Five Steps to Make Your Nurse Leadership Rounding More Purposeful

By Rose O. Sherman, EdD, RN, FAAN

“Good leaders make people feel that they’re at the very heart of things, not at the periphery. Everyone feels that he or she makes a difference to the success of the organization. When that happens people feel centered and that gives their work meaning.” Warren Bennis

One of the big challenges faced by nurse leaders today is finding the time to stay connected to patients and staff. Purposeful nurse leader rounding on patients is quickly becoming a best practice in hospital throughout the United States. When it is done well, it can have a positive direct impact on both patients and staff. It has been shown to improve both patient and staff satisfaction. It is an organized way for nurse leaders to be visible. This can lead to an openness that will build trust and facilitate communication. As a leader, you will learn what is working well on your unit and department, and where there may be need for improvement.

Five Key Steps to Make Your Leadership Rounds More Purposeful

1. Be Consistent

To be effective, leadership rounding must be consistent so there does need to be a specific plan about how and when it will be done. Many health care organizations provide this guidance to leaders but if your hospital does not then establish your own plan. Ideally, you should round on every patient who is hospitalized on your unit during the first 24 to 48 hours after admission. Blocking out the time to do this in your daily schedule is important. Plan on 60-90 minutes each day at a time when you are least likely to interrupt care or treatment routines. These visits will normally take between 5 and 10 minutes but may take longer if the patient has concerns that need to be addressed.

2. Establish Key Questions that You Ask of Every Patient/Family

There is no better way to find out about the care that patients are receiving on your unit than to ask them. Structuring the conversation is important because it will help you to stay on track, structure the encounter and find out the information that you need. The following is a sample script used in many organizations:

Good Morning or Afternoon, my name is _________ and I am the nurse manager on this unit. I am visiting with you today because I am interested in finding how about your hospital stay. Would you mind answering a few questions?
I see your nurse is _______ she/he is excellent and they will take good care of you.
Is our staff responding to your call bells and checking in to see if you need anything?
Are we managing your pain appropriately?
Do you have any concerns that you would like to discuss with me?
Is there anything I can do for you right now to make you more comfortable? I have the time.
Give patient your business card and contact number.

3. Follow up Quickly on Identified Problems

While rounding on patients, you should look for opportunities for immediate service recovery. A nurse manager recently told me a story about rounding on a patient who was quite upset about a test delay. She noticed that the patient had no cards, flowers or visitors at the bedside although she had been in the hospital for three days. The manager went down to the gift shop and bought a small plant for the patient. The patient was so appreciative, she told me. It was clear to me that she was all alone in this experience.

4. Recognize the Work of Staff as You Round

Nurse leader rounding on patients is also an excellent opportunity to interact with staff and listen to their concerns. Prior to rounding, ask staff if there is anything that you should know about their patients. Followup with any concerns after your rounding. Always convey any compliments about staff received from patients.

5.Track the Trends in Comments/Questions/Patient Behavior

Many organizations have rounding sheets such as the Studer Group Sample Leader Rounding Checklist to track patient comments and concerns. Use patient rounding as a way to also look for trends in the population that you are serving that can be helpful in strategic planning. One nurse leader told me that her patients were asking about the availability of IPADs which later led to the hospital installing IPADs in patient rooms – a big satisfier. Another nurse leader shared with me that she could see from her rounding that a growing number of her patients were Spanish speaking. She advocated for her organization to provide a Spanish for health care providers class to the staff.

Often, it is the simple things like leadership rounding that can lead to substantial improvements in the quality of care and staff satisfaction. Although purpose nurse leader rounding is a substantial time commitment, most nurse leaders will also tell you that it is the best part of their day. There is nothing more satisfying than to hear that their staff are doing a great job. In her research with nurse managers, Dr. Barbara Mackoff found that maintaining a line of sight to the patient is critical nurse leader engagement and satisfaction. There is no better way to do this than rounding on patients.

Read to Lead

Mackoff, B.L. (2010). Nurse Manager Engagement: From Theory to Practice. San Francisco: Jones & Barlett.

Studer Group (2010). Nurse Leader Handbook: The Art and Science of Nursing Leadership. Fire Starter Publisher.