What is the dumbest most degrading, most unprofessional thing...

[Chico David]

that you have heard of a hospital requiring nurses to do?

I was in a meeting with a group of nurses yesterday - most of us with more than 25 years as RNs - and was hearing about the lovely new practice of "scripting". What is that? It means giving you - a professional nurse with all of your experience and skills and knowledge - a cute little "customer relations script" that you are supposed to say to patients when in various patient interaction situations.

For example: before leaving the room at one hospital, you are supposed to say " Is there anything else you need? I have the time." (whether you have time or not)

I understand basic sense about being pleasant to patients. I understand courtesy. I even know that a few nurses can use a little work in these areas. but the indignity of giving a professional RN a script to use when we talk to our patients? All because some consultant has told them it will improve the patient satisfaction scores. Cartain of our chains seem to be stars at this sort of thing - part of the corporate mind set I guess.

Anyway, I wanted hear how wide spread is this and what other stupid ways of degrading our practice are you seeing out there?

[seenitallERnurse]

originally posted by

"lucretiamott

i had a hard time paring down my list but to summarize:

i was asked to do the following as an nurse practitioner under managed care planning: {# 1 - 8 }"

wow, shaking my head in disbelief.

[Chico David, BSN, RN]

This thread has turned in an even meatier direction here. Of course the answer to what to do about all of this dumb, unprofessional stuff is to stand together as a group with your fellow nurses and just flat refuse to do it. Sometimes we get away with refusing on our own - after all, we are in pretty high demand - but we do it best when we do it together - and better still in the context of a union with a contract and a grievance procedure behind us. Obviously this scripting and related stuff has become pretty widespread. But it's not going to come to my hospital, since we will organize nurses to put a stop to it.

[Witiku]

Change jobs or voice concerns to those that can make it happen.

When management makes life difficult, I look for a better job. I've been in control of P&P development for years now because I hate bad policy.

These scrtipts are the worst though. To be told what to say to a patient like some mindless automaton.

[RN4MERCY]

http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_40.htm

Could these scripting initiatives have something to do with the new JCAHO sentinal event alert, "Behaviors that undermine a Culture of Safety"? There's another thread in General Forum started by Altra. It's a great thread and other "cynics" are on to this and are taking direct collective action. Here's the link, and below it I am cross-posting one of my responses, which is apropos to the discussion here:

https://allnurses.com/forums/f195/jcaho-behaviors-undermine-culture-safety-316159-3.html

The IOM identified factors in the work environment such as frequent interruptions, and fatigue (overtime, no breaks, mandatory shifts/on-call) that increases the likelihood of errors. I don't remember if a hostile work environment, and specifically verbal abuse was mentioned by name as a stressor for nursing staff, but we all know it exists, and these things too are barriers to our ability to be patient advocates.

I'm afraid this new JCAHO standard will be used to target nurses who advocate for their patients by speaking out against hostile managers, physicians, short-staffing, lack of sufficient equipment and supplies and ancillary support staff. Individuals will be blamed for system problems and I've seen it time and time again at evaluation time; a subjective entry is made on a nurse's evaluation form, or a nurse is called in by management because of an "annonymous complaint." (You're not a team player, you're not approachable, we've had several complaints about you from doctors, families, your co-workers...never with any specific documentation that would stand up in a court of law--it's indefensible and often times anecdotal, without just cause.)

Anyone who's ever tried to file a complaint with JCAHO will understand that they're strictly a proprietary, quasi-governmental organization (an elective deeming body for medicare/medicaid reimbursement to which the hospitals pay a fee in order to belong to the club.) The response from our end has been a 'catch me if you can' because of their unannounced visits, or 'we may get to it during our next survey' kind of thing. No teeth so organizations never really have to change their culture.

That's why we advocate for a strong RN nurse's union and unionization for all employees, so that we have protection against workplace abuses that are demeaning and cause nurses to leave or be fired. Weingarten Rights should be available and enforceable for all! True, there may be a bad apple here and there, but I don't believe anyone sets out to do harm; everyone should be entitled to a fair hearing of the grievance against them, with representation, fact finding and a progressive discipline attempt to show and validate corrective action.

https://allnurses.com/forums/f195/jcaho-behaviors-undermine-culture-safety-316159.html

[PMHNP10]

I have seen these scripted sayings posted IN THE STAFF RESTROOM- directly across from the toilet.

Talk about a new spin on subliminal messages.

