The unhappy nurse

Asking too much

As a nurse myself, I can relate to other nurses when they talk about workload and time management.

Let’s face it, today our patients are coming in in greater numbers and just as sick, and the nurse patient ratio can sometimes push 1:6.

When we ask nurses to become members of teams for performance improvement, survey readiness or policy development, there usually is some reluctance. That’s because they would need to leave their patients to come to meetings.  While they’re juggling these meetings, they need to ensure that the patients’ needs are met and that pain medications are given in a timely manner. In order to do that, they need to find another nurse to relieve them. That nurse, then, has their patient load plus another nurse’s patient load.

Listen to the nurse when she tells you that she would like to participate but she just doesn’t have time.

Where does the buy-in come from?

What is the incentive to volunteer to sit on a policy committee?

This is the crucial point you need to hit home. It’s vitally important to get buy in from frontline staff so that they see the value in whatever it is they are to work on.  Let them know the impact that an outdated policy has on patient care. Show them case scenarios of legal action that were a result of outdated or inaccurate policies.

Often, when a practice has advanced and the policy has not kept up with practice, staff will do work-arounds and end up not following the policy. In addition, attorneys use policies in court and the nurse doesn’t want to be caught practicing outside of their scope or not per policy.

What is the solution?

Before I offer a solution, let me take you through a scenario:

1. As the policy administrator, you try your best to make the policy revision process as seamless as possible. You bring the manual with the policies to the nurse and have her read the one being worked on.

2. Then, you have her write her edits on the hard copy and show her the routing slip so that she can sign it.

3. You tell her who needs to review it so that she can interoffice the hard copy of the routing slip with her edits to the next person on the list. Let’s call this next person the Approver.

4. She hopes the Approver gets it within the week.  Without having time to dialogue with the Approver, she can only hope that her notes make sense.

5. The Approver receives the policy in the mail and since there is no indication of when the input is due, it gets filed on their desk for another time.

6. The policy committee chair seeking the policy asks the nurse who it initially went to, and if they have the policy.

7. The nurse says she sent it to the Approver.  The Approver is contacted, has no recollection of receiving the policy, and requests for it to be sent again.

8. The policy committee chair person resends the policy and the Approver includes his/her feedback.  Unfortunately, the edits from the first nurse are not included in the final version.  The nurse who took time to give her input (which is valuable) is disappointed that her input was missed, and will likely not contribute to policy development in the future.

Unless you can reassure them that their input will not be missed again. Click here to read “The Happy Nurse” to find out how!

Best regards,

Nicola Heslip | Certified Professional in Healthcare Quality | PolicyMedical

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