Customer Service?

  1. What happened to patient care? Why is Nursing about customer service? Most patients do not have the ability to choose the facility they are receiving service from, the Insurance companies make the choice, so who is the Customer? How do you feel about the concept of patient care verses customer service?
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  2. 23 Comments

  3. by   UM Review RN
    Whoa! Is this an assignment?

    If so, we're more than happy to help, but we'd like to see how much you have on your own first.

    Welcome to Allnurses. You have an excellent group of nurses who are willing to mentor you and be a resource to you.
  4. by   Marie_LPN, RN
    I think "customer service" is a load of crap.

    I think it's BS to equate pt. care with 'customer service'. If i'm a pt. (and for the pt.) i expect better care than i'd get standing in line at the local dept. store returns desk which has, what a coinkydink, the words "customer service" above it, which is why the phrase "customer service" being the latest slang in healthcare royally ticks me off. It is not the same deal.

    Quite honestly, i think the phrase "customer service" dumbs down the importance of pt. care. The hospital is not the local Wal-Mart.
    Last edit by Marie_LPN, RN on Oct 12, '06
  5. by   Antikigirl
    Patient care comes first in my book, I do customer service as much as possible just because I am a very helpful friendly person as is and it isn't much of a stretch for me to do things to help make a persons stay in a facility a little easier to deal with!

    However...I see patients as just that patients...not clients, not customers...I am a medic not a PR, recruiter, or a member of the board of my hospital! I am expected to deliver quality care first and foremost, how I do the rest is up to me and my available time given if my facility gives me any for customer service! If I focused more time in customer service I would be fired as an RN because customers want things, patients can't always get those...it is a clash!

    However, I do try to think of things this way. You have three basic types of patient outcomes in regards to a stay. One is disatisfied, two is satisfied, three is completely satisfied!

    If you are disatisfied you will not recomend the facility and may say things to loose patients! This is a bad one and should be avoided. These people also have a tendency to make things difficult for staff or send in a complaint about staff!

    Satisfied is not necessarily going to recomend the facility, kind of half and half on the exerience. They typically won't say anything good or bad...just that it fulfilled what was needed and only what was needed. Okay...not a good thing for return business, but better than dissatisifed.

    Then Completely Satisfied is a person that will recomend your facility to others, and say many great things, and perhaps send a thank you card or compliment to management or administration. Okay...just doing a little extra is worth it to me if I get a thank you and recognition by management or administration! So I go for this by trying to do little things to help make a persons stay a bit better. It is better for staff and pt if they are completely satisfied!

    So as I am working, I check in the back of my mind how I feel the stay is going for my pts, and try to get up to completely satisfied level as much as possible given my role and duties and time!
  6. by   UM Review RN
    OK, forgive me for that first post. I should've read your profile first.

    So I owe you a couple of answers.

    What happened to patient care?

    You'll find the answers in books like Code Green: Money-Driven Hospitals and the Dismantling of Nursing, by Dana Beth Weinberg. ISBN: 0801489199

    Why is Nursing about customer service?

    Nowadays, due to exhorbitant medical costs, hospitals are trying to keep fiscally sound. (Or at least break even.) They're run like businesses. Patients and employees alike understand the concept of "customer." It implies choice, it implies financial responsibility, and it implies service. Nurses and other employees are also defined by the management as "customers."

    Since nursing is why a patient would need to be hospitalized, it is all too evident that many customers DO have a choice about which hospital will treat them--at least, the paying ones--and the hospitals want to keep their business. If the nurses can buy into the concept of keeping the patients happy and comfortable in an environment that is less frightening because it has more homelike (or hotel-like) features, then that is for the good of the patient.

    My only problem with this is that management does not go far enough in explaining that nurses are NOT personal servants, and while the patient can have SOME leeway with a proscribed course of treatment, this is not to say that the patient will get better simply by occupying space in a hospital room and refusing essential tests, treatments, and procedures.

    Perhaps the most important teaching that a nurse can give, on admission, is to outline the Patient's Bill of Rights. At the bottom is the Patient's Responsibilities, which many of them need to hear.

    Most patients do not have the ability to choose the facility they are receiving service from, the Insurance companies make the choice, so who is the Customer?

    I take that to mean that the insurance company would be the "customer" and not the actual patient. However, any patient has the power to complain to the insurance company about the quality of care of a hospital, and the insurance companies actually are setting the standard of care because of what they'll pay and what they won't pay.

