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.
Once again, sounds like the advice of some over-priced consultant which is readily adopted by managers who again and again and again persist in trying to micromanage the practice of nursing.
I refuse to do scripting, when it is clearly a lie...because I do not lie to my patients.
Invariably the places that require 'scripting are the ones where it does become a lie.
As in the facilities that routinely under staff or have the MDs, that are shall we say less personable/optimal, are the ones that are more likely to require this scripting.
Now if they staffed adequately or "trained" their MDs, nurses would not have prop up MDs egos/reputations and would have "the time".
And when the facility fails to do these things and then expects me to lie for them......no dice.
To me the "is nursing a profession?" debate is about semantics and tradition,
I just graduated from NS a week ago..and based on the myriad of nurses I worked with in clinicals, I think some nurses are professional and some are not. The ones that were professional were smart, competent, appropriate in dress language and behavior, knew what they were doing and why, and gave the impression they value and take pride in themselves, their career, and nursing in general. All I know is I want to be one of those professional nurses! :heartbeat So you're saying you don't think that exists/is attainable? To me I think it's a choice and takes counscious effort..
Its scripting and lots of places do it. I personally feel it has no place in nursing since as a patient I would want to be looked at individually and thus not spoken to like every single other patient. However its a buzz word in workplaces everywhere and its probably here to stay as a rule to go by but not follow completely.
And I feel nursing is a profession, and therefore I'm a professional nurse. I can't help it if you have such a low opinion of your skill set.
Like others here, I hate the idea of strict scripting -- though I can see the value in offering suggestions to staff members of things to say in certain situations. It is often helpful to have some "handy phrases" available to use. Not everyone is good at small talk and some people need a little coaching on establishing and maintaining a positive atmosphere and relationship. However, the STRICT use of scripting is ridiculous.
My hope is that nures will rebel -- and just say "NO" whenever possible. The least we can do is to speak loudly and clearly on any employee satisfaction surveys we are given ... speak up whenever we have the chance to discuss our work environments, etc. A lot of hospitals who rely heavily on patient satisfaction surveys (which often lead to scripting) also do periodic employee surveys. Be sure to give them appropriate feedback related to scripting. We can also write letters to the editors of any journal that publishes articles supporting scripting ... or any articles that discuss work environments, professionalism, patient satisfaction, etc. Newspapers doing stories about the "nursing shortage" and/or health careers, etc. They should all be hearing about the evils of scripting.
We need to get our viewpoint out there -- visible for all to see.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
a couple of observations:
first, aren't patients going to figure out how canned this is if everyone is saying the exact same thing? rather than earning credibility, that would undermine it in my eyes.
second, what if so-and-so doc or therapist or whatever is okay or even pretty good but not excellent? are you supposed to lie?
and worse, what if dr. so-and-so is an outright butcher, the respiratory therapist is so lazy he won't get out of his chair in front of the tv in the empty room to bag at a code and the cna is ted bundy on crack?
Yeah, and is there liability when you lie and say "Dr. Slaughterer" is excellent and he butchers the poor patient? Will they come back and sue because you were forced into lying? I'm sure some lawyer will come up with it somewhere.
"My client was told by his nurse that the surgeon was excellent, and based on that advice took it to heart and went ahead with the surgery."
It's interesting that these hospitals that "script" do not think very highly of their own staff. About the excellent message, it is not opening up communication with the pt but it also can be a trust barrier between the nurse and the pt. If the person spoken about is not "excellent," the patient may come to mistrust the person delivering this message and their ability to discriminate excellent from Good, God, I wouldn't have that person take care of my stuffed animal! Another point is that so many hospitals come to count on these satisfaction surveys but in the nurse satisfaction survey, no action may be taken to better the work environment.
Cue cards for nurses? Hmmm, one could have all kinds of fun with that...
What I would do is make a point of holding the card up, and reading from it very slowly and deliberately, like a real bad audition. Then show the card to the family and let them know that this is what they are forcing you to do. Maybe tell them you almost feel like asking if they "want fries with that"...
my hospital has some scripting.. but i just say what i want.. lol... they can hand me all the cards they want .. but i have been a nurse a long time and i don't need help with what to say to my patients..... nurses are professionals, we are college educated , we have degrees, and we are professional.
interleukin
382 Posts
Once again, sounds like the advice of some over-priced consultant which is readily adopted by managers who again and again and again persist in trying to micromanage the practice of nursing.
Nursing cannot be micromanaged!!!!