Are nurses also customers?

[wildtime88]

Here is a unique perspective on nurses being treated as customers. Nurses are not customers you say. Well think again.

I have been working as a local agency and travel RN for about the last 4 years or so. Do I get treated like a customer? You bet I do? I staff local agencies in which their only source of revenue is from nurses generating income? No nurses equals NO revenue. They can have contracts coming out their ears form every facility in the area, but it they do not have nurses to fill the open slots, then they are literally holding a worthless pieces of paper. So if they want to hold on to nurses to bring in revenue, then they go the extra mile and treat you like a valued customer. The same is true of travel companies except most of them also staff other allied health positions as well, i.e. radiology, therapy, etc.

So you say yea, OK, I can see that, but here is where it really gets interesting. I am treated like a customer at the hospitals where I provide my services. Not only by management, but also in some ways by the staff nurses. Here are just a few of the examples. I for the most set the schedule that I want as far as how many days in a row or which days I am available to work. The regular staff is filled in around those way before the schedule has been finalized. On all but 1 or 2 of my 13 week travel assignments I have taken a week off during it and have even had scheduled off before and after it to extend my time off. At the same time the regular staff was complaining that their vacation requests were being denied. I am not normally giving the shitty assignments on a regular basis, I know every one needs a break and I do not mind having to take a turn. But in most cases those assignments never come my way and not because I am not capable of doing them it is just so I will continue to come back. Most of the time I am greeted with a thank you for coming when I arrive and also when I leave. I have received coupons for free meal and even tickets for something going on in town from the hospital. I have been occasion been treated as badly as regular staff or been taken advantage of by regular staff, but guess what? I do not go back and usually end up in a phone conversation with a manager asking why and receiving an apology.

The places that insist on treating local agency and travelers poorly soon find they can not get anyone to come in. We do a lot of sharing of information among us. So as a group. we learn to avoid certain places that are not nurse friendly especially to us.

Most of the experienced agency and travel nurses know that we are in fact customers. We are not any better nurses than most of the regular experienced nursing staff. We are not arrogant as it may appear. We actually know who is providing services to whom. We also know that we are income producers even though the hospital may not bill as such. They do pay out strictly on nursing time alone. You can believe that they recoup their costs in one way or the other. If it is to add on to a med cost, or a frequent test like a CT or bill a little more for a supply item. In the long run, the CEO walks away with just as much in his paycheck or more than he did the week or month before. So does everyone else in actual power at the facility.

Some nurses want to blame us for their lack of wage increases. They have heard

If I have to bargain too much or if the facility I am offering my services too both agency and hospital alike refuse to bargain, then I simply say I think I will go somewhere else where they really need nurses.

Now this works for me and most of us because there are multiple hospitals and agencies in the area and I can travel when and where I want. It also works because of the nursing shortage as well. It also works because I am not willing to settle for less than I am worth as a nurse extending my services.

We are nurses and we are in high demand for the very knowledge and skills we can extend. Unfortunately many nurses do not value themselves too highly let alone see their selves as customers. So they continue to accept what ever is dished out to them. They have no control of their professional practice in any shape or form.

I was talking to a nurses about local agency at a dining table one day with around 10 other people listening in. She said, if we quit and go agency the hospital said they will not use us for a year. My response to her was so if even 30% percent of you left and went agency, then who would they replace you with. This was a isolated midsize town with only one hospital that was already short staff and actively recruiting. She could not answer my question and all I got was a blank stare and not just from her, but everyone else around.

So, yes nurses are customers but many sell themselves way to short even in the remotest of places

[nurs4kids]

Very interesting view, wild. I like it. Keep up the good work!

[sharann, BSN, RN]

Hi Wild,

I guess I'm the first to vote on this one.

Now to save time since I am ready to hit the hey in a few, I'd like to explain my reason for picking "other" on your other poll. My opinions are as follows:

1) ALL hospital staff INCLUDING physicians should (SHOULD) be providing "customer service". By this I mean being as courteous and friendly/helpful as humanly or inhumanly possible given the circumstances. Achieving this is the hard part. I do not feel that this should fall as a nursing task. This is an organizations responsibility as a whole, from housekeeping to kitchen staff, to nurses to RT etc...

2) IIii have heard that the docs are our customers too. This may be true when docs are non-employees of the facility etc, however, I feel that I as a nurse, and a member of the community are a customer as well. How many of MY family members and friends will I encourage to use my hospital if they have a choice. People take nurses opinions to heart.