    Not surprisingly, most patients are not all that well-educated clinically, so they equate "poor care" with "poor service." Things like multiple IV sticks, long waits, unseen MDs, impatient nurses, or bad food become criteria for "poor care" because they're relatively simple, very basic hospital processes.

    And think about it. What sticks in your mind most as a patient, the last time you were one? Was it the lab tech who could not stop jabbing for that vein? Was it the cold eggs? The hunger? The wait for pain meds in the ER?

    My dh is still appalled that I was placed into a room that housekeeping hadn't gotten to yet, and there was still trash on the floor and bedside stand. However, being a nurse, and knowing the hospital's ER had been completely slammed so badly they had to divert, I told him to shut up and sit down, because at least I had a private room. He still remembers that and rates the care as "OK." I still remember that they saved my life, and I rate the care as "Excellent."


    How do you feel about the concept of patient care verses customer service?

    Therefore, I feel that good patient care IS good customer service. What nurse would NOT want her patient to have a clean room, appropriate diet, tasty food, one-stick labs, and a hospital stay as pain-free as possible?

    The only problem is, and always has been, ever since the nursing schools were not part of the hospital, not enough nurses to give this level of care.
    Last edit by UM Review RN on Oct 12, '06
  7. by   BSNtobe2009
    I will totally disagree with you on that one.

    This is how I look at my health insurance card: It's like a charge card and I can take my business anywhere I want to. Hospitals and health care centers are not doing me the favor by treating me, I am doing them the favor by selecting their institution or practice.

    If the doctor is inflexible, the staff is rude, and the nurses won't return my phone calls when I have a question, then I go elsewhere.

    Anytime I have had insurance I have had more than one group to select from for hospital care. In Charlotte it was definiately Presbyterian Hospital, because they have a reputation of treating the WHOLE patient, not just the disease. That is where I have sought treatment and have never been disappointed. Everytime I needed anything, the nurses were right there immediately.

    The Nurses that work for them must be willing to do anything for the patient. If they are not willing to go by the philosophy, then they are let go very quickly. However, they treat their staff extremely well in return.

    That is why, when I graduate, they will be my employer of choice.

    Added Note: I totally agree with Angie's post.
    Last edit by BSNtobe2009 on Oct 12, '06
  8. by   TrudyRN
    [quote=TriageRN_34]Patient care comes first in my book, I do customer service as much as possible just because I am a very helpful friendly person as is and it isn't much of a stretch for me to do things to help make a persons stay in a facility a little easier to deal with!

    Yes, what she said!

    I think that caring for the patient INCLUDES customer service. They are not separate in my mind.

    Lifesaving and medical/nursing care have to come before helping the pt or visitor with non-med/nursing care issues, naturally. But I still try to help get the extra blanket, the coffee, the whatever is requested, to the best of my ability to do it without forgetting my primary work. I stay nice, though. There is a nice way to say to people that you can't do something just now because you have to do something like nursing work now. No need to be rude or impatient or judgmental. We all would like our back rubbed and our pillows plumped, wouldn't we?
  9. by   Antikigirl
    "My only problem with this is that management does not go far enough in explaining that nurses are NOT personal servants"

    BINGO! And this tends to be the biggest misconception and probelm in nursing! If a facility would like to run that way, then nurses should only have 1-3 pts at a time non-critical (and three is pushing it!). Since that isn't reality or fiscially responsible for a company to do...implementations should be set in motion to please the pt in other ways than letting it all fall down on the nurses!!!!!!

    I am a believer in Orem, so I feel that if a pt can do things on their own, I will endevor to make that possible for their own health and well being. That isn't how pts think I will tell you! Many pts feel they are in hospital to get everything done for them while they recoup. That does nothing for the pt except put a persona of nurses being servants and leading a large path to excuse making and procrastination.....not good!

    I am not doing my job if a pt leaves my facility unable to care for themselves (dependant) or a care facility that doesn't have private individual nursing care, or going home with family that can't spend 24/7 with them!

