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?

You are CORRECT! However, you have it backwards. Healthcare is a business. That is NOT the problem. Healthcare has always been a business--or how we pay our bill.

The problem is RATING healthcare. Why? Because patient satisfaction scores are NOT about healthcare, as studies show there is no correlation between satisfaction scores and good healthcare yet satisfaction scores are the driving force healthcare workers must bow to. Not to mention, rating healthcare has NOT added anything to healthcare, other than customer retention and profits. Instead, rating healthcare has only left behind an overwhelming amount of collateral damage.

Ask any administrator to list a single benefit from rating healthcare, other than customer retention and profits, and you will have your answer as to what the problem is.

So YES! You are right but you have it backwards. There is nothing wrong with healthcare being a business. The problem is in rating healthcare. -The Knitted Brow

You are OBVIOUSLY an administrator and/or drinking the Kool-Aide or you are OBLIVIOUS to what is going on around you.

Healthcare is a time-honored profession genuinely dedicated to helping others that is trusted and OBLIGATED with saving lives and stomping out disease. Despite that heritage and DUTY healthcare has been cheapened, by any means necessary and at the cost of so much, into just another customer-driven service. The Knitted Brow

PS You might want to reread what you wrote as well as you might have contradicted yourself.

You HIT the nail SMACK ON THE HEAD and drove it in to the HUB with ONE swing of the hammer! You were that effective.

Reimbursement, as explained in the article is not correct. Actually, it's far from even being close to being correct. It's a LOT more complicated than that but in a very succinct explanation, it is more of a penalty than reimbursement. A penalty which was sold as an incentive, if you could imagine that, and healthcare administrators and pundits took the bait. Thus where we find ourselves today.

Please believe me when I say that I am not trolling you. I am passionate about this topic and this is what I ask administrators who regurgitate the same mumbo jumbo as you are spewing, "What benefit has rating healthcare produced?" You say more respect for patients and families. Ooookayyyy. How about you list another benefit, other than customer retention and profits.

As stated by others here, the literature, both lay and professional, is inundated with articles which discount your claims. But don't worry, other healthcare administrators and pundits know them as well and they rather look away rather than lead.

Not to mention, all that respect you claim healthcare workers show to patients and family has NOT curtailed any of the violence directed at healthcare workers, which has ALWAYS existed but has only gotten more frequent, more brazen and more violent. And professional and government organization policies are PURPOSELY impotent as not to offend patients and/or families.

Allow me to share one more fact, the only thing rating healthcare has left behind is an overwhelming amount of collateral damage, and that is aside the violence directed towards healthcare workers, the opioid epidemic, decreased assess to healthcare, billions of dollars waste every year by both private and government pockets.

But don't forget your homework, list one benefit of rating healthcare.

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

Oh my god use the quote button.

Patient satisfaction scores determining reimbursement was the worst idea in healthcare...ever. Worse than putting leeches on patients. Seriously, most patients have no idea what "good care" is. Why don't we just give everyone a PCA pump with unlimited dilaudid, mini fridges in the room with snacks and drinks, and personal CNAs for each patient to increase our scores? Oh, because hospitals really aren't hotels or spas, we try to get patients better using medicine and evidence based practice. Patients might not like that I'm not in their room every 5 secs, or that the doctor didn't order their 6 percocets as needed like they take at home, and then they give us a poor review. Whoever came up with HCAHPS obviously had no idea how the healthcare system works :sniff::yawn::smokin:

Having patient surveys to find out ways to possibly improve care isn't a bad idea, but should never have been tied to reimbursement, ever. That's one of the core problems in healthcare, in my opinion.

JKL33 said:
Disclosure: Yes I am passionate about this, and no I have not personally had any trouble/discipline in my career, patient satisfaction or otherwise.

YES! You NAILED IT!

Susie2310 said:
Patients absolutely should express their opinions and experiences of the care they receive on the surveys. This provides information to the payor about the services they are paying for by the person receiving them, the patient.

By no means is the opposition of rating healthcare a suggestion that patients cannot or should not complain as they are only venting their frustrations, anxieties and feelings of powerlessness. Instead, the opposition is about the administration's knee-jerk reactions and sequel JUST because a patient complained, to include the overwhelming collateral damage left behind JUST because a patient complained.

MunoRN said:
The way HCAHPS surveys work, is...

Ah, nope. You're incorrect.

HCAHPS, if can believe it, began as an "incentive" to improve healthcare. A slippery slope, which healthcare administrators and pundits took the bait. I could go on, however, it would take some time to explain through this medium.

