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This Nurse Feels Unnecessarily Attacked: What Set Her Off?

Looks like Mr. Administrator has some ‘splainin’ to do!

And I suggest he be straight with my colleagues, because a nurse can sense BS before it is even spoken.

I am not in management, and I never will be.

No, I am one of the “rank and file.” And right now, this member of the “rank and file” is hotter than hell.


What set me off?

A comment in a post on the Health Leaders Media website, entitled Top 5 Challenges Facing Nursing in 2012. The article, written for nursing management, refers to nurses as “rank and file caregivers” and disparages their understanding of the importance of the “patient experience” to reimbursement:

If you haven’t found a way to drive home the importance of patient experience to direct-care nurses, find it now. You know how much reimbursement is at stake, but the rank and file caregivers still don’t get it.

The author goes on to state:

In fact, the nurse-patient relationship has always been about patient experience…Your best nurses instinctively know this. They already create a good patient experience. They help patients understand their care, involve families in decision-making, coordinate multidisciplinary care, sit with patients to explain complex diagnoses, and even, occasionally, have time to offer a quick hug or hand to hold.

What? This is like punching someone in the face and then offering a compliment.

I have a revelation for you – we all know it. We understand what the requirements are for a “good” patient experience and it is what we have been doing as nurses since the dawn of time.

Since “the nurse-patient relationship has always been about patient experience,” why is this a “challenge” at all? This is nursing care, and always has been!

Why are administrations freaking out now that patients will be evaluating their nursing care?

Suddenly, all these new programs are flying into place. Educate! Communicate! Medicate! Smile!

What do you think we, oh, excuse me, the “rank and file caregivers” have been doing all this time?


Let me tell you what the “rank and file caregivers” have to deal with in terms of the “patient experience”.

There is a hospital in my area that has switched their meal service into something that looks, and tastes like the old airplane food from the 1970s. It comes in segmented cardboard trays and is microwaved.

As you can imagine, these meals are not popular with the patients. They give the meals poor scores on the satisfaction surveys.

At a recent meeting, the “rank and file caregivers” were lectured by the food service department that these low scores were the fault of the caregivers for not presenting the food in a pleasing manner, laying it out nicely on the table, and describing it with glowing adjectives.

That’s right, the same “rank and file caregivers” who are managing complex medical problems on multiple patients, coordinating multidisciplinary care, educating patients and family on medication side effects and complex diagnoses and documenting until their fingers are numb were lectured for their lack of culinary presentation skills.

Who is running the freaking show, Gordon Ramsay?

No wonder morale is in the toilet.


Well, I’m off to take my blood pressure meds, and maybe some Ativan.

All I can say is this “rank and file caregiver” is going to keep on doing what she has been doing for over 30 years. They can call it “patient experience” or HCAHPS, or give it any project title they want.

I call it good nursing care, and the patients will finally have a say in what that means.

Don’t worry, admins, if your bottom line depends on the nurses, it’s gonna be alright.

Rank and file, RN, signing off.

*This blog post was originally published at Emergiblog*

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