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.
When I was in computers, we had a phrase for crap like this: "Oh, god, someone let the CEO out of his cage long enough to read a management magazine...."
Just like you've got Baxter and Smith-Kline and all the others marketing medical "stuff" and meds, you've got folks who make their living marketing management "stuff." I'm talking about things like "Total Quality Management" and "Quality Circles" and "One Minute Manager" and the like. Our big one right now is "relationship based care" -- gag.
Management phases are like dizzy spells. Just keep your head down, your mouth shut, and it'll pass. Of course, then it will be something else equally inane and completely out of touch with reality....
Ever gone car shopping? Noticed that every salesman goes through the same stupid routine no matter where you go? How much do you like it?
As a customer I have always found scripted dialogue to be an insult to me. As a patient, I would probably get out of bed and leave if somebody started this BS. Scripted dialogue is an insult to the intelligence of the patient.
I always try to vary my comments but still convey the same meaning. If the patient needs something else, I let them know I will take care of it. If I'm going to be tied up a while, I let them know. Same thing goes for the families.
In other words, nurses should talk TO patients. Scripting equals talking AT them.
Specializes in Community Health, Med-Surg, Home Health.
I hate sounding like a "Stepford Wife" who is so hypnotized that I may go drink the kool aide of Jim Jones. Scripted conversations sound too cultish to me...sorry. I gotta gag.
My hope is that nures will rebel -- and just say "NO" whenever possible.
Right on.
My hospital does not do this (at least not my unit, but I've never heard of it in the other units). But if it tried, I would refuse. Just for fun, before I did, I would ask to see the scripts required of medical staff, mid-levels, PT/ST, and the PharmDs. Simply for comparison, of course.
...yeah, I generally find "doc envy" unpleasant, but I have found it a good strategy to compare my position to that of those with more power, and ask "why do they get that, and I don't?" The answer sometime makes sense, and is generally non-negotiable regardless, but I like making the PTB come up with an answer, nonetheless.
I refuse to use scripting. I do my hourly rounds, and before I leave the room, I ask the patient if there is anything else I can get/do before I leave, but I have always done that, even before hourly rounding was instituted. I will NOT say "I have the time". First of all, I do NOT have the time. I choose to MAKE the time, at the expense of something else, because I want my patients to feel well cared for. Plus, I may not be able to make the time if the poop is hitting the fan. You may just have to wait for fresh ice water until the CNA rounds. Second, I make an effort to connect with my patients in a real, meaningful way. Using a script feels phony to me.
Does the card have scripted replies for your pts response to this? What if your pt says, "No he's not excellent, he's an *******!"
OMG OMG OMG - LOL LOL!!! This is EXACTLY what I was thinking when I read the OP!!!
:yeah::smokin::chuckle:chuckle:
My pts with brain mets have actually SAID this sort of stuff to me - sometimes you have to step out of the room and laugh because you're thinking, well, yes, he is an *$$40^3...
And you want to give the pt one more point on the A&O scale for knowing that!
They started some safety campaign at my hospital and gave us script cards - oh no, not a chance I'm doing that. I do it anyway, so telling me what to say just ain't going to happen...
When I was in computers, we had a phrase for crap like this: "Oh, god, someone let the CEO out of his cage long enough to read a management magazine...."
Just like you've got Baxter and Smith-Kline and all the others marketing medical "stuff" and meds, you've got folks who make their living marketing management "stuff." I'm talking about things like "Total Quality Management" and "Quality Circles" and "One Minute Manager" and the like. Our big one right now is "relationship based care" -- gag.
Management phases are like dizzy spells. Just keep your head down, your mouth shut, and it'll pass. Of course, then it will be something else equally inane and completely out of touch with reality....
OMG!!! ROFLOL! "Someone let the CEO out of his cage to read a management magazine!!!" I gotta write that one down! thanks, I needed that
You know, nothing gets me hotter than a script..I had to deal with the phone company the other day. The person answering my call couldn't think off the script...I don't need your phony apologies, I don't need your pretended platitudes, I need someone who can help me!!!! I got to the point that I asked this person to hand me off to someone else who could actually think, didn't need a script to guide them to help me deal with my issues. I hate scripting and I totally refuse to do it at work. This garbage has no place in nursing, no matter what a stupid management consultant may say.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Another thing I was wondering is how it is going to look to family members where I to actually read from my script card to my intubated, heavily sedated patient with the ICP bolt sticking out of their head. You know the one's that don't even respond to noxious stimuli. Or even better what about my patients who have been declared brain dead and we are waiting for the organ donation people to find a match for the organs. Gonna look pretty stupid reading from a script card and asking question of a person who is officially brain dead.
We don't script and I never would even if they implemented it. Different patients need to be handled in different ways. They are patients not robots and to treat them as such is insulting and idiotic.
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:yeah:
:smokin::chuckle:chuckle:
nerdtonurse?, BSN, RN
1 Article; 2,043 Posts
When I was in computers, we had a phrase for crap like this: "Oh, god, someone let the CEO out of his cage long enough to read a management magazine...."
Just like you've got Baxter and Smith-Kline and all the others marketing medical "stuff" and meds, you've got folks who make their living marketing management "stuff." I'm talking about things like "Total Quality Management" and "Quality Circles" and "One Minute Manager" and the like. Our big one right now is "relationship based care" -- gag.
Management phases are like dizzy spells. Just keep your head down, your mouth shut, and it'll pass. Of course, then it will be something else equally inane and completely out of touch with reality....