verbal 'scripts'

susanmary · Feb 9, 2001

Originally posted by NCRN:
Our CEO has announced that staff will greet patients and visitors with scripts based on those used at Florida Baptist Hospital. The outcome is aimed at increasing patient satisfaction.
Goes like this: Knock on door, enter room, smile, "Hello Mr._, I am __RN, I will be your caregiver until _pm. I want to make sure your care is very good. If at any time we are not meeting your expectations, please call___." " I have time, is there anything I can do for you?"
These are to be recited exactly, we were not given input or a choice. I always want to add "would you like fries with that order"

Have any of you had experience with similar scripts in your hospital? Is patient satisfation improved? How was the reaction by nursing staff?

I take issue with the scripts. I always identify myself to a patient when I walk into his/her room, inform the patient of my shift hours, then write my name, my PCAs, name, and the date on the patient's board. I do not need a script to do this. Perhaps you could tape record a blanket message each day, and play the pre-recorded message when you enter each room -- then you could be assured that you are reciting everything exactly as administration wishes. If you keep a record of the tape, then you will never be fired for saying anything out of order.

Seriously, I agree with every above post -- this is so demeaning to nurses. Do administrators have scripts? Regarding patient satisfaction, there is a notecard placed on each bedside stand stating my managers name & number in case the patient wished to contact her (this was done for patient satisfaction). I don't think she has gotten many calls, though.

Nursing is very personal, and what we say to each patient may vary depending on the circumstances. What is the worst thing that would happen if you did not use the script? I'd band together with your fellow nurses and fight this. Would your local newspaper be interested in this?

MartyL · Feb 9, 2001

Oh, my. I can't even imagine how I would feel if a bunch of pre-scripted people were taking care of me when I am sick! I would feel as if I am not an individual and the staff INSINCERE.

It is a shame that because there are times when we forget our basic courtesy and manners that companies feel they must resort to "outputing" a prescribed, predetermined script!! AS IF nurses cannot think for themselves--so we must memorize a script (hey that's how the TV/Hollywood types do it) and use it and don't dare alter it!

If this is where healthcare run in a business philosophy is taking us, then health CARE is doomed. Lets just call it "altered health adjustment" institutions and staff are "altered health adjustors/consultants/advisors/providers" anything BUT CARE providers. Oh, wake me from this futuristic nightmare.

In my opinion, to "care" requires sincerity, honesty and indivdualization.

Mijourney · Feb 10, 2001

Hi NCRN. Ever watch Star Trek? "We are borg. You will be assimilated. Resistance is futile." I agree with other posters that using scripted communication seems ridiculous. At the same time, there are other professionals such as airline pilots, announcers, and DJs who use scripts for their greetings, and they make much more money then nurses. Phone operators, of course, give scripted messages. When I worked in insurance, we were required to use scripted greetings. We were also instructed to have a smile on our face when we answered the phone so that our tone of voice could sound helpful and receptive. I believe in making the best possible first impression as well as additional impressions with a client/patient and don't have to be prompted. It's part of my work ethic.

I have to admit, more and more, I'm working with others who don't have a good work ethic and will go into a patient's room, grab the patient's arm for a blood pressure, hang a IV bag, bring meds, or poke a thermometer in his/her mouth without so much as a "how do you do." I've been a patient and can personally testify to that.

At the same time, a nurse should be able to have autonomy in patient care without being overly restricted by hospital policy. Giving patient care is personal and individualized and should not be scripted. I wish that when consultants are hired to give advice such as scripted greetings that the staff would be able to get the real whys on changes and would be able to give feedback before something is finalized. NCRN, get your tape recorder out and start reciting your script. Get that smile on your face. Come on, you can do it. Say cheese! Kidding, sort of. Best wishes.

PS: Do you have a PA system to each patient's room that will allow you to simultaneouly give a scripted message before you walk in the room? This is nurse......... Thereafter, you can have a scripted PA message to each room telling the patient/family their approximate wait time for your entrance similar to the phone operators. I had mentioned robots in patient care in some of my posts under other topics before. I guess I shouldn't be surprised about the scripts at the bedside.

[This message has been edited by Mijourney (edited February 09, 2001).]

Trauma Columnist · Feb 10, 2001

This one was just too good to pass up. Not only do we have scripts, but we are required to carry them with us!! Now, I consider myself bright enough to make it though college and 20 odd years in the workplace, but reading off of a card is ridiculous. However, ever eager for a new experience, I read from the cards, as I wipe the pt and gosh, the card got soiled and well...you know I had to dispose of it where it belonged...in the trash!

LOPAIDNURSE · Feb 11, 2001

I'M SORRY. I HAD TO WAIT TILL I COULD STOP LAUGHING BEFORE I COULD REPLY. NOW I AM SOBER BECAUSE I CAN REMEMBER WHEN THE LARGEST HOSP IN OUR AREA HAD NURSES WEAR PAGERS THAT MEASURED THE TIME NURSES DID THEIR TASKS EVEN TIME SPENT IN THE BATHROOM! WHEN THE NURSES JUST LEFT THE PAGERS IN THE JOHN IT STOPPED. WHY ARE WE TREATED LIKE THE LOWEST CASTE IN THE HOSPITAL? DO WE NOT WARRANT ANY RESPECT? HAD TO ASK

panda_181 · Feb 11, 2001

I too am appalled at this "script" stuff. I have never heard of it up here and I hope I never do! How are we supposed to be compassionate and loving and masked with a fake smile at the same time? Doesn't make sense to me...

