Why Nurse Leader Rounding Matters

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

2023 has been a challenging year, especially for frontline managers. Not surprisingly, we are seeing higher levels of burnout in this group. When we feel exhausted and burned out, the temptation is shut down emotionally and shut out sources of stress. This could include routine leader rounding. We can probably give a million excuses for skipping this evidence-based best practice, including a lack of time. Yet leader visibility is now more important than ever. It allows leaders to connect daily with patients, caregivers, and teams at the point of care.

For nurses, leader visibility during rounding has been shown to directly affect retention, recruitment, engagement, and staff satisfaction. For patients, rounding is linked to higher patient satisfaction and care quality. Intentional leader rounding should be designed to do the following:

1. Build relationships with staff.
2. Recognize team members for great care.
3. Ensure care consistency.
4. Gain real-time feedback from patients and families.
5. Perform service recovery if needed.

Follow These Five Steps to Make Your Leadership Rounds More Purposeful

1.  Be Consistent

To be effective, leadership rounding must be consistent, so there is a need for a specific plan about how and when it will be done.  Many healthcare organizations provide this guidance to leaders, but if your hospital does not, then establish your plan.  Ideally, you should round on every patient 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 must be addressed.

2.  Establish Key Questions that You Ask of  Staff/Patients/Family

There is no better way to find out about patients’ care on your unit than to ask them.  Structuring the conversation is important because it will help you stay on track, structure the encounter, and obtain the information that you need.  Many wonderful resources are out there, including this guide developed by CMS.

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 upset about a test delay.  She noticed the patient had no cards, flowers, or visitors at the bedside, although she had been in the hospital for three days.  The manager went 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. Follow up 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 like the Studer Group Sample Leader Rounding Checklist to track patient comments and concerns.  Use patient rounding to also look for trends in the population you are serving that can be helpful in strategic planning.  One nurse leader shared with me that she could see from her rounding that a growing number of her patients spoke Spanish.  She advocated for her organization to teach the staff Spanish for health care providers’ classes.

When staff see leaders who don’t round and are rarely visible, they may disengage. Gallup research indicates that a variance of up to 70% in staff engagement scores can be directly linked to manager disengagement. If you are one of those leaders who recognizes that you are not rounding in the way or as frequently as you should, establish a goal in 2024 to improve your efforts.

© emergingrnleader.com 2023

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From Traditional Nurse Leader to Nurse Leader Coach – Click Here for the Flyer

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Read the Nurse Leader Coach – Available at Amazon and Other Book Sellers

Recommended Book by the Association of Critical Care Nurses – The Nuts and Bolts of Nursing Leadership: Your Toolkit for Success