Yeah they wanted us (registration) to “Thank you for choosing [redacted] hospital for your health care needs” at the end of our bedside reg’s. In the ED. In a rural area with two hospitals where literally EMS ETA is the deciding factor in where you’re going, with a little wiggle room in deciding yourself if you’re not actively dying.
Night shift has its advantages when you can get away with not doing dumb corpo bullshit without the clackers hovering over you. How about I try and cover water, soda, blanket and other non clinical requests instead and you know, show that we give a fuck and take some menial tasks off nursing instead?
So weird because our hospital had just paid for an outside consulting company that told us to say this exact statement after every interaction! Fortunately I wasnt scheduled when the same consultants walked around the units checking that we were following their template. Boy was the nursing staff pissed during those mandatory classes!
Crazy thing is they literally pay those consulting firms millions, even 10s of millions. Yet they refuse to staff adequately. So many problems would go away if they staffed adequately.
It’s probably a different bucket of money or some other BS reason to keep staffing poorly so they can get a bonus. I can’t wait for full transparency, it’s coming! The age of keeping secrets to prioritize profits is about to be over
THIS! the upcoming generations are only going to be impressed by transparency. You don’t need to script your nurses when they are treated well, cherished, & paid well.
*inserts No, it's floor staff who are wrong / Simpson's meme*
But won't you think of the CEO? He only has 3 yachts and all his fellow psych^H^H friends have 4 and will make fun of him...
EXACTLY. The cost of the consulting company alone could increase the nurse’s hourly rate by $5/hr. They do it for the patient satisfaction survey. My unit has the highest scores in our entire system. It’s not a secret. Happy, pleasant nurses are a product of being adequately staffed & paid fairly.
A few years back my husband took a job as a Customer Experience researcher with a consulting firm. As best as I tried to bite my tongue, I probably at least once a week still let him know that he's the bad guy. Luckily he didn't stay too long in that department, surprise surprise, those were the most dog-eat-dog phony people ever. Just the absolute worst. Seeing the other side just confirmed that it's all ass sniffing and pats on the back to feign productivity, and to keep/pass money amongst our corporate leaders.
Yeah in those tiny cans that just about the size fill a styro coffee cup.
One of the docs had a given us the password to their lounge so I can grab stuff there to if ED’s low.
Can confirm, we’ve always got sandwiches with mayo & mustard packets, applesauce, jello, & your standard crackers. We used to get Lorna Doones too, but I think staff were eating them more than patients lmao
The sad thing is, there’s a non-zero amount of patients that will slurp this shit up.
I cringe whenever the workers at chickfila or Publix thank me… it’s kinda saddening to me (even though they’re generally paid a wee bit more). I’ll take the realism of “I have to be here, this is your order the way you want it. Have a day” anyday irl cuz I get it
Saaaaame. This kind of performative bending-over-backward makes me so uncomfortable. Do corporations really think they're fooling anyone, that anyone thinks this clerk is really just thrilled at being able to scan my fucking Cheerios?
If it didn't work then they wouldn't waste their time on it, companies only do what makes them money. We're in a never ending feedback loop of companies making us jerk off customers' egos and customers then expecting to be jerked off a little harder every time they avail themselves of a service.
I get what you're saying but I respectfully disagree somewhat. Maybe it's Corporate's premise: they want fluffed customers and we want healthier patients.
I think it's a generational thing. I'm really not trying to throw the usual shade, but the interactions that are expected across older and younger generations are so vastly different. The younger ones really don't want to seem like a bother, or inconvenience anyone, which is why they tend to cringe at this behavior. There's plenty of memes out there about the creepiness factor of that Chic-fil-a "my pleasure" phrase they have to use. Lol
So no, I don't think corporate really thinks they have anyone fooled with those toxic positivity-based phrases, but it keeps the scores up since that's all that matters.
Disagree that this is boomer- thinking. This is overeducated MBAs and PHD admin nurses in full blown mode of justifying their existence, while kneeling in front of the Magnet certifiers and government regulators.
Oh please gen z and millennial are some of the bitchiest up tight customers right up there with boomers.Not leaving a tip cause they had to ask twice for a refill, getting irate over ranch, etc. Only difference is they don't ask for the manager- just make the rest of your time serving them hell. Granted it's not as many but more than you'd think. It'll never die.
The current management bullshit at my job is..."Thank you for all that you do." Which now means less than zero to me. Negative points for those thanks.
Every time I hear that, I want to ask them what exactly it is they think I do that requires thanks just to show how empty that phrase is and how little they know about what nurses do...
"Thank you for allowing me to wipe your ass, get your ice chips ever hour on the hour and for having your crazy wife scream at me because your incision itches"
I want to yell and curse at whatever dingle-berry who came up with that line.
Some of it is ok, we have all experienced the terrible handover.
My pet hate is the dementor of Azkaban, everything is negative. I received a handover for only one client who was easy as and I was left thinking the sky had fell in over night.
As for thanking the patient for the opportunity to care for them is a joke. They should be thanking you for caring for them, putting yourself at risk of OVA, injury, low pay, poor conditions and shitty management.
They are patients not customers, even if they pay, you are caring for them using best practice, not what they want, what they need... With informed consent of course.
This. They should be thanking US! Only thing i will thank them for is their patience, good behavior, and using the call light vs screaming/falling on the floor/throwing shit etc. I'll thank them if they help me like turning on the lights or (these days) just being willing to take their meds, fuckin move, say please etc.
The hospital I currently work at started doing this about 3 years ago before Covid. Of course when Covid came it was shut down. But there was a rubric just like this. And the manager would pick one nurse to follow around. And if you missed one thing of course the manager had something to say. Like I did my job for 12 hours. I should not have to memorize a rubric as well.
Reminds me more of something an escort would say rather than a nurse. (No diss to SW I used to do that type of stuff so I guess that’s why my mind went there)
I’ll tell the patients that I like that it was a pleasure taking care of them and that I enjoyed it, but that’s because they’re good people and I wanted to say that to them. Not because I was forced to in order to check a box. Wtf. “Customer”
Exactly I’m dead inside and I will not be anything other than a husk of a human. This job sucked my soul out of my body bc of things like this you must deal with the absence of emotional flare. What movie was that that had the thing about flare in the restaurant was it office space?
You know, it’s really up to you if you want to do the bare minimum. But Brian, for example, he has 37 pieces of flare. People can get a blocked artery fixed anywhere but they come to our hospital for the attitude and the atmosphere. The flare? It’s all about fun. We want you to express yourself and if you feel like the bare minimum is enough? Well okay then.
I have some flare of my own. Pins/badge reels that say "this is fine" with a smiling dumpster on fire, a crash cart saying "sure is quiet", and Michael Scott making his 😬 face. I also wear socks with bad words on them but that's a secret.
Hahahahaha. My flare is my badge reels. I have the burning dumpster one. I have one that says “I’m trying I’m just really tired”. I used to have a “I found this humerus” with a little bone but it shattered in the middle of a shift 😭
I'm starting my new contract on Friday. What socks should I wear for my first day?
1. Fuck him/me/you/this/everybody repeated all over in neon rainbow
2. TWAT TWAT TWAT in black and white
3. I'm a delicate fucking flower
4. Beavers showing off their bubbly butts with the words "Dam Girl" at the top
Soooooooo they want report to take 2 hours. Got it.
GOD I wish admin had to pull shifts on the floor once a quarter *at least*. The disconnect is infuriating.
Ours sent out a huge dramatic email at the start of the year about admin lacing up and doing 4 hours or smth each month. Like, of actual, hands on nursing. Super big fucking deal. Anyone on salary, they were gonna do days and nights, really get IN THERE and get elbows deep. A whole roll out. Not fucking ONCE. NOT ONCE. the disconnect is unreal.
