our hospital recently implemented hourly rounding. but before that we have to go through a one on one teaching session with our manager so we can go through a script on how we will address our patient every time we make rounds (a script...sounds like a play!)
"is there anything else i can do for you? i have time."- this should be the exact words we are required to use before we leave patients room.
(i could bring a recorder with me and play it everytime i check on my patient...hehe! ) of course, our patient are expected to be informed of this hourly rounding. and if we don't show up in their rooms or missed the due time for rounding..patient and family can write us up and complain.
take note , we are to document this rounding in a piece of paper. if not our attention will be called for not documenting it. so my guess would be unrealistic documentation. why? most of the time you can be stuck in one patient for 45 mins to an hour esp when you have a needy patient. and they rarely provide us with nurse aide or techs.
(can i just clone myself..! maybe clone a secretary so somebody can enter doctor's order while i do my hourly rounding).
well the reason for this because they want a high score on patient satisfaction..oh yes to be recognize!
how about nurses satisfaction? nah..they don't care!
Hubby and I talked about this about an hour ago, when a local hospital aired a TV ad about their hourly rounding. Hubby is not a nurse, and he said people walking into his room every hour for no reason would be very irritating. Every 2 hours he could take, but not every hour.
When it appears a pt's condition may be deteriorating, there may be more than one nurse in that room continuously until we know what's going on and where we're going with it. Or it may be that a pt's condition warrants checking every 10 or 15 minutes. Naturally, this keeps nurses from checking on monitored x3 walkie-talkies, but so what? The worst thing about mandatory hourly rounding is that it keeps nurses from allocating time most effectively for pt safety.
Initially my hospital started with the generic looking paper sheets for hourly rounds ( this was our practice time), then moved up to more professional looking paper sheets, hung in each room. Started the hourly announcement overhead " would all nurses please begin thier hourly rounds" but never on the "hour" , so while some of us were already finished, some never got started ( that would be me). I was so resistant to this "form" of baby-sitting nursing, that I told the nurse manager I would buy her more pens as Im sure I will keep her busy. I have been nursing for 24 years, and have never felt more stupid then having to be told to stop doing something important with one patient so I could fill in the "boxes" on the pretty papers, and of course ask the important questions. So the papers went by the wayside, they instead made these eraseable laminated plastic things......here is the result.
No more overhead anouncements as the pateints were getting ****** off being woken up all day long.
The dreaded plastic thing - apparently was written on with a sharpie ( I wonder who did that) and very difficult to erase, however once erased, the black ink smeared all over the walls.
Somehow all the plastic things made thier was to the trash, so when asked why I didnt fill in the thing, the standard answer became " hmmmm......I couldnt find it in the room anywhere. :)
It now seems as though its gone by the wayside, and no-one has said anything about it for about 4 months.
Will have to see how long this lasts, but I am sure I am not alone in thinking this was a dumb, unproductive idea and basically served no purpose , it did nothing to improve the HCAPs it didnt lower patient falls , and was terrible for morale.
Why does management think up things like this when everyone knows if you want happier, safer, satisfied patients , you need to make the staff happier, safer and satisfied. Lower the nurse-pt ratio and wallah, I wonder what would happen....... SUCH A DIFFICULT CONCEPT:yeah:
It's not about us. It's about the patients! Since we are being paid by Medicare and Medicaid according to how we perform and what are scores are compared nationally, we have to do everything we can to ensure the patients are satisfied. Our falls have decreased dramatically since we started hourly rounding and offering the 3 P's. Our HAPU have also decreased. If you think about it, we are in the room hourly anyway, why not make the best of it and be proactive instead of being reactive when the call lights go off. BTW, our calllight calls have decreased too since hourly rounding was put into place. Just my opinion...
We had a real OB emergency walk in the door last week and right in the middle of it, a high heels and clip board type (no kidding, she was wearing high heels and had a clipboard) wandered in a wanted to know if this was a good time for her Rounding "rounds." I don't work much so this was new to me....any way, I told her it was a really bad time if she needed the charge nurse to accompany her, and after much ballyhoo, she said, oh, no, I don't need anybody to come with me. Well, then, just go! Anyway, I finally referred her to the nurse who was taking care of the patients she needed to do Rounding "rounds" on and went back to the emergency.
I agree that it is belittling to us as nurses.
Our plastic white board, in some of our rooms is hung on a wall where our daddy sleep couches are placed. So.....work with me.....it is the middle of the night, your patient delivered in the late afternoon, mom, baby and daddy are sleeping for the first time in maybe 24 hours, and I am supposed to walk over, CLIMB over the sleeping dad to put my initials on that board?
I don't think so.
