"undercover" patients in New Mexico

Lovermont · Sep 18, 2004

This has been done in psych hospitals. :stone

Hellllllo Nurse, BSN, RN · Sep 18, 2004

Correction:

This article is about the LTC situation in New Mexico, not AZ.

Nevertheless, great idea.

beckabeckahi · Sep 18, 2004

http://www.aarp.org/bulletin/yourhealth/Articles/a2004-08-26-undercover.html
Great idea. Undercover agents posing as nursing home patients. Wonder when the hospitals will start using undercover patients. Or... undercover nurses.

I too think this is a great idea. Very negligent not providing water at bedside, not bathing, charting in advance--stuff I know NOT to do and I'm just beginning my second semester of clinicals. I agree, you send an undercover nurse in their and you would have seen a whole lot more.

Thanks for posting the article.

begalli · Sep 18, 2004

is it really such a great idea? here's another viewpoint from the editor of rn magazine. (i had to copy and paste the entire memo instead of providing a link because you need a subscription to rn to access this online):

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a worrisome practice

what kind of care were the real patients getting while this was going on?

i was more than a little troubled the other day when i opened an e-mail from a reader in the southwest who described a "secret shopper" program that her facility had recently implemented. for the uninitiated, secret shopper programs "plant" patients in a facility to assess things like wait times, staffers' interpersonal skills, and clinical processes.

our reader had this to say:

"one of the secret shoppers recently came in to our ed. during her visit, the patient complained of chest pain, at which time the chest pain protocol was applied. the patient had ... labs drawn, urinalysis, chest x-ray, [and an] ekg.

"this patient was seen by the ed physician, a consulting cardiologist, an ed nurse, an ed tech, and the director of the ed, who came in to deal with her complaints.

"this patient pulled her arm away during the iv start, refused certain medications, demanded a phone [so] she could call long distance at her bedside ... and was verbally abusive to the staff. this patient took up an ed bed for five hours, then was transferred to the ccu where she soon signed out against medical advice.

"there have been several secret shopper patients that have visited our facility and we as a staff have strongly objected to the entire program. the nurses at our facility are very upset and would like to have our voices heard."

the nurse then asked for my thoughts on the situation. in a word, i was appalled.

a thousand questions rushed through my mind as i read her e-mail: what kind of care were the real patients getting while the secret shopper was getting all of this attention? what would have happened if a nurse had been injured during the failed iv start? who is paying for the time and materials wasted on this patient? what if the secret shopper had been injured? and most importantly, why did the facility take this particular approach to assess patient care? why not shadow a patient, pull charts, or revamp patient satisfaction surveys?

i think the nurse who wrote to me--and her colleagues--need to speak up on this issue in a loud and unified voice. they need to raise questions like the ones that immediately came to my mind. they need to raise them with their supervisors, their risk manager, and the hospital's executives. and they need to suggest alternative ways to assess patient care in their facility.

i'll keep you posted on how this story unfolds. in the meantime, i'd like to hear from you. does your facility use secret shoppers, and if so, to what extent? e-mail me and let me know.

if this is an isolated story, i'll let out a sigh of relief. if it's not, then more than just a few nurses in the southwest have something to worry about.

[email protected]

marya ostrowski, ed. marya ostrowski. editor's memo: a worrisome practice. rn aug. 1, 2004;67:9.

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doesn't sound like such a great idea to me.

RN4NICU, LPN, LVN · Sep 18, 2004

I think this "program" is a ridiculous waste of time and resources!! It takes nurses away from the real patients. Shame on those who do this!

Ooohh this makes me so mad! :angryfire

Imagine being a patient in a hospital and your nurse cannot get to you because s/he is taking care of some a-hole who is just trying to cause trouble and "spy". I do not have the time for playacting patients. Thank God this cannot be implemented in my specialty. (I don't think the babies are going to write an article about the care...but if any of them ever did, I'd hate for it to read - I was hurting and scared, but my nurse was tied up taking care of a baby that was just pretending to be sick and couldn't get to me.)

**canoehead, BSN, RN** · Sep 19, 2004

I prefer this over deciding whether someone gives quality care just based on how well they chart. The interpersonal aspect should be evaluated, and perhaps if TPTB planned on overstaffing that day, or videotaping randomly (with staff knowledge that it could happen anytime) we can get more quality to the patients instead of just the charts.

Hellllllo Nurse, BSN, RN · Sep 19, 2004

I think "undercover" pts are a good idea in LTC, but not in ER!

imenid37 · Sep 19, 2004

What kind of nut case lets someone do things like draw blood, obtain cath urines, and use the bedpan if they don't need to? It must be good amount of money that could be spent paying for real nursing care. Just another way to "blame" the nurses for poor customer service when it is the facilities which create an environment which sets the nurses up to fail by overloading them w/ high numbers of high accuity patients. I attended a lecture on pt. safety on Friday that cited a study which had determined the pt's a nurse is caring for have a 7% increase of dying if their nurse has more than 4 pt's, 14% more than 5, 21% more than 6, etc. The physician giving the lecture said if he was ill in a strange city he would choose the hospital to go to for care based on how many pt's. his nurse was caring for because it was the single most important factor influencing pt. safety. Here's an idea, how about staff nurses going undercover as administrators to make sure they are doing the job. The nurse on the med-surg units in my hospital are often put in awful situations and just basically told too bad. I work OB so we go to help, but don't take an assignment. The patients really need nurses oriented to the floor to care for them, not stand-ins. Perhaps they should pull some upper management who believe that us ob nurses should do more and that the med-surg nurses should walk on water in concrete shoes and see how much they can do. They probably couldn't pour maalox into a med cup. :angryfire

Marie_LPN, RN, LPN, RN · Sep 19, 2004

Undercover pts. are a good idea, yet i have to agree, it IS taking away from the truly sick pts.

Not to mention tying up a bed that a legitimately sick person might need.

Da Monk · Sep 19, 2004

Looks as if those institutional administrators have been fooled again into thinking healthcare practice is akin to working at Holiday Inn Express, WalMart, or Hooters.

Blackcat99 · Sep 19, 2004

I prefer this over deciding whether someone gives quality care just based on how well they chart. The interpersonal aspect should be evaluated, and perhaps if TPTB planned on overstaffing that day, or videotaping randomly (with staff knowledge that it could happen anytime) we can get more quality to the patients instead of just the charts.

Yes this is so true. I know an LTC facility which is JCAHO certified because of it's great paperwork. Nobody seems to care that the residents sometimes have to wait 30 minutes before their call lights are answered. :angryfire