That is how long I’ve been in nursing. Just eight years. I haven’t been on AN in a while. I used to frequent the site a lot to vent with others, and help others with advice. Well, today is a ranting kind of day, so here it goes…
I hate what nursing is becoming. It is become overrun with elite folks who have forgotten what it’s like to just get through your shift. It’s being taken over by money hungry CEOs that are finding neat little ways to package “customer service” with healthcare. Our intelligence is being insulted here! What exactly do I mean by this? Well, what professional do you know gets “scripts” to regurgitate at patients? Why is it that we are not trusted to do our job or say the right thing?
I understand that healthcare is indeed a business. It has to be. If it weren’t, we’d all be working for free. I got that. I do my job. I put my all into my shift. I advocate for my patients. I’ve gone above and beyond…all without recognition.
But, I’m deeply saddened…Now I’m being told that isn’t good enough. All I see for the future of healthcare is walking into a patient’s room at the end of my shift saying, “My name is______, if you felt I gave excellent care call 888-tell-them, and rate me a 10.” Heaven forbid you score less than 10 three times…
Eight years ago, I felt so proud in my whites on graduation day. I felt professional, neat, knowledgeable, and respected. Now, I feel burned up, and abused. For now, I stay in nursing…patients still smile, and thank me at the end of my shift. They cannot detect how I feel under the surface.
But, I am seriously considering leaving healthcare altogether.
I was re-reading through this thread and I had to comment about this post. I do not see allnurses as full of "sad and negative comments". What I see is real life happening before your eyes. I do not see us as "haters" but rather some very skillful nurses that have been in the trenches for years and are disturbed by the way the patient-nurse relationship is moving.
I don't believe that "most" of us are "complaining" "job hoppers". My average time at a position used to be about 5 years. After that I would crave a new adventure so I would move on. Currently, I have been with my hospital for 10 years. So according to your standards, I should be an expert in my field.
I am a member of a professional organization, I do agree that we should always enhance our knowledge and care that we provide but there is only so much one can do with all that knowledge and skill when mgmt throws in all this hooey about patient satisfaction. Have you not read my post about doing everything "right" and still getting dinged for "poor scores"?
Mgmt used to be more about common sense. Just like the thread about the hospital team that coded a patient and was able to transfer them to ICU. That team saved that patient's life but yet they were called into the mgmt office the next day for "being too loud" during the code and "disturbing" the other patients! This is the crap we are speaking of. Long ago, the manager would politely listen to the complaints, nod throughout the conversation and DROP it. Never in a million years would she think about discussing with the staff to "be more quiet" during a future code.
I have a passion for nursing but it is getting more and more difficult to deal with all this other ridiculous mgmt malarkey. I am supposed to say "I have the time" when I don't have the time? There is a no win situation there. If I say I don't have the time, I get into trouble and if I say I have the time and then do not fulfill every single insignificant request, I get into trouble. Scripting and running around trying grant every single wish is interfering with ME caring for the PATIENT.
I have to agree about the scripting. Its better to be honest and tell the patient that you will do your best
to get to their needs when you can rather than lie and say "i have the time".
What do you think about the medicare reimbursement for customer satisfaction? I wonder
if the changes in healthcare last year have caused this change to customer satisfaction based
reimbursement?
Its scary because in a bell curve there will always be someone at the bottom meaning that
even if all the hospitals had 98-99% satisfaction the hospitals with 98% satisfaction will be
reimbursed less than those with 99% despite performing well. I actually think hospitals
Specializes in Oncology; medical specialty website.
So thanks to Studor, who I am sure is making buttloads of money off their "great ideas" we are expected to AIDET and hourly round to scripts. Now we were already introducing ourselves to our patients and families and checking on them hourly, but that wasn't enough to make them score all 9s and 10s on our surveys to such questions as "When you called for help did you get help AS SOON AS YOU WANTED IT" talk about a set up for failure, of course not, they want help before they even ask for it!