I will tell you this, the federal government saw the money they were saving on healthcare the federal government tried to impose similar consumer rating of colleges and universities only to be pushed back by college/university leaders, unlike healthcare, who pointed out the "misguided" consumer rating system was uncharacteristically clueless, quite wrongheaded, oversimplified to the point that it actually misleads and prioritized moneymaking.

https://www.nytimes.com/2015/09/13/us/with-website-to-research-colleges-obama-abandons-ranking-system.html

If you ask me, ALL predictable and have been actualized in healthcare, not only with HCAHPS but with the private rating systems before, like Press Ganey, as well.

So, no, rating healthcare is NOT about healthcare. It is SOLELY about customer retention and profits. And that evidence, not conspiracy theories, is overwhelming. DON'T drink the Kool-Aide! Look me up and we can chat. The Knitted Brow.

klone said:
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.

That is the problem and where the burden lays, healthcare is in desperate need of leadership as most healthcare administrators are not leaders but managers who merely facilitate policy between subordinates and superiors.

Healthcare needs change agents willing to go against the grain, even if alone. A direction that endorses healthcare workers as valuable and trustworthy, supports our collaboration and professionalism and recognizes us as the good-doers over concerns patients may take their business elsewhere.

The overwhelming collateral damage left behind from rating healthcare is NOT new and healthcare administrators and pundits are well aware of it. But they rather follow than lead, claiming, That's what they are doing ‘up the street' and so will we.� None of them having the testicular fortitude to support healthcare workers on their own, much less publicly.

Definitions:

-Leaders get others to do what needs to be done by providing purpose, motivation and direction.

-Managers simply facilitate policy between superiors and subordinates.

-Managers THINK they are leaders. And leaders show up to work.

I know, OUCH! Another problem of healthcare, it fears of TELLING IT AS IT IS! Of course, at the risk of losing our jobs.

LovingLife123 said:
Whether anyone like to believe it or not, healthcare is a business.

I concur, healthcare is a business and how we pay for the mortgage. However, different from other industries, healthcare is a time-honored profession genuinely dedicated to helping others and OBLIGATED with saving lives and stomping out disease. Despite that heritage and DUTY healthcare has been cheapened, by any means necessary and at the cost of so much, into just another customer-driven service just to accommodate a few.

Again, healthcare is like no other industry, NONE! and…

-the only industry with patients

-the only industry with OUR waiting room

-the only industry in which services are sought during some of the worse moments of our lives and during inconvenient times, for uncertain, unpredictable and volatile choices in places that are unknown, unpleasant and unforgiving

-the only industry where regardless of disposable income or time services are sought after and rendered

-the only industry whose workers maintain the public's confidence year after year as the public has recognizes us as the most honest profession and with the greatest ethical standard of any industry

-most notable, healthcare is the only industry where workers go to battle for every so-called customer� and when so-called customers� succumbs—we cry for them as well as the overwhelming numbers of patient experiences are rewarding, for both healthcare workers and patients. However, because of their sheer volume those positive experiences become blurs of one another and unless they are remarkably extraordinary their details are consigned to oblivion.

Yet, the melodramas of the complaining minority are permanently etched in our memories, some physically scarred. It is that misery and frustration which drags us down, as we must navigate, ALONE, that exhausting minefield just to stay safe and/or keep our jobs. Reason enough as to why so many leave healthcare and not fatigue as no one fatigues from helping others.

So, yes, although I agree that healthcare is a business and like you agree that what matters are outcomes, and the safety of healthcare workers and patients I DO NOT agree that surveys should include whether "Your concerns were listened to" or any other subjective means. Healthcare has NOT benefitted, in any manner, from the rating of healthcare, although somewhere on this thread someone did mention rating healthcare has improved respect for patients and families from healthcare workers. Rating healthcare is ONLY about customer retention and profits, a business, and that is fine. However, ONE, that is NOT how it is sold to the public. TWO, all the money (BILLIONS), time and effort wasted chasing after satisfaction scores. THREE, it's not the rating that is the problem but the knee-jerk respond and sequel from administrators when a patient complains. And, FOUR, all the collateral damage left behind. Those are the problems, none new, well documented, and everyone is aware yet chose to look away.

As for customer satisfaction, in every industry, decade after decade, that needle has not moved either. The rating of customers, in ALL industries, is simply another industry that evolves without fixing the problem. It's like metabolic/respiratory compensation, it takes place but DOES NOT fix the problem.

Pardon the dissertation, just my passion.