You're On Stage

Nurses General Nursing

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My friend, a hospital RN says that morale at their hospital is at an all time low. Raises are based on patient satisfaction scores. They have some mandatory training coming up that I think he said was called You're On Stage. Has anyone had this training and if so, what is it? More scripting? More customer satisfaction bull****? Benefits were cut and they have mandatory overtime. It's a non union place.

What are you talking about?

Maybe this: http://blog.cep.com/bid/21152/Health-care-reform-and-patient-satisfaction

I'll admit, I had no idea HCAHPS was going to become a CMS cutoff metric; that makes me sad. :crying2:

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Specializes in CVICU, Obs/Gyn, Derm, NICU.
We had signs in the hallways of the unit saying the whole "how can I assist you today? I have the time". In the picture is a nurse waving with an exaggerated smile.

On stage ... 'nurse waving with an exaggerated smile '

Disneyworld ???

Next they will think of costumes

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They do it where I work but it is called "Showtime" and when fellow employees think that you are not doing what you are suppose to do they go... "that's not very showtime of you." Very annoying.

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It just sounds like somebody has a bad case of the Mondays.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

The thought of having to watch some of the best, but perhaps not as "showtimey" nurses I've ever known suffer the indignity of having to go through a course like that makes me physically ill. Next time I'm hospitalized I'm going to request the grumpiest, crotchetiest old nurse in the place and give her 10s across the board just on principle.

Who knows? She might be the one that noticed that very subtle symptom of me heading south just because of the spidey sense some nurses have.

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What's good for the goose. If hospitals and physicians* are going to be paid based on pt satisfaction, so should nurses. * I don't know that anyone really is, I've not read the health care reform act & I'm just going by rumor. It may all be a crock of sheet, lol.

I doubt nurses will ever be paid on p4p because standard guidelines for administering nursing care would be next to impossible to measure.

to the best of my knowledge it works something like this and of course I am simplifying a great deal.

the crux of P4P (pay for performance) for physicians already exists. it is not patient satisfcation but rather is clinical indicators and metrics that are, best I can see, from the ARHQ. They are things more like : is the physician following established best practice guidelines for treatment. It is voluntary participation but CMS and private payors offer incentives for participants. there are other indicators from CMS called DRG indicators which focus on following standard guidelines for treatment - ie, did a pneumonia pt that came into the ED get a broadspectrum within 4 hours. Was a culture taken before the bs. was administrated? If the pt was a smoker and had an in-pt stay was smoking cessation education/material provided. these indicators are used to rank quality which may be why your manager reads you the riot act if your unit causes the hospital some bad stats - they are published and avail.

for performance indicators the new laws merge the drg and p4p into one set (ultimately) in the first stage it's very lax. (see HHS/CMS website Meaningful use Stage 1) providers will not be paid based upon their performance indicators but they will get either added incentives on payments for good ones or deductions for bad ones, least as I know it to be true. Also outpatient and inpatient different indicators and I believe there may be a few differnces for academic/teaching hospitals.

To me this is a good thing; following standard care guidelines ensures better outcomes, reduced hospitalizations and lengths of stays and healthcare outlays. keeps our parents healthier too!

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Maybe this: http://blog.cep.com/bid/21152/Health-care-reform-and-patient-satisfaction

I'll admit, I had no idea HCAHPS was going to become a CMS cutoff metric; that makes me sad. :crying2:

I agree it's ridiculous - many patients can't be pleased it seems no matter what you do . I'd prefer a better surgeon with a crappy bedside manner any day.

let's hope not. Ihave not seen anything like that in Meaningful Use requirements or discusssion. (doesn't man I haven't missed it tho) But even if it is it won't have much influence on it's own if the provider is getting good scores on clinical indicators.

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Specializes in Trauma, Teaching.

On the whole I don't like scripts nor canned speeches. I prefer to asses each situation and respond appropriately. I am a professional, and gee whiz! I do know how to do that.

On the other hand, I have some coworkers, (not nurses), who don't seem to have been brought up with manners nor have any idea of how to be tactful, polite or courteous, let alone how to de-escalate a situation.

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I can not believe that our health care facilities have had to come to this. Every person working in a hospital, in any department should always be on thier best behavior. We are all adults..and need to act that way. I have seen my share and what a story I could tell.

I was thinking that the OP's answer is role playing.

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I am all for patient satisfaction, and have known some patients who have truly received HORRIBLE treatment at the hospital. But I think that raises that are based only on patient satisfaction scores could backfire on everyone involved. What if a patient with an enlarged heart is mad because he can't have all the salt/sodium he wants? What if a diabetic is mad because they can't eat all the sugary sweets they want in the hospital? Some people don't understand or accept there care, even when it is the best for them.

My dad had been dying of an enlarged heart, congestive heart failure, extremely high blood pressure for about 3 or 4 years. When he went into the hospital for the last time I decided to fed him some of the Hershey's kisses I had ( I was 12 at the time, and this was a 12 ounce bag). A nurse came in a fussed hard at me for doing it. At first my family and I were upset. But she didn't know that my dad was dying (the doctor had been telling mom for years that his heart was so weak that he could die any moment) and that he was doing good to eat anything. They couldn't get him to eat, and sometimes, even at home I could get him to eat when he said he didn't want to. He was so weak I had to unwrap them for him and put them in his mouth. At this point he was basically having his last meal.

Someone talked to the nurse and let her know he was dying and probably getting the last treat he would ever get and let him have that time with his daughter. She came in the room apologizing and assuring him/me that he could have whatever he wanted. He didn't have the strength to eat many more.

What if we had complained on her? That wouldn't have been fair. She was doing her job and corrected herself after she saw her error.

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We have a new policy of hourly rounding. I think the hourly rounding is a good idea, but we are supposed to follow a script of:

"Good morning, my name is _______ and I am going to be your nurse today. I will be rounding hourly to see if you need any assistance with pain, repositioning, or using the bathroom. Is there anything you need right now, I have time."

Like you said, the script makes it sound fake and forced and I would feel alienated if I were the patient.

personally I like this one it lets the patient know what to expect.

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Specializes in Neuro, Cardiology, ICU, Med/Surg.
Yes my friend (fellow RN) works at a hospital in which she does have a line she must say to visitors (not patients), "Hi I'm ________, can I assist you? I have the time." LoL! I think that is so ridiculous, I mean who comes up with this stuff? Makes me think they want us to be robots. I mean really.

Seriously? Who comes up with this rubbish?

I love how so many different institutions force the "I have the time" onto the scripts as if saying so makes it so. I'm sure that so many different institutions' patient satisfaction surveys have a common complaint that says "the nurses never seem to have enough time to answer my questions" (or to do whatever it is the patients/families want the nurses to do). So rather than address the problem of nurses that don't have time, we just tell them to say that they do and "poof!" problem disappears.

I'm praised for my ability to make connections with patients. This comes from close observation of what a particular patient is about and tailoring my approach to fit the patient. Any one-size-fits-all approach just kills that.

I think I'm going to start a new career and be the Scott Adams of the healthcare world and start a comic strip to be the "Dilbert" of the health care industry. I can come to this web site for a never-ending supply of material from stupid scripted sayings to mandated uniforms... Hmmm....:cool:

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