i am in my second week of classroom orientation as a new rn at my local hospital. they are trying to implement a new system or way to improve patient satisfaction. the two things that keep popping up are we are to say:
1. before we leave the patients room: "is there anything else i can do or get for you, i have the time."
2. when they are leaving or being discharged: "thank you for choosing xxx"
i have no problem with number one i do it anyway not the exact phrasing. the second one bugs me. like i am an airline stewardess or something. "thank you for choosing xxx we hope you enjoyed your stay buh bye.":uhoh3:
what are some of the things your institution would like you to implement to improve patient satisfaction?
I know that all of us here are literate, compassionate, and excellent nurses, but the sad fact of the matter is that scripting addresses a larger societal problem:
People are rude and crude nowadays. People no longer have the manners to know how to talk to others, especially to sick people. You wouldn't believe some of the incredibly unprofessional things I've heard nurses and techs say to patients.
Then that needs to be dealt with with the individual involved. I don't want to be 'forced' to follow a script and treated like I'm an imbecile simply because Nurse X is bitchy to her patients. Fire nurse X. This isn't kindergarten where the whole class suffers because one kid acts up. Please....
So therefore, I'm for scripting. I do not say things word-for-word, and I have never promised "excellent" care. But I do tell patients pretty much the same things about things we must discuss - what to expect from the staff, who does what, etc. I tell patients we're going to do our best to help them get better.
I also figure if they're going to make me say certain things, I'm going to take advantage of it and really teach the patients what my role is. So when we have to write our names on the boards in the patients' rooms, I always erase the generic "nurse" and write my name, and "RN" after it.
So I'll say something like: "Hi, I'm Betty, your RN. I'll be giving you medicine and listening to your heart sounds. I want you to call me if you have any more chest pain or pressure, because there are things we can do to fix the problem.
This is Joe, your Tech, and he'll be checking your blood pressure, helping you to the bathroom, and getting you that extra blanket you need."
I then do a visual teaching of the nurse coming into the room, washing hands, and then I add, "Did you notice that when I came in, I washed my hands? This is for anyone who's going to touch you. Your doctors, nurses, lab techs, anyone. Feel free to ask anyone who is going to touch you to wash their hands. We don't want you to get an infection. Then the person will check your armband, like this. They will tell you what they're going to do. Ask any questions you have and make sure you understand the answers. You then have the right to refuse. We want you to make intelligent decisions about your care."
It took way longer to write that than it does to give the 5 minute spiel, but you get my drift. My goals were to establish to the patient that I am a professional and the tech is an assistant. That docs and lab techs get dirty hands too. That the more informed patients were, the better able to understand their treatment and comply with it.
And this is something that you, as a professional do because you feel it is a necessary part of your job and important to the care of the patient. Much different than a script designed solely to improve "patient satisfaction" and get higher scores on surveys.
Whether we use scripts to establish those givens or whether we wing it every time doesn't really matter. The point is to inform and educate the patient, and do it in a polite, respectful, and hopefully engaging manner so that we establish a trusting and therapeutic relationship.
And as a professional, I am perfectly capable of doing so. When I cease to effectively do my job, they should fire me.
heres the newest from our unit decreasing response time for answering patient call lights. the suggestion: putting a sheet at every patient room for hourly checks and saying to the patient every hour i know your light isn't on but i am just making sure you don't need anything.
like we need another form to fill out!
********sigh*******
when i go back to work next thursday, i will probably have this policy also if press-gainey is behind it. hard to turn on a call light if you are ventilated, sedated, and restrained will probably have to fill out the form anyway :angryfire
From a patient's point of view, "Scripting" would seem to be totally inappropriate coming from a highly trained professional whose job (AND their patients' lives) depend on critical thinking and instantaneous response to rapidly changing circumstances. As a patient my instinct would be to RUN, not walk, away from any facility where the solution to any medical situation appears to be forcefeeding the patient a dose of McMedicine.
if i were a patient i would find that intrusive and obnoxious.
my husband said the same exact thing. he said that it would also make him mad enough to keep putting the light on for stupid things like, "can you put my socks on":uhoh3:
This has gone from merely irritating to outright ridiculous.
God, I wish my nursing career had ended pre-Press-Ganey... Nursing caps and giving up your seat for the docs? Big freakin' deal. I'd take that any day over this crappola.
Mine IS over - I really thought I would miss it, but I haven't. All I have to do is spend a little time here!
I worked in Ambulatory surgery when they started this crap at our hospital - and it was some of the most uptite, unpleasent nurses who were trying to shove it down our throats.
I've always gotten along with patients - it's something I'm good at, and received several compliments from them after their stay - I told those gals I didn't need them telling me what to say - obviously I already knew how to talk to patients.
Specializes in Pulmonology/Critical Care, Internal Med.
You all seem to be hitting it right on the head. It would appear that another poster has trepidation about nursing as well. This corporate spin that is being put on healthcare is truly disturbing. I keep on having flashbacks to the days of working in retail management, etc. I remember having to use scripts when I worked at the various vet clinics, we used to get calls that tested us to see if we used the scripts and the slogans. We would get counseling if we didn't use all the points. Most of the points were selling points at that which is what this is starting to feel like.
I wonder if they will start doing things like this as well....create a fake patient or call the units and see how you talk to them.
