Nurse Satisfaction comes before Patient Satisfaction

This Article is going to review and reference the article titled: Patient Satisfaction Must Start With Nursing Satisfaction. Why do these scores matter? Are you a dissatisfied nurse? How can we make nurses happier? Nurses General Nursing Article

Are you in a unit where your patient satisfaction scores are always a struggle? Look around you, are the nurses satisfied with their job? Nurses go into a job to help care for others, but when staffing ratios are unsafe, documentation takes longer than patient care, and you haven't peed in 12 hours, it can become a daunting job.

Who's obsessed with these scores?

Have you been a nurse for a while and don't remember such a fuss in the past about patient satisfaction scores. You aren't daydreaming; it is a newer concept. Hospital administrators, or what many of the nurses refer to as the "bigwigs," or "higher ups" are overly obsessed with the patient satisfaction scores. Why? Hospitals are a business, and excellent scores mean better reimbursement from Medicaid. Reimbursement equals money, and as nurses, we often don't think of the hospital as a business because we are in a caregiver role, not a salesperson.

As nurses, we have to understand this. There is an abundant number of people on the Medicaid and Medicare system, and unfortunately, without reimbursement. Hospitals could not run. Many hospitals are shutting down across the nation because they cannot keep up with the demands.

It's not that we don't want patients to love us

Nurses love their patients, or they wouldn't be a nurse. I have a problem with the concept of the "best patient experience" for everyone. I'll tell you; I don't treat anyone different. I don't care if you are Donald Trump's son or a homeless woman on her 4th abortion, I will treat you the same and give you the best care. My vision is never the patient experience; it is "how would I treat this patient if she was my sister."

We have to take a look at why we do what we do. When nurses become happier, the vision isn't so cloudy. We want our patients to be more satisfied, pain controlled, teaching completed, but sometimes it isn't possible. When nurses are happy, patients will be as well.

Why can't we meet our goals

Hey, "bigwigs," listen up. You have to take care of your nurses, yeah, the little guys. Do you think patients can't tell when their nurse is overworked and underpaid? IF not, you need to be a patient. It is written all over the nurse's face. We have a hard time faking happiness, at least most the nurses I work with.

How to turn the frowns upside down

If you are a nurse manager, take a look at your staff. Do you have a high turnover? Ask you trusted charge nurses, see what they think the issue may be. Hand out a random survey to your staff:

  • What is your overall satisfaction working at our hospital?
  • What is the most stressful thing about your workday?
  • What can we do to improve your workday?
  • Do you feel rested? Do you have enough breaks?
  • Do you enjoy working with your colleagues? Is there anyone here who drives you down?

In conclusion, higher ups, stop spending so much money on national "experts" who think they can help us raise our scores. Take a look of the nurses. Are they happy? What can you do to change that? Hiring an extra nurse to be out of staffing to help give lunches and breaks is going to cost less than all the extra lectures and training. According to Hazen's article, happier people make fewer mistakes because they are more aware of their surroundings, making their workload doable.

How do you think we should fix nurse satisfaction rates? Do you agree that nurse satisfaction reflects patient satisfaction?

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

I'm a believer that if nurses are satisfied, enjoy their jobs and their colleagues, and have good leadership, then it will trickle down to patient care.

Specializes in Travel, Home Health, Med-Surg.
billswife said:
I had a patient once whose daughter literally told me to " her my mother some colder ice".

And I had a patients daughter literally screaming at me once (among many other things) because her Dad wanted a popsicle and we were taking too long...UGH

I believe, as with everything, we let the pendulum swing too far from one side to the other.

Whether anyone like to believe it or not, healthcare is a business. It has to be. Patients are our customers. They have choices on where to go. No customers=no jobs for nurses. Lower reimbursements mean less raises and desperately needed supplies for nurses. And yes, hospitals that provide better care should be properly reimbursed for that care. The problem lies on what is being judged on those surveys.

Food, how quickly we answer that call light, and pain meds should not be apart of that survey. Things like outcomes from that surgery or treatment, did you feel like you were listened to, and bedside manner should be. Did your broken ankle heal properly? Was your baby delivered safely? Is your child back to school? Did your physician listen to your concerns? Did you feel comfortable asking your nurse questions and did they answer those questions for you? That should be these surveys. Not, what was the dang quality of the food? Or did you feel your pain control was acceptable? Sometimes, there is just going to be some pain. Sorry, your ribs are broken. That is painful.

