Many hospital administrators believe that scripting is useful in formulating great patient encounters and influencing Press Ganey scores in a positive manner. However, scripting insults the intelligence levels of the staff members who must recite the canned phrases and the patients who are forced to repeatedly listen to the same scripted lines.
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Amen! Very well written article!! It astounds me that critical thinking has gone way of the "this phrase will get us paid"
Another "good" one.....(or should I say "very good" one....) "This is RN Xyz, BSN, ACLS, PALS, and one hundred other letters behind the name....here, let me write it on the white board for you! I have worked with RN Xyz for a large amount of time (even if it is hours...) and I KNOW that you will recieve VERY GOOD care!! THANK YOU SOOOOOO much for allowing me to care for you!!"
Very good article ( lol)
no, really.
This scripting stuff is something that undermines us as a professional nurse. How phony we must all sound. I had no idea when I took this on that we had to be actors too, in addition to waitresses, housekeeping, etc.
I must admit though, on the d/c instructions of a pt, there was a page that had a picture of the MD who took care of the pt, and he had a small schpiel ( however it is spelled) of how he hoped he provided very good care, and that they would be getting a survey in the mail. I thought that was a good thing to have added to the d/c instructions- makes the doc accountable
Well said and timely article. Thank you. I have always refused to use is. Scripting, starting wages of less than $20/hour, punching time clocks, and the paternalistic manner in which nurses are treated by management give make mockery of those who proclaim nurses are considered true professionals.
Scripting with "very good" won't prevent lowered Medicare reimbursement. To steer clear of cut funding, it has to be "excellent."
I, too, find it contrived to say, but it is a necessary evil. Not enough "excellents" means Medicare cuts in reimbursements, means higher ratios, means reduced patient safety. If all it takes is some careful scripting, then so be it.
But! If I were a patient and heard this, I would immediately down grade my survey comments. But I would tell the personal to stop the spewing that "stuff" firs.t
Scripting with "very good" won't prevent lowered Medicare reimbursement. To steer clear of cut funding, it has to be "excellent."I, too, find it contrived to say, but it is a necessary evil. Not enough "excellents" means Medicare cuts in reimbursements, means higher ratios, means reduced patient safety. If all it takes is some careful scripting, then so be it.
I used scripting once in the hospital and my patient laughed at me. I never used it again.
This one: "Is there anything I can do to make you more comfortable? I have the time!" bothered me the most. I NEVER had time and I was lying when I said I did. The patient knew I was lying. They watched me dart up and down the hall for 12 hours nonstop.
This reminds me of those clothing stores where they force some poor soul to stand at the front of the store and refold the same 500 shirts with the folding board and say "HI!" to every single person that walks in. They lose major points by Secret Shoppers if they don't. And don't think hospitals won't be utilizing them soon as well!!
"I have the time" when that's not the truth at all- how does that square with Veracity – duty to tell the truth? Just sayin'......
Nurses who have the misfortune of working at healthcare facilities that utilize Press Ganey patient satisfaction surveys are probably subjected to the practice of scripting.
For those who are unfamiliar with scripting, here's a brief rundown. Every nurse is supposed to recite the same pre-written scripted phrases to all of their patients with every interaction. The point is to reinforce the phrase 'very good care' in every patient's consciousness so that, upon each discharge, the facility will generate favorable patient satisfaction survey results. 'Very good care' translates into a score of five on the Press Ganey patient satisfaction survey.
A score of five is the highest rating each patient can bestow upon the facility on this particular survey. Likewise, 'very poor care' is the lowest rating any patient can give and would translate into a score of one on the survey.
Here are a few striking examples of the canned, scripted phrases some members of nursing staff are expected to recite to their patients. Be sure to take notice of the prominence of the key words 'very good':
When dealing with scripting, I call shenanigans. I do not use scripting because the canned phrases sound phony and insult the intelligence of the patients. Moreover, repeated use of scripting insults the intelligence of nursing staff because management no longer believes in our human ability to establish connections with patients and families. Does administration truly believe that patients will automatically return surveys with ratings of 'very good care' if staff continually repeats the phrase?
I am wearily cognizant of all the new pressures surrounding the linking of Medicare reimbursement rates to scores received on patient satisfaction surveys, but uttering canned scripts over and over seems robotic and is devoid of any critical thought. Our encounters with patients should be honest and warm, not derived from phony scripts where the primary goal is reinforcement of a particular phrase.
About TheCommuter, BSN, RN
TheCommuter, BSN, RN, CRRN is a longtime physical rehabilitation nurse who has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a Registered Nurse.
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