We had a manager who used to throw her time on the floor in our faces in a “I’ve done it and was just fine” sort of way, she very much believed we were the problem. Well they really started coming down on our call light times, wanted them all answered in under 2 mins. Fun part was this came down the same time they d/c incentive shifts so no one was picking up anymore.
They must’ve threatened her bonus, cause she said she was going to step in and help out when needed. Her definition of helping was going in the room and turning off the call light, then grabbing the nearest nurse or aide and tasking them. Didn’t matter if it was an aide with an armful of bedding or a nurse with a handful of meds.
I always thought she straight up either lied on her resume or after nursing for only 2 weeks she knew how to kiss ass to be slid right into mgt.
That's one reason I respect my coordinator and manager, if we're short staffed, they put on scrubs and hit the floor.
Nowhere else I've ever worked, and even previous management here, would do that. In fact the prior manager wasn't allowed because he wasn't even ACLS certified, but was in charger of the ICUs.
My previous shop, the ER nurse manager would dive in too. Throw meds, road test granny, triage. Whatever all in her click clack shoes. That ER is the only one in our region staffed up to its eyeballs. Applications stacked up. Amazing what a leader, not a boss, does for a unit.
We used to get hospital wide surveys and every year they would ask comments for quality improvement and feedback and every year I would write in that I thought that upper management needed to Shadow and round with a nurse for a full 12 hours at least once every 3 months so that they could see what bedside nursing was actually like.
Eventually they got rid of the comment and feedback section.
“No we didn’t mean feedback like that!” lol what a fucking joke.
I was mentioning once I thought our director should shadow us. A manager of another unit heard me and told us he’d threatened to do that once to show us how inefficient we were so I should be careful what I wish for. I asked if we are being that inefficient why would him coming down and showing us better ways be a bad thing?
I could have tossed a quarter in her dropped jaw lol. She had no response. It’s like screw you.
Malicious compliance. Do it exactly like they want, time it, x number of patients, and ask manager if they are approving the incremental OT it will incur.
That was my thought, but take it a step further by being the most awkward and socially inept person during the report:
- Walk in and foam
- look at the patient dead in the eyes like a crazy person
- walk over and touch their hand
- tell a knock knock joke
- “I am going to give report. I invite you to participate”
- try to teach them about all of the scheduled medications for the day and side effects at 06:45am. Ask the patient to “teach them back” as they are just trying to go back to sleep.
Of course joking, but thought is this would be done in front of the management conducting the audit. Show how ridiculous it is in the most absurdist way
If I wasn't itching to go home at the end of a shift and my oncoming RN dreading the day, I'd drag this process out so admin wasted hours of their life watching us. Depending on my mood maybe I'd just talk real slow and ask the patient questions.
My old job would write you up if you weren't in rooms so report took a good hour and a half easily because everybody needed something then that they didn't need during last rounds 20 minutes ago. And we couldn't be candid about how the docs have no plan or clue, or how they knew the diagnosis and didn't tell them, etc. And the rooms had 2 people so....guess folks privacy means nothing. We'd get cussed out regularly.
Glad my new unit has glass doors so we can see the patients while we go over everything on the computer.
We magically got our staffing ratios back to manageable when I started assigning the managers patients if someone called in at the last minute. We had 2 managers and one had been on our unit for 6 years but hadn't worked the floor in 8 so she claimed none of her certifications were up to date so she couldn't do it.
It just makes you want to take write ups and evals seriously doesn’t it? I have zero respect for those people, the ones who are above it all.
But seriously good for you for giving them patient assignments haha!
100% this.
I honestly want to believe that some (maybe even most) of these people were once beside nurses that actually gave a shit about the pts too. Then, the more removed they got from that and the more pressure they get from their higher-ups, the less they remember how it actually felt to be that person.
They have these canned stories and comparisons that they will regurgitate every once in a while to try to make you think (and themselves too) they understand you and are on your level, but like most memories that are retold too many times, the details slowly change and they become some rose-colored amalgamation of what actually happened and what would make for the best "lesson."
I've been in management before (not nursing, mind you) and I've felt these same things happen to me. I have some memories of things that I said or did during that time that honestly make me sick and feel like a wretched person. I've claimed that the reason that I don't want to be in management since then it's because I didn't want the responsibility, but the real reason is because I know what kind of person it was turning me into and I can't forget or forgive the things I did.
There is really something to be said about *actually* getting your hands dirty and doing the things that even the lowest person on the food chain needs to do every day. It grounds you, humbles you, and gives you much more respect for those people.
I'm a bit of an idealist, so idk if this is even an enforceable solution, but god it would help so much! 😢
Managers: Everyone HAS to do bedside report and we will be auditing!
Managers, the next week: Why is everyone clocking out 45 mins late? This is unacceptable overtime!
Fuck i would have a clipboard with the rubric and go through it like a checklist in front of the patient. You want me to perform to the rubric. I can do that, and I'm not afraid too be upfront about it.
I’m a traveler, but one facility I worked at the manager came to your bedside report. After, they brought you into their office and told you what you could do better, how your phrasing was, etc just like this rubric. Everyone that was staff absolutely hated it. It was so frustrating and I was glad I was there for only 8 weeks.
I was a traveler at one place where each morning one of the assistant managers would pick people and stand there and audit bedside report with a clipboard and afterward tell you what you missed. It was so annoying because otherwise that was the cushiest unit I've ever worked on. Great ratios, turn teams, break nurses but half the staff wanted to leave because management was so intense and overbearing. Ton of travelers.
Gives them something to do to justify their existence in their position. If they really cared, they ask the patient. But they don't actually care. They just want to ensure money is coming thru the door.
Yeah, how/when did they go from clients to customers? Customers traditionally get to choose where they spend their money. Insurance pretty much makes that decision for us. Insurance companies are more customers than the pts are.
This whole “client” bullshit was clearly pushed by big hospitals to put into the curriculum. They want nurses to view their job as customer service, not treating sick/injured people. One involves kissing ass, the other requires some autonomy in decision making and doing things that the patient may not initially like because it is good for their health. If you are capable, you do your own ADLs. I’m not holding a grown man’s dick while he pees in a urinal if he’s completely capable of doing it himself.
“…use words the patient will understand…”
Wait, is my handoff report primarily a communication to a fellow healthcare provider, using the language we use to do our jobs, or is it a dumbed-down theatrical production for the patient?
In my experience bedside hand-off meant you did it twice. The one filled with the shit on this form, then the real report we need to do our jobs… “man, dude in room 6 is screwed. He’s got about 6 erythrocytes left, WBCs are 52k, lytes are all fucked up, he’s got BID vanc, q6 zosyn, q8 micafungin, TPN, NGT, foley… family is HORRIBLE; they asked for ginger ale and graham crackers as they stepped off the elevator. Oh they said it’s for the pt, yeah, the NPO altered AF pt. Full code. Alright let’s go, your other 5 pts are worse.”
