The "magnet hospital" I work in has started a new process, Because we are not busy enough. We are now doing hourly check lists on top of our legal documentation. They say it is required by the president of the hospital. So now in our ER, we have 4 to 6 pt's, usually short staffed, transport our own pt's, clean our rooms, yada ;yady yada, you know the story. Well anyway, we now have to do hourly checklists on all pts. The lists are on a clip board beside the pt's bed, they include the following : is the room clean, did you offer a warm blanket, :bowingpurdid you ask the pt is you can do anything else for them, :uhoh21:did you ask the pt their pain level, for a total of 7 things that are also as stupid. I'm not saying doing these things are stupid, I'm saying double documentation is nuts ! So now when the pt's and visitors get upset because they have to wait for 4 hours for their runny nose that they need percocet for, they can read the lists and have even more ammution to use against us. So, I think the hospital could do more for the nursing staff. I have about had it. Where does the CEO get off doing such things. No wounder things are such a mess with the obvious disconnection of upper management and the " real world". I wounder how often he get called a ****** *****or other choice words. I wounder if he has gone 12 hours for a week without a lunch or heck even to pee. I wounder when the last time his shoes were urinated into by a drunk or spat at by a pt. or called every name in the book or punched scratched all while lifting a 400 LB pt. I want to come up with a list for him. Have any ideas.:yeah: For one I would like him to call a unit every hour to make sure the nurses got to lunch, after all that is a law not a choice. I'm sure we can come up with 6 other things for him to do every hour. He must have the time if all he has to do is come up with more work for an already overloaded staff.
Yes my med/surg floor has been doing hourly rounding for the last year. It is a giant pain in the ass. I am not saying what we are asking isn't important (pain, potty, positioning) but it truly is impossible some days to ask every pt. all of those things every hour. Not when I have 4 discharges and 3 admits and oh didn't you know - my ER pt., direct admit, and ICU transfer are all to the floor at the same time!!
Yeah - days like that, it is a joke! And of course this hourly rounding was implemented by people that haven't worked the floor in years!! :smackingf
Here's the link to the study about this. Our hospital does it as well. I don't mind the rounding; it's another habit and I'm in rooms enough but it's the replacement of the forms that I find irritating. It needs to be an administrative task vs. a nursing task, IMO...
Nurses, wake up!! Wonder why we are all doing this stuff at the same time? Management doesn't think of all this nonsense on their own. For that they need a consultant. This is the Studer Group. Google Quint Studer. They are behind all this nonsense. Formerly famous for "Is there anything else you need? I have the time!" :bow:Studer and Press-Ganey will destroy the US health care system before they're done.
Don't forget to add TJC into the mix!
While I agree that the three P's are an important part of total patient care, the fact that we are required to utter cheesball catch phrase questions and then document these interventions is a HUGE insult to the education and intelligence of nurses!
Nurses, wake up!! Wonder why we are all doing this stuff at the same time? Management doesn't think of all this nonsense on their own. For that they need a consultant. This is the Studer Group. Google Quint Studer. They are behind all this nonsense. Formerly famous for "Is there anything else you need? I have the time!" :bow:Studer and Press-Ganey will destroy the US health care system before they're done.
YES !!!!!!! I agree, they are the source of so much cost to hospitals. All they do is cause havoc. An already overloaded system that takes on more and more to the point that care becomes worse instead of better. I think it is the " emperors new clothes syndrome". The consultant says it's a good idea so the hospital admin thinks , well, I'm paying them so much money they have to be right, even though it doesn't make sense. :bowingpur It's always amazing to me that these admin with all of their fancy degrees really have no idea. It reminds me of the coporate world and government ....... the middle class has been drowning for years but they seem to have had no idea until things crashed. It's the same with bedside nurses. We are yelling from the bottom of the pile, telling anyone that will listen that things are a mess...... my fear is that it is another system that will need to crash before the idiots at the top stop and say....... wait it's not working....... why didn't anyone tell us !
but i dont get it...how in the world is that going to make you a busier hospital????
-H-RN
I think the "we are not busy enough" was sarcastic....
Anyways, this is one of those things that even your facilities management has little say in. Your corporate HQ is likely being fed the koolaid by the aforementioned press-ganey/studer medical consultancy flavor of the week. They have been told that staff will be resistant to it, that it is to be expected, and that the resistance is an indicator of non compliance. Just do it. Do it well, and do it often. That is all management wants to see, I am sure.