Amanda

SoCalGAL · Feb 11, 2001

Hey NCRN, I can't believe my eyes... scripts???? It must be nice to work in a facility that has nothing else to do with its' time!! I can't imagine being MANDATED to say the same thing to every patient! I am a strong patient/family advocate and would REFUSE to accept a scripted dialogue, how insulting Like most of us, I spend a great deal of my time building rapport with my patients and families; I don't need anybody telling me what to say! I think that it's disprespectful that management does not have the confidence in the nursing staff to communicate.... I practice in NC, can you disclose what facility that you're working for (for future reference!)? Hang in there, I support you in your filing system!

Home Health Columnist / Guide · Feb 12, 2001

RE Script:

{Goes like this: Knock on door, enter room, smile, "Hello Mr._, I am __RN, I will be your caregiver until _pm. I want to make sure your care is very good. If at any time we are not meeting your expectations, please call___." " I have time, is there anything I can do for you?" }

Why not use this to your advantage ????

Say the script then add "Our nurse patient ratio today is ____. This is # staff less than we need. I will reassess your condition and bring your meds around ___time but may be delayed due to serious changes in my other___ patients."

bestblondRN · Feb 12, 2001

Originally posted by Mijourney:
Hi NCRN. Ever watch Star Trek? "We are borg. You will be assimilated. Resistance is futile." I agree with other posters that using scripted communication seems ridiculous. At the same time, there are other professionals such as airline pilots, announcers, and DJs who use scripts for their greetings, and they make much more money then nurses. Phone operators, of course, give scripted messages. When I worked in insurance, we were required to use scripted greetings. We were also instructed to have a smile on our face when we answered the phone so that our tone of voice could sound helpful and receptive. I believe in making the best possible first impression as well as additional impressions with a client/patient and don't have to be prompted. It's part of my work ethic.

I have to admit, more and more, I'm working with others who don't have a good work ethic and will go into a patient's room, grab the patient's arm for a blood pressure, hang a IV bag, bring meds, or poke a thermometer in his/her mouth without so much as a "how do you do." I've been a patient and can personally testify to that.

At the same time, a nurse should be able to have autonomy in patient care without being overly restricted by hospital policy. Giving patient care is personal and individualized and should not be scripted. I wish that when consultants are hired to give advice such as scripted greetings that the staff would be able to get the real whys on changes and would be able to give feedback before something is finalized. NCRN, get your tape recorder out and start reciting your script. Get that smile on your face. Come on, you can do it. Say cheese! Kidding, sort of. Best wishes.

PS: Do you have a PA system to each patient's room that will allow you to simultaneouly give a scripted message before you walk in the room? This is nurse......... Thereafter, you can have a scripted PA message to each room telling the patient/family their approximate wait time for your entrance similar to the phone operators. I had mentioned robots in patient care in some of my posts under other topics before. I guess I shouldn't be surprised about the scripts at the bedside.

[This message has been edited by Mijourney (edited February 09, 2001).]

Hi Mijourney. The Star Trek reference was too good not to comment on--it's actually become the motto around our place lately! We have recently been purchased by a large healthcare corporation, with whom EVERYTHING is done according to a formula. The scripting is only a small part of it. There are formulas for dealing with every issue from patient complaints to employee disciplinary actions. It's become so corporate and "assembly line" that it takes all the fun out of communicating therapeutically with patients, not to mention taking away the challenges of thinking on your feet to solve issues creatively. I believe that there is no substitute for a genuine smile and spontaneous dialogue with patients and families to set a positive tone, and all the platitudes and scripts in the world cannot replace the warmth and caring that patients feel from someone who is being "real" with them. So, we all know where those scripts can go......

Stargazer · Feb 12, 2001

NRSKaren, to continue with your script, why not end with, "This regrettably inadequate staffing is felt, in part, to be due to administrative policies which most RN's find incredibly insulting, such as this pre-penned drivel which I am currently regurgitating. If you would like to voice your concerns about this hospital's failure to provide safe staffing levels for its patients, please call Mr. Administrator at _______, his home number."

mijourney--because I, too, am a ST geek, loved the Borg reference! "Your biological and technological distinctiveness will be added to our unit." Heee.

bbnurse · Feb 15, 2001

Scripted rounds by senior nursing management was how that hospital practiced this thing. To make matters worse, now bedside nurses have to do this?? It is ridiculous. I am asked to do this but I use my own words and start with my name and title. I use the "intent" of the verbage but rarely use the script. So far I have met the intent of the requirement, if not the actual script. I think the idea is good but it is wasted in the daily routine of caregiving. I find a way to tell my patients I want to do a good job for them, that I would like to give them everything they need and that I will keep them informed about what I CAN do and CAN NOT do for them. It seems to enlist their support and yet meet the intent of the folks who ask this of us. I understand the hostility and the hollowness of the lies. I refuse to lie. I just do the best I can do and make the "heartfelt" truth apparent in my own way. No complaints yet, but then, I have not been truly watched for 100% compliance to the script. Oh well. I still wouldn't do it that way.

**canoehead, BSN, RN** · Feb 16, 2001

I too would have to go with the tape recorder. Who knows if your pronounciation is up to snuff.

Does policy provide for different scripts to the unconcious, and the confused?

If I am admitted to your hospital I promise to call that number and complain about the lack of human response. Hey, can you post that number...we'll all call in and pretend to be patients.

Hell here's my email- let me know the number and I'll post it and deny ever hearing from you. We'll start a campaign.

[email protected]

[This message has been edited by canoehead (edited February 16, 2001).]