A nurse walked into a patient’s room one day and she saw her patient didn’t eat their soup yet. The nurse inquired and the patient replied, “It’s too painful to sit up all the way to eat soup.” Knowing the importance of nutrition, the nurse left the patient’s room to retrieve a large lidded cup from the supply room located just down the hall and around the corner. She went back to the patient’s room to transfer the soup to the cup. Having done this, the patient found it easier to eat without having to sit up.
Frustrated by the hassle of running around looking for cups, nurses had requested that lidded cups be stock in every patient’s room. The hospital agreed immediately. This in turn adds additional labor and supply costs. Yet even with the implementation of the new process, nurses still reported they didn’t have cups for their patients. The initial problem wasn’t not having enough cups. It was that the soup should have come in a cup for the patient.
The Downfall:
One of us who was working with a healthcare organization, saw another side of the connection with dietary services. Early one morning, a nurse had helped a diabetic patient place an order for lunch. In the interim, the nurse went about caring for her 4 other patients as well as gathering up the supplies and medications this particular patient would need for their pre-blood sugar test, done before the patient eats. Upon arriving, the nurse discovers nutritional services delivered lunch ahead of schedule and her patient was already eating. Many expressed their frustration and were quick to blame the patient, who had been diabetic nearly 20 years. “What was she thinking?” Some ask and others assumed, “She knows she needs her blood sugar checked before she eats!”
At some point, the CEO heard about this problem. Her response stunned me: she said. “She thinks we know what we’re doing. If a hospital delivered you a meal, would you question whether you should eat it?”
Unfortunately, it is processes like these that simply get in the way of patient care. And the many, well-meaning improvements of various support departments can often make things worse rather than better. Now try to imagine the daunting challenge nurses face trying to coordinate the hundreds of other supplies, medications and medical equipment etc., she will need to care for her 5 plus patients! An enormous undertaking when processes flow smoothly, and believe me, that’s not often the case.
On a typical day, a nurse will walk an average of three miles. Up and down the same thirty-foot stretch of hallway over and over again–hunting for and fetching the many things she needs to care for her patients. In fact, she’ll do this 528 times in 8 hours, with no confidence that the healthcare organization will ever change or an expectation that it should. In a typical hospital, the constant hustle required of nurses is a testament to their continued drive to serve patients