Customer Service Model

I am of the belief that no one goes into nursing because they believe it is the "easiest job in the world". Each nurse goes through so much to be in a place to care for others at their worst. And speaking of worst, is a customer care model complete with scripting something good for nurses? Nurses Announcements Archive Article

I beg to differ. When nurses are forced to focus a large amount of time in their day to customer service "Thank you for letting me take care of you" models, can it dumb down nursing practice? Further, are we dumbing down our patients?

Think of it this way. If a model on your unit for continuity of care is that the same nurse have the same patient whenever possible, 2/3 of the "script" that a number of units are using as their customer service tool are well known to the patient in your care. You told them on the first, and perhaps the second day that you are "Nurse Jade" and that you will be taking care of them today. The nurse handing the patient off to you (at bedside, at 7am) introduces you (again) and makes some comment about how you generally rock, that you are an incredible nurse with mad skills. (again). That they will be "in good hands" (Uhm, providing for a theraputic relationship, the patient knows this). You write on the white board. The patient would like to get a little rest before breakfast, but lets discuss goals for the day. (then we all sing a verse of Kumbya, and you get a Press Gainey about how you sing off key).

In all seriousness, scripting out what a nurse is to say, what an off going nurse is to say, assumes that we all are in a place that we are inappropriate, don't have a clue how to communicate, and that all of our patients are clearly demented if they have no sense of who we are and what we are doing for them after caring for them over a period of time.

Even a short term patient can look at one like having 3 heads if we are enthusiastic cheerleaders attempting to convince them we give good care. We do that by showing, not by saying.

Nurses get into nursing due to a desire to help others. Even the most jaded and burnt out nurses on autopilot would not let someone suffer needlessly. With that being said "key words" and phrases that in the end have all to do with reimbursement as opposed to really caring about what a patient is feeling is a huge disconnect.

Further disconnecting is the questions that a patient receives on a survey after they are discharged. "Were the nurses nice to your visitors", in my opinion has not one thing to do with care that a patient receives. And if we are waking patients up to do bedside rounding and make appropriately scripted commentary, there goes the score on if the unit was "quiet".

I am all for patients advocating for their needs. I am all for nurses advocating for their patients. I am further all for patients being an active part of their healthcare process. However, how far away are we from a new nurse script reading for communication, becoming robots who can't anwer a patient's question or completing an assessment without a teleprompter dictating "customer service model" appropriate answers?

No doubt there are extremes, no doubt the physical welbeing of the patient is the most important, and no doubt administators then to take things to the extreme, but one cannot deny that it takes money to run a facility and pay wages, one cannot deny positive experiences in any field help drive that income. Step on the other side of that equation, the meal was great so how it was delivered has no bearing, I fixed your car so customer service is really a mute point, you came here to buy gas so why would you expect me to be polite and thank you. While they are extreme and there is a big difference between the skills and education of nurse to a burger cook, the concept has some application. The emotional welbeing of a patient has been proven to have an affect on patients recoveries. While admin may be overboard, it is not entirely irrelevant. Given the pressures a nurse is under, some of these efforts, while burdensome, may fill in when a nurse is so preoccupied with the physical that the rest gets lost. Lynch me if you choose but my intent was not to dismiss but to give thought

I really enjoyed this comment because I was thinking the same thing myself. Granted, I would much rather not have to be nice to people most days. I would rather just do my job without having to cater to the often disturbed or illogical "feelings" of the people around me. I would rather not have to put up with the ungrateful patient/family who cannot appreciate the fact that I am, for example, wiping poop off his butt while he acts like I don't deserve simple civility.

However, sometimes, I am grateful for the "script" or versions of it (that, interestingly enough, I learned from school rather than the hospital) because, without it, I very well might have lost it with some of my patients/family. And, let's face it, that really isn't going to help their outcome. Furthermore, unfortunately, while most of us don't need the script to say the right thing, there are some in our profession who actually do. Since we already act accordingly anyway, maybe we can not take it so personally (ie, "they think we're so stupid that we don't know what to say!") and just take it as constructive assistance for those who actually need it. C'mon, you can't tell me you haven't met a nurse who could use one or two lessons in basic manners and social interaction.

All that nonsense just makes me want to vomit.

Specializes in Certified Med/Surg tele, and other stuff.
Oh, but don't let a nurse manager or admin in the US hear you say that! We're supposed to be better than a hotel. In fact, our reimbursement is going to be tied to patient satisfaction. If that's not a case of the inmates running the asylum, I don't know what is. If you are a non-compliant diabetic, good nursing care dictates that I not provide a slice of chocolate cake with an ice cream chaser, but patient satisfaction says I should. And now, we'll be dinged if the non-compliant diabetic goes home unhappy but alive. At least if they're dead they can't complain, I guess. It puts nurses in an impossible position.

Amen..

We do courtesy calls within 24 hours after discharge. The calls are automated, but if there is an untoward comment, it goes to a manager or charge nurse who has to return the call. How do they know there is a disgruntled person? They have to carry a pager!

Well, I will be getting a disgruntled phone call this week. I'm the poor sucker that has to carry the pager AND I do discharges.

I d/c'd a pt last week, who was a very negative person and was difficult to discharge. As a courtesy, even though I was freaking swamped, I offered to fax in her script which I did and as I always do, gave her back the hardcopy. As you can imagine, my fax said it went through and when she got to the pharmacy, apparently it did not. She was so mad, she didn't even give them the hard copy and wait for them. Instead she went home without her meds and called us to complain.:banghead:

Specializes in ED, Telemetry,Hospice, ICU, Supervisor.

