Productivity and what

[suni, BSN, RN]

I suppose I should start by saying I am an older nurse. I wish I could retire but these days who can think of that so as I am now pushing 60 I need to say I am tired of hearing the work productivity. When I entered nursing over 35 years ago patients were patients, not consumers, hospitals were where you went when you were sick , too sick to stay home. Now we are a business, there were no Press Ganeys, and HIPPA was more like hippo and you went to the zoo to see it! The econonomy was not great off and on over the years and my pay reflected that nurses were really not seen as being worth that much on the pay scale. After all men were still seen as the breadwinners. Now our salary reflects that many times we are the primary breadwinner in the family.

Productivity is a word that drives me to the brink, I am not sure how much more productive they think I can be, patients are well taken care of, I make nice with visitors who are rude and many think they have a degree in medicine. I do a ton of paperwork and try to attend educational offerings when they provide staff to relief me and take over the patients.

So my idea of being productive and theirs is very different.

Thanks for listening.

[RNperdiem, RN]

You have lived long enough to see the shift in values. The days of seniority being valued are gone in most workplaces; it is all about productivity now.

[RNsRWe, ASN, RN]

Ya know, it really isn't "productivity" that is the buzzword that irritates most, I think. It's "patient satisfaction".

I have seen MANY a floor nurse be clearly less than productive, but no one cares as long as the "customer" is happy.

No, I don't think it's the pushing of productivity that's the problem. I do think that a nurse being called on the carpet because a patient deemed her less than Excellent in all categories IS a problem. Especially when we all know that in order to do the job correctly, the patient may in all likelihood be dissatisfied with something. As in, he doesn't want to stay on his low-salt 1800 cal ADA diet and demands burgers and fries--nurse refuses to allow patient to order in--BAM! She's Unsatisfactory.

[HouTx, BSN, MSN, EdD]

Productivity doesn't have a meaning by itself. It is just a term used to describe a ratio of input:output. For instance, how many cupcakes can you eat in a day? That would be your daily cupcake productivity.

In hospitals, they are usually focusing on "hours per patient day (HPPD)"... in other words, how many hours of nursing work are allotted for each patient on the unit. And it is the nurse manager's responsibility to ensure that the hours worked do not exceed the allowed HPPD. The problems with HPPD are huge. It does not usually take into account the "ins and outs" (admissions, transfers & discharges) that eat up enormous amounts of time. It assumes that everyone is equal & everyone on staff can contribute equally to the work (RN, LPN, CNA, etc.) And most importantly, it does not take into account the differences in acuity. But that is the way that nursing labor budgets are defined. Essentially, nursing staffing is being defined by the CFO - they have nothing to do with what the patient actually needs.

IF - we turned things upside down and used patient outcomes (including satisfaction) as a productivity measure, wouldn't that be fun? We may discover that it takes twice as much nursing time to produce a highly satisfied patient instead of a 'so-so' satisfied one. Would the powers-that-be change out labor budgets? It would be fun to find out. What if we defined productivity in terms of quality? How many extra hours would it take to reduce that length of stay? Speed up healing?

Food for thought