Is there anything else I can do for you? I have the time. (new hourly rounding sheet)

Nurses General Nursing

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We had an inservice yesterday. Now, they've instituted a new fall prevention policy that they basically expect every inpatient to be on. You have to reassess every 12 hours, plus reassess with every change such as a new narcotic or BP med, or transfer to another unit. They want the nursing staff to do hourly rounding, and have a sheet up in each room to check off that this was done, along with what the pt was doing at the time. They expect the nursing staff to ask "Is there anything else I can do for you? I have the time."

I told the woman that I wasn't going to say any canned comments like that, that it would seriously annoy many patients to be repetitivly asked the same question. I also told her that I basically already do this, but I don't want to follow a formula. She replied that many people, especially the CNAs aren't doing this, that probably most nursing staff was, and that this was more to get the CNAs to interact better, and that they would be the ones to do the check sheet. She said that they don't expect you to say the same thing each time, just use that as a guideline.

Well, since I already do this I don't have a big problem, except that the charting will be totally obnoxious and meaningless because I'll most likely hurry through it. Since I work in the ICU, it won't be to bad, but when I float to Med/Surg it will be a PITA to complete all this extra charting. The check off sheet will not be a part of the permanant chart, but will be collected each day and reviewed by the unit managers. I feel sorry for them, that sounds like a dreary task.

Honestly, there are nurses on our Med/Surg unit who sit at the nurse's station quite a bit, so I do think there is a problem that this is trying to rectify. But it's making a lot more charting for everyone. :angryfire

Specializes in Pediatrics.

We had this scripted inservice about a year or so ago, and tried it for a while, but then started having parents complain and a couple people leave AMA because they stated they were being bothered too much.

I mean, SOMEONE is usually in the patient's room every hour anyway, except sometimes in the middle of the night and even then, it's at the very LEAST every 2 hours.

I'm sure it's different between adult and pediatric hospitals though. Parents are not afraid to hit that call light for whatever they need for their child (which is good of course!), where they wouldn't necessarily were they themselves a patient.

Also, heaven forbid you even touch a sleeping child, half the time, even to do your assessments or try to start an IV medicine... i'm sure peds nurses and PCAs know what I mean... (but he just won't tolerate those breathing treatments, it makes him MAD!! ok we'll just let him wheeze and shut off his airway...) So forget bugging them with questions every hour or two... just try to let them (and the parent) stay asleep and assess them as quietly as possible.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

hourly rounding was the standard i practiced in the 80's. is there anything i can do for you now was a phrase i used quite often...also would round and tell patient if i'd be tied up with extensive care in another pts rooms or critical pt situation and time frame get back to them. if unable to do task xyz would give them time frame when i could......

we also went form taped report to bedside report in early 80's cutting report time in half ---could take in more visually with sweep of an eye things unsaid on garbled tape machine.

25 years later, being reintroduced because they worked.

i've always done hourly rounding. it was the standard of care when i started nursing in 1978, and i've always done it. i guess i didn't get that it wasn't the standard anymore. what i'm objecting to is the stnadardized "script" that seems to be expected and the additional check-offs to be made in some little book. while the hourly rounds are a good thing, i fail to see how checking off the hourly rounds in a little bedside book is going to help anything (i'd be tempted to just check them all off at once and be done with it!) and the scripting is rather insulting. we're professionals -- i'm sure we can think of something to say on our own that wouldn't come off as so fake.

Specializes in Peds.

Hi,

The check off lists are a joke.

And not everyone wants to be bothered every hour.

Stop treating me like an imbecile - please start respecting me for the trained professional I am.

thanks,

Matthew

as w/ruby, i too, have considered it the norm to frequently f/u w/my pts.

just my ongoing presence, is sufficient in letting my pts know i am there for them.

approx q2h, i will say, "let me know if you need anything".

pts can always distinguish those from who really give a darn.

leslie

I have to laugh because when I was still in the hospital, they were doing this stuff-a good 2+ years ago. They had some outside company come in and inservice the entire staff. They didn't have the hourly rounding, but everybody, I mean everybody was taught the line "Is there anything else I can do for you-I have the time". My coworkers and I thought it was the funniest thing in the world, like yeah, right! I have loads of spare time! Can't ya see me sitting around with my feet up eating bon-bons? We'd pass each other in the halls and say that, with a wink wink, nudge nudge. That was around the same time we were told that if we ran into anybody who needed help anywhere in the building...let's say,directions-we were not to merely show/tell them the way, we were to physically *take* them wherever they needed to go. Um yeah. I run down to the candy machine to get my sugar because I have no time on a 12 hour shift for a real break, yet I can't give directions to someone how to get to the gift shop, I have to take them there? Sheesh! The majority of the people could easily understand directions as the layout was pretty straight forward, not too many places were confusing to get too.

Specializes in Med/Surg; Psych; Tele.

To be fair though, it's really not all that bad. It only takes about 5 minutes to run around all the rooms at the end of the shift and fill them out, lol.

Ha HA ha! Thanks for making me laugh and smile!

"Sitting around"?

:jwdrp:

*** choke, sputter ***

more like RUNNING around, if we were just sitting around the hourly rounding would make sense, but we are not

I can't believe all the posts on this subject. I think all hospitals are going toward this same program. We have been doing hourly rounding for about a year and we have to use key words like "very satisfied" I don't do it because it doesn't sound genuine. Some of our patients get annoyed with the hourly rounding and ask us not to do it. Because they are trying to get some rest.

I am shocked that nurseing has come to this. The ceo's and upper management don't have a clue what it is like to be a floor nurse. The expectations they have of us are unrealistic because they don't have a clue.

Specializes in ICU, nutrition.

Hourly rounds sheets...kind of reminds me of when I was a hostess at Shoney's, we had to initial on the back of the bathroom door that we'd made hourly rounds and cleaned up. :uhoh21:

I work in the ICU (when I'm at the bedside) so I basically make hourly rounds, not formally, but doing hourly vitals, giving meds, resetting pumps, checking vent alarms, etc, I know I'm usually in the patients' rooms an average of hourly. When I worked nights I tried to leave the patients alone a little to sleep. :yawn: :zzzzz :yawn: :zzzzz :yawn: :zzzzz

Yeah, because the patients sleep at night, right?:hhmth:

When I used to float to the floors on nights I'd do hourly checks, but if they were asleep I wouldn't wake them up! Certainly not to ask if they need the three Ps. :lol2:

I feel for ya, and I'm sure it's coming my way...

reading these posts made me think, i've been told by many a nurse that patients felt safer on Nightingale wards these are long narrow wards with two colums of patients beds opposite each other and kitchen sluice clinic room and bathroom and toilets either end with one or two private rooms called side wards. Nurses could see all of there patients from the nurses station and this is probably why they felt safe.

my trust had adapted all these wards into bays or has built new bay based wards.

And if you shove a broom up my butt I'll sweep the floor when I walk.

Careful, that's coming!

Specializes in M/S-Ortho-Renal-Peri-Op.

That is truly funny!! Multi-tasking!! My question is what happens to all the paper???? It is not part of the pt. record!!!! It is totally nerve racking when we are suppose to be going green ect...and paperless, that we would implement another non-useful peice of paperwork!!!!!

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