my hospital has been requiring the lovely hourly rounding protocol for a few years now. i remember back when it was first introduced that mgmt tried to make it sound like a team effort, that any staff members would be involved to the extent of their scope of practice. umm, i am beginning to think no one but nurses and patient care techs have any actual scope.
in a lot of ways, i understand this. we nurses and our techs are of course more familiar with our pts and what is appropriate for them. however, it can get frustrating when we are in report and techs are busy with vitals and baths etc and dietary takes in a tray and barely sets it up so the pt can reach it. instead, they come out to get one of us to do this. for some pts, i understand the rationale behind dietary not being allowed to adjust bed settings, but it seems they could help at least a little. (perhaps with the a/o pt who just have trouble shifting around to reach their bed controls) also, the other day during report, a nurse had to go into a pt's room to adjust the thermostat because the pt was uncomfortable and apparently nurses and techs are the only ones allowed to do this, though housekeeping had been in the room.
yes there probably are reasons for it all being this way, but i cannot help but get a little cranky when mgmt acts like "we are all in this together" only to realize they mean, it is up to you floor nurses and the few techs you have to make it work.
I love when patients' families yell at me and the nurse because dietary can't seem to remember that patient so-and-so hates fish/beef/etc. I'm like sitting there thinking, You folks called us in here, saying it was an emergency... only to tell us that your mother hates carrots? Honestly, take it up with dietary. Didn't they give you people the dietary phone number to call, should something like this happen?
YES!!! I don't put dietary orders in, I don't type them up, I don't make the trays, I don't even pass them (our place is trying a new thing before anyone yells at me for not passing trays lol)....yet me as the Nurse gets called in to be complained to because the tray wasn't set up right, so and so hates broccoli, the ticket is typed in wrong, the dietician forgot to change their diet in the computer, etc etc. All stuff I have nothing to do with and due to the way the staffing is set up, stuff I don't have time to deal with. ARGH!
On the other hand, we have some GREAT RT's who are very helpful and I really appreciate them! :redbeathe
Our therapy is really great about toileting people. They're not the sort who will run down every hall looking for me or another CNA just to put some little old lady they could lift with one finger on the toilet.
I will say that I would rather not have housekeeping or dietary transfer patients for us. One time a dietary aide pushed a guy back to his room and put him in bed. Twenty minutes later, my coworker was rounding and found him on the floor. Turns out the aide put him in the bed, but not all the way in. He had the patient laying on the little foam bumpers that strap to the bed, but were unstrapped because the patient wasn't sleeping. And then the fall happened.
Our therapy is really great about toileting people. They're not the sort who will run down every hall looking for me or another CNA just to put some little old lady they could lift with one finger on the toilet.
I will say that I would rather not have housekeeping or dietary transfer patients for us. One time a dietary aide pushed a guy back to his room and put him in bed. Twenty minutes later, my coworker was rounding and found him on the floor. Turns out the aide put him in the bed, but not all the way in. He had the patient laying on the little foam bumpers that strap to the bed, but were unstrapped because the patient wasn't sleeping. And then the fall happened.
Oh, I didn't mean that the housekeeper SHOULD get the patient up to the bathroom--actually, they aren't allowed to TOUCH them. My problem is that this dingbat kept asking every patient if they needed something they hadn't asked for, she couldn't provide, but the power of suggestion being what it is just created a pile of new workload for the few people who COULD help those patients. Which is why someone eventually smacked her (figuratively) on the head.
Specializes in Orthopedic, LTC, STR, Med-Surg, Tele.
I used to work somewhere that had a housekeeper who would in EVERY SINGLE ROOM ask each patient "do you need to go to the bathroom?" and then when the patient almost inevitably said "yes", she'd run out to get one of us (nurse or aide). She had to be told to STOP ASKING, since so many of these patients figured "what the heck, as long as she's offering". Not realizing, of course, that SHE wasn't going to stop right there and help them up (because, of course, they had no ability to get there on their own and it was a ten-minute ordeal). No, by the time she'd tracked down every nurse and every aide--remember, she asked EVERY PATIENT as she went room by room emptying the trash--everyone was annoyed that they had been kept waiting.
Kinda wanted to kill her myself, but this time management stepped in and shut her up :)
Specializes in Orthopedic, LTC, STR, Med-Surg, Tele.
I love it when dietary dumps a tray and it's not discovered for awhile, so some poor little old lady has to have her, like, fish filet heated up in the microwave. Delish!!! :barf01:
Most of our diet techs are awesome and go the extra mile for our patients, but since I started working nights I hardly ever see them, sadly.
I have this picture in my head...in it, there is a meeting and in the meeting, every speciality service comes. This includes security, RT, OT, PT, speech, dietary, social work, etc. They all decide who does what part they will do. When they get to all the unpleasant, undesirable things that make their work flow or performance look bad, they immediately identify it as "a nursing task."
TV repair? Technically, its engineering's problem but nurses can "trouble shoot" patient complaints, right? lol
I love when patients' families yell at me and the nurse because dietary can't seem to remember that patient so-and-so hates fish/beef/etc. I'm like sitting there thinking, You folks called us in here, saying it was an emergency... only to tell us that your mother hates carrots?
