Hourly Rounding--pushing back

[CharmantUn]

Has anyone successfully pushed back against hourly rounding against management?

I've been through mandatory "sim labs" on hourly rounding that take 20 minutes per nurse to hit management's entire script, managers checking that our whiteboards are updated and the patients are happy during every shift, and frequent reminders about hourly rounding during daily safety huddles. It's too much.

Management seems to believe this is the magic fix for our poor HCAHPS scores--I believe the numbers never going to improve so long as we are understaffed, only have semi-private rooms, and really inflexible food service.

How have you pushed back?

[dudette10, MSN, RN]

^^^^ They initially tried telling us this is how it would be-that the chaplains, PTs, OTs, RTs etcetera would be responsible for rounding on the patient if they were in thr room, take care of any needs they could, and document properly.

It would NOT be solely up to the nurses and techs, no siree! Teamwork! Really, it will be easy and won't add any more to your workload-it will help!

Anyone wanna bet how long it worked that way? Actually I don't think I saw anyone other than a nurse or tech round. Shocking, I know. And just as suprising, it *did* add work to already overworked nurses and techs......

What is worse is when no one answers bed or chair alarms except nurses and aides. As I was leaving the nurses station to answer a bed alarm the other day, I saw a house supervisor RN, and RT, and an MD walk right past the room that was alarming. By the time I got there, the patient was halfway out of bed. I reported it to the units nurse manager, but I haven't heard anything to indicate that info was acted upon.

[Nurse Leigh]

^^ Ridiculous and totally not suprising.

[Rexie]

We're supposed to do the hourly rounding but with the poor staffing we're given, we do what we can do. Every now and then, management will get it into their heads that we're going to focus on hourly rounding again. During one of these pushes a few months back, the managers actually did rounding a couple of times a day - and whenever the patient had a request, they would hunt down the nurse and interrupt her providing care for other patients so she could bring pain meds, toilet a patient, or whatever. It was infuriating.

[turnforthenurse, MSN, NP]

I hate how hourly rounding is so scripted. At my last job (as an ER charge nurse) I got a lot of pushback from staff. And I totally understand. We were chronically short-staffed and I just told them to do the best that they can. I was responsible for rounding as well as upper-level management.

We made hourly rounding a team effort. It doesn't have to necessarily be the nurse who is in there every hour - ANYBODY can round. The doc, XR/CT, techs, ancillary staff, etc. We also implemented a rounding position for a staff member who focuses solely on rounding - both on patients and in the triage area. That has helped improve satisfaction scores and also help out the nurses as well. We are not as frustrated since that implementation.

At my current job, they really haven't pushed the whole "hourly rounding" thing on us. We don't have to do any special documentation aside from the notes we make in the computer. They are now starting to implement AIDET but aside from that the charge nurses and managers focus more on the customer service aspect of rounding.

[runsalot]

I like hourly rounding. But if my cna is not doing it too than I end up taking every one to the bathroom. And I don't have time for that.

[AJJKRN]

Hourly rounding, AIDET, and initialing Pt whiteboards with dry erase markers will be what pushes me away from the bedside at my hospital. Why does management not realize that pushing all of this crap down our throats (they are actually at the point of threatening us with write-ups if we don't comply) plus being short staffed without enough new or experienced nurses or techs to go around, is not adding to our increased turnover/poor retention to the bedside? These are suppose to be really intelligent people running the show too!!!

I would just like to state that I work at a really good entity but I think they are snowballing Pt and staff satisfaction down a hill with all of this nonsense and I don't know how they will recover if we keep going at the rate of ignorance we are going at right now.

[klone, MSN, RN]

What's wrong with AIDET? Genuinely curious.

[martymoose, BSN, RN]

being short staffed without enough new or experienced nurses or techs to go around, is not adding to our increased turnover/poor retention to the bedside?

I'm sure they don't mind. someone quits, they either don't replace them, or they hire new grad or someone at a much lower rate than previous person.

Also, sorry I don't have the article right now, but research showed that hourly rounding did work. So that's what the idiots are going by. They just don't seem to notice that it takes staff to do this PROPERLY.

[AJJKRN]

I'm sure they don't mind. someone quits, they either don't replace them, or they hire new grad or someone at a much lower rate than previous person.

Also, sorry I don't have the article right now, but research showed that hourly rounding did work. So that's what the idiots are going by. They just don't seem to notice that it takes staff to do this PROPERLY.

Its not the hourly rounding or AIDET itself that is the problem...it's the signing the majic whiteboard (that's not part of the permanent chart) and the scripting they give us with the threat of being written up if it's not to their standards. It doesn't matter if you were in a code to the managers and rounded on Pt's 15 minutes late. I also refuse to ask a fully grown and fully capable Pt if they need to go to the potty every hour!

[whichone'spink, BSN, RN]

What's wrong with AIDET? Genuinely curious.

AIDET is the kind of BS you would expect from a waitress at Ruby Tuesday, not from an educated professional who went through 4 or more years of school to care for the sick. It's why I am getting away from the bedside.

Even in perioperative areas, AIDET is expected. My manager is requiring all perioperative staff (like me), as well as OR staff and anesthesia staff to attend an inservice on AIDET because patient satisfaction rates have been low. I don't get it. In PACU and Phase 2, I actually DO have the time to attend to patients' needs, unlike on the floor. Call lights are rare, and if they go off, they are attended to quickly. I don't know why there is this discrepancy.

[Here.I.Stand, BSN, RN]

I had to google AIDET...really?? The A & I I'm good on, but the D? Um, we'll plan for a CT around 0500, but depends on how many pts the ED is stabilizing? Otherwise, sorry I'm an RN, not a secretary. I don't keep the MD, PT, OT, SLP, CT, MRI, portable rad tech, phlebotomy, after hours tray service, or EVS's schedules. And I'm not giving time frames that may or may not be correct. I have said I don't have their schedules too...but I did say it with a smile!

And the T...uh... thank you for choosing us as your nearest level 1 trauma center? Well yes, actually it was EMS that chose us.

[Karou]

AIDET is a joke. I wish I could go back in time and come up with it so I could be filthy rich.

It's almost offensive to me. The material is so cheery and fake that it's gag inducing. The few people who could benefit from a class on common sense/politeness, aren't listening anyway.

Don't forget to thank your patient! I say thank you so much now that I am no longer using it correctly. I'm auto pilot. I told a five year old "thank you!" tonight after I gave out candy for Halloween. Then I burst out laughing. Ridiculous.

"I have the time!" Is the biggest lie in nursing.

I am really very good at the politics of nursing. I do my own version AIDET naturally. It's common sense behavior + my personality. I still hate the program and resent having to attend an annual class on it.