Low Press "Gag"ney Scores- help!!

[General E. Speaking, RN, RN]

Getting discouraged with the Tele Unit Educator part of my job. It is a supplemental position (4hrs/wk) in addition to my fulltime charge position. I want to concentrate on things like "Anatomy of a Code", cardiac drugs, when to call a Rapid Response, Pre and Post CABG patients. Instead I am being told that since our Press Ganey pt satisfaction scores are so low, I must figure out a way to increase those through education. What??I feel the problem is with some crappy uncaring nurses that they have hired-mainly on the night shift. Mgmt is aware of these nurses yet I feel enough is not being done. We do have a new charge nurse coming to nights that supposedly has a backbone. My coordinator is new to the position so I think she is formulating a plan to address these nurses eventually... In the meantime, how do I teach empathy? How do I teach nurses to keep your patients informed? How do I teach nurses to pay special attention to pt needs? Seems to me these are all Nursing 101.

I don't ilke Press Ganey anymore than any other nurse. It makes me feel like a kindergartner who gets their color changed on a daily basis for bad behavior. However, it is here to stay so we must live with it. There are ways around these questions. For example, you may not know the exact plan for the day but you can say something like this.." You were admitted with chest pain. We will do cardiac enzymes Q 4 hrs for 3 sets and this will let us know if you had any heart muscle damage. You are on the heart monitor so if you have any chest pain or palpitations... A cardiologist will be seeing you and depending on your risk factors (explain) he/she will decide if you need a stess test, heart cath, follow up as out pt, etc.... I'm not sure when the doctor will come but he/she usually rounds at ____ time. Let me call the CT Dept and see if they can tell me when you test will be done...."

These low scores are making my job harder. I now (as charge nurse) am expected to round with each nurse and fill out together an additional paper with 9 patient satisfaction questions on each patient. This takes forever to coordinate between my duties and theirs.

There is talk about getting a swing shift nurse to help with admits/discharges and adding another tech which will help tremendously with the scores, I am sure. But in the meantime...I am going crazy.

[Imafloat, BSN, RN]

You may need more than 4 hours a week to fix this. You need to look at the specific areas you are scoring low on and the comments and see what is recurring. You may need to reeducate your staff.

We have access to our Press Gainey Comments and scores and I read them regularly. I am sometimes shocked by what I read. I use it as a learning tool for myself.

[General E. Speaking, RN, RN]

We do get to read comments from the patients on the surveys. You are right, it is a good learning tool. Sometimes a patient that no matter what will not be happy. Lately, it seems that these are the only ones who are sending in surveys. I am trying to encourage the nurses to encourage the happy patients to fill it out too. It is depressing day after day to see your units scores in the toilet.

[d'cm]

Don't worry about fixing anything, just make up some pretty presentation that you think would impress your supervisor so she can impress her supervisor ... - that's what it is all about. Or, find meaningful work.

[General E. Speaking, RN, RN]

Don't worry about fixing anything just make up some pretty presentation that you think would impress your supervisor so she can impress her supervisor ... - that's what it is all about. Or, find meaningful work.[/quote']

lol. I may end up doing just this.

[classicdame, MSN, EdD]

our scores went up when Admin made a point of getting rid of low performers. Medium performers are encouraged to move to higher level. If consistent drop to low then they need to leave. Maybe a presentation on company expectations on behavior (Code of Conduct) with signatures? I agree with d'cm. Sometimes supervisors do not know the difference between education and behavior modification. You cannot "teach" people to live up to expectations, you can only define the expectations.

[Lucky0220]

I am a new nurse, second career, after working in the dental field for many years as an office manager. Although we didn't have companies like PG, we constantly had to strive for patient satisfaction due to high competition in the area. The main thing that I am noticing, both at my hospital and from all the posts here, is that our ratios are just too high. Having 6 and sometimes 7 patients on a MedSurg floor, with not enough CNA's or a unit secy, or if you do enough, one gets pulled to another floor that is short, makes for very stressed out, unhappy nurses! You have to work extra hard to keep that smile on your face and not let the patients know how busy you are, no matter what. They do not want to hear about it. They want to feel cared about and it is very difficult to spend adequate amounts of time with each patient so that they do feel cared about when you have that many patients.

I don't understand how management cannot see that this is the problem. Happy employees for the most part, perform better. Therefore, happier nurses = happier patients, in my opinion.

[General E. Speaking, RN, RN]

I am a new nurse, second career, after working in the dental field for many years as an office manager. Although we didn't have companies like PG, we constantly had to strive for patient satisfaction due to high competition in the area. The main thing that I am noticing, both at my hospital and from all the posts here, is that our ratios are just too high. Having 6 and sometimes 7 patients on a MedSurg floor, with not enough CNA's or a unit secy, or if you do enough, one gets pulled to another floor that is short, makes for very stressed out, unhappy nurses! You have to work extra hard to keep that smile on your face and not let the patients know how busy you are, no matter what. They do not want to hear about it. They want to feel cared about and it is very difficult to spend adequate amounts of time with each patient so that they do feel cared about when you have that many patients.

I don't understand how management cannot see that this is the problem. Happy employees for the most part, perform better. Therefore, happier nurses = happier patients, in my opinion.

