I often read in the nursing press and here on AN about how nurses are professionals (usually seems to be nurses telling each other this, as if to convince themselves). I don't feel like one. Never have. One thing always made the idea of nurses as professionals seem unlikely to me - punching a time clock. Something has recently convinced me that beyond all doubt we are NOT professionals. Recently a hospital where I work casual (not my full time gig) has instituted hourly rounding. That's fine with me since as a critical care nurse I usually spent most all my time in patient rooms anyway. What really got me is that when we do our hourly rounding we are supposed to say certain things. These things are provided to us on little cards with quotation marks around them. Our instructions are to repeat them exactly as as they are written every time we are in a patients room. An example of what we are supposed to say:
"I see your ______ (nurse, CNA, therapists, doctor etc) is ________ , he / she is excellent"
Now come on, can anyone else tell me of any other "professionals" who are ordered what exact words they are to say to their clients / patients / customers? We are not talking about communication skills training here, witch might be appropriate. I asked around and the physicians and PAs where not provided with quotes of the exact words to say to their patients at each interaction.
I told the nurse manager that I wasn't going to do it, that my patients deserved better than canned-ordered-from-on-high insincere statements. We will see what happens.
Specializes in Vents, Telemetry, Home Care, Home infusion.
Is there anything I can do for you? I have the time
I usually used that phrase when working in the hospital OR would round and tell patients why I would be tied up: Patient critically ill, wound care that took 30 min -45 min. Patients really appreciated knowing why they would not see me for awhile. My call lights were less than other side hall who did not give patients such courtesy. Simple thing that cost no money...an brought patient satisfaction. Continued to use that phrase with homecare patients and now with office staff I interact with... along with trying to have a smile in my voice --succeed about 98%.
Phrase it in a way that suits you so it doesn't appear canned. You might be surprised that patients appreciate the care and consistency....especially when you've been on the other side of the bed rails.
I usually used that phrase when working in the hospital OR would round and tell patients why I would be tied up: Patient critically ill, wound care that took 30 min -45 min. Patients really appreciated knowing why they would not see me for awhile. My call lights were less than other side hall who did not give patients such courtesy. Simple thing that cost no money...an brought patient satisfaction. Continued to use that phrase with homecare patients and now with office staff I interact with... along with trying to have a smile in my voice --succeed about 98%.
Phrase it in a way that suits you so it doesn't appear canned. You might be surprised that patients appreciate the care and consistency....especially when you've been on the other side of the bed rails.
I agree with you that it's appropriate and effective to have a "message" that is consistent between staff members, but it's silly, unless you are dealing with a Pt population that is entirely nitwits, to have robot-speak. They're going to immediately notice the phoniness of canned text.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
I usually used that phrase when working in the hospital OR would round and tell patients why I would be tied up: Patient critically ill, wound care that took 30 min -45 min. Patients really appreciated knowing why they would not see me for awhile. My call lights were less than other side hall who did not give patients such courtesy. Simple thing that cost no money...an brought patient satisfaction. Continued to use that phrase with homecare patients and now with office staff I interact with... along with trying to have a smile in my voice --succeed about 98%.
Phrase it in a way that suits you so it doesn't appear canned. You might be surprised that patients appreciate the care and consistency....especially when you've been on the other side of the bed rails.
You could use that phrase or another, similar one because it reflects a reality that can be seen & understood. You were going to be tied up with something, so you did the courteous thing, as well as what worked for you with time management, ie people knew you weren't going to be available, so they hopefully didn't interrupt you. A script would have been superfluous, because it described a behavior you were already engaged in.
If you give someone the card, and they don't know why they're saying it (ie leadership strategy you referenced), I think it's worse than nothing! If someone is forced to say, "I see so-and-so is your tech, or whatever, she/he is excellent" and they don't mean it, a normal person is going to pick up on that tension. It would be great to have people verbalize more freely when they do notice/appreciate another's excellence. Sorta doesn't mean as much if everybody is "excellent". Personally, I get a great deal of joy when I can share with my patients my genuine feelings about a better than average co-worker, or even tell that person, "you really do such a great job, I wanted to let you know how much I appreciate it". That blesses the giver and receiver, because it's rooted in truth.
I know I haven't taken a zillion Leadership and Management Strategies seminars, read the groundbreaking new theories by academics, and I don't disparage those who are immersed in that and find it so amazing. However, I do find an undercurrent of snobbery (not you!!:wink2:) directed at those who balk at/fail to understand the theory. Perhaps I am a simpleton, but most of the theories can be boiled down to age-old strategies without the fancy names.
PS I work in homecare too, so if we cross paths, and you say, _______ is excellent, I will say, 'ah-haaah, Quint Studer!" :chuckle
I tell my patients I have the time when I have the time. I don't tell them I have the time to go "freshen their water" or help them change their socks when my other patient is crashing or I'm an hour behind on meds. I want them to know if they need something, now's the time to ask when I do have time.
We don't punch in/out. I do think that helps us feel like we're treated more like a professional.
Funny thing is, in nursing school we were taught the whole "so and so is EXCELLENT" bit is UNtherapeutic communication, undermining the patients concerns.