I must confess...it is not below me to take that piece of propaganda and stick it in the urinal face up; nothing subliminal to the message I'm sending back:saint:

[MaryAnn_RN]

We were given badges to wear today that say we are...

"Happy to help

Never too busy to talk,

Please stop me"

Whatever...I won't be wearing mine if I can help it.

[MaryAnn_RN]

I managed to scan it in AND upload it

[RN1982]

LOL. Take that button, lay it on the floor, place foot over button and proceed to move leg in up and down motion until button is destroyed.

[wooh, BSN, RN]

We were given badges to wear today that say we are...

"Happy to help

Never too busy to talk,

Please stop me"

Whatever...I won't be wearing mine if I can help it.

OMG!

"Never" too busy to talk. Because there's "never" an emergency. Because all we do is sit around filing our nails until someone wants to talk?

[withasmilelpn]

Thankfully, my facility has not tried to script us ..... yet. Sounds like HR's next "big idea" tho. Gawd, I hope not. But... my hospital has given us some pretty crazy stuff to do.

Administration cut our housekeeping staff in 1/2 to preserve the almightly dollar. Then, of course, we have our "mawk joint commision survey" where we get dinged because there is spots on the floor and full linen carts and equipment in the hall and the keyboard on the clerks computer was messy. So what happens??? The suits get in a big way and decide to make a "chore list" for the nurse staff.

Clean the nurse station counter qshift.

Dust the stock room (and all the little shelfs and buckets) twice weekly.

Mop (yes, mop) behind the nurses station twice weekly.

Clean the doctors dictation room and remove any HIPPA violations qshift.

Bag the dirty linen and take it to the bins qshift.

Sanitize ice machine daily.

The list goes on and on and on with all this crap.

I mean, don't get me wrong. #1 I reconize the necessity of cleanliness in a hospital environment. #2 I don't by any means consider myself "above" cleaning.

But does anyone else agree that a nurse is supposed to take care of her patients, not be running around with a mop and bucket or a dustrag making sure everything is all tidy? But oh, the almighty dollar.... Lets cut jobs and squeeze all the work we can out of our nurse staff!! Hows that look on your patient satisfaction score, buddy?

Seriously? Where do you work? I think the day they came to us with that list I'd turn in my resignation.

[ShifraPuah]

OMG!

"Never" too busy to talk. Because there's "never" an emergency. Because all we do is sit around filing our nails until someone wants to talk?

What.The.He!!?!

I want to know WHO comes up with this stuff?

WHO sits on their collective butts and thinks, "Hmmm...we have budget cuts...OK, get rid of CNAs, LPNs, and RNs on X, Y, Z floors...but wait! Oh yes! Let's improve morale on those floors with these cute little buttons!"

The nerve. Idiots. Let them come spend a week (same hours as all staff--CNAs, LPNs/LVNs, RNs, NMs--and NO meals/BRPs) and see how they like it.

Buttons should read:

Too busy to help,

Too understaffed to talk,

Don't stop me 'cos I might run you over!

[mazy]

I recently resigned from a corporate-owned nursing home which required us to utter the following script upon answering the telephones: "It's a great day at XXXXX Health and Rehab Center. How may I direct your call?"

Delurking here. Commuter I think we worked for the same corporation.

Only management answered like that, the nursing staff hated it, so much that we didn't even care what they said, and fantasized about answering "it's a sucky day at..." I hated calling in to work, I just wanted to talk to the person I needed, not listen to a long drawn-out speech about rainbows and lollypops. Life is too short.

No wonder the drs. were always angry and screaming by the time they got through to the nurses. Also, no one understood the phone system so calls got dropped and bounced all over the place... One call kept getting bounced into a patient room, turns out it was the dr. I had paged three times to talk about that specific patient. I thought it was kind of funny, the dr. not so much. He had been returning each and every one of my pages, all calls diverted to the room of a very unpleasantly demented lady.

We also got constant memos with our paychecks telling us we had to smile, and explaining that if we see someone walking around with a clipboard of a specific color, that meant that they were taking a potential pt. family on the tour. That binder was a cue for us to turn those frowns upside down.

Apparently, it's OK for staff to be unhappy, as long as we slap on a happy face to get the patient in there. Once we've roped the pt. in we can all go back to being miserable.

How many staff meetings did it take to come up with that convoluted logic?

And a little off the track here, we were also told that if a patient's toilet backed up, we had to plunge it. Ummm. Can you imagine being a pt and watching your nurse plunge the toilet?

I like the image of the robot nurse bopping into the wall.