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Thoughts on improving caring

Nurses   (5,567 Views | 29 Replies)
by mstev001 mstev001 (New) New

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You are reading page 2 of Thoughts on improving caring. If you want to start from the beginning Go to First Page.

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Caring is a systemic issue, from the top down. I would like to see the staff script the things they would like TPTB to say to them. Caring is contagious....catch it!

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canesdukegirl has 14 years experience as a BSN, RN and specializes in Trauma Surgery, Nursing Management.

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Hmmm...sounds a bit Stepford to me, and my knee jerk reaction would have been similar to what you experienced at your staff meeting. I can't shake the image of 'Cheerleader Nurse' wearing a big C on her scrubs, encouraging all the nurses to Care!

"C-A-R-E...what's it gonna be? I know you will agree; this cheer sounds just like Disney! So put your minds together, Press Ganey wants it better! If we set the scores ablaze, then next year comes a RAISE!" (insert jumping, back handsprings, etc. here.)

All kidding aside...

Lord have mercy, you have been tasked with a difficult mountain to climb. I don't agree with the scripting nonsense. I think that the issue would be better received if you focused on stress reduction techniques for the nurses (as a few others suggested). One can't very well fill someone else's glass if their own well is dry, can they?

Perhaps you can focus on Maslow's hierarchy of needs. Build your presentation from that. Ask the nurses what they think of each tier. Example:

You: Maslow's second tier is safety. What examples can you guys give me that makes you feel safe?

Answer from the peanut gallery: My husband.

You: That's a good one. Spouses make many of us feel safe. What do you think about a pt who is dealing with their illness and their resulting worry for their spouses? Do you think this hinders their recovery? How can we intervene as nurses?

PG: We can educate the spouses on the dx process and show them how to continue care at home so that they feel like they are contributing to the recovery/care of their spouse. We can also ask for a SW consult for home health care to enforce teaching done at the hospital.

See how you can offer a different view of caring here? This is stuff we already know. To pose the questions would perhaps be a gentle reminder that all of the nurses know this stuff already. Awareness is oftentimes all we need.

You have a wealth of information to go on in this regard. The end result usually comes back to caring, no matter which tier you refer to.

I hope this helps some! Good luck tomorrow!

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Altra is a BSN, RN and specializes in Emergency & Trauma/Adult ICU.

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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

I'm a bottom-line / big-picture kind of person. So my questions about this are as follows:

1. What is the "problem" that your department is trying to solve? What does "improve caring" mean? Are your patient satisfaction scores low? If so, is there a common theme in survey results? Is it pain control, something about the routine of the unit, etc.? Is there a perception among staff and/or management that some aspect of patient-nurse interactions is not up to par?

2. If what you are really trying to address are not patient care/outcomes measures ... but personal interaction ... are you prepared to formulate policies that govern this? Are you prepared to say to a nurse who is by nature introverted, or just doesn't talk a lot, or is naturally brusque but very clinically competent ... that their expertise is just not good enough?

3. What is it specifically that you want nurses to do differently? Are there individual nurses who could benefit from some individual counseling from management on word choices and/or body language? Can this be accomplished without adding another entire layer of performance standards for the entire nursing staff?

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PostOpPrincess has 19 years experience as a BSN, RN and specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

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Please forgive me, but you're making me laugh. Out loud. A lot.

I care a lot. But no one can tell me how to improve on such an abstract concept.....some of us just aren't lovey-doveys, huggers, kissers, or smilers...but that doesn't mean we don't care.

Besides, how can one quantify caring and on what scale? It's all perception.

So you have your work cut out for you.

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whichone'spink has 3 years experience as a BSN, RN.

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Sadly, these stupid things seem to be assigned to the new grad who can't say no because they'll get the sack. This is what I have to look forward to?

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1 Article; 207 Posts; 5,918 Profile Views

Finally the previous 2 posters brought up what I had been thinking after reading the OP. Isn't caring somewhat subjective? I mean, if a nurse came into my room and continued to call me honey and baby me, I would probably puke! But my friend would absolutely love it and think she had the most caring nurse in the world. We all have different personalities, both patients and us nurses. Who can really judge if you are being caring or not? Will there be guidelines for types of people? Being caring to the stone hard man in room 101 that just wants to be left alone to sleep is certainly a lot different than being caring to the little old lady in 102 that is scared, lonely, and wants constant attention. Seems to me like caring is like pain: it is what the reciever perceives it to be. And can you really assess that like you can assess pain?

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Hygiene Queen specializes in ......

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Score... for caring...

Ya know, this is exactly the ridiculous crap that management comes up with that always gets me in trouble...

Because I end up sitting there, in front of the boss, with a look of horror and disgust... muttering to myself... rocking back and forth... seizing on the floor...

This usually draws their attention to me. Then they ask me what I think.

Then I get in trouble...

No. I have no self-control.

Kudos to the OP for taking his project seriously, in spite of his feelings... me? I don't know if I could.

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Whispera is a MSN, RN and specializes in psych, addictions, hospice, education.

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You said the rating thingie already exists. Who developed it? Someone who researches caring?

I think caring if very nebulous and means different things to different people.

Maybe you could ask those present what the word means to them and how they show they care for their patients. Go around the room and have each person state one thing he/she does. See if there are things lots of people say. You could have them write them too as if they're votes for "the most important thing I do to show my patients I care."

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*Posh* has 6 years experience and specializes in med-surg/ tele.

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I work with a nurse that "cares" and her patients love her. She gets the gold stars from management and generally just kisses their a$$. She doesn't "get" the "nursing" part of it though. She does just enough to get through the day, has no initiative and it sucks to follow her the next day because you're stuck cleaning up what she didn't do... Is this what they want or do they want somebody who will get the job done right? I hate this crap...

Can you tell I just had a no lunch, no pee, two code, q2 dilaudid/morphine IVP kind of day? Good luck, OP...

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47 Posts; 3,809 Profile Views

I love Jean Watson's human caring theory, but there is no way anyone can quantifiably measure the amount that another person cares. Caring is in the heart. Just because someone can go through the motions and recite a customer-service oriented script does not mean he or she is caring. So, basically, IMHO, the whole premise of what you have been asked to do is stupid and makes me think your boss has not been a nurse that long. Best of luck to you. Sounds like you have your work cut out for you.

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tralalaRN has 21 years experience and specializes in pediatrics.

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How to basically teach caring? Yikes. This seems pretty innate to me - either you've got it, or you don't. But to teach this? It reminds me of that movie Harrison Ford was in a number of years ago where he is a cocky physician. .until he's dx with CA and goes through tx for it. All his Dr. buddies are still so cocky and disrespectful of patients, but now he's no longer really one of them, because he's been to the other side. At the end, he has recovered, and a new flock of med students arrives on the scene. .he gives each of them a diagnosis, and then tells them that they are going to have to go through all of the diagnostics that someone would have to if they actually HAD that dx. The look of horror on the med students' faces is a sight to behold as they are getting prepped for colonoscopies, etc. Nothing like a little personal experience to hone one's caring. . Now I'm not saying that you should set up a diagnostic shop for every nurse on the unit, but would be interesting. .

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caroladybelle is a BSN, RN and specializes in Oncology/Haemetology/HIV.

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Tralala,

Actually, I believe you have mixed up 2 movies, similar in plot.

William Hurt in "The Doctor" was about the cocky MD that got cancer, and had the change of heart about how he behaved to PTs, teaching house staff to be more empathetic.

Harrison Ford was in "Regarding Henry" was about the lawyer (?), that suffered through traumatic brain injury, underwent rehab and became more honest and ethical in his dealings.

Similar movies that were of the same era.

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