Hourly rounding. Are you kidding me?

[dudette10]

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!

[icuRNmaggie, BSN, RN]

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?

The unlicensed assistive personnel should be assigned to completing this form or online flowsheet. Not you. For what it's worth, I think it is demeaning for a Registered Nurse to fill out a flowsheet such as this. I am in control of my documentation and care and I don't let anyone tell me what to chart.

[CardiacKittyRN]

The unlicensed assistive personnel should be assigned to completing this form or online flowsheet. Not you. For what it's worth, I think it is demeaning for a Registered Nurse to fill out a flowsheet such as this. I am in control of my documentation and care and I don't let anyone tell me what to chart.

Unfortunately, we don't have CNAs or tech. I work on a cardiac progressive unit and our unit and ICU do not get techs, because management feels that because of our acuity we should not delegate to techs. Only ER and med surg floors get them. I never check all the boxes unless I actually do them. Walkie talkies get the pain check, "call light in reach" and occasionally room temp check. Or pt sleeping, in which case I obviously don't wake them to ask these questions. Some nurses check all across the board every hour on the hour. I document as I go.. Sometimes it's an hr and a half sometimes it's 30

Min, based on when they call or I just do a peek in round. Anyone who believes all our those things get done every hour, for each our 4, sometimes 5 pts, is a fool.

[icuRNmaggie, BSN, RN]

I would like to add one more thing. I am working with a few ex mil CNAs who have taken total ownership of this hourly rounding thing and their assigned duties. Having clear guidelines has allowed them to take pride in and ownership of the job.

We need to remember to give accolades at every opportunity to those CNAs and techs who really make all the difference. They are worth their weight in gold. They don't make a lot of money and maybe they are scholarship students. So recognition in some tangible way makes it all worthwhile.

Someone noted before that it is hard physical work. We also need to make sure they get their breaks.

[Here.I.Stand, BSN, RN]

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?

Hmmm...wonder what the EBP is behind this? 'Cause I'm pretty sure that interrupted sleep increases the risk of delirium, previously known as ICU psychosis. Yeah I can see if they are immobile and need q 2hr turns, or need frequent VS or neuro checks, you have to do what you have to do. But someone who is stable, A&O, and can position self should not be disturbed hourly! And to tell RNs that they are required to do a pre-set list of specific nursing functions q 1 hr? And "4 P's," like we need help to remember "pain, potty, positioning, possessions?" Hmm I'm in a patient's room, can't remember what to do...OH! I need to ask about POTTY! POSESSIONS...that means his call light needs to be in reach! He just had surgery, but can't think what he might feel...Ooh, ooh, PAIN!! The first "P!" Do we not have nursing judgment? Because that's what it implies. Really, we can't figure out how to assess our pt's pain or figure out a toileting plan? And it's not possible that said toileting plan might just be that pt is independent?

I feel better now.

[Here.I.Stand, BSN, RN]

We were shown this at the general RN orientation at my hospital--

I watched it with my buccal mucosae between my teeth.

I work in an ICU with 1-2 pts, and we're in there at least every hour anyway...plus our manager is way too wise for this kind of nonsense. It hasn't seemed to be pushed in the MICU/BICU/stepdown units that I've floated to either, but I don't know about the floors. It was the Inpatient Medicine NM that showed it though, so she must endorse it.

[kysmommyrn, BSN]

Oh geeze, that video just made me throw up in my mouth!

[CardiacKittyRN]

Here.I.Stand I couldn't agree more!!! It's like really, gee whiz I should do diaper checks, position changes, and ask about pain?! Never would have know without my trusty checklist! And that video... All I will say is oh. My. Lord. I am slightly offended that as a nurse I'm portrayed that way. Yuck.

[icuRNmaggie, BSN, RN]

We were shown this at the general RN orientation at my hospital--

I watched it with my buccal mucosae between my teeth.

I work in an ICU with 1-2 pts, and we're in there at least every hour anyway...plus our manager is way too wise for this kind of nonsense. It hasn't seemed to be pushed in the MICU/BICU/stepdown units that I've floated to either, but I don't know about the floors. It was the Inpatient Medicine NM that showed it though, so she must endorse it.

That was dreadful. I shut it off when they danced with bedpans on their heads.

[Here.I.Stand, BSN, RN]

That was dreadful. I shut it off when they danced with bedpans on their heads.

So you missed the conga line and the promise to be there before they call?

I agree, it is dreadful.

[BloomNurseRN, ASN, BSN, RN]

We were shown this at the general RN orientation at my hospital--

I watched it with my buccal mucosae between my teeth.

I work in an ICU with 1-2 pts, and we're in there at least every hour anyway...plus our manager is way too wise for this kind of nonsense. It hasn't seemed to be pushed in the MICU/BICU/stepdown units that I've floated to either, but I don't know about the floors. It was the Inpatient Medicine NM that showed it though, so she must endorse it.

I think I threw up in my mouth a little. Wow.

[amberella123]

Is hourly rounding something you can totally delegate to cnas? Just wondering. That way you could do your own rounds when you can. I do hourly rounding as a cna now. Which, either way, as a cna or nurse, is pretty frustrating.

[kbrn2002, ADN, RN]

the rounding queen might be one the funniest things I've seen! Well, scary-funny as I believe that it actually is meant to be taken seriously.