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.
When I open my mouth to speak with a patient, I make sure my bottom has found a chair. The perception regarding the time I spend with them increases and they feel more welcomed. Then I end my encounter with, "Can i do anything else for you? I have the time."
That last bit is part of our scripting. Yay, scripting.
Specializes in Ortho/Uro/Peds/Research/PH/Insur/Travel.
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.
When a patient expresses frustration when a nurse or nursing assistant isn't available EXACTLY when they need/want them AND we're short-staffed, well, I encourage the patient and/or their family to speak with the manager or, better yet, their surgeon. That is the ONLY way to get things changed.
Maybe administration just needs to have the cajones to address the nurses who continually barely do their jobs that leave plenty of time for Facebook and texting.
Or the nurse who comes to her night shift job in a LTC facility in order to sleep for 6 out of 8 hours, right in front of the house supervisor, no less; providing conversation topics for all of the nursing assistants and other nurses alike.
I've gone above and beyond before, I just choose to keep it to myself. That is rewarding enough. If I get a letter from a family member or patient, that is treasured.
We have new scripted lines and charting requirements every week. It's getting nuts. I spend half my time pandering to needy people and the other half charting. It never ends.
Occasionally I will get a card which is always nice but do I care if management recognizes my "gold star" performance? Lol no.
I chart efficiently and get my job done in order to get patients out of the hospital. No more no less.
I work in home care case management and the "above and beyond" ones are the ones doing things for patients OFF THE CLOCK. Sorry but I work my butt off all day, most of the time working far more hours than I am paid for. I barely see my family as it is, so my off time is spent with them!
I actually had a job interview a while back where that was actually a question they asked!!! "Give an example of when you went above and beyond in your job". Uggggggghhhhhhhhh
I think the very existence of jobs like this play a huge role in the high cost of health care. And serve as proof that the free market isn't as efficient as we are led to believe. Its full of useless people creating the illusion that their useless position is somehow necessary. Just as much as any government bureaucracy.
Fire all the extraneous dead-weight and use the money to hire more nurses and aides. Not saying upper management is uneeded. But all the administrators buzzing around thinking up slogans and going to meetings and making little power points?.... off with their heads.
I don't blame management necessarily because I find a lot of managers and directors have served their time in the trenches and are pretty reasonable. They're also getting this stuff shoved down their throat by the people above them.
I agree, and understand that most of the time, they're just trying to do they're job.
But there are managers that seem to just regurgitate the ridiculous demands being made by their bosses, and those who say things like, "I see and appreciate how hard y'all are working, but here are the areas I'm told we need to improve. Let's try x, y, and z, and see if that helps."
When staff feels appreciated they are much more likely to stick around, even with some unpleasant working conditions. I don't think a manager deserves respect (as a manager) JUST for having out their time in.
I see what you are saying, but I consider teamwork a part of the job. That's why I'm finding it hard to qualify "above and beyond."
Yes, I agree, but unfortunately not all nurses see it this way. I personally believe those lazy nurses who don't understand this are the ones who prompt the administration to come up with stupid, pretentiously cheery ways to try and encourage everyone to work harder. Instead they could just address the problematic nurses specifically, but they don't usually seem to have the "cajones" to (as someone else pointed out).
It is my belief that the phrase "above and beyond" came into play as health care became another money driven industry. Everybody wants everything right now. This works well in some places , but in health care does a request for ice water come in front of a code or a fall? We are to make each patient and family member feel as if they are the only person we care for. Health care is not like waiting in line at the bank or store, sometimes you may be the next to be served, but some one else's needs come first. I have always tried to give 110% to my job as a nurse. I would answer other staffs call bells and check on their beeping IV pump, until it got to the point that I was the only person taking care of all these concerns. I can't take every patient on the unit to the bathroom. Above and beyond means different things to different people.
Obviously you are an administration specialist.....
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".
This campaign is what I call "happy horses###t" My hospital system spends a lot of money on publicity campaigns, one of which has a surgery patient saying "The service was excellent". That makes my skin crawl- I'm not a f###### servant! We have morning meetings where we are supposed to say that we are here to serve and we are world class! I refuse to say that, and I've noticed that fewer and fewer people say it. You can't fool all the employees all the time.
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sistrmoon, BSN, RN
842 Posts
That last bit is part of our scripting. Yay, scripting.