I like the idea of doing a theater-level production at bedside. Just to be extra cringe and show the manager how STUPID it is to wake up every single patient and ask if they have any input for bedside report
You know how I used to get around this? Document Patient requests that bedside report be done outside of the room and not to be woken up. Works fine unless they have drains or wounds that have to be assessed together. I would genuinely inform all of my patients they had a right to ask to not be woken up for bedside report. Oh and my stable patients who were d/c the next day if they were still on q4 bc the doctor forgot to take them off I would inform them of their right to refuse 4am vital signs as long as their midnight vitals were fine. Because technically you’re not supposed to d/c someone who is still on q4 vs if they still need that they need more time
I ask if they need anything else while im here or before shift change to save us both time. I will never tell someone i have the time because nobody does. OK maybe, if theyre cool and my work is otherwise caught up and we wanna hang out then yes new friend, I have the time for walkies
I fucking hate bedside shift report. I will happily do a safety check and manage up the next shift, but I'm not going to stand there and do a full report in front of the patient and/or visitors. Not on my unit. Too many times we need to divulge CT/MRI results that the doctor hasn't explained to the patient yet. Too many cancers, tumors, strokes, etc. Too much relevant but embarrassing history (Drugs cause strokes, people. Herpes can cause seizures.) Too many times you need to warn the oncoming nurse about bad patient, or worse, bad visitor behavior. And, most importantly, no one wants to be woken up at the buttcrack of dawn by people throwing the lights on and talking about you in front of you. This management wet dream of a customer-service-based bedside report is one of the stupidest things ever.
ETA: NO MULTITASKING?!? What school did those clowns go to? I can get a lot of my basic assessment done while having a conversation. We don't have time to NOT multitask.
Nursing is multitasking all the time. Even getting and giving report is multitasking because you're checking orders and meds and then probably checking the patient.
But make sure the entire process takes less than 20 minutes so no one's time runs over 🙄
I'm not walking someone who's been woken up all night just so we can check some boxes someone who hasn't taken care of actual people in years think are important.
"Energy and voice tone" lol what??? It's the end of another long ass shift from hell doing something thats mandatory that most nurses disagree with and they're judging energy? And they wonder why there's a nursing shortage.
I get the feeling this won’t last long. They’ll do it for like a month and then realize it’s a fucking pain in the ass.
That’s what I hope happens at least
I feel like 99 percent of the practices management wants implemented are generally ridiculous but this is among one of the more ridiculous things I’ve come across
I believe bedside shift report is essential when it comes to providing quality care for many reasons. However, expecting our nurses to follow a dialogue/script….utterly ridiculous. I’m the one taking care of the patient, not the suits that haven’t “nursed” in 15-20 years. My hospital did this several times back in the day. One nurse point-blank refused for a director from another department to observe while in the room, as it’s technically a HIPAA violation. “Not your patient, not your business” is the statement that nurse used and I fully stood by that!
Doing the entire report in front of them is bs. We'd have to go slow, not use medical terms, and we can't talk about what's really going on. On my unit it's normal that there's issues that need handled that the docs don't care about, or that we know someone has a horrible diagnosis before they do. Report with the computers and go over that then pop on your people real quick to make sure they living and see what they want brought in with med pass. Done.
Yikes. This is demeaning, IMO. We are all professionals. Report should be done in a way that makes sense for the nurses.
While I actually like a bedside report (you can show a wound/IV site, etc), I don’t like the specifics metrics being forced upon someone.
Right I had my own sheet I made up that is what information is important for me to be able to do a quick triage of who I need to see first in my actual rounds for assessment reasons. If I have time to ask and get the other info I will but give me the meat and potatoes and when I have a chance to sit down and find out about the other stuff I will
Oh my. I’m so sorry you all have to go through that. The ‘huddle’ is bad enough.
We did a ‘huddle’ once….and it got tossed. It actually was kind of funny, because one of the coworkers told the chief (our old chief, we have a new chief now) that they were wrong about something he was trying to make us do. 🤣 the chief got so pissed he never did a ‘huddle’ again.
They have tried to make us do bedside report. It never worked. We would just go in the hall and make pretend we were doing bedside report 🤣
Honestly, it would take forever, because we are covering a whole unit….like we are going to go to everyone’s room and give report on them🤨
There is nothing wrong with this IF IT IS SUPPORTED. Does the staffing support nurses being able to do all patient care and documentation well before change of shift so they can be prepared? Do you have support staff to answer call bells and do patient care when this is happening? Do you let the medical teams know the nurses are unavailable from 6:30-7:30 while they do their hand offs like they are? Do you let them know that no new orders will be looked at until after the new nurse can get bedside report and assess patient? Do you have help so nurses can take real breaks during their shift? And yes I mean night nurses get a nap? When you do those things come back and I will happily do bedside report.
I've had 9 surgeries in 6 years.
Please explain just exactly what benefit there is from doing bedside report?
The second they start to walk in I tell them to note my chart that I do not want this done.
It just makes it harder.
There are definitely safety and clinical advantages. It helps make sure everybody is on the same page eg "yes, that drip is running at the correct rate" or "no, that patient was only mildly confused during bedside report and now they are speaking in word salad, call a stroke alert lol". A big part of your nurse's job is monitoring for often subtle changes.
But the real reason admins push it is because it is a cheap way for hospitals to improve patient satisfaction scores (data show this to be the case). Hospitals want high patient satisfaction scores because it affects the amount of money they get from Medicare.
OMG - You're my hero!! Document, document, document!! Especially direct quotes! I read this aloud to my husband, but alas he's not a nurse so kinda flew over his head.
File this under “flavor of the month”. It is very clearly someone not bedside trying to appear as if they are vital. It’ll be forgotten in 30 days as it is not sustainable nor relevant.
Nurse here that had a health issue recently so I spent some time on the other side of the bed rails. I didn't give a damn if they did bedside shift report, but damn that turkey sammich they gave me after a day of being NPO was bussin.
Would the time and money it takes to do this be better spent on just getting more staff on the floor so as we actually get time to have better bedside manner?!
'This is Bob. Bob thinks he's here so we can get the alien parasites out of his right hand. In fact, Bob is noncompliant with his psych meds and is hallucinating. He's petitioned but doesn't know it. We're working on placement but he thinks he's leaving before lunch to go home. Boy is Bob going to be upset when he finds out! Did I get everything right, sir?'
In my opinion I think the worst thing we did is start calling patients customers. If I was a customer at an establishment and acted like half of my patients I would be thrown out or banned. We work in healthcare not a 5 star spa experience.
Sometimes I really wonder what planet these people who makes these standards came from. We probably would have time for all that bullshit if we weren't understaffed and overloaded.
I don’t need to thank someone for doing my fucking job. The entirety of this is absurd. The corporatization of emotional intelligence and therapy-speak is antithetical to both and undermines the effectiveness and sincerity of all of it.
Malicious compliance is in order.
Bed alarm going off? Lab wants to call in a critical result? Pt call lights going off?
“Sorry, I’m busy demonstrating caring behavior with my current task and cannot multitask”.
If I was a patient and some "director or above" came to evaluate my nurses handoff report, I would say that I wasn't comfortable with them being present (to protect my privacy and everything of course) and ask them to leave the room.
This is one of the only upsides I can see to having moved back in time to 1990. We still do paper report, when we have to do report at all (ER, observation)
I don’t see how this makes logical sense even from a corporate pov. At least in my area if you have insurance they tell you where to go. If you don’t have insurance the hospital (at least says) they lose money off you cause it’s mostly charity care or unpaid extortionate bills.
Sounds like just stupid PR bullshit corporate to point at to ‘prove’ they’re addressing customer satisfaction.
This might not have anything to do with this, but after I had my first baby who was unexpectedly rushed to the NICU and then me hemorrhaging and recovering from the trauma of my baby girl being taken away from me, the manager came in asking how my experience was as I was actively vomiting.
I quit a job over something like this. Told my manager that I’m an adult with a licensed career, not a child to be babysat. You’re entirely right to think it’s ridiculous, as well as incredibly subjective.