Our dietary department just leaves the trays in those warmers in hallways for us CNA to pass out. All 74 of them plus handing out the correct beverage, positioning patients in bed, etc. while being expected by management to toilet everyone on time and respond to call lights in a "timely manner." And it's only two CNA's passing trays, too.
The best "the patient needs you now" call I ever got to a room was a patient who wanted to know the address to the hospital. Literally I'm running around the corner in the middle of doing 15 different things and the secretary stops me and says, "Kel, the patient in room 10 needs you now". I say, "do you know what she needs?" She says, "you." I open the door and get "what's the address to the hospital?" Do you THINK the secretary could have asked her that when she called and said, "I need my nurse." Because if she had, she could have easily told the patient the hospital's address.
I have this picture in my head...in it, there is a meeting and in the meeting, every speciality service comes. This includes security, RT, OT, PT, speech, dietary, social work, etc. They all decide who does what part they will do. When they get to all the unpleasant, undesirable things that make their work flow or performance look bad, they immediately identify it as "a nursing task."
TV repair? Technically, its engineering's problem but nurses can "trouble shoot" patient complaints, right? lol
And on and on and on...
I'm pretty sure it's not just a picture in your head. :)
The best "the patient needs you now" call I ever got to a room was a patient who wanted to know the address to the hospital.
The best "the patient needs you now" call I ever got to a room was a patient who wanted to know the address to the hospital. Literally I'm running around the corner in the middle of doing 15 different things and the secretary stops me and says, "Kel, the patient in room 10 needs you now". I say, "do you know what she needs?" She says, "you." I open the door and get "what's the address to the hospital?" Do you THINK the secretary could have asked her that when she called and said, "I need my nurse." Because if she had, she could have easily told the patient the hospital's address.
Yes, I've had to train the people who answer the CB's to ask what they want the nurse for? (Instead of just coming to me and saying so and so needs the nurse. IDK what for.) because I started getting annoyed when I'd stop what I was doing and find out they wanted a book from their dresser, a glass of water, or their window shade up. Lol.
My daughter works in the dietary department of our local hospital (which is not the hospital I work at, not that it matters). She is strictly FORBIDDEN from moving anything in the room to make a space for the tray, FORBIDDEN from putting the tray over the patient, FORBIDDEN from setting up (even if her work load allowed time for all of that, which is doesn't). When she gets to Grandma's room all she can do is set the tray on whatever open space she can find and leave. Of course, she is regularlarly asked by patient's to do all of the above but she isn't allowed to. Being the helpful sort that she is, this drives her crazy.
Instead, she gets to explain how she's not allowed, but she'll let the CNA or RN know right away. Said CNA or RN usually bites her head off at best, complains to her manager at worst.
It's a no - win on both sides, folks. And when I come home to hear my daughter's stories of how she's treated BY NURSING STAFF, I am ashamed of my so-called "profession".
The above example is a great one of the BS that nurses and support staff have to put up with. The hospital preach "we will kiss your butt" but in all actuality , only nurses and techs are allowed? try telling that to the public. so now the nurses and techs have damage control to clean up after because the food person isnt allowed to do anything with a tray?????this is sheer BS. I swear to you know who that the "companies" are setting us up for failure.And Im sorry that the food service person is getting mistreated for something out of her control. I swear i think the "companies " love it when we all fight with each other too. ridiculous.
I cannot wait to get out of this profession. Professional idiot- i guess, for staying.
i think part of the frustration is because we may not know what each type of staff can or cannot do. if they are allowed to assist in any way, though, they certainly should.
tri-rn, i am not trying to disparage dietary for not doing things they are not allowed to do, but i am sure some facilities do allow them to do some things, and it is frustrating when these people do not do what they can, leaving more work for the rest of us.
also, i kinda stopped short at the part where you mentioned her not having time to assist even if it were allowed. now, being a nurse, i am sure you know the myriad responsibilities we have, compared to someone delivering trays. i am sure they ride her about being efficient, but look at all the things we must do or ensure are completed.
nurses seem to get all the blame and none of the credit. (and yes, i know a good tech is super helpful in getting stuff done and deserve some credit too!)
since no one from "above" seems to want to give credit where it is due, maybe we should all take a moment to pat ourselves on the back and acknowledge each other (every staff member who helps out, regardless of title) for getting it done!
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DizzyLizzyNurse
1,024 Posts
YES!!! I don't put dietary orders in, I don't type them up, I don't make the trays, I don't even pass them (our place is trying a new thing before anyone yells at me for not passing trays lol)....yet me as the Nurse gets called in to be complained to because the tray wasn't set up right, so and so hates broccoli, the ticket is typed in wrong, the dietician forgot to change their diet in the computer, etc etc. All stuff I have nothing to do with and due to the way the staffing is set up, stuff I don't have time to deal with. ARGH!
On the other hand, we have some GREAT RT's who are very helpful and I really appreciate them! :redbeathe