I have met too many patients, and family members, who know (or think, same thing) that their nurse or doctor is FAR from excellent. I can not tell a boldfaced lie. Nor do I insist on treating people as though they are completely stupid. When I have demanding or needy patients, I use scheduling techniques to make them feel like they can trust me to help them. "I just wanted to stop in and see how you are, I just got here" as I do a quick VS and assessment. "I will go see my other patients now, be back in about an hour, you gonna be ok till then? Anything you need first?" Then during med pass, similar question, not EXACTLY the same... If anything is needed that requires me to step out of the room- say to look something up, or find something, or go get the item requested, I tell 'em that "I will be right back with that" and that is the ONLY time I use that phrase, if it's really going to be right then.
Patients can tell if you're being condescending, sarcastic, or if you're not trustworthy. They really dislike all of those things. I will not do scripting, and I feel sorry for the people who deal with me as a customer, when they have to use scripting on me. I know they'd rather talk like a normal human, but they want a paycheck. If I were sick and my nurse did that silly crap, it would not make me feel sorry for him or her; it would annoy the snot out of me. If there is ever a time when a human needs other people to be real and sincere with them, it is when they are sick.
My hospital started the scripting a couple of years ago,....didn't go over real well.........I'm waiting for the big button I have to wear that says "If I don't offer you a warm blanket, please call 1-800....and you'll recieve two free tylenol on your next visit"!
I am taken aback every single time I read about you guys clocking on/off, being monitored and having scripts. How on earth can you feel like a professional, autonomous, or an equal part of the team...
nurses may act in a professional manner, nursing is NOT one of the "professions".....lacking in the independence required.
I can think of many professions that aren't associated with a lot of independence. Teaching, for example. Even college professors have to submit a detailed syllabus and answer to a board. Typically, whether you're an attorney or an engineer, you begin your career by taking orders and fitting into a fairly structured hierarchy. Some, through experience and/or further education, rise within that hierarchy and gain more freedom. But there will be others who, in effect, become experts at what might be seen as a basic level and are happy to do it.
One "down and dirty" method of deciding if something is a profession is asking whether you can get a master's degree in it. I'm sure there are a few loopy exceptions, but I'm thinking this is as good a way as any to make that determination.
What is your definition of a profession/professional?
I am taken aback every single time I read about you guys clocking on/off, being monitored and having scripts. How on earth can you feel like a professional, autonomous, or an equal part of the team...
we CAN"T. it's TERRIBLE! but don't worry....my goal is to provide very good care. i have been a nurse for 9 years and i have time. if my goal was to provide excellent care, i'd go for that, but unfortunately, surveys indicate that patients don't respond as well to "excellent" as they do to "very good." i could be excellent, but it's not in my lines......
Specializes in PICU, NICU, L&D, Public Health, Hospice.
I would define a professional as a person who is an "expert" in their field. That would explain why we can have professionals in sports, professionals in learned careers, and professionals in your local fast food restaurant. I think that what is troubling for most nurses is that we are not treated the way that we imagine that professionals should be treated. In fact, nurses are sometimes just treated down right badly.
On the point of scripting. I do understand the concept of "scripting" especially as it applies to customer surveys. If the survey asks a question using language that the client is unsure of they will often not respond in as favorable manner as preferred. Encouraging your staff to actually USE THAT WORD IN A SENTENCE during the visits will improve the scores on that survey item. Providing pertinent examples of how that might work can be helpful to the professional who may already have their own "script" that gets them into and out of rooms/visits in a timely fashion. The success of this approach can be a very effective way to improve specific areas on a customer survey.
There are valid concerns voiced about lying. There are valid concerns about completely invalidating a patient or family's right to have a low opinion about a care provider. These concerns can actually be supported by evidence and should be taken back to admin with alternative suggestions. It IS EASY to find out who is taking care of your patient and make a statement of excellence about one of them without lying or suggesting that the patient is wrong in their assessment of the person. I think that we can demonstrate our professionalism by taking this sort of direction from an employer and "making it our own"...afterall, our sincere desire to reassure patients and make them feel comfortable with their care naturally leads us to say something marvelous about some member of the team who is caring for that patient. Bingo, we have made our boss happy, we have improved the patient's perception of the staff and positively impacted his experience (little things do matter), and we have done so with a smile on our faces because we are professionals.
I think we all bristle at the idea of being told what we must do. I don't like it when my employer gives me a script for my voice mail, but I understand the potential ramifications of not scripting that. Does anyone remember back in the day when they didn't even script the way the phones were answered in a hospital unit? I would suggest that having a script for that function improved customer satisfaction as it provided stability when some professional other than the unit clerk answered the phones in the ICU or where ever.
NRSKarenRN, BSN, RN
10 Articles; 19,199 Posts
I usually used that phrase when working in the hospital OR would round and tell patients why I would be tied up: Patient critically ill, wound care that took 30 min -45 min. Patients really appreciated knowing why they would not see me for awhile. My call lights were less than other side hall who did not give patients such courtesy. Simple thing that cost no money...an brought patient satisfaction. Continued to use that phrase with homecare patients and now with office staff I interact with... along with trying to have a smile in my voice --succeed about 98%.
Phrase it in a way that suits you so it doesn't appear canned. You might be surprised that patients appreciate the care and consistency....especially when you've been on the other side of the bed rails.