"Customer service" and nursing - page 8

I've seen a lot of people talk about 'customer service' in a disparaging manner, as if that is not what nursing is about and it's making their lives harder to provide it. Could someone explain... Read More

  1. by   wooh
    Not being able to say you were busy, that's just management's way of passing the buck. If we can't say we were busy, then the patients can blame it on lazy nurses rather than the real problem, which is inadequate staffing (or even if adequate, the fact that we aren't private duty nurses!)
  2. by   Batman24
    The hospitals seem to want it both ways...they want the nurses to cater to every whim of every patient and family member and yet they don't want to provide the staff in order for that to even remotely possible. Patient care will always come first, but when nurses have so much of their plate due to short staffing than getting a juice for the hubby of a patient can't be a priortity. Ever. If you can you do it and if it puts another patient at risk you don't. End of story.

    And for those of you written up for idiotic things can you flat out refuse to do so?! I would have a heard time signing anything I didn't agree with. I would write up my side, but I still wouldn't be comfortable signing their document.
  3. by   rnsrgr8t
    Quote from rnin02
    There is one issue about customer service, that will never, ever be solved. Its the way people, both staff and patients ("customers") percieve things. Everybody puts a different spin on what they hear. I've been more aware of that lately, in my current work environment (the nursery) because I can hear both sides of the story sometimes. For example, a parent will come in with their baby for assessment, or whatever. And after they leave, the nurse I'm working with will say "did you hear that? can you believe that?" etc, etc. And meanwhile I'm thinking, heard what? sounded normal to me! Or an L&D nurse will come over to talk to us, and someone I'm working with will just interpret what she says differently than me. We, as nurses, may think we are saying something politely, the patient, or their family, hears it as rude, condescending, whatever. And I used to work on a unit where we weren't allowed to say we were too busy. I'm still not sure what we were supposed to say??? My former manager would say that patients don't want to hear about other people's problems. Well, I'm not going to violate HIPPA, or go into any details, but I think telling a patient you had an emergency, or, in the case of the nursery, couldn't leave till someone came to relieve you (obviously we can't leave the babies alone!) is appropriate. Otherwise they don't know what to think about what was going on, and for some people, their first instinct is to assume you were ignoring their needs.

    :yeahthat: This is a great thread and I agree a lot of what this quote says. I do have some comments. I have some thoughts. I have worked in pediatrics for almost 10 years. Yes, we do have a different perspective and expectation for dealing with their families. We are better staffed than the adult world and that makes it easier. There are extremes to any situation. There are definitely rude nurses/MD's/CNA's etc. out there. A lot of their attitude could be b/c of being overworked and underappreciated. On the flip side, there are a families/people out there that are NEVER going to be happy no matter what you do. The important thing here is for the appropriate amount of perspective. I bend over backward and do the most I can for my families. The people I work with know this and my managers know this as well. I rarely hear about families complaining about me although I am sure it happens b/c they know that I try my best to do everything I can for my families. I also work in a division that is appropriately staffed. In my previous job, I was overworked and there was unrealistic expectations re: customer service. If, by myself, you expect me to work with a doctor who is seeing 70 patients in 8 hours or triage more than a hundred phone calls during flu season... my customer service skills are going to suffer and there is absolutely nothing I can do about it. Even if I try. I was getting written up by my manager on a weekly basis because I did not talk to the families enough (I am sorry, but I cannot talk about the weather, the news etc) or did not spend an hour telling a mom how to treat diaper rash, did smile enough,e of you are going to slam me for this but it really is all about preception. If you are dealing with people that are very self centered and don't appreciate the job you do, they have a warped idea of what is appropriate. You do the best you can!
  4. by   Tweety
    Quote from TrudyRN
    But, Tweety, we can't run around quitting q time something goes wrong.
    Of course not, things go wrong a dozen times a day. I promise you though, if I get written up because I didn't go fetch someone a coke, then that's not a place I will work in. While I work at a customer service oriented place, they aren't that extreme as some of the place in this thread. I understand the frustration if employers are being that petty.

    Now if I get written up for being rude to a family member "get it yourself, do you think I'm room service and you're at the Hilton?", then I would humbly sign it and go on.

