Why can't we just be nurses anymore?!?!?

Posted
by MrsWampthang MrsWampthang, BSN, RN Member Nurse

Specializes in Emergency room, med/surg, UR/CSR.

Our hospital is a big fan of Press Ganey, as well as Studor Group stuff, AIDET, and passport to excellence. I feel so overwhelmed and frustrated because I feel like they are throwing too much at us at once. We have to make sure we give "very good service," we have to comply with "department goals," as well as form our own "personal goals." We are expected to follow a "script" when addressing our "customers." Our performance evaluations will be based on how well we achieve our personal goals as well as our department goals, and as always, there is the Press Ganeys that we regularly get chastised for not achieving in the 90%. Maybe I am coming off as a whiny baby, but I don't need a script to tell me how to talk to my patients, and I don't need any Studor group training to tell me how to treat my patients. Why can't I just focus on being the best nurse that I can be without the pressure of complying with guidelines set down by people that, in all probability, have never been in any kind of healthcare position? :devil:

Again, sorry this comes off as whiny. I'm just feeling a little frustrated. I love nursing, and I think I am a pretty good nurse. I don't belittle or run down my coworkers, and I try to be a shoulder for those that need it. What makes this all so much more aggravating is that we only get a 3% raise every year. Whoopee! So no matter how well I achieve my goals, the department goals, follow the script, etc., I am going to get the same raise as the most under achieving employee in the hospital. I will always give my best to my patients, no matter what, but right now I don't feel like there is any incentive to follow all this extra stuff that they are throwing at us. Why give more than the minimum when that is all that is needed to get my biggie 3%?

I could really care less if our department ever achieves 90%. I don't need some skewed survey to tell me that I do take excellent care of my patients. How can that survey accurately reflect our department's performance when it isn't handled out to every patient that comes through the door? Historically people only send surveys back when they have something to complain about anyway.

Sorry this is so long. If anyone wants to chastise me for my bad attitude, that's ok. I deserve it. I just don't know how much longer I can stand all this pressure to be a customer service technician rather than a nurse, which is what I went to school for. :crying2:

Pam

stidget99

stidget99

342 Posts

99% of what you have said are my thoughts. We are told to provide "excellent" care and I do try. However, how can I provide that "excellent" care when I am forced to take too many pts with crappy staffing?

mysticalwaters1

mysticalwaters1

Specializes in ER (new), Respitory/Med Surg floor. Has 3 years experience. 350 Posts

Our hospital is a big fan of Press Ganey, as well as Studor Group stuff, AIDET, and passport to excellence. I feel so overwhelmed and frustrated because I feel like they are throwing too much at us at once. We have to make sure we give "very good service," we have to comply with "department goals," as well as form our own "personal goals." We are expected to follow a "script" when addressing our "customers." ..... but I don't need a script to tell me how to talk to my patients, and I don't need any Studor group training to tell me how to treat my patients.

Pam

Yeah my hospital does press ganey and i'm sorry it's all a bunch of bull. I hate it and i hate people trying to enforce scripting. One key thing is to knock before you enter a pt's room. I actually did this before press ganey give a little rap or say i'm comming in. My manager pulled me out of a pt's room as I was in the middle of cleaning him to tell me about pt's door's and i go back into the room and close the curtian when i come out she's like what did you forget to do. I didn't knock or say when i closed the curtain "I am closing this for your privacy." I was so mad. It kindof died down because it is crap. Wow that's negative! Management even tried to have us all sign a paper that we'd agree to script. It scareed me because it's like well if i don't script or get it exactly right or script for each pt q30min i'll be fired! I just wrote i received the document.

That's the problem that it IS scripting and pt's see it. ONe pt when i knocked said "what do they tell you you have to knock or something?" It's annoying. It's like service people you come across that are overly jolly and i guess what gets me it's FAKE! Be natural and corteous with out this garbage. And the other issue is your scores would be low if say the pt didn't get what they ordered from dietary or something ridiculous like that. Wheww!

Sorry!

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Dixielee

Dixielee, BSN, RN

Specializes in ER. Has 38 years experience. 1,222 Posts

I think we have a severe case of management gone wild! They are so far removed from the real world, it is sickening. My daughter is a designer for an archetectural firm in North Carolina. She wanted to get into healthcare design for several reasons, mostly based on what she had heard from me over the years. She told me her firm was hired by a major hospital to design their administrative building. This building was NOT even on the campus of the hospital, nor could you see it from the hospital. It was WAYYYYY down the street. The budget for this building was astronomical. She said she was sick when she saw how much they were spending for high end carpet, imported granite, chandeliers, etc. Yet, I bet there are nurses in their hospital right now who can't find the right equipment and do not have the staff and resources to do their job. But, By crackie, the admin building will look sharp!

On a related note....my favorite response from a patient in one of those stupid surveys said....."The rats outside the ER kept me awake at night". Not sure exactly what she meant, but we got a good laugh out of it.

