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?

[mmc51264, BSN, MSN, RN]

I get pts that complain often about not being allowed to sleep. They are woken up every hour. No critical thinking involved in a night shift. i worked one not that long ago and we timed VS with 0000 meds and I had to poke my head in to check PCA #s. That pt was SO grateful that I allowed them to have 3-4 hours of uninterrupted time. We round, but I don't necessarily wake someone up unless there is concerns.

[AJJKRN]

I get pts that complain often about not being allowed to sleep. They are woken up every hour. No critical thinking involved in a night shift. i worked one not that long ago and we timed VS with 0000 meds and I had to poke my head in to check PCA #s. That pt was SO grateful that I allowed them to have 3-4 hours of uninterrupted time. We round, but I don't necessarily wake someone up unless there is concerns.

The PTB are practically mandating that we wake the Pt's up every hour so they know that they are be rounded on...whether or not I follow the rules on all of this nonsense will probably lead to my career suicide with this company that I otherwise am proud to have worked for for over a decade now. Tis sad that the bedside is coming to this.

PS. I've only been a nurse for four years now and all of these Pt satisfaction hoops weren't even in inception when I started (as a nurse) at my entity. Funny how prior to all of this we were in the high 80's and 90's for Pt satisfaction but we were better staffed and had less turnover of experienced staff then. Huh, I guess that's NOT a coincidence though!

Now I think we're all over the place but as low as the 50's/60's in some areas.

[martymoose, BSN, RN]

The PTB are practically mandating that we wake the Pt's up every hour so they know that they are be rounded on..

I know if I was a patient being woken u every hour I would make sure all the scores would be zero!!

Or......... is that what management wants?????? I swear they try to sabotage us. Maybe for new cheaper hires who will do anything for a job????

[Karou]

I get pts that complain often about not being allowed to sleep. They are woken up every hour. No critical thinking involved in a night shift. i worked one not that long ago and we timed VS with 0000 meds and I had to poke my head in to check PCA #s. That pt was SO grateful that I allowed them to have 3-4 hours of uninterrupted time. We round, but I don't necessarily wake someone up unless there is concerns.

Sleep is so important in the hospital, and so difficult to get. Care clustering helps. I ask about quality of sleep with my physician assessment, and if a patient is having difficulty sleeping I ask them why. Sometimes it's pain, bathroom needs, or inability to go to sleep. If I can help the root cause then I will. If its rounding or interruptions then I will limit those as much as possible and have a discussion about the patients right to refuse hourly rounding. If they choose to, I will place a sign outside of their room "Please do not knock or enter unless medically necessary. See nurse first". I'll add a nurses note about the patients request, and document "refused" under hourly rounding.

[Dafabb, LPN]

Hr Rounding!(Worthless,interrupts pt.care,doing your job in a timely manner). 38 yrs. as a nurse. After I learned to organize I would go in q2h to check my pts. This I did faithfully barring in a situation. Charting, I would get up and walk my rooms q2h. The regime was pretty accurate. Many times I would be the only ones doing it. Whatever their needs would be the criteria of wake up or just stand their and watch. We wake most up enough with their normal routines for meds,BS,IV. I would try to make sure they went to BR before sleep. I would put everything they needed on bedside table so they would not have to ask. This became my routine. If I had one of those constant callers I would ask them why they are doing so. I would then make sure they had everything they needed at hand and told them you have been fluff,buff,duffed and all you need are in reach. I will come and check on you in 2 hrs. Please call me if only in true need.(I probably already medicated them too). Most of the time this stopped that(always exceptions) NOW they want 1 hr checks. It might happen but many times it does not. Days are much busier for different reasons. Nights are for sleep when possible. I leave my doors cracked and they never know i was there. Whatever their problem is how often I wake them. This all about pt. satisfaction/rights. In my humble opinion they have taken this way too far and pt.s are now feeling entitled. There is a fine line between being cared for and being entitled to. If you are late or you don't answer right they get upset. Oops there's a neg. mark They don't think about all the good you have done all shift only the 1 thing you didn't do. We are not just nurses anymore. We are waitress,housekeepers. In most place you can only doing an adequate job not and exceptional job. If we could do our job right the "exceptional" would come without having this extra interruption. But OH MY how would these people earn their money if they didn't sit around and figure a way to make our jobs harder!