Sanity is madness put to good use. – George Santayana
Do you remember this person? She is a bedside nurse. She walks up and down hospital hallways in her white nursing shoes all day long while caring for her patients. She is trained for active duty. I’m asking you this question because nursing researchers have had an epiphany. They believe that they have discovered something new in the field of bedside nursing.
Over the years I’ve observed that the more degrees and letters that a lot of academic nurses get behind their name, the more out of touch they become with bedside nursing. This came to light once again when I attended a mandatory inservice at work. I was told that we were going to talk about an innovative concept that was going to revolutionize patient care and the nursing profession. Imagine my surprise when the speaker talked about hourly rounds. Did you know that nursing researchers have discovered that patients are happiest when their nurses spend time with them at the bedside every hour, and anticipate their needs? Wow, what a concept. Academic nurses living in the ivory tower of higher learning have discovered through years of painstaking research that patients also want nurses to answer their call light promptly when they need help getting to the bathroom. Holy cow! Hourly rounds decreases the amount of time patients spend using their call lights, decreases injuries due to patient falls, and increases patient satisfaction while they are in the hospital.
Did I miss something? I remember learning all this stuff years ago when I was attending a lowly diploma nursing program. We were always walking up and down the halls in our nursing shoes. No one conducted studies on how to make patients happy back then. A little common sense goes a long ways. The formula to good patient care starts with clean bed sheets and a filled water pitcher, and ends with a connection to your patient. That’s not new. That’s nursing.
midwest woman
June 11th, 2009 at 4:31 pm
I have to spend so much damn time documenting I do it that I don’t have time to actually do it well. Here’s your ice water catcha later gotta put my initials on 3 different pieces of paper wish I had time to stay.
The only letters needed behind an academic nurse is b.s.
mdfloyd
June 11th, 2009 at 8:11 pm
I work at a university medical center — about every two years we get drug into classes to learn the latest “performance improvement” program/theory ever created in the history of mankind. And it’s always the SOS, just with new initials. I don’t work with patients but us non-clinical folks are surrounded by just as many idiots as you nurses.
Purple stinkey onion
June 11th, 2009 at 8:11 pm
I took care of a very sick mother last week. I felt very blessed that my assignment was no too heavy & I was able to spend a lot of time with her and her husband and family. I was able to provide education early prior to discharge day. I was telling her about what is like years ago when we actually and gave pm care. That night I was able to do this for her and she cried and said this was the best she felt during her stay the back rub and just having someone to talk to during this very stressful pregnancy meant the most. It broke my heart to hear her say this, but it was so true. Nursing has changed over the past twenty years and not necessary for the better. Good old fashion nursing care like you said is the heart of nursing, no need to have a study proving that if you ask me.
Reality Rounds
June 11th, 2009 at 10:32 pm
I have always said that common sense is something you can not teach. I also know there is power behind the numbers. Maybe staffing will increase because some academic “BS” nurse showed that better nursing saves lives. I am a staff nurse and a nurse educator, but I don’t hate on the nurses with advanced education who are trying to advance the profession of nursing. I often wonder if doctors rag on their researcher peers for not being at the bedside. Nurses are great at tearing each other down.
Jean-Luc Picard
June 12th, 2009 at 6:38 am
A good look on how things were
Mother Jones, RN
June 12th, 2009 at 6:45 am
Reality Rounds, I’m not tearing everyone down. Just some of those pie the sky people out there who have their heads up their butts. You know what I mean. Not every person in academia is an educated idiot. But why are nurses compelled to prove the obvious to hospital administrators? A resounding “hell no, we aren’t going to take this anymore” in a loud, collective voice is more effective than another research study that eventually is forgotten.
Lil' Sue
June 12th, 2009 at 11:50 am
Yes, I’m with you, Mother Jones–how many Ph.Ds did it take to figure that one out? I too learned this decades ago at diploma school. At my last beside nursing job, about 7 years ago on a busy telemetry unit, I was informed by management that I “spent too much time with patients”. Yeah, well, that’ll happen when you try to give good patient care!
Liz
June 12th, 2009 at 11:08 pm
I always meant to be a hospice nurse, but first I did my 3 years hospital nursing. There will never be enough time in the day to do all the tasks that need doing and all the documenting and still have much time to talk to patients. Hourly rounds are a great idea, but then who’s going to document it? Or, who’s going to hang the IVF, chemo, blood, antibiotics and document all of that, too? Never mind med rounds and vital signs.
Hospice nursing is truly one on one. I can spend as much or as little time with the patient and family as I need to. Some days I may have more visits than others, but overall it’s exactly what I hoped nursing would be. The only fly in the ointment is the EMR….it takes 3 times longer to document in the laptop than it did on paper.
Sean
June 13th, 2009 at 5:28 pm
Ahhh yes. The epiphany of ‘time at the bedside’. I remember this from a former hospital where I was working PRN. I loved how it was promoted as ‘new’.
Makes you think a little bit about the state of nursing today with our shortage of staff and over-flowing patient work load.
Who has time to be in every patient’s room, every hour?
Hmm.
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naughty
June 15th, 2009 at 12:28 pm
MJ,
I totally get your lament. But here is the flipside. What we “know” as nurses and caregivers to be true, isn’t always backed up by “evidence”. Yes, I hate that word sometimes, too. But if we are all going to join Obama’s bandwagon of “evidence based practice”, then I guess I will be (a wee bit) grateful for the poor wretches who choose to do that kind of research work. The “art” of nursing is the he”art” of where we begin our daily tasks, and it takes time, thought, and care. It is also very tough to validate, and therefore justify, and maybe it will help us earn more respect, and better staffing.
nurseshark
June 16th, 2009 at 12:53 pm
I agree good patient care involves actually taking the time to care for your patients. I miss working on a floor where the nurse to patient ratio was actually manageable, so more time can be spent with my patients.
Now working as a [mainly ortho] rehab nurse, I’m supposed to get our patients to do as much as they can on their own (ideally, as close to their level of ability before their hospital stay), teach them skills (eg: putting on pants and shoes while on hip precautions) and make them practice, so they can go home. I have to admit that, with the amount of patients we have to take on (5-8/nurse) and the fact that we are an 8hr shift unit, hourly rounds might be a bit extreme, but checking in on them in a timely manner is always a good idea.
If anything, I’m sure many bedside nurses can relate to the after meal bathroom rounds!
bayousweethrt
June 18th, 2009 at 8:50 pm
Our hospital just implemented hourly rounds also. They even play this stupid chiming sound to remind us and a sign in log is posted in each room the nurse must initial. I think it’s ludacris! When I floor nursed, I was in my rooms every 1-2 hours and all my documentation was up to date without anyone reminding me to do my job.
SuzieQRN
June 23rd, 2009 at 4:14 pm
Hourly rounding is the “new” thing at my hospital too. Some of the younger nurses I have worked with are having a very hard time with this, and not b/c they are necessarily too busy. The ones who have complained the loudest are appalled that they have to spend time with those patients (read the word “patients” with loads of scorn and a touch of superiority). Being a psych nurse myself, I find it difficult to envision any kind of nursing where compassion and a touch of humility (as in therefore but the grace of god go I) are not as important as the evidence based and best practice components of the work. I learned nursing as an ART and a SCIENCE. But then, having practiced for 28 years now, guess I am an outdated fossil, hmmmm?