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

[MrsWampthang]

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?

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.

Pam

[MrsWampthang, BSN, RN]

It just makes me so aggravated because if we don't follow their scripts or speak out about this all being crap, we could be fired for not being a team player. Forget that we are already short staffed and some of the nurses we do have couldn't nurse their way out of a paper bag. Let's fire the good nurses who don't comply with the Stetford Nurse image, pay out overtime to cover the holes left by this and spend lots of money and time hiring and orienting new nurses. Meanwhile let the nurses who backstab, and gossip remain because they are buddies with the charge nurses.:angryfire Ok, now I'm really whining. Sorry but I saw one of the best nurses the department had get fired for trivial BS like this so I guess I'm a little cranky.

I am on a hospital wide committee, but when I mention a getting department committee together, I get blown off.

I just wish the hospital would focus on employee satisfaction as fiercely as they focus on customer satisfaction. It just makes sense that a happy employee is going to make for happier patients. If everyone loves working where they work, they will reflect that in their attitude and work habits. Patients will see that, and will benefit by it. "It" rolls down hill after all doesn't it? Instead they put stress and resentment on us by forcing us to comply with their Stetford Nurse image; never mind that we already care about our patients and take excellent care of them, that's apparently not good enough.

Sorry guess I am really whining or venting. I guess I'd better close this before I really get on a roll. Again, thanks for the support.

Pam

[tntrn, ASN, RN]

I agree totally with everything the OP stated. Not whining. No way. It's really so planned anymore I wonder if PATIENTS (not clients, not consumers) feel any compassion from us at all. I know I find it more and more difficult to have much time for compassion, not to mention actual bedside nursing. I work perdiem and the staffing levels at our place are going bare bones, so I get cut more and more. Not complaining about that, because I do have a very full life outside the hospital, but it's hardly worth it anymore to set aside a day for work only to find out at 1 pm that I could have done something else.

Really, seriously thinking of resigning: completely from nursing. I love what I used to be expected and allowed to do, but no longer are we allowed to do that. There's the computer, the scripting (I used to always ask when leaving the room if there was anything else I could do. Now that we're told to say that, it feels so frickin' fake!) Then there's the new ACLS thing that we've been told we'll have to finish by the end of the year. That's the straw I think because our unit is not at risk for needing that. I think I'd be more dangerous having it and not using it for another 5 years...plus they'd expect me to be competent if and when. I just don't see myself going there.

I'm nearly at the time when retirement would be coming anyway. I think JCAHO and all the others have made that decision easier. I have other things I can do at home to make my spending money.

Going to work is now longer fun. I don't mind hard work; but in the "old days" we worked hard but we could have fun at the same time. Now it's hard to feel that way. Always someone telling you how you could give better service. And BTW, when someone requires me to go to a service excellence lecture, they are assuming I don't already give excellent "service" and that really offends me.

I don't know what the solution is, but I see a lot of nurses who are just buying into it and will go blindly with the flow. I'm willing to rebel, but how do we do that?

[fallfoliage]

Ok so I wil Jump in here.. Your post a great question and several great points about service excelemce programs.. I wanted to respond, as i am management.. Press ganey is supposed to be a tool to guide us not the gospel of what we are doing.. It is true that pt that have a complaint they will be the ones most likley to fill these surveys out . Therefore they need to be interpreted that way .. I have yet to find an organization ( i have worked at 5 ) that know how to interpret the scores properly ..That being said the healthcare profession needed something to raise the bar of customer service.. I have seen it deteriorate in my 30 + year career. Yes we are busier and leaner but the patients are still sick and hurt and need us.. Unfortunatley scripting has been developed because of some in our environment who were not taught manners. I have called MD offices and heard DR>>> Office what do you want ??? Or a family member that is calling my ED to be told I am to busy to get that phone to your mother ..?? . I have also heard an Nurse in the ED call a pt a "scank" . I understand the days of refreshments and backrubs are gone , but pt and families still desrve respect EVEN if they do not give it to us ...

