Vanderbilt Medical Center to have nurses cleaning up

[DidiRN]

"Cleaning the room after the case, including pulling your trash and mopping the floor, are all infection-prevention strategies. And it's all nursing, and it's all surgical tech. You may not believe that, but even Florence Nightingale knew that was true," said a hospital administrator to staff in a video obtained by the Channel 4 I-Team."

http://www.wsmv.com/story/23364976/vanderbilt-medical-center-to-have-nurses-cleaning-up

[Mr. Murse]

Everyone's talking about the patient risk in terms of infection, but what about in terms of time for effective patient care? I work on a busy surgical floor and if I had to clean out every discharged patients room and handle the rest of my duties.......well, there simply wouldn't be time. We average 6 or 7 patients (sometimes 8) per nurse. If they dropped the patient/nurse ratio to 4/1, then maybe it would be more realistic.

It's not even that I mind cleaning, it's just not practical unless they're also changing the patient/nurse ratio.

The Florence Nightingale statement is just asinine. You can't possibly compare the medical world of the 19th century to that of the 21rst century. Was the lady that said that even a nurse?

[wanderlust99]

Good for the nurse who reported it to the news! Vanderbilt's student paper put out an article on environmental services low wages years ago when I worked there. Maybe 5 or 6 years ago? They ended up getting raises after that. I don't know the conditions of that place, it's been so long since I've been there. We were never required to empty trash like a lot of night time ICUs require at some hospitals.

It's tough to find a good hospital in our country. I'm not really surprised by this. I was there when they went magnet and we got our raises after that. This doesn't sound very "magnet" like. It's funny how magnet hospitals are turning into the worst places to work nowadays.

[Guest219794]

Vanderbilt is a magnet hospital and level 1 trauma center with a lot of respect in the community and if cleaning starts taking time away from pt care they may see satisfaction rates drop.

I disagree. In order to add the time consuming task of cleaning rooms, the nurses will have to take time away from something else. Many nursing tasks fit in to one of two categories, with some overlap: 1- Tasks directly related to medical based pt outcomes, like triple checking meds, thorough assessments, etc. 2- Tasks related to increasing customer satisfaction. Prompt delivery of tea, quick response to call bells used for trivial issues, etc.

As long as the nurses focus on customer service instead of actual pt care, satisfaction ratings should stay high, with only a small increase in re-admissions, infections, and death.

[SoldierNurse22, BSN, RN]

I disagree. In order to add the time consuming task of cleaning rooms, the nurses will have to take time away from something else. Many nursing tasks fit in to one of two categories, with some overlap: 1- Tasks directly related to medical based pt outcomes, like triple checking meds, thorough assessments, etc. 2- Tasks related to increasing customer satisfaction. Prompt delivery of tea, quick response to call bells used for trivial issues, etc.

As long as the nurses focus on customer service instead of actual pt care, satisfaction ratings should stay high, with only a small increase in re-admissions, infections, and death.

I must disagree. While there is (as you said) some overlap between customer service actions and nursing actions, getting granny her tea versus turning her q2 hours...which do you think is customer service related and which do you think is going to prevent serious physical harm to the patient?

If you're focused on customer service type issues, you are not going to be able to accomplish all the nursing tasks that are essential to keeping patients safe and (relatively) healthy. Not when you're running for Mr. X's tea, Mrs. Y's extra pillow, calling Mrs. Q's sixth cousin twice removed to tell them she wants to see them because she can't hear on the phones at your hospital, trying to figure out how to get Mr. L's family a ride back to their hotel, and now you have to clean Room X because that patient was discharged. Customer service issues can be time consuming enough on their own to pose a serious threat to quality nursing care. To add on an extra chore to a nurse's already bustling schedule is nothing short of criminal.

To excuse this kind of behavior with Florence Nightengale is despicable. Absolutely, she advocated for cleanliness and fresh air. Anyone who's ever read Notes on Nursing knows that. But it's 2013, and many of the duties that nurses performed in eras past have been delegated to other services because nursing as a field has expanded and gained vital responsibilities that cannot be delegated.

Not that I go to work thinking of customer service anyway, but if you told me I had to clean rooms as a nurse working an inpatient ward, your tea would have to wait. Under the outline above, there's no way I'd be taking away from assessments and patient health/monitoring/ADL/safety-related concerns in order to fluff pillows and scrub floors. Perhaps I'm one of those "bad nurses", but I've told patients and family members that I cannot call their relative right now because I have other patients and needs to attend to. I will get back with them if and when I have the time, but I cannot take away from another patient's pressing needs to tend to matters that are less important in the grand scheme of things.

I'd love to see a mass exodus of nurses from this place. This is one of those areas where nurses need to stand together and do what we're supposed to do: advocate for our patients and for ourselves.

[beckster_01, BSN, RN]

As long as the nurses focus on customer service instead of actual pt care, satisfaction ratings should stay high, with only a small increase in re-admissions, infections, and death.

As long as there are only small increases in death it's ok.

The cost of the increase in nosocomial infections has got outweigh the cost of paying cleaning staff. Does anyone know if insurance pays for readmissions? I'm thinking surgical readmits e.g. Incision site infections.

[aTOMicTom]

I bet it will be addressed and corrected quickly, if it's even true. Media have been known to scandalize things for their own ends, you know.

[Chisca, RN]

So tell me again why Unions are such a bad thing?

[TakeTwoAspirin, MSN, RN, APRN]

I'm sure I'll be corrected if I'm wrong but it looks, at least from my understanding, as if they are talking primarily about cleaning the rooms in the OR and peri-operative areas. As a peri-op nurse, and past surgical tech., I have always helped to clean the OR once a case is over. Although we do have teams to do this they are frequently in other rooms and in order to get a fast turn-over in the OR everyone needs to chip in. I don't feel like I'm too good to pick up a mop to help the team out, and I certainly bag trash as the case is running to save on turnover. In our OR everyone who is not assigned to a specific room (whether they be RNs, techs, or POAs) go to rooms being turned-over and assist with whatever needs to be done.

The only difference between what they are doing at Vanderbilt and what happens in many, if not most ORs throughout the country, is that there will be no "official" housekeepers now so the nurses and techs will have to do it every time instead of when the need arises. Getting the rooms turned over efficiently with everyone doing what needs to be done has been the culture in the OR for as long as I have been working in an OR.

[HeatherGurl84]

Oh dear lord......

[klone, MSN, RN]

Oh, this makes me so angry I could spit. How dare they pull out Florence Nightengale? Florence Nightengale didn't have to chart in a bajillion different places on 5-8 patients to satisfy hospital and JCAHO standards and prevent litigation! Florence Nightengale nursing is so far removed from the nursing of today that it's so ridiculous and irrelevant to compare nursing practice then and now! What a bunch of hogwash!

[SummerGarden, BSN, MSN, RN]

I worked in one ER, where the nurses had to clean the rooms between patients. Initially I thought that it made sense. After working there for two weeks I realized it was the nastiest ER I have ever had the displeasure in which to work! It was always dirty/filthy! Good luck to the patients of Vanderbilt.

[JDZ344]

Urgh.