So now I have to say Hello my name is __________ and I will be your nurse for the next 12 hours. I have been a nurse for ___years and I have been in this department for ______years, so I have seen over 100 or 1000 or 10 patients with your diagnosis. I am also a certified whatever nurse. I or one of my colleagues will be ROUNDING on you hourly. During those rounds we will be asseseeing the 5 P's (explain the P's) and although I may not speak to you about each of these P's every time I am assessing them. I will be discussing this P and that P with you each time since that is a need specific to you. When I round hourly I would like to meet all of your needs at this time; so if there is anything you need please ask at that time. If you have a need that CANNOT wait until the next hourly round then please use your calllight. (But we are to "gently reeducate" them if they call in between rounds for something that could wait - ya that'll make them happy!) It is our goal to ALWAYS provide you with EXCELLENT care. If at any time you feel you are not receiveing EXCELLENT CARE please speak up so that we can better provide you with EXCELLENT CARE. Is there anything else I can do for you while I am here; I HAVE THE TIME? (even though they just called me over the intercom to tell me that there is a doc on the phone, another patient needs pain med and there is clearly a commotion in the hall behind me).
Oh and during bedside reporting we must introduce so and so your night nurse who has been a nurse for 1 year or 100 years and has no experience here as it is her first night or she has been here for 50 years and either way she is a great nurse who will provide you with EXCELLENT CARE!
Just let us provide excellent care an not talk about it! And don't expect us to score 9 and 10 or ALWAYS on a survey with questions that are worded to make us fail!
Sorry so long, but now imaging actually saying that to every patient you care for today. Oh yeah and I also need to assess them, give their meds, provide their treatments, draw their labs, order their meal when they don't like the first one, call the doc because they want to know when they are being discharged, etc etc etc!
How the hell do you remember to recite that tripe? Judas Priest! Do you write it on your hand?
as to the medicare re-imbursement, I think they know that it impossible for anyone to fulfill that kind of pt satsfaction 100% of the time ANYWHERE. Those bastards know it, and will get out of paying anything. Say buh-bye to the hospitals.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
So thanks to Studor, who I am sure is making buttloads of money off their "great ideas" we are expected to AIDET and hourly round to scripts. Now we were already introducing ourselves to our patients and families and checking on them hourly, but that wasn't enough to make them score all 9s and 10s on our surveys to such questions as "When you called for help did you get help AS SOON AS YOU WANTED IT" talk about a set up for failure, of course not, they want help before they even ask for it!
So now I have to say Hello my name is __________ and I will be your nurse for the next 12 hours. I have been a nurse for ___years and I have been in this department for ______years, so I have seen over 100 or 1000 or 10 patients with your diagnosis. I am also a certified whatever nurse. I or one of my colleagues will be ROUNDING on you hourly. During those rounds we will be asseseeing the 5 P's (explain the P's) and although I may not speak to you about each of these P's every time I am assessing them. I will be discussing this P and that P with you each time since that is a need specific to you. When I round hourly I would like to meet all of your needs at this time; so if there is anything you need please ask at that time. If you have a need that CANNOT wait until the next hourly round then please use your calllight. (But we are to "gently reeducate" them if they call in between rounds for something that could wait - ya that'll make them happy!) It is our goal to ALWAYS provide you with EXCELLENT care. If at any time you feel you are not receiveing EXCELLENT CARE please speak up so that we can better provide you with EXCELLENT CARE. Is there anything else I can do for you while I am here; I HAVE THE TIME? (even though they just called me over the intercom to tell me that there is a doc on the phone, another patient needs pain med and there is clearly a commotion in the hall behind me).
Oh and during bedside reporting we must introduce so and so your night nurse who has been a nurse for 1 year or 100 years and has no experience here as it is her first night or she has been here for 50 years and either way she is a great nurse who will provide you with EXCELLENT CARE!
Just let us provide excellent care an not talk about it! And don't expect us to score 9 and 10 or ALWAYS on a survey with questions that are worded to make us fail!
Sorry so long, but now imaging actually saying that to every patient you care for today. Oh yeah and I also need to assess them, give their meds, provide their treatments, draw their labs, order their meal when they don't like the first one, call the doc because they want to know when they are being discharged, etc etc etc!