    To me customer service isn't about providing the patient with their every whim and being a waiter and/or their maid. If I can't get them a coke, then I need to find a way to say I won't do it, but with kindness. It's about them percieving they are understood and cared for. I can make them wait for an hour for pain medicine, or forget them and leave then on a bedpan for 30 minutes, but if I provide good customer service, they'll get over it and love me in the end and will not give me bad customer service scores.
    Last edit by Tweety on Apr 10, '07
  5. by   LilPeanut
    Quote from Tweety
    To me customer service isn't about providing the patient with their every whim and being a waiter and/or their maid. If I can't get them a coke, then I need to find a way to say I won't do it, but with kindness. It's about them percieving they are understood and cared for. I can make them wait for an hour for pain medicine, or forget them and leave then on a bedpan for 30 minutes, but if I provide good customer service, they'll get over it and love me in the end and will not give me bad customer service scores.

    You have encapsulated my thoughts, very nicely said.

    Perhaps the real question is then: why are adult hospitals so vastly understaffed in comparison with peds?

    And for those who were concerned with my hoho box, the point is that when you are completely confined to bed and can't do anything for yourself, no matter how you arrange what, there will be things out of reach and stuff you need help with.

    People cope and show fear in different ways. I would ask everyone to take a look, an unbiased look, at the posts that have been made. While many have a good point and a very valid point of view, the disdain and almost vitriol for families is apparent. Something needs to change about that.
  6. by   wooh
    LilPeanut, I think you have to realize that peds is just an ENTIRELY different ball of wax from adult nursing. Generalities coming: People are grateful when you get their kid better. Parents are so consumed with getting their kid better, that they don't care how uncomfortable they are, just make Little Suzie better. When I'm starting an IV on a kid, the parents just want it in with minimal discomfort to the kid, so they stay out of my way. On more than one occasion, I've been in the middle of starting an IV on an adult, and their family member, mid-cannulation, has asked me to go get them coffee. Not to mention, I go and tell someone "I'm sorry it took me so long to get in here, I was stuck in another room" at my peds job, mom will be, "Oh, I understand you're busy, all these poor kids being sick." Say the same thing walking into an adult room, "Well I needed you too!!" Basically, with peds, families have their priorities in order, and don't mind ME having MY priorities in order. Adult nursing, it's all about making them feel like they're at the Hilton.
  7. by   RNDreamer
    sorry, but I HAVE to ask...what(or who) is TPTB? thanks in advance
    Last edit by RNDreamer on Apr 10, '07 : Reason: ...
  8. by   TazziRN
    Quote from NYDreamer
    sorry, but I HAVE to ask...what is TPTB? thanks in advance
    The Powers That Be
  9. by   DusktilDawn
    Quote from LilPeanut
    You have encapsulated my thoughts, very nicely said.

    Perhaps the real question is then: why are adult hospitals so vastly understaffed in comparison with peds?

    People cope and show fear in different ways. I would ask everyone to take a look, an unbiased look, at the posts that have been made. While many have a good point and a very valid point of view, the disdain and almost vitriol for families is apparent. Something needs to change about that.
    What your viewing as disdain and vitriol towards patients and their families is actually frustration, not necessarily with the patient/families, but with what customer service SHOULD NOT be within a health care setting. Nurses are frustrated BECAUSE THEY CARE. People seem to find this a hard concept to grasp, if you truely care about your patients and their outcomes, you are going to become frustrated and perhaps even angry at anything that threatens that. If nurses really didn't care, it wouldn't bother them and they would have left the job a long time ago.
    I've seen a lot of people talk about 'customer service' in a disparaging manner, as if that is not what nursing is about and it's making their lives harder to provide it.