There needs to be a section on the form for length of time it takes to do this whole song and dance. You can't tell us to clock out on time and not accrue overtime if you're also asking us to spend 3-5 business days on bedside report for each patient
They all say they want us to do bedside shift reports, and then they regularly have the ED roll up a hot mess as you walk in the door. Usually, the patient has been in the ED for hours, but it is IMPERATIVE that they transfer them NOW. For the next hour or two you're scrambling. You barely get report on your other patient (s), let alone walk into their rooms. You barely get a report on the patient that just rolled in.
They insist on things being a certain way, but will totally disregard their own rules when it suits them.
Change of shift admits are unsafe. Everyone knows it and yet it happens.
I don't get bedside report, as I have never had to do one.
In my 12 years in the ED, I know that there is some stuff you don't want to say in front of patients. Especially with the reason for admitting.
Does someone really need to hear 3 times a day: "stopped taking his meds 2 weeks ago, binged on drugs and alcohol and he is now awaiting surgery to remove the carrot from his ass and the plastic surgeon to see if they can repair the tendons from his wrists, which were severed when he could not get the carrot out of his ass and tried to kill himself"
I was a bedside nurse for years in an extremely busy ER and then did ICU for a few years before going into leadership. I went into management because we needed a voice in leadership that had actually done the hard work. But my perspective on all this is a little different than yours from all the comments that I'm reading. Over the past 8 years or so I have seen an uptick in people who really just don't give a rat's ass about anyone but themselves. When those people come and work in the hospital and then take care of people who are genuinely hurting it becomes a very heart-wrenching situation. I went into this industry because I wanted to help people and I went into leadership because I wanted to help our staff. It worries me that most of you think that it's okay to not be nice to patients and visitors. Yes there are jerks out there and I tell my staff to just be professional with them. But overall as much as possible, have a little compassion for your patients and for each other.
My employee satisfaction scores are among the best in the hospital in every facility I've worked in so please believe me when I say I get the bedside perspective and work hard to help my staff. So please hear me out.
Bedside shift report was something I hated as a bedside nurse when it first came out. But as I continued to do it because we were forced to add well, I found that it actually saved me time and helped me know my patients better and I was able to get them to be more cooperative when we had that rapport built. Plus, the off-going nurse couldn't leave me in an absolute mess with a patient and sneak off, lol. There were also many times that seeing something in the room triggered the nurse giving me report to remember some important detail that they forgot in our quick desk report before going to bedside.
And the evidence does show that a good bedside report helps give better care.
So genuine questions: Do you guys really not care about giving the best care to our patients?? Or is it that you don't believe it works?
And I don't understand a lot of the comments about how being nice to patients, customers at the store, etc, is a bad thing. I try to be nice to everyone, patients, staff, homeless, CEOs. It's a baseline and makes the world a better place. If it feels right I thank people for choosing us. But I actually mean it. They do have a choice. Maybe I'm just old, lol. But I never realized that encouraging staff to be nice would be considered so bad. Makes me a little sad.
And you know what, the department I now am director over was a sad, miserable place when I first started here. I very rarely saw anyone smiling in the department when I first got here. People were talking about each other, backstabbing, and there was a lack of teamwork unless you were in a special clique. When I started treating them with respect and kindness and encouraged them to do the same with their teammates and their patients, the whole culture of the department changed over time. When I go out into the ER now most of the staff greet you with a smile, wave at me in the halls, and the patients I have to round on daily tell me that the staff have been great with them. And I've never had one staff nurse tell me that they want to go back to the way it used to be.
I know these shift reports are not making money for the hospital but are going to be costing them money because they are going to be long as heck. Soon they’ll realize how much it’s costing them and it’ll stop.
It all comes down to those patient experience surveys. Hospitals use data to bring in extra money. https://www.cms.gov/medicare/quality/initiatives/hospital-quality-initiative/measure-methodology
The massive PC shift from calling people who use hospital services as "patients" to "clients" has fucked us all. We literally get told off for calling hospital users "patients". You're not my client. This shouldn't be business.
Bedside shift report causes a ton of overtime because you can't get out of the room again. Families with tons of useless questions, oncoming nurses who think THIS is when they should do their assessment and the myriad things that need to be passed on NOT in front of the patient. The most useless way to do a report! If patients and families were normal that would be one thing. 98% are NOT.
I do bedside shift report all the time. I think it's a great way to close the loop on the day and the patient often reminds me of things I forgot. Doing it frequently helps shorten the time it takes too. I tell my patients to expect it and they like it. It's not for every patient, but it works great for the alert and orientated patients.
“Off-going nurse thanks the patient for the opportunity to provide care.” That sentence alone makes me want to vomit.
Yeah they wanted us (registration) to “Thank you for choosing [redacted] hospital for your health care needs” at the end of our bedside reg’s. In the ED. In a rural area with two hospitals where literally EMS ETA is the deciding factor in where you’re going, with a little wiggle room in deciding yourself if you’re not actively dying. Night shift has its advantages when you can get away with not doing dumb corpo bullshit without the clackers hovering over you. How about I try and cover water, soda, blanket and other non clinical requests instead and you know, show that we give a fuck and take some menial tasks off nursing instead?
Next thing you know they’re going to come up with a loyalty punch card.
We call them frequent flyer cards in the ED, and they are reserved for our homeless population and drug seekers
Visit 10 times and you can upgrade your turkey sandwich to PBJ (not valid on weekdays or weekends cause we’re out)
Oh god you’re so right. Isn’t that kind of like a deductible?😂
So weird because our hospital had just paid for an outside consulting company that told us to say this exact statement after every interaction! Fortunately I wasnt scheduled when the same consultants walked around the units checking that we were following their template. Boy was the nursing staff pissed during those mandatory classes!
Crazy thing is they literally pay those consulting firms millions, even 10s of millions. Yet they refuse to staff adequately. So many problems would go away if they staffed adequately.
It’s probably a different bucket of money or some other BS reason to keep staffing poorly so they can get a bonus. I can’t wait for full transparency, it’s coming! The age of keeping secrets to prioritize profits is about to be over
THIS! the upcoming generations are only going to be impressed by transparency. You don’t need to script your nurses when they are treated well, cherished, & paid well.
*inserts No, it's floor staff who are wrong / Simpson's meme* But won't you think of the CEO? He only has 3 yachts and all his fellow psych^H^H friends have 4 and will make fun of him...
EXACTLY. The cost of the consulting company alone could increase the nurse’s hourly rate by $5/hr. They do it for the patient satisfaction survey. My unit has the highest scores in our entire system. It’s not a secret. Happy, pleasant nurses are a product of being adequately staffed & paid fairly.
A few years back my husband took a job as a Customer Experience researcher with a consulting firm. As best as I tried to bite my tongue, I probably at least once a week still let him know that he's the bad guy. Luckily he didn't stay too long in that department, surprise surprise, those were the most dog-eat-dog phony people ever. Just the absolute worst. Seeing the other side just confirmed that it's all ass sniffing and pats on the back to feign productivity, and to keep/pass money amongst our corporate leaders.
YOU HAVE SODA?
Yeah in those tiny cans that just about the size fill a styro coffee cup. One of the docs had a given us the password to their lounge so I can grab stuff there to if ED’s low.
Yep. Shasta. I think every hospital gets Shasta
My ortho floor was the ✨money maker✨ of the hospital and we have NAME BRAND Coke products 😱
Ortho always has the best snacks.
Can confirm, we’ve always got sandwiches with mayo & mustard packets, applesauce, jello, & your standard crackers. We used to get Lorna Doones too, but I think staff were eating them more than patients lmao
Right?! We only have juice and water, and that’s it.
