I Have The Time and Other Lies

Nurses Relations

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I will admit that have been remiss on keeping up on what nurses at AllNurses have to say on the hourly rounding mandate. But my hospital seems to be going over the top and literally forcing nurses to script their interaction with patients.

We have hourly rounding quarterly validations and over 75 percent of the RNS failed recently (though we have been doing it for 2 plus years).

The nurses failed to use the works: "hourly visit" but may have phrased it as hourly rounding

Also not stating: "What is the most important thing I can do for you today?"

But the icing on the cake is that they are requiring us to state, "I have the time."

The funniest part is that the patients are continually commenting on how ridiculously busy all the RNS are and the phone rings 5 times the minute we enter a room.

One patient's husband stated to me: "I have never witnessed one of you nurses walking casually or slowly, you are always hurriedly going somewhere with intention."

We obviously do not have the time! We have no time.

One patient recently refused to have a foley placed because the RN kept receiving phone calls. Mind you that she did not answer the phone but the patient became upset and said he thought he deserved at least 5 minutes of uninterrupted time with his caregiver.

Is this common in other facilities or is my place of employment just unique?

That sounds exceptionally poor, IMO.

Specializes in Med/Surg, Tele, Dialysis, Hospice.

Forcing nurses to say "I have the time" when they clearly don't is demeaning, dishonest, and deceptive. It's bad enough that they stretch nurses thinner and thinner, but to force them to lie and pretend that they are well staffed and have all the time in the world? Despicable. I doubt if many patients are fooled by this either. When I worked on a busy med/surg tele floor, many of the patients and their families felt sorry for us and often commented on how busy we were and how we were kept running the entire shift.

But the icing on the cake is that they are requiring us to state, "I have the time."

The funniest part is that the patients are continually commenting on how ridiculously busy all the RNS are and the phone rings 5 times the minute we enter a room.

Is this common in other facilities or is my place of employment just unique?

I'm a Swedish nurse and thankfully we don't have to deal with this "script" nonsense. The patient is in the hospital because they need medical care, it's not the same as going out to your local Pizza Hut for a bite to eat. The focus is on providing high quality care, not "customer service".

As you pointed out, the patients are neither blind nor stupid. They notice if their nurse is being run ragged by the patient load/duties. It's pretty obvious that we don't have an abundance of time at our disposal. In my opinion being forced to say "I have the time" is insulting to both the patient and to us.

I'd go nuts if I had to carry a phone, when providing direct patient care. I only do when I assume charge duties. My co-workers can find me easily enough in case of an urgent matter and codes will be announced (one way or the other, depending on my place of work). The only time i carried a "distracting" device was on a telemetry floor where every nurse carried a pager. When I was new on that floor I almost had a cardiac event of my own everytime a patient brushed their teeth and the pager would beep and read "v tach" ;)

I'm a Swedish nurse and thankfully we don't have to deal with this "script" nonsense. The patient is in the hospital because they need medical care, it's not the same as going out to your local Pizza Hut for a bite to eat. The focus is on providing high quality care, not "customer service".

As you pointed out, the patients are neither blind nor stupid. They notice if their nurse is being run ragged by the patient load/duties. It's pretty obvious that we don't have an abundance of time at our disposal. In my opinion being forced to say "I have the time" is insulting to both the patient and to us.

I'd go nuts if I had to carry a phone, when providing direct patient care. I only do when I assume charge duties. My co-workers can find me easily enough in case of an urgent matter and codes will be announced (one way or the other, depending on my place of work). The only time i carried a "distracting" device was on a telemetry floor where every nurse carried a pager. When I was new on that floor I almost had a cardiac event of my own everytime a patient brushed their teeth and the pager would beep and read "v tach" ;)

In America, the focus is on providing a "resort" type experience, with physical wellbeing secondary to the patient "enjoying" their stay. This means that we don't enforce diets, nor do we prevent patients from smoking or other things. We just "strongly advise", etc. but NEVER rudely. Basically, an American nurse is a butler/waiter/maid with an understanding of pharmacology and physiology. The patient is in charge of their stay, and doctors and nurses cater to their demands for drugs (mostly pain meds proscribed upon request, etc. even from known drug-seekers) and things like that in an effort to get reimbursement from the broken system. Personal behavior of any sort is excusable so long as none of the staff have to call in because of the injury, and no rape occurs. Other than that, the patient is allowed to do as they please with staff, physically.

Just my experience.

You called it correctly, "script nonsense." Along with all the other hourly rounding. I wonder if the hospital has any clue as to how many millions of dollars they have wasted on hourly validations, classes, conferences, mandates and meetings on this crap!

Are they really too ignorant to realize that if they just staffed correctly and gave RNs the resources and staffing we need that the patients would benefit, the hospitals would not be a revolving door of nurses, and the employees would be happy and satisfied. This leads to good care. I don't know any RN on my floor who doesn't have the best interest of their patient in mind. However when they are completely stressed, overwhelmed and run ragged they can not provide the best care. Very sad.

Specializes in ICU / PCU / Telemetry / Oncology.

I am the first to admit that I do NOT do hourly rounding! It's unrealistic. It takes me a full hour or more just to chart on 5-6 patients! Too many tasks and too little time to do them. Don't even have time to chat or keep patients company. I get upset when patients need to take their pills one at a time as opposed to in one gulp. That's really sad.

And to that former middle manager that insisted that we use a script, "I'm here to do my hourly rounding." ... : [what I'd say would clearly be banned by AN, use your imaginations] ... :D

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Specializes in Oncology.

My hospital generally staffs safely and appropriately based on acuity and census. We've never been scripted and our patient satisfaction scores are very high. I always ask before I leave a room if I can help the patient with anything else. They don't hesitate because they can tell I really am not run ragged. If I am busy, I'll say, "Okay, I'll bring that in as soon as I can." My patients all have long lengths of stays, so they have learned to trust that if we say we'll do something we usually really will. We don't need to be scripted, because believe it or not, most nurses WANT their patients to be happy, healthy, safe, and comfortable and will do what they can to ensure that.

Specializes in OR, Nursing Professional Development.

Isn't it sad that educated professionals are given a script and told how to interact with people? While I'm not holding my breath in anticipation of it happening during my lifetime, I can't wait until the tide finally turns and the medical/nursing field focuses on providing health care once again.

Yes, we had to watch those ridiculous videos about AIDET/Studer Group/hourly rounding.

The dialogue they want you to use when interacting with "customers" and their families is appropriate maybe if you live and work in the land of the Care Bears. Not so much here on planet Earth.

Come on, who talks like that? It's almost like they're programming us to behave and function as inanimate robots, devoid of any emotions or personalities.

It was beat into our heads that we had to read the script word-for-word to ensure we used the "key words" that the patients would recognize on their surveys. Personally, I think the whole thing is a facade disguised as being "in the best interest of the customer" when all they really care about is the bottom line...the surveys and patient satisfaction scores.

What a load of garbage.

How many of those 75% of nurses that "failed" are just going to end up charting that they did what they didn't do just to make the employer shut up? Your place of employment sounds rough though.

At my place of employment, we have hourly rounding slips that we have to initial and time for every hour we were in the patient's room. Supposedly because they can show patients and family as proof that nurses have rounded on them. I always get dinged because I either fill them out honestly or I have no time to fill them out even if I was in the room. Other nurses lie and fill out the damn slips. I don't.

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