I enjoy the workings of your mind Wildtime.

Goodnight.

[thisnurse]

wild ...good post.

i guess it depends on your perspective.

we can all be considered customers. the hospitals are customers too if you look at it the way you do.

but that aside, while i am acting as a nurse, i am not a customer. i provide service to my customers...which are the patients and the hospital.

[Whisper]

I don't see how Nurses can be seen as customers in many situations, many hospitals can not afford to call in bank or agency nurses, so the ward staff have to pull double after double. When we do get agency nurses they are always treatd well, but there is always a bit of resentment when they leave on time!

[wildtime88]

thisnurse,

By your description, then doctors can not be considered customers either especially if it is the only facility around. Kind of goes back to the old way of thinking we have to keep the doctors happy when nurses would give up their chairs and bring them coffee.

You really need to rethink this. You have a unique education and skill sought after by someone else in order to produce revenue in the long run. By the very fact that we are being saught after for our unique skills, knowledge, and abilities makes us customers.

The service you extend can be to any organization you so choose and it is to provide care to a patient among other things. If a customer does not like the treatment they are getting they go somewhere else and so do nurses. In fact, that is exactly what is going on all over the country. Today more than ever hospital are advertising for customers in the form of nurses, yet the reality is when you actualy begin providing them with a service in order to open up a revenue in the form of a hospital bed then then we some how no longer become a customer.

I know this is a new perspective for you to understand, but a good question for you is, why do you not want to be seen as a customer and be treated like such?

I am treated like one. And if your facility uses agency or travelers on a regular basis, I can almost bet they are treated like one as well. The facility offers us something and we either accept of decline it, in exchange we allow them to use our services.

[thisnurse]

wild,

i agree with you regarding everything you have said but i can't understand why you are saying we are customers. i think we are more like suppliers. i think the hospitals are our customers.

im not a nurse who gives up her chair for a doctor. no way. i see them on the same level as us.

i agree totally with all of your sentiments but i think im more hung up on the word "customer".

to me that implies recieving a service.

maybe you can help me understand what you mean by "customer".

who are we getting services from?

[hoolahan, ASN, RN]

To me the use of customer here is like customer=having a choice of where to shop. As an agency nurse, you may be treated like a customer, but the staff may be treated like cr@p. But you know what I see as an agency nurse? The staff see this, and they choose to shop with the agency. Sure they may not be able to work at their former location for 6 months, but after that they go back. THEY tell the hospital when they will work. They take home twice as much.

As far as agency nurses making so much and robbing the staff, that is also cr@p. How much do the nurses in the hopsital think it costs the hospital to give them partial pay on health insurance, tuition reimbursement, vaca sick and holiday pay. Agency nurses usually don't get those, though wild might since he's a traveler. I am local agency, I don't block time, so I get no bennies, don't need 'em.

So, yes, nurses can and do shop around for the best deal, and they should! After witnessing the effects of nurses shopping elsewhere, one local hospital gave every employee a raise, #3/hr for 0-3 years, $4/hr for 3-5 yrs, and $5/hr for >5 yrs. OK, it's not phenomenal, but they saw the writing on the wall, and paid nurses for their loyalty. Many who were thinking of leaving stayed.

Am I following you here wild?

[P_RN, ADN, RN]

I agree with Wild. I wonder if I were younger-(and healthier :) ) if I might like to try some travel nursing. I haven't travelled much in the last few years and it would seem a way to get some variety. Plus I have never even been west of the Mississippi River!

To those who say "no the nurses cannot be considered customers" or "this is our home here in this hospital" well we aren't allowed to treat it as our home. We are told from morning to night what to do, when to do it, and how to do it. That is certainly not how a customer is treated. And it is CERTAINLY not how I will be treated in my home.

I say that nurses are treated as necessary *evils* by hospitals.

They hate to have to live WITH us and the certainly can't live WITHOUT us.

[thisnurse]

ok NOW i understand the point you are making. in that sense, yes we are customers. sometimes i have tunnel vision and cant see past staff nursing.

you are absolutely right, we are customers. can i change my vote?

sorry....sometimes im a bit slow

[wildtime88]

thisnurse,

Sure you can change your vote and you just have, but better than that you have just changed your point of view as well as your self perspective. This is what a lot of nurses have to do. It could be a slow and hard process as you have demonstrated, but if nurses do not, then there will be a lot of things that will never change.

In other words, you have just taken the first big step in actually taking charge of your own career and future.