Thoughts on improving caring

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My name is Michael, and I work in the ICU as a RN. The reason i am creating this post is to discuss a topic that was brought up during a staff meeting and to see where people stand on the idea. At the last staff meeting i attended the director focused on a topic central to nursing care, and how to improve it; that topic being caring. Her goal is to improve staff caring in the ICU. I mean, yes, this is a great idea. Improving caring improves patient satisfaction, i don't see a problem with this. The problem i guess lies in her approach. She wants to create a template and protocol for caring, and it all seems so scripted. The unit needs another protocol like i need a hole in the head. I can't get around to reading the three billion that exist already. A scaled template would rate caring on a scale of 1-5. 1 being below average, 5 being outstanding caring. The implementation of this scale would go something like this: "Susan, i can see you're having a tough time with that patient and their family, right now you're caring is at a 2, how can we improve that? what can we do to bring you up to a 4, i have some ideas." Great and all, but i've only been a nurse for a year, how do i go up to a nurse who's been working for 30+ years and tell them that their caring sucks. I probably wouldn't. Nor do i feel that it is my place to whip out a template and find their caring level based on set definitions for each number 1-5. This template exists by the way, and a lot of research went into creating it.

Ok, so i want to get back to the real reason i'm posting this. In the previous paragraph my tone sounded a bit negative, but i'm not opposed to the idea of improving caring. The other staff were a bit offended at the suggested ideas. Feeling that caring is learned, not taught, and everybody cares differently. Tomorrow i need to put together a presentation on caring for our staff meeting, and i feel like i am hitting a brick wall when it comes to ideas. I want to create a presentation that meets the needs of my director, but also a presentation that i wont get stoned for by the staff. The staff have been given a chance to present ideas with little ground gained during discussion.

Does anyone have any ideas of improving nursing caring, without offending staff in the process? Do you think a protocol or scale is appropriate? A caring committee has been created, which I'm not a part of, but i'm willing to bring ideas to the table. Like all change, there is a ton of resistance being met. I am not afraid to be a change agent, as long as it's done tactfully. Any ideas or suggestions on the situation or for my presentation would be greatly appreciated. I have a feeling i'm going to be presenting a neutral presentation on caring that involves nursing theories and what it caring means for nursing.

Thanks,

Michael

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Specializes in critical care.

maybe you can find something on Jean Watson's website? http://www.watsoncaringscience.org/

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Specializes in Critical Care.

Caring means time. The more time that's taken up by purposeless tasks means less time be "caring". I'm not sure you can really judge someone as being uncaring because they are forced to spend hours charting on something that has no use in the care of a patient rather than spending the time required to care.

I've never been convinced that you can teach someone to be a caring person. You can teach physiology, pharmacology, etc, but if someone is uncaring then there's no way to teach that away.

The whole caring scale thing sounds interesting, is this an official scale like a GCS or Braden? For some reason it reminds me of Office Space where the restaurant manager is lecturing about lack of "flair".

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"Susan, i can see you're having a tough time with that patient and their family, right now you're caring is at a 2, how can we improve that? what can we do to bring you up to a 4, i have some ideas."

Ah a sneaky one. It is simply a thinly veiled way of weaving customer service "dings" with method of delivery that is intended to trick the nurse into believing that this all is intended as a way to help each other get through the day.

I am sorry for ya OP, I'd be taking forever trying to figure out how not to screw myself seven different ways with my own solution to this one too.

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Specializes in NICU.

I'm not sure this will be helpful, but my first thought was that you could turn it around and talk about how important it is to take care of ourselves so that we can then care for others. You could discuss techniques for stress reduction, work-life balance, etc. I'm not sure how much new information is out there, but at least the staff can't argue against taking care of themselves :).

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Ktliz, Thank you for the website. I have a strong feeling that her theory is going to be the foundation of my presentation.

MunroRN, I also agree that caring can't be taught. Interesting perspective on caring and time, i hadn't thought to explore that avenue. It's similar to those scales, where each number has a set of bullet points required to define them. But not used as a documentation tool. More an unofficial guide to caring specific to our ICU and or hospital created by the nurse specialists.

Onaclearday, You are 100% right, it's meant to be perceived as more constructive criticism to improve customer service. However RN's i'd like to think are very well educated, and these statements actually come off as more offensive than beneficial depending on how well the person is at presenting the statement. People, and nurses in particular, don't like to hear that they are bad at something, especially as something as personal and innate as caring.

Tomorrow is going to be interesting, that's for sure. I can just hope that my director talks so long that we run out of time for my presentation!

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I'm not sure this will be helpful, but my first thought was that you could turn it around and talk about how important it is to take care of ourselves so that we can then care for others. You could discuss techniques for stress reduction, work-life balance, etc. I'm not sure how much new information is out there, but at least the staff can't argue against taking care of themselves :).

This is funny because so many of the nurses have suggested this idea! I've had in depth/humorous discussions on the topic! Definitely worth a powerpoint slide.

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Specializes in Med/Surg, Academics.

Because I have a hard time operationalizing "caring," I googled a bunch of stuff. I did come across a book by Watson that is titled something like "Measuring and Assessing Caring in Nursing." Of course, none of my googling revealed the actual assessment tools.

I did read, however, the beginning of the book, and some of the text is available online. Watson spends a lot of time writing about my original issue: operationalizing caring and how it can be done objectively?

I know your timeline is short, but maybe you can go to the medical library in your facility and see if they have the book. If your librarian doesn't have it, wouldn't it be funny? A facility that doesn't have the Bible of caring in professional nursing by the High Priestess of the concept?

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Great idea! I'll head into work early and see if they have it!

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Okay, so what makes someone a 2?

What makes someone a 4?

What objective criteria is used?

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. A scaled template would rate caring on a scale of 1-5. 1 being below average, 5 being outstanding caring. The implementation of this scale would go something like this: "Susan, i can see you're having a tough time with that patient and their family, right now you're caring is at a 2, how can we improve that? what can we do to bring you up to a 4, i have some ideas." Great and all, but i've only been a nurse for a year, how do i go up to a nurse who's been working for 30+ years and tell them that their caring sucks. I probably wouldn't. Nor do i feel that it is my place to whip out a template and find their caring level based on set definitions for each number 1-5. This template exists by the way, and a lot of research went into creating it.

Probably the same people that created nursing diagnoses.........

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Caring to me means being able to put yourself in someone elses shoes. Put yourself in that bed,ask how would I like to be treated. How would I like to be spoken to? Think of the things you've said to patients and picture them being said to you.

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