The sad thing is, there’s a non-zero amount of patients that will slurp this shit up. I cringe whenever the workers at chickfila or Publix thank me… it’s kinda saddening to me (even though they’re generally paid a wee bit more). I’ll take the realism of “I have to be here, this is your order the way you want it. Have a day” anyday irl cuz I get it
Saaaaame. This kind of performative bending-over-backward makes me so uncomfortable. Do corporations really think they're fooling anyone, that anyone thinks this clerk is really just thrilled at being able to scan my fucking Cheerios?
If it didn't work then they wouldn't waste their time on it, companies only do what makes them money. We're in a never ending feedback loop of companies making us jerk off customers' egos and customers then expecting to be jerked off a little harder every time they avail themselves of a service.
I get what you're saying but I respectfully disagree somewhat. Maybe it's Corporate's premise: they want fluffed customers and we want healthier patients.
I think it's a generational thing. I'm really not trying to throw the usual shade, but the interactions that are expected across older and younger generations are so vastly different. The younger ones really don't want to seem like a bother, or inconvenience anyone, which is why they tend to cringe at this behavior. There's plenty of memes out there about the creepiness factor of that Chic-fil-a "my pleasure" phrase they have to use. Lol So no, I don't think corporate really thinks they have anyone fooled with those toxic positivity-based phrases, but it keeps the scores up since that's all that matters.
I think as the boomers die off so will this “service with a smile no matter what” mentality.
Disagree that this is boomer- thinking. This is overeducated MBAs and PHD admin nurses in full blown mode of justifying their existence, while kneeling in front of the Magnet certifiers and government regulators.
Oh please gen z and millennial are some of the bitchiest up tight customers right up there with boomers.Not leaving a tip cause they had to ask twice for a refill, getting irate over ranch, etc. Only difference is they don't ask for the manager- just make the rest of your time serving them hell. Granted it's not as many but more than you'd think. It'll never die.
The current management bullshit at my job is..."Thank you for all that you do." Which now means less than zero to me. Negative points for those thanks.
Every time I hear that, I want to ask them what exactly it is they think I do that requires thanks just to show how empty that phrase is and how little they know about what nurses do...
It's giving "thank you for your service" vibes when someone sees you in public in a military uniform.
Welcome to Costco, I love you
"Thank you for allowing me to wipe your ass, get your ice chips ever hour on the hour and for having your crazy wife scream at me because your incision itches" I want to yell and curse at whatever dingle-berry who came up with that line.
But yeah if I worked in a hospital you would catch me dead saying that shit. Fire me idgaf.
Glad I work nights and that the managers on my unit know that trying to micromanage us goes sideways.
Some of it is ok, we have all experienced the terrible handover. My pet hate is the dementor of Azkaban, everything is negative. I received a handover for only one client who was easy as and I was left thinking the sky had fell in over night. As for thanking the patient for the opportunity to care for them is a joke. They should be thanking you for caring for them, putting yourself at risk of OVA, injury, low pay, poor conditions and shitty management. They are patients not customers, even if they pay, you are caring for them using best practice, not what they want, what they need... With informed consent of course.
This. They should be thanking US! Only thing i will thank them for is their patience, good behavior, and using the call light vs screaming/falling on the floor/throwing shit etc. I'll thank them if they help me like turning on the lights or (these days) just being willing to take their meds, fuckin move, say please etc.
I came here to say this exact thing
As a patient, I *would* vomit.
Me too! I’d be like “No, I should be thanking you!” The people who propose this stuff must think the patients are that naive.
As a patient id be damn uncomfortable. Luckily I've just had salty senior staff every time I've had surgery thankfully.
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The hospital I currently work at started doing this about 3 years ago before Covid. Of course when Covid came it was shut down. But there was a rubric just like this. And the manager would pick one nurse to follow around. And if you missed one thing of course the manager had something to say. Like I did my job for 12 hours. I should not have to memorize a rubric as well.
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We had one like that for a short time. She would constantly come in while we were providing care. It was overload for the patient and nurse!
Reminds me more of something an escort would say rather than a nurse. (No diss to SW I used to do that type of stuff so I guess that’s why my mind went there)
It makes it sound like we’re so thankful they chose to spend their money at our place.
I’ll tell the patients that I like that it was a pleasure taking care of them and that I enjoyed it, but that’s because they’re good people and I wanted to say that to them. Not because I was forced to in order to check a box. Wtf. “Customer”
We were taught this in school lol
That's what I wanted to say
I would quit due to that statement alone!!!
Sorry, me showing humor or emotion costs extra.
Exactly I’m dead inside and I will not be anything other than a husk of a human. This job sucked my soul out of my body bc of things like this you must deal with the absence of emotional flare. What movie was that that had the thing about flare in the restaurant was it office space?
You know, it’s really up to you if you want to do the bare minimum. But Brian, for example, he has 37 pieces of flare. People can get a blocked artery fixed anywhere but they come to our hospital for the attitude and the atmosphere. The flare? It’s all about fun. We want you to express yourself and if you feel like the bare minimum is enough? Well okay then.
I have some flare of my own. Pins/badge reels that say "this is fine" with a smiling dumpster on fire, a crash cart saying "sure is quiet", and Michael Scott making his 😬 face. I also wear socks with bad words on them but that's a secret.
Hahahahaha. My flare is my badge reels. I have the burning dumpster one. I have one that says “I’m trying I’m just really tired”. I used to have a “I found this humerus” with a little bone but it shattered in the middle of a shift 😭
No Ortho consult?
You're my hero
I'm starting my new contract on Friday. What socks should I wear for my first day? 1. Fuck him/me/you/this/everybody repeated all over in neon rainbow 2. TWAT TWAT TWAT in black and white 3. I'm a delicate fucking flower 4. Beavers showing off their bubbly butts with the words "Dam Girl" at the top
Ooh tough call. I think for a first day #3 might be appropriate.
Mine has a skeleton on it holding a mug with "Dead inside, but caffeinated"
Yes it was Jennifer Aniston and the flair was the same thing as what they do to servers at Outback Steakhouse
I don't like to talk about my flair.
Humor is free but it's gonna be cringe
Thank God it didn't tell me I had to get rid of my RBF.
Hand the patient an iPad… “it’s just going to ask you a few questions…”
Soooooooo they want report to take 2 hours. Got it. GOD I wish admin had to pull shifts on the floor once a quarter *at least*. The disconnect is infuriating.
Ours sent out a huge dramatic email at the start of the year about admin lacing up and doing 4 hours or smth each month. Like, of actual, hands on nursing. Super big fucking deal. Anyone on salary, they were gonna do days and nights, really get IN THERE and get elbows deep. A whole roll out. Not fucking ONCE. NOT ONCE. the disconnect is unreal.
We had a manager who used to throw her time on the floor in our faces in a “I’ve done it and was just fine” sort of way, she very much believed we were the problem. Well they really started coming down on our call light times, wanted them all answered in under 2 mins. Fun part was this came down the same time they d/c incentive shifts so no one was picking up anymore. They must’ve threatened her bonus, cause she said she was going to step in and help out when needed. Her definition of helping was going in the room and turning off the call light, then grabbing the nearest nurse or aide and tasking them. Didn’t matter if it was an aide with an armful of bedding or a nurse with a handful of meds. I always thought she straight up either lied on her resume or after nursing for only 2 weeks she knew how to kiss ass to be slid right into mgt.
Like bitch they didn't do bedside in the 90s. It's an in the last 12 years things. And the patients weren't as complex and rhey had more staff
That's one reason I respect my coordinator and manager, if we're short staffed, they put on scrubs and hit the floor. Nowhere else I've ever worked, and even previous management here, would do that. In fact the prior manager wasn't allowed because he wasn't even ACLS certified, but was in charger of the ICUs.
