Sunday, August 07, 2011

the tale of the evil nurse gnome

Somewhere in the hidden recesses of any hospital, in a dark, dank cubby next to the boiler room, sits an evil PHD nurse gnome, rarely seen, with lots of time on their hands. She appears periodically to drop pearls of wisdom into the unknowing laps of the bedside nurse peon. These gnomes have a magical ability to cast a spell over anyone above the level of staff nurse in the food chain. They call a meeting of "the nursing management", enter the room with a flourish with charts and graphs and data and statistics, so loaded down with research that it scares the shit out of everyone in the room. Being dazed with fear and under the spell cast by the gnome, they can only mumble "oh yes", nodding their head so rapidly that they have a sore neck the next day. The gnome dazzles, gesturing wildly, spinning tales of happy nurses, happy patients, happy satisfaction surveys, enchanting all who listen. She paints a picture of peace of earth, good will toward men, brotherhood, a veritable garden of eden if only her scathingly brilliant idea can be implemented. She is a powerful sorceress and "the nursing management", readily agrees to go immediately forward to convince the ignorant masses (read nurses) that this idea is heaven sent.

On the occasion of the monthly staff meeting, the nurse manager appears, somewhat dazed, twinkling, eyes bulging, pacing back and forth at the front of the room, suddenly shouting, "cast your attention this way all ye who enter here, for I have a tale to tell that will astound you and inspire you....". A wave of fear crosses the room...alas the nurse masses recognize the edict is about to come from on high that will add yet another burden to their already heavy lot....the managers voice booms forth the new and heavenly idea: "We, the esteemed leaders of this institution have come forth once again with a spectacular, brilliant, genius of an idea...and it shall be called HOURLY ROUNDING. Yes hourly rounding my brethren. At the beginning of the patient visit ye shall enter the room, introduce thyself, put thy name on the board with the magical magic marker, inform the patient that you will be back hourly to check on their myriad of needs: pain, potty, hydration, warmth, updates, perhaps you can do their taxes in your spare time...then as you exit the room, I want you to initial a document a scroll (paper) attached outside each room...a tracking device as it were which shall be collected each day - analyzed, sorted, recorded, stored...well you get the idea....and woe to those whose initials do not appear.." "Now many of you may be wondering why we would institute such an idea in an emergency room where we run in and out of the room every five minutes it seems....ah....well...because...well just because...just do it you fools! Now go forth, spread joy and happiness throughout ER land...."

As the nurses filed out, shoulders sagging, one nurse drew up to her full height of 5'3" and stated boldly: "Forget this shit, I ain't doin' it and strode away..."


rnraquel said... too. It is supposed to magically raise our scores!

Anonymous said...

Holy shit. Do you work in my hospital? Our nurses have to do that (or at least document that they did) too!

girlvet said...

Dr Kill - I saw what you did, I know who you are...heh heh heh

binkRN said...

I think my words when this wicked message came forth were utterly similar.
This has its merits on the floor, I think we all get that. (Even though it really has no effect on patient care IMHO- except to piss off patients who actually don't need stuff every hour.)
But in the ER, this is beyond ridiculous.
A close second is "scripting"- where we are supposed to say the same stuff to all patients, blah, blah, blah. Well, I already have a script: My name Bink, and I will be your nurse. That's all they need to know, unless something else comes up, I am not offering more information.

Nurse K said...

We gotta do that shit too, except I always think it shouldn't be pain, potty, position, it should be:

1. Sandwich
2. Assurances of cab voucher
3. Dilaudid IV until unconscious
4. Juice

midwest woman said...

actually bink RN it doesn't have it's place on the floor either. They want us to round and enter it into the computer as we go. What a fucking waste of time. You can either actually check on your folks and do something or make shit up and put it inthe computer. You don't have time for both. I've seen people at the end of the shift neatly click on 9, 11 etc and enter in their rounding data just to be compliant. That to me seems to be false documentation but since they've got us by the short and curlies on this people are terrified not to do it. Our computers are so used unfriendly there's is no way in hell to do it quickly. I timed it and it takes 1 to 2 minutes to click on all the stuff they want covered. Plus they want paper documentation which hangs in the room.
Girlvet, did you really say that???!!!!

Anonymous said...

Y'all are being Studerized. Best recourse is to refuse en masse to do that foolishness. Just say no. Strength in numbers and all that.

GB, RN said...

OMG...I know this routine too well. We had an idealistic new grad with a masters come up with hourly rounds, but she took it a step further and created little flip cards outside the room that the nurse would flip during hourly rounds. That way, when he/she looked down the hall, they could tell what room they had been in.

That lasted a whole week. The staff largely ignored them.

Nurse K said...

PS One of my great accomplishments as a nurse manager was keeping the "check sheets" (marking your initials on a piece of paper on the patient door when you went in it) out of our ER. There was 65,000 patient visits/year or something in my ER. The people on top wanted us to save all these pieces of paper and reference them should a patient complain about their care. I'm just like, "Would the hospital approve warehouse space in our FY 2011 budget for these pieces of paper? If not, before this is implemented, I would like a definite plan for where 65,000 pieces of paper are to be stored each year so that they are easily accessible when needed."

No one wanted to stand up and say that they wanted to pay for warehouse space for the 65K pieces of paper/year. Shot down. You're welcome, nurses.

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