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PeachPie 8,715 Views

Joined: Mar 15, '06; Posts: 531 (25% Liked) ; Likes: 525

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  • Nov 14 '11

    I posted on this issue a couple of days ago in another forum, so I am basically going to copy and paste my same response over here.

    The mingling of customer service and patient care personally disgusts me. Healthcare facilities are designed to provide patient care. However, they are not in existence to provide customer service. There's definitely a difference between nursing care and customer service. Keep reading to see my point.

    The chef at the Hilton will provide excellent customer service by preparing a juicy steak and baked potato covered with several pats of artery-clogging butter for the patient with coronary artery disease. The hotel cook will go out of his way to display excellent customer service by baking an entire sugar-laden red velvet cake for the noncompliant diabetic patient. The bellhop at the Ritz-Carlton will provide excellent customer service by escorting the COPD patient to a lush patio where smoking is allowed. As long as customers are paying for the services to be rendered, employees in the hotel, hospitality, and tourism industry will do these things for the sake of great customer service. After all, they want the 'paying customer' to return someday.

    It is crucial that patients and visitors realize that the hospital is for patient care, not customer service. It is scary that customer service scores on surveys will soon dictate reimbursement rates for healthcare facilities.

  • Oct 9 '11

    I guess I'm too well educated to understand most of that, but I can assure you that today's health care crisis predates the Obama administration.

  • Aug 23 '11

    I was born to parents one of whom was first generation Irish Catholic, the other, part German, mostly Irish and VERY Catholic. I attended Catholic Elementary, Catholic High School and Catholic College. My education far exceeded my public school counterparts in NYC. I felt called to serve as a young person. I worked with the nuns at my HS about my potential "calling". I was immediately turned off when I was informed that nuns "today" (1979) need to have a college degree to bolster their 'calling' to a vocation.

    About that time, I met the first man I fell in love with. That makes a decision to enter the convent even more challenging. I chose life outside the convent.

    Moving on in life, I chose non-denominational churches over Catholic ones (much to the dismay of my parents).

    In no way, so I blame Vatican II for the demise of the vocations. What is the inherent problem is that for the first 1400 yrs of Catholicism, priests did marry. Once ALL vocations became celibate, the further reduced the pool of those willing to comply and even then, they didn't. The Church should never have gone there. Women had only the celibate option and with women becoming more educated and having had opportunities that did NOT include marriage, this was a foregone conclusion.

    Originally, nursing was only for the unmarried! So much has changed. The elephant in the room has long can Catholics retain their foundations and still be relevant?

    I can only thank God for those who served. I just couldn't become one of them...and both my husband and my children are forever grateful for that choice!

  • Aug 18 '11

    I know where you are coming from, I have been a nurse for almost 20 yrs and back is holding out for most part. When I suggest the slide board or some other transfer device I am almost laughed at, or it cant be found. I resort to using a garbage bag to slide patients over and it works. the one that gets me is 'can you go help someone out out the car' since i wk er. I've threatened patients when i get out there , how did you get yourself in the car why is it different now that you suddenly cant get out by yourself (unless unconscious) i sometimes tell them if ya cant help get out ill be glad to call 911. but yes as far back as i can remember i am always asked to help and im not that big but "male". well enough soapbox

  • Aug 18 '11

    Quote from alisrn
    so, nicugal, were you never a new graduate nurse? lol

    i believe, in the long run, if a new graduate is trained and is treated like a nurse by the other nurses and not like a lower life form on the floor, that nurse would be more inclined to feel included in the team on the floor and, therefore, the new nurse would be more inclined to stay on after orientation and beyond. it's the nurses who forget that they were once new graduates that create the problem of losing money on hiring new graduates. i think if lateral violence and bullying among nurses is addressed in a hospital and protocol was in place to prevent it, many new grads would stay on, making it worthwhile for hospitals to precept new grads.

    alissa, rn in ma
    that's a load of bullpuckey.