You make valid points. I believe the staffing issue boils down to money. Plus, they expect us to work with higher acuity patients on the floor. With the co-morbidities of the patients these days, it is not unusual for each patient to have 4-5 doctors all writing orders throughout the day. Multiply that by 5-6 patients (7-8 if you count turnover) and the amount of things the nurse must prioritize and accomplish is astounding. We are constantly being asked to do more with less resources. One more piece of paper adds up. Then you add in all the core measure patients and required paperwork in order for the hospital to get reimbursed. Not to mention the regular paperwork:admission form, flow sheet, graphic sheet, diabetic flow sheet, anticoagulant sheet, influenza/pneumo vac screenings, smoking, nurse-pharmacy communication sheet paper, home med sheet, DVT screening form, etc...

I am weary. Which is why I am moving to ICU in 2 months. Not expecting an easier time, only different because of the ratios.

[Kooky Korky, BSN, RN]

lol. I may end up doing just this.

And what a pity that would be. Another great nurse wasted because of PC male bovine doodoo. Wow, was that creative terminology or what?

Seriously, I would hate to see you wasting your time on this foolishness but it would be worse to lose you altogether. I wonder what it's going to take for those who worship these PG scores to realize how they are just destroying nurses and nursing.

[Kooky Korky, BSN, RN]

Getting discouraged with the Tele Unit Educator part of my job. It is a supplemental position (4hrs/wk) in addition to my fulltime charge position. I want to concentrate on things like "Anatomy of a Code", cardiac drugs, when to call a Rapid Response, Pre and Post CABG patients. Instead I am being told that since our Press Ganey pt satisfaction scores are so low, I must figure out a way to increase those through education. What??I feel the problem is with some crappy uncaring nurses that they have hired-mainly on the night shift. Mgmt is aware of these nurses yet I feel enough is not being done. We do have a new charge nurse coming to nights that supposedly has a backbone. My coordinator is new to the position so I think she is formulating a plan to address these nurses eventually... In the meantime, how do I teach empathy? How do I teach nurses to keep your patients informed? How do I teach nurses to pay special attention to pt needs? Seems to me these are all Nursing 101.

I don't ilke Press Ganey anymore than any other nurse. It makes me feel like a kindergartner who gets their color changed on a daily basis for bad behavior. However, it is here to stay so we must live with it. There are ways around these questions. For example, you may not know the exact plan for the day but you can say something like this.." You were admitted with chest pain. We will do cardiac enzymes Q 4 hrs for 3 sets and this will let us know if you had any heart muscle damage. You are on the heart monitor so if you have any chest pain or palpitations... A cardiologist will be seeing you and depending on your risk factors (explain) he/she will decide if you need a stess test, heart cath, follow up as out pt, etc.... I'm not sure when the doctor will come but he/she usually rounds at ____ time. Let me call the CT Dept and see if they can tell me when you test will be done...."

These low scores are making my job harder. I now (as charge nurse) am expected to round with each nurse and fill out together an additional paper with 9 patient satisfaction questions on each patient. This takes forever to coordinate between my duties and theirs.

There is talk about getting a swing shift nurse to help with admits/discharges and adding another tech which will help tremendously with the scores, I am sure. But in the meantime...I am going crazy.

I think it would be a real eye-opener for your bosses to have them spend a shift on the floor, right alongside a nurse. A whole shift. Not just a Hillary Clinton moment. A whole shift - no potty, no meal, no water bottle at the med cart. All of their questions would be answered. In fact, you should make sure that nurse gets held, at the last minute, for a mandated, involuntary double shift - and has to come back just one shift later. and the boss has to work the double and then come back and do another shift right with the nurse. They just might stop their crappa dappa doo. Oh Yeah! :dzed: :hlk:

Have you discussed with them that you were hoping to do cardiac education? What say they to that?

[Kooky Korky, BSN, RN]

You may need more than 4 hours a week to fix this. You need to look at the specific areas you are scoring low on and the comments and see what is recurring. You may need to reeducate your staff.

We have access to our Press Gainey Comments and scores and I read them regularly. I am sometimes shocked by what I read. I use it as a learning tool for myself.[/quote

What kinds of things do they say?

[General E. Speaking, RN, RN]

Not directed at me but I wanted to comment. We had a very difficult patient. Complained about everything. Constantly calling "service hotline" number posted in every room about our 'service guarantee'. On the nurses light every 5 min. I spent a great deal of time in his room (as charge nurse). I sat down and listened and listened and listened to his painfully detailed history and about how most doctors are idiots, etc... He came in with dizziness. The doctor wouldn't even round on him unless I was with him (to serve as a witness, I guess, since the patient called him an idiot too.) CT, MRI were negative and he was dx with positional vertigo. My supervisor also spent a great deal of time relistened to his long story and detailed medical history. Everyone knew he was a difficult patient and we generally tried to accommodate all his requests, questions and needs.

When the survey came back he had written basically a 2 page letter about how awful we were. We never explained to him what was happening, nobody told him any results of his tests and we never came when he called. He said he sat down there in his room for 4 days with dizziness and nobody helped him.

Pretty much all lies.

We also get "dinged" on our surveys repeatedly because of room decor, length of doctor visits, and food. We are trying to fix what we can but sheesh some of it is out of our control!