Relationship based care/Playing the game

Nurses General Nursing

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My hospital is trying to obtain magnate status. They have hired the Studor Group as a consultant. At the same time another consultant is teaching us relationship based care. Some of the things they have us doing are wonderful, but the projects as a whole leave us with odd feelings. It feels like a game we are being forced to play. They are trying to improve patient satisfactions scores by scripting everything that we do. It all feels very fake. To increase patient satisfaction scores, patients must give us an "Excellent" rating. If they use any other word except "Excellent" our satisfaction scores drop. We are taught to throw the word around throughout our daily routines. It almost seems like we are brainwashing the patients. We do things like hourly rounding when you ask the patient the 3 P's. Do they need something for pain. Do they need pottied or positioned? It all sounds good on paper, but I'm not sure it really gets done. There are numerous other scripted things that they have us doing. We recently started our Primary Care Nursing project. It does not seem to be working very well. They just keep telling us "it works, because other hospitals are doing it." Is anyone else familiar with these concepts and is it really working in other hospitals.

When we actually have time for REAL patient care...you know, that stuff we learned in nursing school and never saw again! People whom are ill need time and meticulous care. They need the care that all of us long to provide...if we'd ever find the time! At one job, I work in transitional care with 20-25 patients. Sometimes I'd get two admits on my section. I'd leave nursing long before I'd do that again! I miss my patients, though! They were victims of a cold, uncaring system!

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When we actually have time for REAL patient care...you know, that stuff we learned in nursing school and never saw again! People whom are ill need time and meticulous care. They need the care that all of us long to provide...if we'd ever find the time! At one job, I work in transitional care with 20-25 patients. Sometimes I'd get two admits on my section. I'd leave nursing long before I'd do that again! I miss my patients, though! They were victims of a cold, uncaring system!

Amen, sister!

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They post the results of the surveys (by the month) on the back of the bathroom stalls-you can't get away from it!haha

Our Press Gainey scores get posted in our staff bathroom. One particularly bad month (when there were only 4 respondents for our floor) TWO different MDs that used that bathroom wrote on it that they wouldn't trust anything with a sample size that small.:) The main complaint was that we didn't take care of something until the next shift came in. I remembered that patient, we kept going in there before the end of the shift, the patient was prancing around the hospital off the floor until an hour after our shift ended. But there goes my raise because our PG scores aren't high enough!

Maybe we should have said "excellent" over the hospital intercom at least 5 times while they were roaming the halls and lobby.:)

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LOL

Is it just me, or do you find yourself reading some of the posts here describing crap like this and just wanting to *smack* someone?

I want to stick a P somewhere that the sun don't shine myself.:)

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Specializes in Med-Surg, HH, Tele, Geriatrics, Psych.

I'll take 2 Reglan, please. The hospital that I worked at for 6 years came up with this stupid crap. They hired some big wig company to tell us what we were doing wrong in the area of customer service. Heck, we would have told them what was wrong for FREE. Hire more nurses and CNA's. Lower nurse:patient ratios and listen to our concerns.:uhoh3: Ohhh Brother!!!!!

We were told to say "Is there anything else I can do for you before I leave your room?". The problem was, 9 times out of 10, yes, there was something else that we could do for them, which took an extra 10-15 minutes, then they would be back on the call light 5 minutes after you left the room because they "forgot" something! The idea was that if you asked them this question before you left the room, it would cut down on frequent call light use. Nada, DID NOT WORK!.

Another thing they wanted us to say, when (or if) the patient said "Thank You", you were supposed to respond, "It was my pleasure" and SMILE.

I have always been one to speak my mind. I am also educated and articulate;). You do not need to put words in my mouth, thank you very much. I am an adult, not a 4 year old. After a year of this ridiculousness, I left for greener pastures. See Yaaaaa!

We, as professionals, are absolutely right to be offended by being told how to act, how to speak, etc...I wonder what would happen if they gave the docs a script? OMG!!! Heads would roll!

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Specializes in Tele, Infectious Disease, OHN.
If one more check-out person at the grocery store asks me, "Did you find everything you needed today?" I think I'll scream. It's obviously a scripted line they are forced to say to every customer. PI am tempted to give them smart-a**** comments back, but I know it's not their fault that they are forced to ask the exact same question every time.

Really, this whole "scripting" idea is ridiculous. It's a good idea to suggest some possible lines that people can use when they check on a patient, etc. -- but the nurse should always be allowed to personalize it and/or use a little judgment to be sure that what he/she says is appropriate for the specific circumstances. Some people are shy and can use a few suggestions to get them started. But that's a far cry from forcing a specific script.

One more thing to drive good people out of nursing.... another "excellent" idea mutilated beyond its usefulness.

Want to see something funny? I actually asked for something I could not find. Talk about a deer in the headlights moment... Now I know it is a scripted line so I don't try and confuse them. I am talking about grocery stores, not nurses. That is what happens when you post after Thanksgiving libations!!

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Specializes in Tele, Infectious Disease, OHN.
Our Press Gainey scores get posted in our staff bathroom. One particularly bad month (when there were only 4 respondents for our floor) TWO different MDs that used that bathroom wrote on it that they wouldn't trust anything with a sample size that small.:) The main complaint was that we didn't take care of something until the next shift came in. I remembered that patient, we kept going in there before the end of the shift, the patient was prancing around the hospital off the floor until an hour after our shift ended. But there goes my raise because our PG scores aren't high enough!

Maybe we should have said "excellent" over the hospital intercom at least 5 times while they were roaming the halls and lobby.:)

Maybe put a subliminal message on the TV..This experience is so excellent! I want to come back to the excellent hospital for another excellent time! Seriously, I am in shock that this garbage has gotten this far. For those of you who have to deal with PG all I can say is good luck.

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Specializes in None yet - looking for a job.

Maybe they could show "wayne's world" on the t.v. all day.

Wayne's world, party on, Excellent!

Or you could just tell them (if they are nice) if they promise right down excellent on the survey you will give them excellent care.

Why don't they give us more customer service mind control classes in our pre-req's?

:lol2:

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Specializes in PCCN.

ok, now that we all know that this stuff is rediculous,what are we supposed to do about it? Obviously we have the choice to vote with the feet and walk away, but then what?I only have experience in that "customer service" environment.are there other nursing jobs that might pay close to the same? (only concern is that i am still paying off my school debt for this lovely degree.) those of you who have changed, how did you change?( sorry, i just realized this my be a diversion of the topic)

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If you haven't had a chance, go ahead and read the book, Harwiring Excellence by Quint Studer. Really, it's a quick read. I think Studer's stance is really pro-nursing. He talks about getting nursing staff what they need (and uses examples from his own past) so they are empowered to do their job. He makes the assumption that nursing WANTS to give excellent care, but that others in power do not listen to or respond to their concerns. He recommends as a critical step that administrators GO OUT ON THE UNITS and talk to staff about what they need. Not just smile and stand around, really listen and take action. I think ol' Studer has some good suggestions, it's just that alot gets lost in the implementation. He clearly makes the point in his book that if you want to get good scores back, you have to start by getting the staff what they need to do their job. Don't let your PR people get you sidetracked with their scripting business, give it right back and ask them when the leadership rounding is going to start.

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