Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.
Catch-all: noun [usu. as modifier]
a term or category that includes a variety of different possibilities: ex. the stigmatizing catch-all term “schizophrenia”
The first thought that came to mind after I heard that Vanderbilt University Medical Center had laid off its housekeeping staff and assigned cleaning patient rooms to nursing was this: Has anyone from the hospital’s administration ever looked inside the nursing staff’s refrigerators, microwaves, or sinks?
Universally, nurses’ staff lounge kitchens nearly rank biohazard status. In every unit a single nurse, but often it’s the unit secretary, martyrs herself (or himself) by emptying these refrigerators of forgotten food. She washes the moldy containers and places them on a nearby countertop, with this message scrawled in Sharpie:
CONTAINERS NOT TAKEN HOME BY WEDNESDAY WILL BE THROWN OUT! (Caps intended)
Another sign commonly posted above the staff lounge sink or microwave by this same nurse or unit secretary reads:
CLEAN UP AFTER YOURSELF! YOUR MOTHER DOESN’T LIVE HERE!
Fact: Nurses know a lot about infection control, but this does not automatically make us good housekeepers. Besides, nurses already have a job: keeping hospitalized patients safe while assessing their needs and administering their care.
While Vanderbilt’s decision to lay off its housekeeping staff and assign cleaning patient rooms to nurses may be unprecedented, it is not innovative. Using nurses as catch-alls for various jobs not designated to specific departments is an established tradition of hospital administrations. Obtaining patient meal choices, handing out food trays, distributing patient satisfaction surveys, and wiping down used equipment (including toys in pediatric units) are a few examples of nonnursing tasks I have been assigned during my career. No doubt other nurses can add more to this list.
It is not, however, the purpose of this post to call out a single institution. Hospitals around the country are struggling financially. Many are millions of dollars over budget. All are seeking ways to trim their budgets. But why were nurses singled out for shouldering the burden?
As illustrated above, housekeeping does not go hand in hand with nursing skills. All hospital employees can be educated about the various cleaning solutions and regimens for cleaning patient care areas. Nurses were selected because of their proximity to patient rooms. However, housekeeping employees are not stationary fixtures in hospitals. They circulate through various hospital floors, and are summoned to clean patient rooms as needed. Therefore, all hospital employees have the potential for cleaning patient rooms.
Why not share the burden of hospital budget reduction by assigning every department patient room cleaning duties on a rotating basis?
For instance, one week, pharmacy will carry the housekeeping pager and clean patient rooms. The following week, dietary will, and then laboratory, clinical educators, hospitalists (this will probably fall to the residents)—and, in an overwhelming display of support, the hospital administrators can pitch in too.
Now that would be innovation.