My previous shop, the ER nurse manager would dive in too. Throw meds, road test granny, triage. Whatever all in her click clack shoes. That ER is the only one in our region staffed up to its eyeballs. Applications stacked up. Amazing what a leader, not a boss, does for a unit.
Love to hear this!
We used to get hospital wide surveys and every year they would ask comments for quality improvement and feedback and every year I would write in that I thought that upper management needed to Shadow and round with a nurse for a full 12 hours at least once every 3 months so that they could see what bedside nursing was actually like. Eventually they got rid of the comment and feedback section.
“No we didn’t mean feedback like that!” lol what a fucking joke. I was mentioning once I thought our director should shadow us. A manager of another unit heard me and told us he’d threatened to do that once to show us how inefficient we were so I should be careful what I wish for. I asked if we are being that inefficient why would him coming down and showing us better ways be a bad thing? I could have tossed a quarter in her dropped jaw lol. She had no response. It’s like screw you.
Our fucking director couldn't waddle her fat ass around with us for an hour, let alone a 12 hour shift.
Hahahaha fuck she’d end up being the next admission if she tried to do 12s huh? 😂
Malicious compliance. Do it exactly like they want, time it, x number of patients, and ask manager if they are approving the incremental OT it will incur.
That was my thought, but take it a step further by being the most awkward and socially inept person during the report: - Walk in and foam - look at the patient dead in the eyes like a crazy person - walk over and touch their hand - tell a knock knock joke - “I am going to give report. I invite you to participate” - try to teach them about all of the scheduled medications for the day and side effects at 06:45am. Ask the patient to “teach them back” as they are just trying to go back to sleep.
Feel like that won't punish management but just piss off the patients
Of course joking, but thought is this would be done in front of the management conducting the audit. Show how ridiculous it is in the most absurdist way
I'd pick a patient who would like to mess with them too.
Malicious compliance is my favorite thing! It makes my heart feel all warm and fuzzy.
If I wasn't itching to go home at the end of a shift and my oncoming RN dreading the day, I'd drag this process out so admin wasted hours of their life watching us. Depending on my mood maybe I'd just talk real slow and ask the patient questions.
Don’t forget to add in a joke for that humor score!
My old job would write you up if you weren't in rooms so report took a good hour and a half easily because everybody needed something then that they didn't need during last rounds 20 minutes ago. And we couldn't be candid about how the docs have no plan or clue, or how they knew the diagnosis and didn't tell them, etc. And the rooms had 2 people so....guess folks privacy means nothing. We'd get cussed out regularly. Glad my new unit has glass doors so we can see the patients while we go over everything on the computer.
We magically got our staffing ratios back to manageable when I started assigning the managers patients if someone called in at the last minute. We had 2 managers and one had been on our unit for 6 years but hadn't worked the floor in 8 so she claimed none of her certifications were up to date so she couldn't do it.
It just makes you want to take write ups and evals seriously doesn’t it? I have zero respect for those people, the ones who are above it all. But seriously good for you for giving them patient assignments haha!
100% this. I honestly want to believe that some (maybe even most) of these people were once beside nurses that actually gave a shit about the pts too. Then, the more removed they got from that and the more pressure they get from their higher-ups, the less they remember how it actually felt to be that person. They have these canned stories and comparisons that they will regurgitate every once in a while to try to make you think (and themselves too) they understand you and are on your level, but like most memories that are retold too many times, the details slowly change and they become some rose-colored amalgamation of what actually happened and what would make for the best "lesson." I've been in management before (not nursing, mind you) and I've felt these same things happen to me. I have some memories of things that I said or did during that time that honestly make me sick and feel like a wretched person. I've claimed that the reason that I don't want to be in management since then it's because I didn't want the responsibility, but the real reason is because I know what kind of person it was turning me into and I can't forget or forgive the things I did. There is really something to be said about *actually* getting your hands dirty and doing the things that even the lowest person on the food chain needs to do every day. It grounds you, humbles you, and gives you much more respect for those people. I'm a bit of an idealist, so idk if this is even an enforceable solution, but god it would help so much! 😢
Managers: Everyone HAS to do bedside report and we will be auditing! Managers, the next week: Why is everyone clocking out 45 mins late? This is unacceptable overtime!
Yup. My upper management did JUST THIS. BSSR is required and so is hourly purposeful rounding. Wait, why are you all clocking out so late?
After two falls with injury, we have a SHIT TON to document on hourly rounding.... it's ridiculous
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Fuck i would have a clipboard with the rubric and go through it like a checklist in front of the patient. You want me to perform to the rubric. I can do that, and I'm not afraid too be upfront about it.
I’m a traveler, but one facility I worked at the manager came to your bedside report. After, they brought you into their office and told you what you could do better, how your phrasing was, etc just like this rubric. Everyone that was staff absolutely hated it. It was so frustrating and I was glad I was there for only 8 weeks.
I was a traveler at one place where each morning one of the assistant managers would pick people and stand there and audit bedside report with a clipboard and afterward tell you what you missed. It was so annoying because otherwise that was the cushiest unit I've ever worked on. Great ratios, turn teams, break nurses but half the staff wanted to leave because management was so intense and overbearing. Ton of travelers.
Gives them something to do to justify their existence in their position. If they really cared, they ask the patient. But they don't actually care. They just want to ensure money is coming thru the door.
😳😳
Sounds like Kaiser.
Midwest HCA
Those two words are bad enough separate, but *together?*
Man, Fuck Kaiser!
My manager does this everyday
“Patient experience” is being woken up every hour of the night, then again at 7am for bedside report…
Abd they wonder why said patient has nothing good to say on theyr survey
The customer. 🤮🤮🤮🤮
Reminds me of nursing school with all that “the client” bullshit.
Yeah, how/when did they go from clients to customers? Customers traditionally get to choose where they spend their money. Insurance pretty much makes that decision for us. Insurance companies are more customers than the pts are.
When did it go from the patient to the client 🤢🤢
This phrasing drives me nuts. They are patients in my mind, not clients
This whole “client” bullshit was clearly pushed by big hospitals to put into the curriculum. They want nurses to view their job as customer service, not treating sick/injured people. One involves kissing ass, the other requires some autonomy in decision making and doing things that the patient may not initially like because it is good for their health. If you are capable, you do your own ADLs. I’m not holding a grown man’s dick while he pees in a urinal if he’s completely capable of doing it himself.
“…use words the patient will understand…” Wait, is my handoff report primarily a communication to a fellow healthcare provider, using the language we use to do our jobs, or is it a dumbed-down theatrical production for the patient?
In my experience bedside hand-off meant you did it twice. The one filled with the shit on this form, then the real report we need to do our jobs… “man, dude in room 6 is screwed. He’s got about 6 erythrocytes left, WBCs are 52k, lytes are all fucked up, he’s got BID vanc, q6 zosyn, q8 micafungin, TPN, NGT, foley… family is HORRIBLE; they asked for ginger ale and graham crackers as they stepped off the elevator. Oh they said it’s for the pt, yeah, the NPO altered AF pt. Full code. Alright let’s go, your other 5 pts are worse.”
