Hourly rounding. Are you kidding me?

Nurses Relations

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I don't think it's physically possible for one nurse with seven patients to do so. Most places share the job with a CNA, so it is really every two, which is consistently doable most days. But if it's just the nurse with seven pts? C'mon!

Why does administration think that a meaningful round is a minute per room? Sometimes, I'll walk away from a patients room after 15 minutes (toile ting, answering questions, getting water, calling dietary because the pt is unhappy with the food). And that is someone who is stable!

Specializes in ER, Med/Surg.
Pyxi

Is this the correct plural form? I've always wondered. :roflmao:

Specializes in Med/Surg, Academics.
If by hourly rounding they mean hourly flybys to make sure they're still alive, OK, perhaps... if they mean help them to the commode, on/off a bedpan, listen to them ("I have the time")... and chart and pass meds... no fing way.

On the rare occasion that I draw a slate of med-surg boarders, it's sometimes impossible to even get meds passed on schedule considering I have to visit several Pyxi, had the foresight to order meds tubed from the Mother Ship, and taken the 10 minutes to tell some patients about each one, let them scrutinize the pill, take them o-n-e---b-y---o-n-e---b-y---o-n-e... and then drop every 4th one during their inspection.

Yet another reason I'm an ED, NOC shift lifer

I had one guy today take a full three minutes to take two pills. About drove me mad!!!

Honestly, this is why I left the hospital. I couldn't wrap my head around caring for more than 5 pts with complex issues adequately. I was beginning to think I was the only one who felt that way.

Specializes in PCCN.
Why are we constantly being set up for failure??

I ask this every single day.......

Specializes in PCCN.
I had one guy today take a full three minutes to take two pills. About drove me mad!!!

that's ok, i was told that the prev. shift , the pt took 1.5 hours to eat/drink/be fed(dysphagia).

we aren't staffed for that.....

Specializes in Geriatrics, Dialysis.
that's ok, i was told that the prev. shift , the pt took 1.5 hours to eat/drink/be fed(dysphagia).

we aren't staffed for that.....

Not hospital but LTC...we have a resident like this. 1 to 1.5 hours for each meal. A CNA has to help the whole time. There are only 3 CNA's for 28 residents and having one off the floor up to 3 hours of an 8 hour shift really puts a huge strain on the remaining staff.

Specializes in MICU, SICU, CICU.

The CNAs should be accountable for hourly rounding, providing fresh water, meals, baths, toileting, mouth care and bed changes.

They should be logging on in each room and documenting the four Ps each hour. This is a very important quality measure which defines their role and responsibilities. The patient should be informed that Joe your CNA will check on you every hour at a minimum.

The nurse is responsible for everything else.

edited to add: I don't work in LTC and have a lot of respect for all of you that do. I could never handle those kinds of ratios..

I don't care if we hourly round, more staff still equals less falls and greater pt satisfaction. When will administrations "get" this? Lol

Specializes in SICU.

I can totally relate on being on crunch time (med surg) and having the patient tell me their life story while taking forever to take medication... It is completely frustrating and definitely feels like a set up for failure.

Specializes in Med/Surg, Academics.
The CNAs should be accountable for hourly rounding, providing fresh water, meals, baths, toileting, mouth care and bed changes.

They should be logging on in each room and documenting the four Ps each hour. This is a very important quality measure which defines their role and responsibilities. The patient should be informed that Joe your CNA will check on you every hour at a minimum.

The nurse is responsible for everything else.

edited to add: I don't work in LTC and have a lot of respect for all of you that do. I could never handle those kinds of ratios..

Should be accountable, but often aren't. There is one floor and one shift I work on where the CNAs are awful. They do give bedbound patients baths but never enter the rooms again except for vitals and blood sugars or if the nurse has delegated specifically. Unless it's delegated: no oral care, no turning, no up to the chair, no fresh water, no 1:1 feeds. Seriously.

I've also caught them in so many lies about what they have or haven't done, it's crazy. I've gotten over their constant bad attitudes when delegated to; I just ignore it and delegate anyway. But I have to delegate every. single. thing. I could report to them in the morning that a patient needs turned q 2, but I have to remind them q 2. Same for 1:1 feeds. I just suck it up and specifically delegate everything. Multiple nurses have gone to the NM with complaints and nothing changes.

I've learned that I can't do everything and provide the care my patients deserve on my own without going completely crazy every shift.

Specializes in MICU, SICU, CICU.

Yes in some areas of the country CNAs think that because you make twice three or four times as much as they do you should be working two three or four times harder. They are what they are. It is what it is. Your patients deserve better. You deserve better working conditions.

I suggested the hourly rounding by CNAs because it has made an immense difference. I would sell it to risk management, the directors and managers where you are in a quiet way. The next time you have a patient fall and have to list contributing factors and suggestions for improvement, suggest it. There is a lot of research out there, attach it to that report. You are a smart girl. You can do this without ruffling any feathers.

Imagine... no more two hour smoke lunch smoke nap breaks, no more CNAs hiding out in a charting room hidey hole, no more dead asleep coworkers. Your CNAs actually being held accountable instead of acting like sulky children. Oh yeah your RN might mean something again. It's awesome. It's revolutionary. It works.

Specializes in Cardiac.

We are required to do hourly rounding where I work too and are suppose to check a box for "pain, position, potty, room temperature, exit alarm", another box for turns, and then a blank for "other comfort measures provided". I work nights and I'm sorry this is ridiculous. I will not ask an adult who is A&O if they need a position change or to pee. I do try to poke my head in the door at least hourly, but all the questions don't get asked - if would drive the pts crazy! However most of our pts are very busy with multiple drips, q2 turns or changes, or are close to critical so were honestly in their rooms more often.. Wonder what someone would say if I had time to chart how often I went in some rooms and the time spent?

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