my job.

Nurses can't go above and beyond when caring for their patients...it's like trying to travel at the speed of light!

Anyway, it's been grating on my nerves. Partly because it's coming from administrators who have either never taken care of patients, or haven't done it in decades. And partly because I'm being asked to meet an unattainable goal. Any thoughts?

If y'all have any "going above and beyond" examples, please share.

Specializes in Forensic Psych.

Maybe if admin took their own advice and went above and beyond with staffing, I'd have more time to do my own aboving and beyonding. Garbage.

Rip them all down and plaster their office with them

Specializes in PACU, pre/postoperative, ortho.

"Above & Beyond" is such a subjective concept. For some pts, it's ridiculously easy to make them happy & for others....it's simply ridiculous.

I agree to a certain degree, but I see what they're talking about at the same time. I know nurses who do the minimum of what they have to do to get through a shift. Go assess patients, pass meds, chart, then sit until you absolutely have to get up to do something again, whining about how tired they are. If a call light goes off, they answer it then dish it off to someone else even though they may have plenty of time to take care of it themselves. They dodge having to help anyone else out basically, anything that doesn't fall directly in their required set of responsibilities to their own group of patients.

With that in mind, "above and beyond" is doing things that help the team and the patients as a whole even though they may not be your designated responsibility. If you hear an IV pump beeping that needs a new bag, go change it even if it's not your patient. If someone outside your assigned group needs assistance to the bathroom and your group needs nothing immediately, take 2 minutes to do it. If a patient that's not yours asks for pain meds and you have a free minute but their nurse is tied up, go take care of it. etc. etc. etc. Basically, doing more than you are required to do in order to help the whole. I have to admit, when I work with motivated, helpful people who do more than they're required to do, then everything just goes so much more smoothly. On the other hand, people that do the minimum they have to make for a much more stressed, exhausting, frustrating shift.

I do agree though that it's frustrating when it's coming from an administration that has no idea what actually goes on on the floor, and basically they're saying "help us milk you for all you're worth".

In this case ,management doesn't care what you do for your coworkers. This is all about schmoozing the patients.

Try telling them you hung an IV for somebody, see how far that goes.

Specializes in hospice.
Maybe if admin took their own advice and went above and beyond with staffing, I'd have more time to do my own aboving and beyonding. Garbage.

Rip them all down and plaster their office with them

Can't love this any more. Glad I didn't have my coffee cup up to my face when I read it.

Trust and believe, the posters didn't last long, at least not on my unit.

I am of the opinion that campaigns of that nature are the result of an extraneous administrator attempting to validate the necessity of their position.

"I shouldn't be the one who gets laid off. I'm the one who implemented the 'Nursing Staff Going Above and Beyond' project!"

OR the more likely...

"I deserve another raise and/or promotion. Not only am I responsible for improving the health of our employees by putting up fliers near the elevators encouraging them to take the stairs and sending out mass emails with healthy living tips such as 'Try eating fruit for dessert,' it was ME who was in charge of the 'Nursing Staff Going Above and Beyond' project!

Also, for your enjoyment...

Doctors and Nurses Fight Back; Proposal to Link Hospital CEO Salaries to Employee Satisfaction Passes Senate - Medical Satire - GomerBlog

Ohhhhh, if only...

Specializes in NICU, PICU, Transport, L&D, Hospice.
Also, for your enjoyment...

Doctors and Nurses Fight Back; Proposal to Link Hospital CEO Salaries to Employee Satisfaction Passes Senate - Medical Satire - GomerBlog

Ohhhhh, if only...

Which is exactly why I believe that nurses, when asked by patients and visitors, should provide the truth about staffing and other issues which will potentially adversely affect their care and outcomes. It is time for the public to KNOW who is responsible rather than assuming tht the nurse is lazy or just uncaring.

Examples of above and beyond:

+ I went to the car of an admitted patient to fetch his briefcase when he found out he was being admitted.

+ I once gave a very long ride back to the city to a discharged patient - a traveler from Russia who crashed his rented motorbike while on a weekend break from the tech conference he was attending.

+ I carry with me phone chargers for every make and model of cell phone of which I'm aware because people often end up in the ED without their chargers and, while we provide phone access, who remembers phone numbers these days?