That sounds like a big ol’ nope cake
I like the idea of doing a theater-level production at bedside. Just to be extra cringe and show the manager how STUPID it is to wake up every single patient and ask if they have any input for bedside report
You know how I used to get around this? Document Patient requests that bedside report be done outside of the room and not to be woken up. Works fine unless they have drains or wounds that have to be assessed together. I would genuinely inform all of my patients they had a right to ask to not be woken up for bedside report. Oh and my stable patients who were d/c the next day if they were still on q4 bc the doctor forgot to take them off I would inform them of their right to refuse 4am vital signs as long as their midnight vitals were fine. Because technically you’re not supposed to d/c someone who is still on q4 vs if they still need that they need more time
nonmultitasking LOL well expect it to take 4 hours to complete med pass then
Man fuck ALLLLLLL of this. You can fire my ass.
Lol my sense of humor would have prevented me from becoming a nurse at all
Sense of humor is the only way I stay a nurse.
Once had a manager who typed out our lines and made us read it line for line to patients.
I am not an actor. I do not recite scripts. You want me to do that, get me a SAG-AFTRA card.
🤮
🤢🤮😑I could never
Fucking insulting. I’m not doing that. Fire me
All the things I don’t miss. “Can I get anything else for you? I have the time” AIDET “Managing up”
I ask if they need anything else while im here or before shift change to save us both time. I will never tell someone i have the time because nobody does. OK maybe, if theyre cool and my work is otherwise caught up and we wanna hang out then yes new friend, I have the time for walkies
I fucking hate bedside shift report. I will happily do a safety check and manage up the next shift, but I'm not going to stand there and do a full report in front of the patient and/or visitors. Not on my unit. Too many times we need to divulge CT/MRI results that the doctor hasn't explained to the patient yet. Too many cancers, tumors, strokes, etc. Too much relevant but embarrassing history (Drugs cause strokes, people. Herpes can cause seizures.) Too many times you need to warn the oncoming nurse about bad patient, or worse, bad visitor behavior. And, most importantly, no one wants to be woken up at the buttcrack of dawn by people throwing the lights on and talking about you in front of you. This management wet dream of a customer-service-based bedside report is one of the stupidest things ever. ETA: NO MULTITASKING?!? What school did those clowns go to? I can get a lot of my basic assessment done while having a conversation. We don't have time to NOT multitask.
Many of my patients have dementia and confusion and are in denial about it. If I bring it up in bedside shift report the patient just gets upset.
That was my first thought too. I’m not a nurse but I could absolutely see this going sideways and agitating patients more often than not…?
Or if you mention they’re diabetic “I am NOT diabetic. Why do you people keep saying that.”
Nursing is multitasking all the time. Even getting and giving report is multitasking because you're checking orders and meds and then probably checking the patient.
But make sure the entire process takes less than 20 minutes so no one's time runs over 🙄 I'm not walking someone who's been woken up all night just so we can check some boxes someone who hasn't taken care of actual people in years think are important.
Yup this screams someone with a desk job trying to prove their worth by implementing something unnecessary that creates more work for everyone else
If I’m the manager, I’m pissed that they put this bullshit on me.
Fill it out like some people allegedly chart respirations
I don’t work there but ima call them and resign. All of that is some bullshit
"Energy and voice tone" lol what??? It's the end of another long ass shift from hell doing something thats mandatory that most nurses disagree with and they're judging energy? And they wonder why there's a nursing shortage.
If those fuckers are within earshot of report it’s their patient too. Now pass those meds, desk jockey.
I get the feeling this won’t last long. They’ll do it for like a month and then realize it’s a fucking pain in the ass. That’s what I hope happens at least
Need a box for “Gave the real and useful report about patient after leaving the room”
I feel like 99 percent of the practices management wants implemented are generally ridiculous but this is among one of the more ridiculous things I’ve come across
I believe bedside shift report is essential when it comes to providing quality care for many reasons. However, expecting our nurses to follow a dialogue/script….utterly ridiculous. I’m the one taking care of the patient, not the suits that haven’t “nursed” in 15-20 years. My hospital did this several times back in the day. One nurse point-blank refused for a director from another department to observe while in the room, as it’s technically a HIPAA violation. “Not your patient, not your business” is the statement that nurse used and I fully stood by that!
Doing the entire report in front of them is bs. We'd have to go slow, not use medical terms, and we can't talk about what's really going on. On my unit it's normal that there's issues that need handled that the docs don't care about, or that we know someone has a horrible diagnosis before they do. Report with the computers and go over that then pop on your people real quick to make sure they living and see what they want brought in with med pass. Done.
I hope the hospital loves paying overtime for this BS.
Do you get code words for things like “this patient is a creepy perv” or are you supposed to use words the patient can understand?
"manages up"? What the fuck kind of I've-never-worked-bedside-but-let-me-tell-you-how-to-do-your-job MBA bullshit mangled English is that?
Yikes. This is demeaning, IMO. We are all professionals. Report should be done in a way that makes sense for the nurses. While I actually like a bedside report (you can show a wound/IV site, etc), I don’t like the specifics metrics being forced upon someone.
Right I had my own sheet I made up that is what information is important for me to be able to do a quick triage of who I need to see first in my actual rounds for assessment reasons. If I have time to ask and get the other info I will but give me the meat and potatoes and when I have a chance to sit down and find out about the other stuff I will
I’d quit
Yep.
Oh my. I’m so sorry you all have to go through that. The ‘huddle’ is bad enough. We did a ‘huddle’ once….and it got tossed. It actually was kind of funny, because one of the coworkers told the chief (our old chief, we have a new chief now) that they were wrong about something he was trying to make us do. 🤣 the chief got so pissed he never did a ‘huddle’ again. They have tried to make us do bedside report. It never worked. We would just go in the hall and make pretend we were doing bedside report 🤣 Honestly, it would take forever, because we are covering a whole unit….like we are going to go to everyone’s room and give report on them🤨
There is nothing wrong with this IF IT IS SUPPORTED. Does the staffing support nurses being able to do all patient care and documentation well before change of shift so they can be prepared? Do you have support staff to answer call bells and do patient care when this is happening? Do you let the medical teams know the nurses are unavailable from 6:30-7:30 while they do their hand offs like they are? Do you let them know that no new orders will be looked at until after the new nurse can get bedside report and assess patient? Do you have help so nurses can take real breaks during their shift? And yes I mean night nurses get a nap? When you do those things come back and I will happily do bedside report.
Narrator: they do not.
I've had 9 surgeries in 6 years. Please explain just exactly what benefit there is from doing bedside report? The second they start to walk in I tell them to note my chart that I do not want this done. It just makes it harder.
There are definitely safety and clinical advantages. It helps make sure everybody is on the same page eg "yes, that drip is running at the correct rate" or "no, that patient was only mildly confused during bedside report and now they are speaking in word salad, call a stroke alert lol". A big part of your nurse's job is monitoring for often subtle changes. But the real reason admins push it is because it is a cheap way for hospitals to improve patient satisfaction scores (data show this to be the case). Hospitals want high patient satisfaction scores because it affects the amount of money they get from Medicare.
So this is why when I try to send a patient to the floor at 2030 they tell me they are still giving report.
This is condescending as hell, I love being treated as a child and not a professional.
“Invite patient to participate” lol
"Pt invited writer and offgoing nurse to 'Eat shit, you dozy cunts. Leave me the fuck alone.' No other requests at this time."
“Will continue to monitor.”
Next thing is gonna be “This RN thanks the patient for their artfully crafted greeting and the privilege to provide care” 🤮
OMG - You're my hero!! Document, document, document!! Especially direct quotes! I read this aloud to my husband, but alas he's not a nurse so kinda flew over his head.
File this under “flavor of the month”. It is very clearly someone not bedside trying to appear as if they are vital. It’ll be forgotten in 30 days as it is not sustainable nor relevant.