Your point on Goals raises another question for me . Was staff involved in setting Departmental Goals if no shame on managment .. These goals shouls align with the Organization mission and your personel goals should tie in to the mission and the department goals . You should not feel like tyou have several differnt goals .. That is frustrating.. It sounds like you are a competent caring RN unfortunatle as i am sure you have witnessed not all RN are like that...Hang in there and keep doing your best that is all your patietns ask .. Remember you really work for the PATIENtS not the manager . Paula

[Batman24]

You aren't whining. I feed bad for nurses that are supposed to follow a script and am thankful every day that my hospital doesn't have this requirement. I couldn't work where I couldn't treat my patients as individuals and was required to be a Stepford Nurse. If they are entrusting us not to kill them by giving proper meds, etc. they should certainly trust us to be able to communicate with our patients in an appropriate manner as well.

And waking a patient every hour when there is no reason to do so is cruel. It's putting an administrative agenda above the well being and health of the patient. Idiocy.

[nursemike, ASN, RN]

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.

It's a little depressing to read my three-year-old post and think how much younger I was, back then.

I still don't think we're "doomed," but it sure can be an uphill fight, at times.

[SDS_RN, RN]

"Remember you really work for the PATIENtS not the manager ."

As good as that sounds that is not the truth. Who can yank your job from underneath you for not "complying" or "complaining" about the BS politics? It's management not the pt's. We implemented a new system at work awhile back and while going through the change we were told that even if we complain about it we could loose our jobs. Yes we are there to care/work for the pts but management is ultimatly responsible for nurses being "fired" or "let go". They will find a BS reason to get you out one way or another if they want you gone. We are all replaceable so I've heard a time or two before.

[Virgo_RN, BSN, RN]

Just wanted to say I'm sorry, Pam. I think if our hospital tried such a thing, the administrators would find themselves on the receiving end of a nurse revolt.

[pagandeva2000, LPN]

This nonsense is not about patient care. It is about "Stepford Wives Nursing". It is embarassing, degrading and insulting to nurses on all levels. I hope that one day, management is stuck with no nurses. Get tape recorders and parrots with licenses to take over.

[truern]

i just wish the hospital would focus on employee satisfaction as fiercely as they focus on customer satisfaction. it just makes sense that a happy employee is going to make for happier patients. if everyone loves working where they work, they will reflect that in their attitude and work habits. patients will see that, and will benefit by it.

i so agree with this statement.

and management, please take down the customer satisfaction reports in the nurses' lounge.

[RN MSN CNOR]

I understand your frustration, however all of us can use some help in how we communicate. We moved to scripting on our PACu because our we had patient complaints about nurses not addressing thier pain, nothing was further from the truth. However when a patient arrive in PACU and asked for medication they were often told not now, it isn't time. Or some words to that effect

We went to a scripted or better framed communication: new response something like, lets get you comfortable and situated so we can ascess your needs. We want you to be as comfortable as possible. We DESCRIPTED the words no, not and never and replaced them with comfort safety etc. We try to avoid any responce that can be reviewed as negative.

This has helped the nurses, focus on patient comfort, patients feel the personalized care based on thier comfort.

I get that people do not words put into thier mouths, we do need to be aware of how we are percieved. That simple change dramatically decreased the complaints.

Our nurses are the best they can be and felt good about being able to do thier own script within the guidlines and they quickly saw that perceptions can change with a minimum of work on thier part.

[floatRN]

When I call the customer service line for a company, I can tell when the person on the other end is reciting a script. It comes across as insincere and its annoying.

I always was polite and respectful to my patients and I would sincerely ask them if they need anything before leaving their room. Now our hospital wants us to say "is there anything else I can do for you? I have the time." That sounds fake when I say it and I just can't do it. Besides, won't the patients notice if all the nurses say the same things all the time? They will feel like they are being cared for by robots. Why can't we just have natural, personalized interactions with our patients?