FIGURE
As a commercial airline passenger, you listen to flight attendants review federal safety requirements while the plane taxies out to the runway. They demonstrate how to buckle the seat belt and how to use the floatation device, and point out the location of the emergency exits. Those of us who travel often probably hear the next phrase in our minds even before the flight attendant says it. That's because while listening to these instructions, we're experiencing "scripting."
Patients' perceptions
As nurses, we've learned scripting beginning with our first day of nursing school. We're taught to perform assessments in a consistent manner, taking a head-to-toe or a body-systems approach. We use this method to ensure consistency in patient assessment for any actual or potential problems. This type of scripting enables us to implement an appropriate care plan. Consider the five rights of medication administration. They comprise a script, and by always following this script, we decrease the likelihood of making a medication error, thus improving patient safety and outcomes.
Hospitals aim to improve customer service environments to meet increased demand from competition and to grow market share. Research shows that scripting dramatically increases the patient's perception of delivered care quality. 1 Scripting for direct caregivers is one method used to improve a patient's hospital experience. Phrases such as, "My role is to ensure your safety and comfort while you're here," or "I'm closing this curtain to ensure your privacy and confidentiality," are prime examples of scripts nurses can use. For more on enhancing service initiatives, see p. 26 of this issue.
Nurses' reactions
Some nurses react negatively to the idea of implementing these scripts, equating it with the action of a robot. Although nurses know how to communicate with patients, it's difficult to send a consistent message given increased patient acuity, shorter lengths of stay, and multiple responsibilities.
Effective scripting yields surprising benefits. In the orthopedic unit in the medical center where I work, the nurses were disrupted from their routine by frequent patient calls. In many cases, the nurse had just left the room when he or she was called back. With this in mind, the nurse manager instructed staff to implement the script, "Is there anything more I can do for you while I'm here?" The results were astonishing. Patient calls decreased by half, nurses more effectively cared for their patients, and satisfaction scores dramatically increased. This simple sentence sparked significant change.
As nurse leaders, we're constantly challenged to employ creative management to improve our environments. Remember the power of the spoken word.
Reference