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March 23, 2012

Does scripting patient care go too far? Some nurses say yes

Daily Briefing

In an effort to boost satisfaction scores, hospitals increasingly are asking nurses to use scripts in their interactions with patients, but some nurses say the strategy goes too far.

Hospitals take cues from entertainment industry
To prepare for value-based purchasing, hospitals have adopted various satisfaction strategies and customer relations models from other industries, including the entertainment and restaurant sectors.

For example, Lawrence General Hospital in Massachusetts requires nurses to wear laminated cards that hang around their necks that suggest phrases each nurse should use at the end of a patient visit. Meanwhile, at Baystate Franklin Medical Center in Greenfield, Mass., nurses are asked to use a patient's name at least three times during each shift.

Hospital executives say using "key words at key times" can help patients feel more comfortable and less anxious, which supports healing. In addition, consultants say research indicates that patients are more satisfied with care when they feel that nurses made time for them.

Nurses express concern over standardized interactions
Some nurses argue that providing communication outlines for patient care goes too far, the Boston Globe reports. For example, medical-surgical nurse Ann Lewin said scripts make her feel like a "Stepford nurse," noting that patients could notice that nurses use the same phrases.

However, Lawrence General CNO Elizabeth Hale said their communication tips are intended to provide "a foundation" for nurse-patient interactions. She noted that it is "important to provide standard language as a way to ensure that introducing oneself, for example, becomes hardwired into our communication" (Kowalczyk, Globe, 3/21).


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