    most of the new graduates i meet take the job knowing that they're planning to stay the barest minimum of time required to get into anesthesia school or to graduate from a np program. they have no intentions of staying long enough for the hospital to get a return on investment on their orientation.

    lateral violence and bullying is not nearly the problem that a lot of folks here make it out to be. it's much easier to say you quit (or were fired) because you were bullied than to say you couldn't handle the workload or learn the drugs or critical think your way out of a paper sack. although i don't know every one and every situation, every single new grad that i know who says they left because they were bullied actually had problems with their work. many of them believed that any negative feedback was "bullying" or "lateral violence", and that's an issue. not an issue of lateral violence, but an issue. many of them went through multiple preceptors and "second chances" but still didn't get it. some of them (read the "fired for no reason" thread) actually believed they were awesome nurses who were just being picked on yet failed to recognize it when they made some really basic mistakes. (and some really huge mistakes.)

    the folks who want to blame "lateral violence" or "bullying" for every negative interaction that occurs in the workplace trivialize it for those few who actually do experience it, and that's wrong.

  • Aug 18 '11

    I currently work in the computer industry and one thing that we know is to never trust a user's input to be what you expect it to be and that goes for things that aren't life and death. The article said that the dosage would've been fatal for an adult, it would seem that the people designing the systems would build some intelligence into them that they have upper bounds and expected ranges. If anything goes outside of those bounds, it should cause an alert. If range is x to y and the input is z, well someone should know that it is a possible error. Technology is great but there has to be some checks built in, ideally both system automated checks and a second pair of eyes.

  • Aug 18 '11

    Quote from Not_A_Hat_Person
    Whatever happened to "my body, my choice?"
    How does this make sense at all? It says you're in geriatrics? Babies are extraordinarily different than the elderly. They are a vulnerable population like the elderly, but they cannot make their own sound judgments like some mentally sound elderly.

    Late preemies carry substantial risks for all sorts of things when compared to their full-term cohorts up to and including mortality. Because the dates of a pregnancy can be off by 2 weeks, what we think is a 38 weeker can be 36 weeker and what we think is an okay 37 weeker is actually 35 weeks.

    It's like subjecting a child to unnecessary surgery just because of the parents wants for convenience.

    Good on Portland for taking this initiative! Less $$ in the hospital's pocket for c-sections and NICU stays, but it's about darn time people started standing up for our unnecessary late-term preemies!

  • Aug 18 '11

    My guess is that it stems from the March of Dimes initiative, but I'm glad to see it whatever the motivation. There is a tremendous amount of fetal brain growth that happens between even 36 and 39 weeks. Leave 'em alone until they're fully cooked!

  • Aug 18 '11

    Quote from Not_A_Hat_Person
    Whatever happened to "my body, my choice?"
    It's not just all about me anymore (the birth mother).
    Does anyone ask the unborn baby's opinion on if he/ she wants to take the risk of complications just so they can be induced for the convenience of doctor and mother? Seems morally irresponsible to me.

  • Aug 18 '11

    My OB-GYN's office was doing the "right thing" years ago. So many inductions done for convenience sake is not the best thing for babies. I believe this is also being done because the Oregon Health Plan is footing the bill for so many of the births and the state has a vested interest in saving money as well.

  • Aug 18 '11

    Yes, but I guess I left out the fact that the patient condoned this, because after we asked the family to leave twice, the patient stated she wanted them to stay. My interpersonal dynamics with the family? I think that I was dealing with some very F'd up people with equally F'd up family dynamics and handled it as best as I could. I now realize that I left a lot out of this post, because I tend to be very wordy, wanted to hear some other experiences, and was trying to get to the point. Apparently, I did this ineffectively. Patient (a & 0 x 3 and ACS) also condoned their behavior by insinuating that I had incorrectly impute her meds on the med rec (actually med rec done in ED), and that I also told her that she was taking a med that she never heard of (gave both trade and generic names). And this is after I went through the med rec with entire family. Fortunately, family had brought all of her script bottles with them. Went through med rec on computer again (one by one, script bottle by script bottle)...guess what, no error. Also, I have been around long enough in life to realize when someone is basking in attention. The next morning, the patient apologized to me for her family's behavior. Told her it was no problem, "they just care about you." That did not stop her from calling her family an hour later on the next shift and saying that she was poisoned because her nurse gave her the wrong antibiotic. Another sad play for attention. Well, from my understanding, only 8 of the family showed up and caused a big disturbance. Security was called and visitors were limited to 1 at a time, excluding those who had caused the disturbance. make a long story short (LOL), I did the best I could and gave this patient the same care that I give to all of my patients, despite the fact that my patience was definitely tried. Peace Out.