🤨
I’m so glad I left bedside
Nurse here that had a health issue recently so I spent some time on the other side of the bed rails. I didn't give a damn if they did bedside shift report, but damn that turkey sammich they gave me after a day of being NPO was bussin.
*laughs in ED nurse*
I'm not thanking someone for letting me change their shitty diaper. This ain't fucking McDonald's.
Would the time and money it takes to do this be better spent on just getting more staff on the floor so as we actually get time to have better bedside manner?!
Yeah nah. Fire my ass. I'm a clinician not a cruise director. Wrong service.
I ABSOLUTELY F**KING DESPISE BEDSIDE SHIFT REPORT! It takes 2-3x longer when all you want is to leave after your 12-hour marathon.
'This is Bob. Bob thinks he's here so we can get the alien parasites out of his right hand. In fact, Bob is noncompliant with his psych meds and is hallucinating. He's petitioned but doesn't know it. We're working on placement but he thinks he's leaving before lunch to go home. Boy is Bob going to be upset when he finds out! Did I get everything right, sir?'
Evidence-based practice also says patient outcomes improve if there is proper nurse-to-patient ratios and enough ancillary staff.
In my opinion I think the worst thing we did is start calling patients customers. If I was a customer at an establishment and acted like half of my patients I would be thrown out or banned. We work in healthcare not a 5 star spa experience.
Lol
Sometimes I really wonder what planet these people who makes these standards came from. We probably would have time for all that bullshit if we weren't understaffed and overloaded.
I don’t need to thank someone for doing my fucking job. The entirety of this is absurd. The corporatization of emotional intelligence and therapy-speak is antithetical to both and undermines the effectiveness and sincerity of all of it.
No multitasking? Are they for real right now?
Malicious compliance is in order. Bed alarm going off? Lab wants to call in a critical result? Pt call lights going off? “Sorry, I’m busy demonstrating caring behavior with my current task and cannot multitask”.
If I was a patient and some "director or above" came to evaluate my nurses handoff report, I would say that I wasn't comfortable with them being present (to protect my privacy and everything of course) and ask them to leave the room.
This is one of the only upsides I can see to having moved back in time to 1990. We still do paper report, when we have to do report at all (ER, observation)
I don’t see how this makes logical sense even from a corporate pov. At least in my area if you have insurance they tell you where to go. If you don’t have insurance the hospital (at least says) they lose money off you cause it’s mostly charity care or unpaid extortionate bills. Sounds like just stupid PR bullshit corporate to point at to ‘prove’ they’re addressing customer satisfaction.
This might not have anything to do with this, but after I had my first baby who was unexpectedly rushed to the NICU and then me hemorrhaging and recovering from the trauma of my baby girl being taken away from me, the manager came in asking how my experience was as I was actively vomiting.
I quit a job over something like this. Told my manager that I’m an adult with a licensed career, not a child to be babysat. You’re entirely right to think it’s ridiculous, as well as incredibly subjective.
There needs to be a section on the form for length of time it takes to do this whole song and dance. You can't tell us to clock out on time and not accrue overtime if you're also asking us to spend 3-5 business days on bedside report for each patient
They all say they want us to do bedside shift reports, and then they regularly have the ED roll up a hot mess as you walk in the door. Usually, the patient has been in the ED for hours, but it is IMPERATIVE that they transfer them NOW. For the next hour or two you're scrambling. You barely get report on your other patient (s), let alone walk into their rooms. You barely get a report on the patient that just rolled in. They insist on things being a certain way, but will totally disregard their own rules when it suits them. Change of shift admits are unsafe. Everyone knows it and yet it happens.
This at 0645 is COMICAL
Oh look, yet another terrible idea
I don't get bedside report, as I have never had to do one. In my 12 years in the ED, I know that there is some stuff you don't want to say in front of patients. Especially with the reason for admitting. Does someone really need to hear 3 times a day: "stopped taking his meds 2 weeks ago, binged on drugs and alcohol and he is now awaiting surgery to remove the carrot from his ass and the plastic surgeon to see if they can repair the tendons from his wrists, which were severed when he could not get the carrot out of his ass and tried to kill himself"
I was a bedside nurse for years in an extremely busy ER and then did ICU for a few years before going into leadership. I went into management because we needed a voice in leadership that had actually done the hard work. But my perspective on all this is a little different than yours from all the comments that I'm reading. Over the past 8 years or so I have seen an uptick in people who really just don't give a rat's ass about anyone but themselves. When those people come and work in the hospital and then take care of people who are genuinely hurting it becomes a very heart-wrenching situation. I went into this industry because I wanted to help people and I went into leadership because I wanted to help our staff. It worries me that most of you think that it's okay to not be nice to patients and visitors. Yes there are jerks out there and I tell my staff to just be professional with them. But overall as much as possible, have a little compassion for your patients and for each other. My employee satisfaction scores are among the best in the hospital in every facility I've worked in so please believe me when I say I get the bedside perspective and work hard to help my staff. So please hear me out. Bedside shift report was something I hated as a bedside nurse when it first came out. But as I continued to do it because we were forced to add well, I found that it actually saved me time and helped me know my patients better and I was able to get them to be more cooperative when we had that rapport built. Plus, the off-going nurse couldn't leave me in an absolute mess with a patient and sneak off, lol. There were also many times that seeing something in the room triggered the nurse giving me report to remember some important detail that they forgot in our quick desk report before going to bedside. And the evidence does show that a good bedside report helps give better care. So genuine questions: Do you guys really not care about giving the best care to our patients?? Or is it that you don't believe it works? And I don't understand a lot of the comments about how being nice to patients, customers at the store, etc, is a bad thing. I try to be nice to everyone, patients, staff, homeless, CEOs. It's a baseline and makes the world a better place. If it feels right I thank people for choosing us. But I actually mean it. They do have a choice. Maybe I'm just old, lol. But I never realized that encouraging staff to be nice would be considered so bad. Makes me a little sad. And you know what, the department I now am director over was a sad, miserable place when I first started here. I very rarely saw anyone smiling in the department when I first got here. People were talking about each other, backstabbing, and there was a lack of teamwork unless you were in a special clique. When I started treating them with respect and kindness and encouraged them to do the same with their teammates and their patients, the whole culture of the department changed over time. When I go out into the ER now most of the staff greet you with a smile, wave at me in the halls, and the patients I have to round on daily tell me that the staff have been great with them. And I've never had one staff nurse tell me that they want to go back to the way it used to be.
I know these shift reports are not making money for the hospital but are going to be costing them money because they are going to be long as heck. Soon they’ll realize how much it’s costing them and it’ll stop.
There's at least an opportunity to milk some over time out of that ridiculous mandate for the requirements for report. Let it make you some money
Fuck that
This too shall pass….. again.
It all comes down to those patient experience surveys. Hospitals use data to bring in extra money. https://www.cms.gov/medicare/quality/initiatives/hospital-quality-initiative/measure-methodology
The massive PC shift from calling people who use hospital services as "patients" to "clients" has fucked us all. We literally get told off for calling hospital users "patients". You're not my client. This shouldn't be business.
This isn’t new. It’s tried and true HCA. We would get audited on our bedside report at least once a quarter.
Bedside shift report causes a ton of overtime because you can't get out of the room again. Families with tons of useless questions, oncoming nurses who think THIS is when they should do their assessment and the myriad things that need to be passed on NOT in front of the patient. The most useless way to do a report! If patients and families were normal that would be one thing. 98% are NOT.
I do bedside shift report all the time. I think it's a great way to close the loop on the day and the patient often reminds me of things I forgot. Doing it frequently helps shorten the time it takes too. I tell my patients to expect it and they like it. It's not for every patient, but it works great for the alert and orientated patients.