*** Uh, YOU don't actually say all that do you? If so I encourage you to take a leadership role in refusing to act in such a condecending manner to your patients and providing great nursing care. Refuse to recite this B.S. and encourage the newer nurses in your unit to follow your lead. They tried this where I work and were met with immediate refusal from the nurses and had to drop it.
Specializes in Oncology; medical specialty website.
^^^^
we have cue cards.
as to the medicare re-imbursement, I think they know that it impossible for anyone to fulfill that kind of pt satsfaction 100% of the time ANYWHERE. Those bastards know it, and will get out of paying anything. Say buh-bye to the hospitals.
Tell me you don't whip out a cue card in front of a patient and rattle that spiel off in front of him/her? Really? Seriously? And management thinks this is a good thing? If I were a patient, I would find it very disconcerting to see my nurse referring to cue cards to talk to me.
I read about this in my NNU magazine, but this is the first time I've "heard" someone actually say they had to do it. Creepy.
I work in SC; a hire and FIRE at will state. Unfortunately a mass revolt will not do us any good in a non-unionized environment. So I do my best to fit in the majority of the script when admitting a new patient; meanwhile they are usually looking around for the tv remote, talking to their family or asking when they'll get to eat.
One of my *favorite* parts of the survey we often "fail" is did your nurse provide you with reasons to call your doctor upon discharge? I do not know how we get negative responses on this when part of our pre-printed discharge includes reasons to call doctor after discharge and I have never seen a nurse not review this on discharge.
Ugh, don't get me started.
But I do like the town crier idea! (Especially since I am originally from Massachusetts!)
What do you think about the medicare reimbursement for customer satisfaction? I wonder
if the changes in healthcare last year have caused this change to customer satisfaction based reimbursement?
I do NOT understand at all. This is one of those stupid ideas that a pen pusher decided. Somebody please explain to me? They think more satisfied = better outcomes?
How about this... lower nurse patient rations= better outcomes and decreased mortality
Why isn't this the target? Because it costs more money...I suspect.
I work in SC; a hire and FIRE at will state. Unfortunately a mass revolt will not do us any good in a non-unionized environment. )
yep.our hands are tied.
do this, or you dont have a job.
and lest us forget that mgmt knows there's someone right behind you waiting to take your spot.
as an aside- I know for a fact when I was telling off a representative for a credit card company, I realized they are using these canned comments too. The guy could hardly deviate from his cue card- and he was so monotone that despite me raising my voice, it made no difference to him.
All it did was make me more mad that these people are also subject to this BS too. I made sure they knew that was WHY I was cancelling them.
I'll never say that script. And I'll never hourly round either. I don't even initial those dumb hourly round sheets. I haven't done it for a year and no one has ever said anything, nor have I had patient complaints. If they have a problem, I can get a job somewhere else no sweat! I get phone calls from recruiting companies a few times a week...
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
yep.our hands are tied.
do this, or you dont have a job.
and lest us forget that mgmt knows there's someone right behind you waiting to take your spot.
as an aside- I know for a fact when I was telling off a representative for a credit card company, I realized they are using these canned comments too. The guy could hardly deviate from his cue card- and he was so monotone that despite me raising my voice, it made no difference to him.
All it did was make me more mad that these people are also subject to this BS too. I made sure they knew that was WHY I was cancelling them.
patients must think we are really stupid.
And managemnt knows we are expendable.
I will just say again........that nursing has come to this.............a very sad state of affairs indeed...:crying2::crying2::crying2:
(Especially since I am originally from Massachusetts!)
:crying2:
tahoe77
83 Posts
I have to agree about the scripting. Its better to be honest and tell the patient that you will do your best
to get to their needs when you can rather than lie and say "i have the time".
What do you think about the medicare reimbursement for customer satisfaction? I wonder
if the changes in healthcare last year have caused this change to customer satisfaction based
reimbursement?
Its scary because in a bell curve there will always be someone at the bottom meaning that
even if all the hospitals had 98-99% satisfaction the hospitals with 98% satisfaction will be
reimbursed less than those with 99% despite performing well. I actually think hospitals
will shut down over this eventually.