I just tell my patients that I will be in there at least hourly and probably more often and that I won't be disturbing them to write on the board, but that they will be asked about it later. Most of them are on board with it and do not wish to be disturbed hourly because some Admin type thinks it is necessary.
I, personally, would lodge a complaint with the Admin if I didn't need to be disturbed that often. And if I do need to be disturbed that often, perhaps I should be in a unit where the patient census is way less than 8:1 (which is what it is on the Med/Surg floor in our hospital.
It's crap. Nontherapeutic, disingenuous, insulting BS that does nothing to improve pt care. I refuse to follow scripts in my communication with patients. It is against my ethics as a nurse and everything I was taught. I am an educated professional, and I will treat myself like one even if my management will not. I do "round" on my pts and check on them just about hourly, but I will not lie to people and tell them that I will be in every hour on the hour. What if my pt is crashing? Oh gee, I might not get to ask someone if they need to "go potty." It makes me want to throw up. Whoever came up with hourly rounding is an idiot and needs to remember what it actually means to be a nurse and not a customer service representative.
I'm glad to see I'm not the only one dealing with this. We have been told that we should not tell the patients to call us if they need us because we should "anticipate" their needs. I'm sorry- but I always let them know that if they need something to please put the call light on even though they will be rounded on frequently. I haven't seen a huge improvement since we've begun hourly rounding.
"...I have the time?" REALLY you have to say that out loud? Every hour? I wouldn't be very surprised if the patient said "geeee whatcha doin with all you time? Buggin me?" I think that statement in itself is creepy. "Well, if you have the time, can you get me my remote, change the channel......etc etc" I think hourly rounding is not a bad idea, especially if you have to document every hour, you should be rounding. However, I would think that patients would get the impression that a nurse is not "doing anything" if we keep implying that we have all this free time.
I was a patient not too long ago. The thought of someone coming around every hour and say do you need anything would ware my nerves down to nothing. They said at the beginning of the shift after the assessment," If you need any thing put on your light." I remember thinking,"Yeah, sure and wait for an hour" So when I had pain I put on my light, the intercom came on someone said, "Can I help you" scared me to death the quickness of it, when I told them that I need a pain pill. The Nurse was there in 30 sec. So if I was in a hospital that had someone come around every hour leave me alone. I need some rest. But of course this is just me.
Yup, anyone wake me up, they probably would find out how good my vocab is ! If not a R cross might do it.....
I was a patient not too long ago. The thought of someone coming around every hour and say do you need anything would ware my nerves down to nothing. They said at the beginning of the shift after the assessment," If you need any thing put on your light." I remember thinking,"Yeah, sure and wait for an hour" So when I had pain I put on my light, the intercom came on someone said, "Can I help you" scared me to death the quickness of it, when I told them that I need a pain pill. The Nurse was there in 30 sec. So if I was in a hospital that had someone come around every hour leave me alone. I need some rest. But of course this is just me.
I'm glad to see I'm not the only one dealing with this. We have been told that we should not tell the patients to call us if they need us because we should "anticipate" their needs. I'm sorry- but I always let them know that if they need something to please put the call light on even though they will be rounded on frequently. I haven't seen a huge improvement since we've begun hourly rounding.
I haven't either, and we just recently started hourly rounding. There should be someone in the room at least every hour, but the CNA's are supposed to round on the odd hours and the RN's are supposed to round on the even hours. After 0000, we are supposed to round every 2 hours. If I don't have to do an assessment or give meds or anything, I don't wake the patient if they are sleeping. I glance at the propaq monitor and make sure they are breathing and then sign the form. Management also stated they do not want us waking up sleeping patients to increase their satisfaction. Personally, I would be a little irritated if there was someone coming into my room EVERY HOUR.
Apparently the hospital has done this before, but after awhile they do away with the rounding sheets. Every one of those sheets goes to the CNO, too...I highly doubt she goes through every single one of them :icon_roll
In psych, we have someone--usually a tech--rounding on every patient Q15-30 minutes. This doesn't mean they are asking the patient "are you OK, do you need anything" Q15-30 minutes...it just means they're checking that the patient is alive and safe Q15-30 minutes. Though most techs are great about communicating any pertinent information they feel may require a nurse to intervene...but not all do.
I try to vist all of my patients at least every 2-3 hours, just to see for myself if they are OK and if they need anything. But the majority of patients are pretty good about tracking staff down if they need something.
Not_A_Hat_Person, RN
2,900 Posts
Hubby and I talked about this about an hour ago, when a local hospital aired a TV ad about their hourly rounding. Hubby is not a nurse, and he said people walking into his room every hour for no reason would be very irritating. Every 2 hours he could take, but not every hour.