:angryfire Need to rant a minute ... then would appreciate your suggestions...
Our most esteemed powers that be have said that for each patient we bring to a bed...we need to ask them "what is the one thing that I can do for you that will assure that I am giving you very good care?"
WHAT??? I understand in the in-patient setting that the "little things" matter, as they do in the ER, and I'm all about warm blankets and coffee for visitors (or whatever) ... when I have time. But by asking the question, aren't we setting the expectations higher, and then when I can't "get me out of here in 1 hour or less" or "get rid of my pain" or "keep me fed (belly pain)" ... I totally have no chance of meeting their expectaion! Besides ... I really thought ER was to take care of the presenting problem ... and say GoodBye!
Truly, I treat my patients extremely kindly, I keep them informed, work my tail off ... but am I crazy to feel like this is setting up a disaster?
Here's the thing... if you know you try to attend to the little things with your patients, only ask these scripted, impersonal questions when the "powers taht be" are around. ask your own way, take care of whatever you can, and focusing on ONE thing is not going to make the patient happy anyways, just try ( when you ahve SPARE(haha) time) to talk to your patints, same as you already know. press ganey is not appropriate for hospitals in my opinion, because it ignores outcomes and weighs questions sot hat EVERYTHING negative is the fault of the nurse but everything positive is the result of good physician care. just my personal bias on press ganey, and of course there is merit to the attempt to make your patients more comfortable, as patients frequently choose where they seek care.
Yes! We are supposed to say the same stupid line: Is there anything I can get for you? I HAVE TIME. I think we're all using the same consultant!
What I hate more than anything else (and so I just don't do it...) is that we have these little business cards with our name on it, we're supposed to hand them to the patient as we put then in their room, so they know who their nurse is. Somehow that makes me feel like a waitress! I tell them my name, of course, but these cards...something way too hokey about it!
VS
i would only agree to hand out the cards if the docs had to as well.
otherwise i would say i've been advised not to practice that by counsel.
Specializes in Vents, Telemetry, Home Care, Home infusion.
I used scripting in late 79 thru 80's while on telemetry /resp unit before it came into vogue after idea from our RN educator. My side hall rarely had call lights on. Often warned pts if complicated wd care or patient circling the drain and I'd be busy for xyz minutes. Others wanted to know my "secret"...did let them in.
Give this scripting business a chance...still works for me now in homecare when "I've got the time, is there anything else I can help you with?" or "I've got the time, is there another referral/problem discharge I can help you with" is used..... 20 % time get second referral
Reminds me of the 'ask me if I washed my hands' stupidity.
You aren't hiring a high school drop-out that needs their hand held. You are hiring a highly trained beside monitor and intervening professional.
Professionals do not need your (TPTB's) hand-holding sanctimonious condescension.
Some admins think of nursing as their greatest assets. Some as their greatest liabilities. This 'scripting' garbage is a hallmark of a management team that thinks of nursing as overpaid prima donnas that need to be 'put in their place'. Ummmm, I don't think so.
Reminds me of the 'ask me if I washed my hands' stupidity.
You aren't hiring a high school drop-out that needs their hand held. You are hiring a highly trained beside monitor and intervening professional.
Professionals do not need your (TPTB's) hand-holding sanctimonious condescension.
Some admins think of nursing as their greatest assets. Some as their greatest liabilities. This 'scripting' garbage is a hallmark of a management team that thinks of nursing as overpaid prima donnas that need to be 'put in their place'. Ummmm, I don't think so.
I would refuse. I've quit jobs over less.
~faith,
Timothy.
Now hang on a second...Not all scripting is a ploy by management to justify their positions. And not all of it is belittling or anti-autonomous.
Patient satisfaction surveys are here to stay whether we like them or not. Many of these surveys ask patients about specific items such as "safety", "patient education", and "discharge planning".
