Rounds+Scripts_FNL with art 11/8/10 4:36 PM Page 20
Losing Our Voice
In their quest to boost patient
satisfaction scores to maximize
revenue, hospitals are forcing
RNs to act like waiters and hotel
staff. Nurses say this obsession
with the appearance of care,
not actual clinical outcomes,
is jeopardizing patients
and the nursing profession.
By Heather Boerner and Lucia Hwang
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N AT I O N A L N U R S E
W W W. N A T I O N A L N U R S E S U N I T E D . O R G
ILLUSTRATION BY CHOPPY OSHIRO
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fren garza has been a registered nurse
for 23 years. He checks armbands, doublechecks medication prescriptions and dosages, and
constantly monitors his adult psychiatric patients
for signs of psychosis, depression, or that they
might hurt themselves or others. He spends time
talking to them about their self-destructive urges
and comes up with treatment plans that help
them recover from trauma.
But if Garza were to follow the orders of his managers to
the letter, he'd spend his shifts running from one room to the
next, checking instead on whether his patients have water or
need to go to the restroom, always ending his hourly rounds
with, "Is there anything else you need? I have the time."
"I feel like a butler or a concierge," said Garza, who works
at Alta Bates Summit Medical Center in Oakland, Calif. "It's
the same thing a waiter or someone in the service industry
would do. It has nothing to do with my clinical skills."
Garza's story may sound all too familiar. In nursing stations
from Massachusetts to California, nurses are facing two disturbing trends. First, the federal government is tying patient
satisfaction scores to Medicare and Medicaid reimbursements,