We are doomed!

payday

payday

121 Posts

Regarding having to spit out a script: My opinion is if you want a parrot, hire one.

stidget99

stidget99

342 Posts

"We are doomed". I don't think that we are doomed. But I do think that this new push will lead to a lot of great nurses leaving the profession. I don't know. Maybe we are wrong. Change can be good. I think back to how state institutions were say 50 years ago--residents running around in underwear or naked, meds not being given, poor food, over crowded living spaces, poor sanitary conditions, etc...... State surveyors came in and told staff how things were going to be changed and over the course of several years, things have gotten better for residents living in the institutions. Maybe we all just need to be patient and see what happens. But I do know this. I really resent management for coming in and telling me that I need to remember to do things that I have already done out of common courtesy (i.e. knocking on the door). However, I am also told that I must knock on the door EVERY TIME I enter a pt's room. I disagree w/ that one. I work the noc shift. I refuse to knock when I am just peeking in on them to make sure that they are still breathing! As you can probably see, I am really torn on this issue. On the one hand, I resent the crap out of management. But, on the other hand, could these changes be good for nursing....in the long run?????

nursemike, ASN, RN

Specializes in Rodeo Nursing (Neuro). Has 12 years experience. 1 Article; 2,362 Posts

"We are doomed". I don't think that we are doomed. But I do think that this new push will lead to a lot of great nurses leaving the profession. I don't know. Maybe we are wrong. Change can be good. I think back to how state institutions were say 50 years ago--residents running around in underwear or naked, meds not being given, poor food, over crowded living spaces, poor sanitary conditions, etc...... State surveyors came in and told staff how things were going to be changed and over the course of several years, things have gotten better for residents living in the institutions. Maybe we all just need to be patient and see what happens. But I do know this. I really resent management for coming in and telling me that I need to remember to do things that I have already done out of common courtesy (i.e. knocking on the door). However, I am also told that I must knock on the door EVERY TIME I enter a pt's room. I disagree w/ that one. I work the noc shift. I refuse to knock when I am just peeking in on them to make sure that they are still breathing! As you can probably see, I am really torn on this issue. On the one hand, I resent the crap out of management. But, on the other hand, could these changes be good for nursing....in the long run?????

I like your attitude. I heartily agree with the prevailing view that common sense and common courtesy are far better than some phony-sounding script. Generally, I hate the whole idea of seeing patients as "customers." Or "clients." The best hotel in the world doesn't do peri care. But I do see the point that we need to make patient satisfaction a goal, and I think we all agree that we don't need patients to be passive recipients of whatever we think is best for them (nice as it might be if some were).

At my hospital, most of these sort of initiatives are done by committee, and one suggestion I would offer is to get involved with these committees when there's an opportunity to do so. Sometimes it does help to have a voice there for the "real world," and in my experience, sometimes they actually listen.

Silverhawk

Silverhawk

55 Posts

99% of what you have said are my thoughts. We are told to provide "excellent" care and I do try. However, how can I provide that "excellent" care when I am forced to take too many pts with crappy staffing?

You can't. That's why we need good nurse to patient ratios. It's a win/win for both! The state legislature is the only way to go.

talaxandra

Specializes in Medical. 1 Article; 3,037 Posts

The best hotel in the world doesn't do peri care.

Clearly you're not going to the right hotels :chuckle

We're lucky down here that there's (so far, touch wood) any of that malarky, but as night follows day, so does Australia follow the US.

I hate the idea of scripting. Like other posters have said, it's not like patients can't tell. The whole thing just sounds like consultancy rubbish to me.

LPNer

LPNer

252 Posts

"We are doomed". I don't think that we are doomed. But I do think that this new push will lead to a lot of great nurses leaving the profession. I don't know. Maybe we are wrong. Change can be good. I think back to how state institutions were say 50 years ago--residents running around in underwear or naked, meds not being given, poor food, over crowded living spaces, poor sanitary conditions, etc...... State surveyors came in and told staff how things were going to be changed and over the course of several years, things have gotten better for residents living in the institutions. Maybe we all just need to be patient and see what happens. But I do know this. I really resent management for coming in and telling me that I need to remember to do things that I have already done out of common courtesy (i.e. knocking on the door). However, I am also told that I must knock on the door EVERY TIME I enter a pt's room. I disagree w/ that one. I work the noc shift. I refuse to knock when I am just peeking in on them to make sure that they are still breathing! As you can probably see, I am really torn on this issue. On the one hand, I resent the crap out of management. But, on the other hand, could these changes be good for nursing....in the long run?????

A part time supervisor asked me the other night what I was doing? I was standing just inside the door of a pt room, watching him breath, counting. When I finished, I came away from the door to talk to her. She was amazed that I thought I could assess a pt from the doorway! I told her, that was not my assessment, but "rounds." He has no IV to check, he is PO day 3 and everything has been great with him, why not let him sleep?

According to her, I could not chart anything about that encounter. I do not undertand why. "Resting quietly, resp easy". This, in months and years to come will prove, if ever questioned, that I did know he was fine at 0300.

Maybe I should have gone in AGAIN that hour and awakened him. After all, we woke him at 2345, again at 0200 and I will awaken him at 0400 for pain med before CPM from 0500 - 0700. When are they supposed to sleep to have the energy to get anything out of PT when they start showing up shortly after 0700, even before breakfast! (PT gets some of them OOB and into a chair for breakfast, helps them judge who will need how much time for PT that day. After all, they only have - usually - 3 days inpatient to get moving, unless they go to rehab.) This particular man is a total knee replacement. Most of our pts are total knees, hips or laminectomies.

I can't imagine having a script for interaction. People are so different, how do you customize that script?

Tweety, BSN, RN

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 30 years experience. 32,349 Posts

You're not whining. It does get a bit overwhelming when they want you to script, attend committee meetings, keep up with competencies, CPR, ACLS, make sure you get your CEUs for your license (plus we have to get 4 hours a year of trauma hours), etc. etc. etc. etc.

danu3

danu3

621 Posts

I hate the whole idea of seeing patients as "customers." Or "clients." T

Or in mental health, it is call "consumer" and I just can't get adjusted to it. I keep having this image of people lining up at an electronic store to buy a TV or something.

-Dan

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