I guess I just disagree with nurse satisfaction is the only thing and that will make patient satisfaction better. I can tell you from experience that 100% employee satisfaction does not always translate into happier customers. There has to be a balance.

Quote
Feb 19 by Susie2310

The patient is the recipient/consumer of the health care services and they/their insurance are paying for their care, so yes, they have the right to express their opinion about the quality of the care they have received, and it is reasonable that their experience should count as part of quality of care measurements for reimbursement purposes. And don't forget, without the patient bringing income into the facility, the nurses wouldn't get paid! Yes, nurses wouldn't have jobs - I know this is a shock to some.

Patients often do have the option of where to receive care, so it is pretty foolish to say that their opinions about the care they received shouldn't count for reimbursement purposes. It's actually pretty insulting to patients to assert that they are so ignorant/biased/unaware that they can't determine their quality of care in any meaningful way and are unqualified to comment but should just shut up and gratefully receive health care services (nursing care/medical care). Yes, of course some patients for a number of reasons (illness, infirmity, etc.) may be less able to objectively appraise the quality of their care, but they as patients/consumers of health care services have the right to express their opinions about the quality of care they have received just like other patients/consumers.

A very large part of good nursing care deals with things patients dislike and don't care of want to do. Much of the educating that goes along with an improved long term outcome many times flies in the face of their lifestyles. People in general, not just patients, do not react positively to what they aren't ready to hear or do and they rarely will not carry that bias to the surveys.

So now they want nurses to create of culture of making the patient happy instead of what is actually best for the patient's immediate and future health. We all know this and for those nurses that care about patient's outcomes it creates a professional and personal conflict. It is very difficult to feel satisfied about your work once put into this type of a position. So it it my personal opinion these surveys and the managerial pressure that comes with them has had a huge negative impact on the work and professional satisfaction of nurses everywhere.

Great read my Linked In friend Janine~ :cat: you hit the nail on the head! Michelle

Specializes in Nurse Health Writer / Author.

hahah thanks Michelle ;-)

Specializes in Nurse Health Writer / Author.

Easier said than done...you know? :( We don't have the time with ratios being high, and our shifts being long, but never long enough to get all the work done.

Specializes in Nurse Health Writer / Author.

Nurse Satisfaction is not the SOLE answer to patient satisfaction, you are absolutely right.

Specializes in Nurse Health Writer / Author.
Daisy4RN said:
Quote:

"Hospitals are a business, and excellent scores mean better reimbursement from Medicaid. Reimbursement equals money, and as nurses, we often don't think of the hospital as a business because we are in a caregiver role, not a salesperson"

And this is the first problem!!! Reimbursement should not be based on the satisfaction of sick people who do not understand job descriptions. I agree that happy nurses will (for the most part) make happy patients. Best way to do that is to let the nurse be autonomous in her/his daily activity, and to provide the time to do just that.

Easier said than done...you know? We don't have the time with ratios being high, and our shifts being long, but never long enough to get all the work done.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
JanineKelbach said:
Easier said than done...you know? :( We don't have the time with ratios being high, and our shifts being long, but never long enough to get all the work done.

Hi Janine - when responding to an individual post, please hit the "quote" button in the bottom right corner of that post. That way, we will all know who/what you are responding to. Thanks!

Specializes in SICU, trauma, neuro.
MunoRN said:
There's certainly some improvements that could be made, but as a basic premise I don't see a problem with payers providing financial incentive for facilities to provide more support for those providing care.

Except from what I hear (I've heard "pt satisfaction surveys" come from my manager's mouth exactly once in the four years I've worked under her) this isn't generally what happens. Rather than using that info as an incentive to increase staff, they blame the nurses. Remember that empathy exercise where the nurses were made to lie on a cart in the ED hallway, wearing goggles and denied access to the BR? I want to say it was a hospital in Illinois? They would have done well to staff more nurses, but they decided that the nurses simply didn't do well enough because they don't know what it's like to be a pt, nor did they care.

Specializes in SICU, trauma, neuro.
Daisy4RN said:
And I had a patients daughter literally screaming at me once (among many other things) because her Dad wanted a popsicle and we were taking too long...UGH

Unacceptable. That should warrant a call to security, not faster waitressing. ?