+ I once gave a patient the shirt I had worn to work before I changed into my scrubs because his had been cut off and he had nothing to wear.

~~~

The stupidity of the system encouraging nurses to go above-and-beyond is that, if it's a routine thing then it's not above-and-beyond. It's like expecting everyone to be above average... it's a logical absurdity.

It is logically, factually, and temporally impossible to go 'above-and-beyond' on a regular basis.

Specializes in Forensic Psych.

~~~

The stupidity of the system encouraging nurses to go above-and-beyond is that, if it's a routine thing then it's not above-and-beyond. It's like expecting everyone to be above average... it's a logical absurdity.

It is logically, factually, and temporally impossible to go 'above-and-beyond' on a regular basis.

Maybe I'll start diagnosing patients and prescribing medications. That would be above and beyond, right?

From a patient's point of view, it depends on how you define "Above and Beyond."

I was vomiting a lot after one of my operations, the nurse cleaned me up and changed my liens each time, after the 2ed time offered me some meds, after she gave them I asked if she could sit with me for a few minutes if she had that time because I did not want to be alone if I got sick again, she sat with me for a good 10mins at least. Although all she did was sit and chat with me, it provided great comfort to me knowing I just had someone there for me.

I once had a family member come and visit me in the hospital and they were NOT being supportive at all, they even made me get sick, my nurse that night told them, I need to provide some care to my patient which will take a while, since it is late would you mind leaving for the night and they did. She offered me a hug and told me to not let others get me down and that I am doing the best I can. I later went to sleep and woke up with a card on my tray table signed by all of nurses on shift, each wrote very positive, encouraging things, which really lifted my spirit. I remember her saying I know it's not much but we wanted to give you a little boost, I replied "You did, Nurses are my favorite profession ever, I'm getting a kick out of this."

Another time I had med ordered that wasn't the easiest for me to take and I preferred another type which was easier for me to take, I told my nurse this, who I knew was very busy, rather than her say It's going to do the same thing as the other just take it, she looked at me and said ok I'll call your doctor and see if its ok if I give you that med, awhile later she returned with med I preferred.

To me in all of these situations my nurse did go "Above and Beyond" She gave up something very valuable to a nurse her TIME. Time to sit with me, time to write and sign a card, time to call the doctor to have med change while she was very busy. My nurses might not have looked at it as "Going above and beyond" But I sure did. Time is valuable to a nurse and they gave me some when I need it.

It's all in how define it. Remember sometimes no matter what you do, you can't please everyone.

Specializes in LTC, med/surg, hospice.

We get a newsletter that has stories of employees going above and beyond doing things such as

-arranging a party for a frequently hospitalized child that is spending an important birthday or occasion in the hospital

-arranging a mini wedding ceremony in the hospital so a cancer ridden/ill patient can witness their child's wedding

-raising money for a pt family to stay at local hotel, or staff buying clothing for a long term hospital patient

Employees do those things because they want to. It loses the value when its forced. Then it becomes a contest of who can out "above and beyond" the other.

Specializes in None yet..
My take on this is to be a bit insulted. Posters, placards, email messages.....all telling you to "go above and beyond" intimates that all you do every day is the minimum. And instead of saying "thank you, Staff, for all you do", they are asking you to do more, because you aren't doing enough?!

Plus requesting completion of an unmeasurable goal such as they're promoting is....well.....unrealistic.

Perhaps management would like to give an example of what "above and beyond" is to an assemblage of staff? At that time, naturally, each and every person can then offer what they ALREADY DO that meets the request of "above and beyond".

Then take down the signs :cautious:

RNsRwe's response is so much classier and helpful than my knee-jerk "stupid ass admins!!!" What an excellent way to produce burn-out, cynicism and lack-of-job-satisfaction.

In contrast, one of the "neighborhood coordinators" where I work doesn't ask, he observes and tells. A few days ago, he brought Hagen Daas ice cream bars to shift change meeting after a particularly hard day. He expressed admiration for all we do, including specific examples of patience and customized care for two very demanding, negative residents. He said he doubted he or many people could do our jobs adequately, let alone exceptionally as we do and that we are doing "God's work."

That little bit of noticing our excellence and affirming it made another tough day a lot less tough.

What if no administrator could get his/her job until they'd worked in the positions they supervised?

Bottom line: I'd be soooo tempted to graffiti artist those posters!

:devil:

We

+ Add a Comment