Ask the nursing expert ... about dealing with workplace 'sabotage'

I have been a registered nurse for a long (long) time and as director of nursing still find my “foundation” principles important, but find my newer nurses more technology-oriented. I feel that much is missed when hands-on assessments are missed at the beginning of each nurse’s shift. What do you think? 

I strongly feel that patient assessments for baseline information at the beginning of each shift cannot be safely omitted. On a long-term care unit with mostly stable residents, an initial look at each resident right after shift report and narcotic count is crucial. I call this making rounds. It is so important for a nurse to have an initial sense of the wellbeing of his/her residents when the shift begins, as resident/patient conditions can change very quickly. Pain levels can be assessed, positioning checked, current interventions viewed, safety checks and more can be done during the initial rounds of a shift. Issues can be addressed before a potential problem worsens. On a sub-acute unit, frequent checks are crucial. Rounds also can occur during med passes and treatment interventions. Computers cannot yet replace the hands-on assessment of a nurse.

Do you feel that a facility with high turnover would benefit from a Retention and Rewards Committee, and if so, what benefits do you see? 

These committees are called many names, including “Recognition and Rewards Committee,” “Retention and Motivation Program,” etc. Showing that employees are valued and appreciated through recognition is a win-win situation. Be sure that there are movers and shakers on the committees and that the administrator sets aside a budget and gets behind some fundraising initiatives to support social events and gift giving!