I think this was being started about two and a half years ago when I left the hospital. It was just one more piece of paper the nurses and STNA's had to sign. I don't think it was really being done, just the paper being signed. Last time I worked the floor I didn't see anyone doing it. Probably just another fad that will soon disappear when something else comes along. Gives management the ability to spend money and go to free lunches anyway, right? I sure wish they would put the money into hiring proper staff and then the rounds would be made because you would have the time. *sigh* But, I guess that would be, I don't know, COMMON SENSE!
We have the hourly rounding also. We only do it for high fall risk pts and supposedly they said our falls have reduced since the implementation.
What a laugh. More than 50% of the nurses refuse to do it too. I fill them out but I think I might follow everyone else. This past weekend was a perfect example of why we are unable to do so.
We had 4 pts calling out. HELP! or NURSE!. All confused. One climbing out and another Trach pt on the call bell every 10min. The Trach pt ended up with FSBS of 49 and could not get the D50 in thru the picc.(and could not get another iv in) So one nurse spoon feeds him to get his sugar up because his arms/legs felt numb. At the same time a pt falls. And we deal with that. Keep in mind we had 3 nurses with 18 pts and no tech. But the red sheets are supposes to help. ?!?!?!?. Unless those hourly rounding sheets can talk to the pts and clean them up when necessary, they are a waste.
It seems over the years more and more junk keeps getting added to nursing without any relief of patient load. The legal system and competition among hospitals is helping drive the "nursing shortage."
Nurses, wake up!! Wonder why we are all doing this stuff at the same time? Management doesn't think of all this nonsense on their own. For that they need a consultant. This is the Studer Group. Google Quint Studer. They are behind all this nonsense. Formerly famous for "Is there anything else you need? I have the time!" :bow:Studer and Press-Ganey will destroy the US health care system before they're done.
"Consulting - If you're not part of the solution, there's good money to be made in prolonging the problem."
Specializes in NICU, PICU, PCVICU and peds oncology.
I work in an ICU where we still do paper charting. We have a four page Z-fold flow sheet on which we document our hourly vital signs (including LOC, colour and pacemaker settings), I&O and ventilator settings. Now we've added a fifth page, stapled on to the back, that has hourly boxes for positioning; eye, oral and pericare; restraints; oximeter probe repositioning; saline locking of PIVs; HOB elevation; ventilator circuit position; circuit condensation draining; suctioning ETT, oral and nasal and a sig block. Plus we have a separate form for neurovitals and yet another for neurovascular; epidurals and PCA are also separate documents. We have MARs for routine meds, PRNs and STATs and infusions. Then there's the microbiology flow sheet that we're to fill in when we do cultures and receiver results so that the doc doesn't have to look in the chart for the results; the CQI goal sheet, the wound assessment form and the safe patient transfer form. To all of this we also throw in minimum q2h narrative charting. I spend more time charting than anything else. Thank God (and Brian) for the stash of allnurses.com pens I carry around.
is the room clean, did you offer a warm blanket, :bowingpurdid you ask the pt is you can do anything else for them, :uhoh21:did you ask the pt their pain level,
for a total of 7 things that are also as stupid. I'm not saying doing these things are stupid, I'm saying double documentation is nuts ! So now when the pt's and visitors get upset because they have to wait for 4 hours for their runny nose that they need percocet for, they can read the lists and have even more ammution to use against us. So, I think the hospital could do more for the nursing staff. I have about had it. Where does the CEO get off doing such things. 
No wounder things are such a mess with the obvious disconnection of upper management and the " real world". I wounder how often he get called a ****** *****or other choice words. I wounder if he has gone 12 hours for a week without a lunch or heck even to pee. I wounder when the last time his shoes were urinated into by a drunk or spat at by a pt. or called every name in the book or punched scratched all while lifting a 400 LB pt. I want to come up with a list for him. Have any ideas.
:yeah: For one I would like him to call a unit every hour to make sure the nurses got to lunch, after all that is a law not a choice. I'm sure we can come up with 6 other things for him to do every hour. He must have the time if all he has to do is come up with more work for an already overloaded staff.
KacyLynnRN
303 Posts
Yes my med/surg floor has been doing hourly rounding for the last year. It is a giant pain in the ass. I am not saying what we are asking isn't important (pain, potty, positioning) but it truly is impossible some days to ask every pt. all of those things every hour. Not when I have 4 discharges and 3 admits and oh didn't you know - my ER pt., direct admit, and ICU transfer are all to the floor at the same time!!
Yeah - days like that, it is a joke! And of course this hourly rounding was implemented by people that haven't worked the floor in years!! :smackingf