It's not called "dumbing-down", sounds too harsh. Lets call it "streamlining" so everyone is one the same page here.

Its not called "cheerleading", it sounds too unprofessional. Instead lets call it "synergy".

This is what I think goes on in the mind of admin as they roar about "customer-service". I swear I think on of our big-wigs used to be a district manager for McDonalds.

Most customer service models involving such things as scripting, rounding logs are put in place by those that are not at the bedside. They have no concept of what the nurse at the bedside does. They have little to no respect for the nurse taking care of the patient. Administrations want the patient to have a perception of good care. Sadly perception and reality are not one and the same.

If only they would be as concerned with safe staffing ratios.

If we can figure out a way to show them that safe staffing ratios actually MAKE or SAVE them money (and strict logic says they do: better staffing = more time to pay attention to detail and must = lower HAI, fewer falls, fewer pressure/skin problems, etc, which all = less money the facility absorbs) they'll be on that in a second.

HEY - I GOT A MASTER'S THESIS IDEA OVER HERE FOR THE TAKING!! Should've kept my mouth shut!

I think it "dumbs" everyone down: Us, patients, families, the whole facility. As mentioned in OP, how many times can a patient hear the same stupid script? It makes us all look like the geeky kid trying desperately to impress the popular kid. :no:

It's worse than that. It makes us sound like dithering idiots who have to be told what to say. I mean, we are ONLY NURSES... (*sarcasm sarcasm*)

I think this is generally a product of privitized healthcare where profit margins trumph patient care. Here in Canada patient satisfaction is a foreign term, something I hear of only when I visit this forum. Public healthcare emphasizes family/patient-centered care which focuses on doing things that are in the best interest of the patient. Our job as healthcare providers is to return you back to optimal health so that you are able to intergrate back into society. I'm still shocked when I read that patients fill out customer service surverys after discharge, how bizarre.

A hospital is a hospital, not a hotel.

Public hospitals (state and federal - read into that what you will) in this country are embracing it too. It is not limited to private hospitals. Not every hospital in the US is supported as a not-for-profit institution, maintained mostly by revenue. We still have 'county' hospitals and state hospitals, such as those attached to large state universities.

And we have military/VA hospitals. As I was saying, read into that what you will.

They're ALL starting to do some aspects of it here.

Specializes in ED, Telemetry,Hospice, ICU, Supervisor.

I was present at a meeting for staff to give their 2 cents to their floor director.

1. When the RNs asked for more help such as hiring 1 or 2 CNAs to helpd with ADLS, the response from admin was " RNs in other states do more with less staff". ( FYI, CNAs no longer exist at my facility)

2. When the admin was asked about patient health and satisfaction the admin response was " use your communication skills to inform them what you are doing/when you will be back/ etc". (FYI, this is already done)

3. When asked if unit secretaries will disappear like the CNAs did the admin answer was "NO, but we will CONSOLIDATE resources as needed". ( I think this means were cutting down, but not all)

In all honesty, the summary to this whole meeting was "RNs need to work harder". Felt kinda insulted really.

Why is "Customer Service" and Health Care used in the same sentence? Health Care should NOT be treated like a spa or hotel. Patient satisfaction scores should be based on health/medical care only, not based on TV channels, soda's, if the nurse waited on the family or if the nurse gave the diabetic a piece of cake. It seems like nurses can't really nurse,They have to spend time doing little meaning less stuff,they have to give in based on a score and that's wrong. When ever I was in the hospital what did I care about? Can they fix my problem?, what can they do to fix it?, was the staff friendly?,did they explain things to me that I don't understand? When can I leave?? :) If I got great "CARE" that's all that mattered to me. That's what the "score" should be based on. Who ever thought of the "Customer Service" model needs to have their head checked!!!

I was present at a meeting for staff to give their 2 cents to their floor director.

1. When the RNs asked for more help such as hiring 1 or 2 CNAs to helpd with ADLS, the response from admin was " RNs in other states do more with less staff". ( FYI, CNAs no longer exist at my facility)

2. When the admin was asked about patient health and satisfaction the admin response was " use your communication skills to inform them what you are doing/when you will be back/ etc". (FYI, this is already done)

3. When asked if unit secretaries will disappear like the CNAs did the admin answer was "NO, but we will CONSOLIDATE resources as needed". ( I think this means were cutting down, but not all)

In all honesty, the summary to this whole meeting was "RNs need to work harder". Felt kinda insulted really.

This is not unusual. I am curious as to what "other" states and/or facilities do so much more with so much less. Oh, that and the undercurrent of how "well paid" everyone is.....

The concept is great; the application is wrong. I appreciate excellent customer service, as does the next person, I'm sure. Hospitals might have a better chance at pushing the excellent customer service initiative, WITHOUT the scripted lines. For most things to work well, the people doing it have to believe in what they are doing and I don't get that vibe here, which is a fail for the hospitals.

It might work better if employees are kept reasonably satisfied, which in turn passes on to the patients. I think it's laughable:). because inasmuch as our hospitals push the scripted lines and all, they still get grumpy reviews, mostly. You can just tell the lines are scripted and not genuine, further upsetting the patient even more, because they can see through that.LOL.

But again, the concept is great just wrongly applied.