And let's face it...most of our patients don't realize that discharge planning begins on admission and that nurses spend time every single day providing education to them. And how many patients, when asked after-the-fact by an anonymous phone surveyor, realize that scanning their armband, raising their siderails, and asking their name & birthday repeatedly were for their safety? How many realize that they received patient education throughout their stay and not just in the 15 minutes before they were escorted out the door?
Maybe not word-for-word scripting, but certainly "key words at key times" (anyone heard that phrase at work? ), in these situations can be beneficial in the long run.
And for the record Timothy...I totally agree with your opinion of the "ask me if I've washed my hands".
Now hang on a second...Not all scripting is a ploy by management to justify their positions. And not all of it is belittling or anti-autonomous.
Patient satisfaction surveys are here to stay whether we like them or not. Many of these surveys ask patients about specific items such as "safety", "patient education", and "discharge planning".
And let's face it...most of our patients don't realize that discharge planning begins on admission and that nurses spend time every single day providing education to them. And how many patients, when asked after-the-fact by an anonymous phone surveyor, realize that scanning their armband, raising their siderails, and asking their name & birthday repeatedly were for their safety? How many realize that they received patient education throughout their stay and not just in the 15 minutes before they were escorted out the door?
Maybe not word-for-word scripting, but certainly "key words at key times" (anyone heard that phrase at work? ), in these situations can be beneficial in the long run.
And for the record Timothy...I totally agree with your opinion of the "ask me if I've washed my hands".
:balloons:
I could understand the concept of wanting to ensure that key concepts are conveyed.
But: you're too stupid to do that unless we tell you EXACTLY what to say. Nope, I have a problem there.
I use the concepts of scripting, but won't use the preplanned scripts given by management. Some of it actually does make my life easier. People get offended if you leave the room to do something else while they're on the bedpan. But using the magical words of, "I'll give you some PRIVACY, ring the call light when you're finished," and they think you're thoughtful and remember you gave PRIVACY on P-G. I also have started my own little script of, "Ok, we've got water, some extra pillows, extra blankets because it tends to get cold at night,...., is there anything else I can get for you right now? Well, ok, my name is wooh, and I'll be here until morning, let me know if there's anything else I can get for you." That way they're reminded what they DO HAVE (instead of focusing on what they don't), given a chance to ask for more, and they think they're getting something special. And I've reminded them of my name along with all the nice things they have. So they think of me as nice and giving. When really, I just don't want them bugging me for the next hour. We were getting dinged on "given information about the facility" on our P-G, so I've started saying when I hand them what used to be "a handout about the hospital," that I'm giving them "information about our facility."
Yes, P-G is stupid. And scripting to get higher marks on it is like "teaching the test" for standardized testing in schools. But it keeps management off my behind. I won't use the phrase, "I've got the time" though unless I really mean it. I'll script, but I refuse to lie!!
I use the concepts of scripting, but won't use the preplanned scripts given by management. Some of it actually does make my life easier. People get offended if you leave the room to do something else while they're on the bedpan. But using the magical words of, "I'll give you some PRIVACY, ring the call light when you're finished," and they think you're thoughtful and remember you gave PRIVACY on P-G. I also have started my own little script of, "Ok, we've got water, some extra pillows, extra blankets because it tends to get cold at night,...., is there anything else I can get for you right now? Well, ok, my name is wooh, and I'll be here until morning, let me know if there's anything else I can get for you." That way they're reminded what they DO HAVE (instead of focusing on what they don't), given a chance to ask for more, and they think they're getting something special. And I've reminded them of my name along with all the nice things they have. So they think of me as nice and giving. When really, I just don't want them bugging me for the next hour. We were getting dinged on "given information about the facility" on our P-G, so I've started saying when I hand them what used to be "a handout about the hospital," that I'm giving them "information about our facility."
Yes, P-G is stupid. And scripting to get higher marks on it is like "teaching the test" for standardized testing in schools. But it keeps management off my behind. I won't use the phrase, "I've got the time" though unless I really mean it. I'll script, but I refuse to lie!!