Another poster mentioned that she gets along great with her patients, I find it increadible that this seems to be something that we even have to discuss. Why shouldn't we get along with the majority of our patients. Its unfortunate that nurses are finding themselves overworked so much that they are no longer able to do their jobs effectively as patient liasons (advocates). But then again when you have to do so much redundant paperwork, and have multiple charts with multiple things spread out all over is it any wonder. Dr.s orders in one chart, VS in another, notes in a third, the list goes on and on.
I can also tell you that most corporations when they talk about press-gainey scores also tell you that for every 1 customer that has a bad experience will tell at least 10 others about your experience, but for every patient that has a great experience you'll be lucky to get 3 others who know about it.
Excellent customer service is the rule not the exception. I know personally I've done this exact thing. I will tell everyone and their brother if I've had a bad experience somewhere, but hardly ever tell them about good times. Its not done on purpose I just expect folks to be nice when I go somewhere where i'm paying for something. We tend to focus on the negatives not on the positives....just turn on the TV all you hear now a days, so and so was murdered, this many more troops died in Iraq, etc. You never hear about the large grant to fight aids that was given to make a vaccine, or how they have built multiple schools and hospitals in some of the hardest hit areas of Iraq allowing children who couldn't go to school the ability to now go to school.
Its unfortunate that we as professionals are being subjected to that, but then again hospitals don't view nurses as professionals, thats for doctors and administration only they are the professionals. We are just another employee with minimal training whos job can be outsourced to less educated techs. We are the indians and they are the chiefs above such silly things like press-gainey scores. Imagine if we got to give the hospital a press-gainey score for workplace environment and docs a press-gainey score for how they treat patients and nurses. HA.......I think he!! would freeze over. :)
Imagine if we got to give the hospital a press-gainey score for workplace environment and docs a press-gainey score for how they treat patients and nurses. HA.......I think he!! would freeze over. :)
Actually, we rate our hospital, managers, doctors, and workplace environment through P-G yearly. :)
The problem is getting people to believe that the results are completely confidential.
Specializes in Pulmonology/Critical Care, Internal Med.
Actually, we rate our hospital, managers, doctors, and workplace environment through P-G yearly. :)
The problem is getting people to believe that the results are completely confidential.
Wow, really !!!! Why do folks not think they are completely confidential, do you have to put down your name or something? That makes me kind of happy to know that you can rate your boss as well. :)
Wow, really !!!! Why do folks not think they are completely confidential, do you have to put down your name or something? That makes me kind of happy to know that you can rate your boss as well. :)
Apparently we (employees and professionals) are also thought of as "customers."
People thought that their ratings were not confidential because they could only use employer computers and in order to log in, you had to use your own information. It was useless to tell folks that the ratings were going straight to a third party, so many people were afraid to say what they really thought. Besides, the managers all had access to the free-form comments (so they could make improvements), so they could guess who said what, given the unit and the shift and sometimes, the complaint. Rarely were complaints made to the surveyors that had already not been discussed at work.
So if a manager wanted to make a quick improvement in the unit's scoring, poof! the person suspected of making an unsatisfactory comment would be "encouraged" to leave in the form of not getting desired vacation time, getting written up for inconsequential things, unfair assignments, etc.
heres the newest from our unit decreasing response time for answering patient call lights. the suggestion: putting a sheet at every patient room for hourly checks and saying to the patient every hour i know your light isn't on but i am just making sure you don't need anything.
like we need another form to fill out!
you do this to me at 0300, and i'm going to be seriously pi$$ed.
Specializes in Pulmonology/Critical Care, Internal Med.
ohh geeze! that just gets my panties all in a wad, and I'm a boy!!!!!! makes me so mad!!!!:angryfire They make you use your computer with your ID and the managers can see the comments, my god!!!! These Press-gainey folks sure are pretty dumb, I would not want my manager to see my scores, and there should be a thing that if you did say something bad about your managers behavior, etc there is a clause that either a manager from another unit has to do the write up or the person above the manager has to do the write up for a certain period of time (6 months). Although I'm not sure thats even a good way of doing it. Great now yall've gotten me all depressed on my B-day weekend.
Actually, we rate our hospital, managers, doctors, and workplace environment through P-G yearly. :)
The problem is getting people to believe that the results are completely confidential.
Apparently we (employees and professionals) are also thought of as "customers."
People thought that their ratings were not confidential because they could only use employer computers and in order to log in, you had to use your own information. It was useless to tell folks that the ratings were going straight to a third party, so many people were afraid to say what they really thought. Besides, the managers all had access to the free-form comments (so they could make improvements), so they could guess who said what, given the unit and the shift and sometimes, the complaint. Rarely were complaints made to the surveyors that had already not been discussed at work.
So if a manager wanted to make a quick improvement in the unit's scoring, poof! the person suspected of making an unsatisfactory comment would be "encouraged" to leave in the form of not getting desired vacation time, getting written up for inconsequential things, unfair assignments, etc.
will probably have to fill out the form anyway :angryfire
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EmmaG, RN
2,999 Posts
And this is something that you, as a professional do because you feel it is a necessary part of your job and important to the care of the patient. Much different than a script designed solely to improve "patient satisfaction" and get higher scores on surveys.
And as a professional, I am perfectly capable of doing so. When I cease to effectively do my job, they should fire me.