    I do things to help the pt feel more comfortable yes, but I am a realist...and my pts soon know that when they get my lecture on doing for themselves what they can do even in this given situation. I have had complaints actually if I didn't do a full bed bath to a pt that is totally mobile or can do parts themselves with assistance on gathering things for them to do it with! But, the facility tends to stick with the theory I have that pts can do things for themselves to increase dependance outside of hospital so I am very lucky there! (my hospital has so many nurses on the board and in administration...and was founded by a single nurse...so nursing respect is a biggie there!!!!!!! ).
  10. by   TazziRN
    I believe in it to a point: pts deserve to have staff who are as polite as they can be under the circumstances, but I don't think they should be able to get what they want. We recently lost an ER doc because admin got too many complaints from pts about him. The most common complaints: "He wouldn't give me a prescription" and "He wouldn't give me any pain medicine." For the first, he doesn't give abx for viruses and people get mad at him. The second, he does medicate for pain, just tries to avoid the narcs. Not fair, in my opinion, for people to be able to complain and have him fired because admin is worried about customer service.
  11. by   MedSurgeMess
    Quote from BSNtobe2009
    I will totally disagree with you on that one.

    This is how I look at my health insurance card: It's like a charge card and I can take my business anywhere I want to. Hospitals and health care centers are not doing me the favor by treating me, I am doing them the favor by selecting their institution or practice.

    If the doctor is inflexible, the staff is rude, and the nurses won't return my phone calls when I have a question, then I go elsewhere.

    Anytime I have had insurance I have had more than one group to select from for hospital care. In Charlotte it was definiately Presbyterian Hospital, because they have a reputation of treating the WHOLE patient, not just the disease. That is where I have sought treatment and have never been disappointed. Everytime I needed anything, the nurses were right there immediately.

    The Nurses that work for them must be willing to do anything for the patient. If they are not willing to go by the philosophy, then they are let go very quickly. However, they treat their staff extremely well in return.

    That is why, when I graduate, they will be my employer of choice.

    Added Note: I totally agree with Angie's post.

    But what if the next time whoever was supplying your insurance card (parent, employer, spouse, etc.) found out during enrollment that the facility of your choice is no longer a network provider? This happens a lot in the area where I am, one day the provider is covered, the next day NOT! All pts deserve to be treated respectfully, but I draw the line at being the servant, which unfortunately, many pts and family come in expecting! I am really worried about the direction that healthcare is taking in this country!
  12. by   htrn
    Customer Service = Can I get your guests a pop, coffee, juice? Cream or sugar with your coffee? I'm sorry the batteries are dead in your TV remote control, I stand her and change the channel for you until you see something you want to watch. Would you like a movie? We have over 300 to choose from.

    Good Patient Care = I know it is uncomfortable, but in order for you to avoid complications we need to get you out of bed and walking. I know you're really hungry, but you are NPO until you pass gass because.... When you are at home, these are the things you need to do take care of yourself or manage your condition.

    I hate the fact that we HAVE to focus on customer service and that customer service is what admin is focused on. Unfortunately, sometimes you have do say or do things that patients do not like in order to provide good patient care. I'm sorry, sometimes these things can be mutually exclusive. I really try to provided good customer service just because that is what I WANT to do, but I will not knowingly comprimise good patient care just to make the customer happy.
  13. by   lpnstudentin2010
    as a patient i think customer service is a load of c#@p. I think the medical procedures come first. Now if someone does not have family with them (such as me at night) I think nurses need to take a little more time, that is unless there is someone else willing to help. When ever my roomates friend or boyfriend was going to get something from the kitchen for my roomate they always asked did I need anything (if I was awake obviosly) and they were always asking even when they were not going. They were willing to help me. There needs to be more of this mentality of comunity helping. If more people just looked and saw...o her nurse is busy why dont I get her that ginger ale she wants. then there would be a lot of "better customer service" in hospitals.
  14. by   banditrn
    Yep, the hospital that I worked for got heavily into the 'customer service' thing, which was based on the Disneyland model.

    They paid LARGE bucks for each employee to attend multiple classes - they advertise on radio and in the papers, etc.

    Did they add any extra staff to effect all the extra 'customer service'? Nope!!

    We had family members come in who thought that we should be doing THEIR bidding. We had patients who felt that staff should pay for their scripts because they 'forgot' their $2 co-pay. And on and on.

    Any and all complaints from the 'customer' were treated as valid, even when they were just crap.

    Yes, I always treated my patients and family with respect, but I demanded that they treat me well, too, and would not tolerate being abused. I also felt that some of my co-workers needed some lessons on how to deal with people, but I always felt that it was their personal problem and should have been dealt with in that way.

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