  • Aug 18 '11

    Do Good,

    Essentially correct except that to assess whether a hospital loses you have to know what the break-even point actually is. In all likelihood the break-even point is months, not years. All industries employ people that may not work out, and these costs are well understood, so nursing is no different.

    If hospitals feel that their turnover rates are excessively high they have the same options as any employer: Make their working environments more attractive: Higher pay, career ladders, better benefits, better patient care, modern equipment, educational programs, sign-on and/or retention benefits, loyalty.

    Hospitals, like most employers, would like an endless supply of high quality, low cost, compliant nurses. They would like to be able to keep salaries down, benefits low, and the ability to move patients through their facilities like slaughterhouses move cattle. Committed, caring, and professional nurses tend to interfere with such plans because they have higher expectations than disinterested, uncaring, and unprofessional nurses.

    But hospitals use RNs, regardless of whether they are new or experienced, to meet minimal staffing standards. So even nurses that do not work out help hospitals meet regulatory requirements, so it isn't as though there are no benefits from day 1...

  • Aug 18 '11

    I think the key here is return on investment. But, we have to back up a little bit to understand how the ROI is more difficult to realize than it used to be.

    The employee/employer relationship has changed in the past 30 years. Loyalty by an employee is no longer rewarded, and employers will kick an employee to the curb without an ounce of regret. The dynamics have changed, and those dynamics were driven by the employer.

    Now, those employers are seeing the rotten fruits of their tactics. (Don't they always...after their bottom line has been affected?)

    Employers will realize an ROI only if the new grad stays on for two years or more. That new grad, sufficiently trained, can then serve as a preceptor.

    See the give and take? Sufficient training, adequate staffing = a new grad that can then become the expert to whom other new grads turn. ROI in a nutshell.

    But, how many times have we seen that NOT happen, just through the postings here on AN. Insufficient training, inadequate staffing, and the new grad (who isn't even close to "expert") is drowning. He/she gets the hell outta Dodge, just to be faced with an expectation of the new employer about having "expert" skills because of the one year experience...and drowning yet again.

    Businesses, as I've said before, are dangerously myopic. Reactionary instead of innovative. Kicking the individual to the curb rather than taking a critical look at the processes that influence mistakes made.

    My post is probably more theoretical than you desired, but I believe a long, hard look at the bigger picture would solve some of our economic problems. Unfortunately, so many of our leaders (politicians, executives, Wall Street, etc.) can't see the forest for the trees. If anything, that will be the downfall of corporations, regardless of industry.

  • Aug 16 '11

    Thankfully the time I had to get letters, I actually knew the people. Although asking my manager for a letter the week after I got in trouble was stressful. Perhaps for the dean you don't know, invite them to lunch not so much as just for the letter, but to ask for their advice on a number of things. That way it's a "bribe" for their mentorship, rather than just a bribe for the letter.
    For the ones that know you already, just ask for the letter. They're used to writing them, it's part of their job. When I did end up getting what I needed my letters for, I brought my recommenders a small bag of chocolate with a thank you card letting them know my happy news. But beforehand does seem a bit on "bribery" side.

  • Aug 16 '11

    Just wait until you have a male boss who is doing the nasty with one of your female coworkers, and she ends up getting waited on hand and foot--with a smaller workload--while most of the work is dumped on you.

    When they think with their d**cks, they are worse than any woman you could possibly describe.