I've been a nurse for 13 yrs. I have some idea of what works for me and not. So, I 'script' my own little phrases and explanations that have worked for me in the past. But there is a difference between me remembering what works for ME and being told by how to talk.
I think it IS belittling to think that I can't relate to my patients without some consultant 'testing' that content in some focus group. Besides, it's pointless to try to put us all in the same cart. Non-verbals from tone, facial expression, dress, etc etc tells at least as much of the story as some stupid script.
And making your staff annoyed by belittling them w/ a 'script' is almost certain to shine through the non-verbals.
Look, at the moment my employer doesn't trust me to deal with their pts, they should really find somebody else. Because, I assure you, there are so many more things about that nurse-pt relationship that if TPTB don't trust the communication process, they are just fooling themselves. That's like the airline maintenance crew only checking that the seatback tables are in an 'upright and locked' position.
Don't be surprised when this pilot is annoyed by the level of assistance provided by that maintenance crew. . .
And the 'I have the time' comment. Ha. Instead of realizing what their focus groups are telling them and adjusting for it, they'd rather just 'script' a lie to cover it.
And the 'I have the time' comment. Ha. Instead of realizing what their focus groups are telling them and adjusting for it, they'd rather just 'script' a lie to cover it.
We weren't just given scripts... we all had to attend classes on how to use the scripts, ie., "Don't stand at the door when you ask if there's anything else you can do", etc. (Lucky me, this came about when I was moving from my secretary job to my RN job, so I was able to take the class 3 whole times!!)
Ha. I don't think it's made a difference- I cannot think of anyone who's actually used the script.
I've been a nurse for 13 yrs. I have some idea of what works for me and not. So, I 'script' my own little phrases and explanations that have worked for me in the past. But there is a difference between me remembering what works for ME and being told by how to talk.
I think it IS belittling to think that I can't relate to my patients without some consultant 'testing' that content in some focus group. Besides, it's pointless to try to put us all in the same cart. Non-verbals from tone, facial expression, dress, etc etc tells at least as much of the story as some stupid script.
And making your staff annoyed by belittling them w/ a 'script' is almost certain to shine through the non-verbals.
Look, at the moment my employer doesn't trust me to deal with their pts, they should really find somebody else. Because, I assure you, there are so many more things about that nurse-pt relationship that if TPTB don't trust the communication process, they are just fooling themselves. That's like the airline maintenance crew only checking that the seatback tables are in an 'upright and locked' position.
Don't be surprised when this pilot is annoyed by the level of assistance provided by that maintenance crew. . .
And the 'I have the time' comment. Ha. Instead of realizing what their focus groups are telling them and adjusting for it, they'd rather just 'script' a lie to cover it.
~faith,
Timothy.
I see your points and I agree with much of what you've said. Like you, I have a good idea of what does & doesn't work for me when relating to patients. I like to think I've become pretty good at it in the last 12 years.
But...not all nurses (come on, we've all worked with them) are as aware of their words & nonverbal cues. Not all are as cognizant of how they come across to the patients. Unfortunately not all give a flyin' flip!
I really enjoy reading your posts throughout the forums. Thanks for the conversation!
bekah79il
17 Posts
Here's the thing... if you know you try to attend to the little things with your patients, only ask these scripted, impersonal questions when the "powers taht be" are around. ask your own way, take care of whatever you can, and focusing on ONE thing is not going to make the patient happy anyways, just try ( when you ahve SPARE(haha) time) to talk to your patints, same as you already know. press ganey is not appropriate for hospitals in my opinion, because it ignores outcomes and weighs questions sot hat EVERYTHING negative is the fault of the nurse but everything positive is the result of good physician care. just my personal bias on press ganey, and of course there is merit to the attempt to make your patients more comfortable, as patients frequently choose where they seek care.