Patient and Staff Agreements?

  1. I'm on a committee to revise our Code of Conduct to be reflective of expectations for staff, patients and visitors. We are determined to reach a higher standard of respect, dignity, and collaboration at our hospital/school.
    It's been a bit hard for me to wrap my head around my fellow nurses finding a comfortable level of apathy, but I have seen it and it's discouraging. I recognize that our senior leadership is definitely correct that we need to "up our game" when it comes to changing our culture towards excellence.
    My question for everyone; Do you have agreements with your patients and staff regarding expectations of behavior? We are brainstorming how to integrate this into the daily culture. There was suggestion of an additional board in the room with our mutual promises printed, on which everyone involved in the patient's care could sign as they came in and introduced themselves..?
    Our hospital security is very on board as is senior leadership. I'm just curious if other hospitals are doing something similar or have something in place. We have looked at the ICARE model as well.
    Thank you for your help!
  2. Visit schreiba profile page

    About schreiba, BSN, RN

    Joined: Dec '09; Posts: 7; Likes: 3
    Had to quit the ER after 8years to go full time to; from US
    Specialty: 5 year(s) of experience


  3. by   JKL33
    So you mean to say that your administration wants to come down even harder on nurses for "customer service" and "patient satisfaction" under the guise that they are also going to hold patients and visitors to some kind of behavioral standard. Because we both know the latter is never going to happen.

    Why would you even present this issue this way, even here on this forum - let alone to your staff IRL?

    Have you and your administration considered that a refusal to level with people (staff) is the ultimate disrespectful behavior?

    It's been a bit hard for me to wrap my head around my fellow nurses finding a comfortable level of apathy, but I have seen it and it's discouraging
    Having written out and deleted a rant not fit for publishing, I'll just say the train of thought you present here is heard frequently and remains utterly baffling.

    There's a line in an R.E.M song, "Withdrawal in disgust is not the same as apathy."

    If your administration would like a culture of excellence, they must treat people excellently. That is all there is to it. As far as I can see, they are pretty apathetic about that. They just cannot bring themselves to try it. Only a complete fool (and abusive jerk) kicks the dog and then blames him for whimpering and wonders why he won't play fetch any more. Pathologic thought process, that is.

    If your administration doesn't like it, the good news is that it is completely within their power to change it.

    Sorry I can't be of more help and encouragement. This is just shameful, though. So completely sick of it.
  4. by   Emergent
    JKL, you are, as usual, the voice of reasonable commonsense here. Thank you!
  5. by   schreiba
    No. I do not "mean to say" that.
    Our current Code of Conduct is a very punitive listing of every horrible thing one could do to cause disciplinary action. It's verbiage is very negative. We want to have a positive code of conduct that not only details basic expectations, but does so in a collaborative way. We are tired of being held to an invisible standard with vague, negative consequences.
    All that being said, I don't begin to have the energy to refute all of your assumptions based on your personal experiences. My question was simple.
    I apologize for hoping that someone could provide some constructive advice rather than attacking me based on their own bias. Obviously I did not know my audience.
  6. by   JKL33
    You could could have explained the situation as you did in your second post. What you chose to start off with instead is that you can't understand (your perception of) your fellow nurses' level of comfort with apathy about excellence in care and that administration wants to "up our game." I'm sorry if I misunderstood, although I am certainly not alone in my suspicions about what administration might mean whenever they want to improve something. In fact, if they were that fantastic I wouldn't expect your staff to be operating under a punitive system with invisible standards and vague, negative consequences, to begin with. So there's that.

    I stand by what I said. Let me ask you this: What do you or admin believe the Promise Board is going to accomplish? Will there be patient expectations on it that one could point to and say, "Now Joe, you are not respecting the promise you made here?" No. (Hear me out, I'm not being sarcastic). Okay, then if no, what is it's purpose? To have a visible reminder for patients of the excellent attitudes with which we hope to work together? Okay, fine, but I think it would be fine as a preprinted and framed statement; hang it on the wall. Signing it every day doesn't change its existence, but it is kind of ? I don't know, demeaning, to make a rule that an adult professional is going to make a big show of signing this each day, isn't it? Because its purpose is to convince the patient of something, not to actively change anything. line with my previous "offensive" commentary, it is yet another thing that 1) admin comes up with 2) staff does. It's another trick to perform, and tricks don't change anything. People are apathetic because of repeated insults like this.

    I am missing how re-writing the CoC to be fair and just involves the nurses signing something in front of each of their patients every day. Serious question.

    I'm sorry if I don't understand what the real deal is, here. Maybe I literally don't understand what you're saying and what your admin is proposing. (?)

    I see a Culture of Excellence being more an agreement and understanding between staff and admin, not staff and patients (the Code of Ethics quite nicely puts forth our duties to patients already). I don't mean to offend you any further but I continue to suspect that the admin wants this to be "collaborative" because it gives them some leeway to focus alllll of this mostly on the nurses, meanwhile their own change (which is imperative) along with any possible change in expectations for patients' behaviors, will remain much more nebulous.