Scripting Provides Firm Bedrock for New Nurses

HealthLeaders Media Nursing Leaders, July 13, 2010

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It was not an auspicious arrival in San Diego for the annual conference of the National Nursing Staff Development Organization. I arrived last Wednesday just in time for a 5.4 earthquake.

I must confess that I didn't feel the earth undulating beneath me, which disappointed me greatly when I later watched the news reports and saw items falling off shelves and swimming pools sloshing.

But the earthquake proved to be an interesting metaphor for the graduate experience, which was greatly on the minds of the nursing professional development specialists attending the conference.

We discussed the difficulties new nurses face in their first job as they deal with the transition from nursing school to practice. Considering all the competing demands on their time and the pressure they experience, they can feel like the ground is moving under them as they struggle to keep their footing.

With that in mind, our conversation turned to scripting.

Some nurses and administrators recoil at the term "scripting," envisioning robotic intonations of "Have a nice day!" and fearing the loss of personalized interactions.

Those who have already tried it, however, know that scripting enhances—rather than stifles—communication, ensures consistency in practice, and arms nurses with tools to handle difficult conversations with patients, peers, and physicians.

Scripting is best known in customer service iterations. If you don't like the idea of scripting, one of the staff development professionals in San Diego noted, eavesdrop on some of the things nurses say to patients. Staff have their own scripts and they say the same thing day in and day out, much of which is not the message you want delivered to patients.

Some people instinctively know how to greet people, identify themselves, and provide clear and concise explanations that build relationships with patients. Many do not. And new grads are often so focused on trying to remember the technical steps of patient care that the last thing on their mind is explaining what's going on for the patient.

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