Sunday, November 1, 2009

How in the world is this legal???

I'm not sure if you all are aware of what our govt is up to when it comes to healthcare. I'm not talking about the $1 trillion dollar cost to cover 6 million people with a low cost health plan, I'm talking about patient satisfaction.

There used to be a time that we could say to our very demanding patients..."look, this isn't the Hilton, it's a hospital." Somehow, it's all changing though. Not that patient satisfaction wasn't important back then, but now...if the patient is on Medicare & isn't satisfied with their hospital stay.....the govt doesn't have to pay the hospital for that patient. How in the world is this legal???

And we wonder why hospitals are struggling to keep their doors open & shortstaff us on a daily basis...all over the country. Probably due to non-payment. Don't get me wrong...I'm all for patients being satisfied & I try my best to meet their needs...but there are usually 4 types of patients:

1) confused/dementia/out of their mind & probably wouldn't even remember being at the hospital or even recognizing that they were in a hospital

2) demanding patients who have something to complain about no matter what you do

3) patients that seem genuine & happy, don't ask for anything or if they's immediately taken care of....only to complain a day or two later that none of their needs are being met

4) drug seekers who are never happy with what you do unless they are getting their latest fix

So, as you see, it's nearly impossible to achieve high patient satisfaction scores. This doesn't stop hospitals from trying though. Instead of hiring extra staff...such as patient care techs or more nurses so we have a better nurse to patient ration...they have decided that nurses can also do customer satisfaction type work.

Just when I think "what else can they possibly come up with to add to our workload"...they come up with more non-nursing things. The hour rounding. Sounds nice in theory, doesn't it? We are supposed to stop in at each patient room every hour & ask "Are you having any pain? Do you need to go potty? Do you want to change your position in bed? Do you have any other needs that I can help you with?" Again, sounds nice in theory. But every freaking hour? Just when do they expect patients to get some rest?

Ok, fair enough, I can handle it. What else can they throw at us? Hahahaha...why do I even ask? Now they want us to go in a 1/2 hour before the lab techs come around....they want us to wake up our patients to alert them that the lab will be drawing blood in approx 30 min. This is to be done any time between 2 am & 4 am. The lab will give us a 30 min notice. Somehow this will make the patients less frightened when the lab tech actually enters the room. As if it is the lab tech they are frightened, it's the needles!

And if this isn't order to keep them awake for that 30 min period before lab gets there, we should bring them fresh water, empty the garbage & volunteer to help them to the bathroom. Are you kidding me? Seriously. Is there anyone that wants to be woken up at 2 am with a 30 min notice that lab is on their way? Do you want me bringing you fresh water at 2 am? Emptying the garbage can? I know if I were the patient I would be saying something like "GET OUT OF MY ROOM NOW!!!!!!!!" or "LET ME SLEEP!!!!!!!"

Ok, so seriously....what more can they add? Ha......more. We also have to ask when we do our initial assessment..."What is the most important thing we can accomplish for you tonight?" They look at me like I am insane or a bit off the wall.

And if that wasn't enough....the superuser post I had a week or so ago. I'm a superuser to show doctors how to put in their orders. Is this really part of nursing? Can't they hire ancillary staff to be available to the doctors rather than pull nurses away from the patients? Or how about the unit know...the ones that usually put in the orders. Wouldn't that make more sense since now they won't have as many orders to put in?

Sigh...I am afraid to ask "What else can they add?" Cause I'm sure there is a whole list of non-nursing ideas that they have.

I'm all for patients being satisfied with their hospital stay. I'm also realistic enough to know that by opening this door & allowing the patient to dictate what they consider "satisfaction" will be nearly impossible to achieve. We're not a high class hotel or a shopping mall, we're a healthcare facility. Let us get back to focusing on health.

It's wishful thinking though...sigh.

1 comment:

Amanda said...

I hear you! We have rounding logs in each room where we have to sign and write down what we did each hour to prove that someone was in the room Q1h. Then they put dry erase boards in the room where we have to write 3 things that we need to do in order for the patient to feel that we provided "very good care".