    Could someone explain that more for me?
    I think your equating "customer service" and providing good bedside care as the same thing. There's nothing wrong with that, what others are saying is that is not how it is being viewed by our administrators. If TPTB viewed "customer service" the same way, nurses wouldn't have an issue with it.
    Sorry, but if I'm juggling a bunch of patients on a busy med surg floor with no PCA to help me, and one of my post-ops suddenly starts bleeding, I'm not going to leave that bleeding patient to go warm up a bowl of soup. The manager was well aware of the circumstances but she still wrote me up for it anyway.
    I got called to NM's office next day and yes she understood the situation entirely but I still got written up because the Grandma-needs-a-coke person had complained that I told them I was too busy to get Grandma a coke. That was "poor customer service." Told NM I don't have customers, I have patients, the one with her guts lying all over the bed came before grandma and her coke, and he could jolly well have walked his big butt down the hall and got Grandma the coke himself.
    Customer service, my eye.
    In both these instances, the NMs should have backed up their employee and taken the time to explain why the soup and the coke was not a priority. Instead, these NMs reprimanded both these nurses. Absolutely inappropriate under the circumstances. How can nurses not be frustrated under these circumstances?
    I shouldn't have to be written up because a visitor asked me for a soda or snack and I directed them to the vending machines.
    I don't think things like not having change so my patient's boyfriend can buy a soda should not have any bearing on my annual eval.
    Most units don't keep food on the floor for visitors, directing them to the vending machine was appropriate. I'm sure most of us, if we had change for a visitor don't have an issue with giving it, however, it should not be an expectation. Neither of nurses should have even had these instances brought to their attention, these complaints should have been filed under G. Neither incident should have been used to write the nurse up or had any impact on an evaluation. Again, how can nurses not be frustrated by this?
    We had a experience recently on our ICU. We had a pt who was admitted Jan 26,07. Still inpatient. All problems started one night when the nurse asked the family to please go to the waiting room because the pt needed to be stabalized. The family was pissed that they were asked to leave at this time. So they put in a complaint to the manager and demanded that she not take the pt again. This was agreed upon by mgt. Another nurse had this pt and in the succeeding time let family stay and as did I except for bathing and changing. No issue with me at this time, but with the other nurse they had issues (I am not sure what). Again put in complaint to mgt. (not about me) and this nurse not allowed to have this pt. As time went on more and more staff were put onto this list for "frivilous" complaints. Like "Too many people to turn him making me feel like he was fat." The pt was a large man about 6'5" and 350 pounds. On nights took 2-3 staff to turn due to male staff able to help. On days many of the women are pettite so it would take more to turn him. We also had her complain that while cleaning him a RN lifted his leg and he winced. He was getting stiff so he was probably sore but we had to lift his leg so we could make sure we got all the stool off of him. Staff explained that and a complaint was written that she "Threw his leg up in the air and hurt him". We had it so one nurse couldn't work one whole side of the unit. The pt wife would say "nurse jane is looking at me and laughing at me" This would occur even when she wasn't on duty. Eventually mgt was getting pages from this woman at home. She was so "Out of control" due to our inability to set limits with her due to "Customer service". Her son threatened a nurse that answered a call light saying "You have abused my father by having his trach too tight and he can't defend himself but I can defend him. I have taken on guys bigger than you." Due to all the problems with the family we had to transfer the pt to another ICU. I didn't have a problem taking care of this pt, but I was never sure what would put me on the "List". At one point half the floor was on the list. I understand that the family was having control and coping issues. I am empatheic and sympathetic to that. But we definately needed to set limits. It was to the point that no one wanted to have this pt but becasue of the family.
    This family was allowed to totally disrupt an ICU, unacceptable. Staff was put in the position of not wanting to take care of this patient because this situation was allowed to escalate, again unacceptable. Again inappropiate management. Measures should of been taken prior to the situation becoming out of control. If necessary counselling for the family to help them cope with the situation, and most certainly a health team meeting including the family where limitations should have been set.
    I got written up for bad customer service for giving a mom smoking cessation information while her baby was in the hospital and would desat every time mom came back in from smoking (the woman stunk of smoke!) I was nice when I did it, but if she doesn't want to hear it, it doesn't matter how nice I am. My patient's safety called for me to do something mom didn't want. Customer service wise, I guess I shouldn't have though.
    An RT recently got written up by a family member when he told the family it would be best if they did not smoke in front of the pt anymore, who was in the ER and being admitted for COPD exac. The family claimed he gave them a rude lecture, when all he did was make one comment.
    In both these instances the nurse and the RT could have had liability issues FOR NOT counselling these people. Health teaching is such an important part of our job and no nurse or other health professional should have to be afraid of being written up when they provide information to patients. Again, how can nurses not be frustrated.
    Last edit by DusktilDawn on Apr 10, '07
  10. by   Cattitude
    DuskTilDawn~~~~ Thank you for taking the time to quote all that. Sometimes people that have never experienced the wrath of families simply cannot understand. You made perfect sense. Frustrated, yes, I think so! Many of us are.
  11. by   Cattitude
    Quote from TrudyRN
    Also, it is not the norm in retail or waitressing to deal with life and death, mortality and morbidity, getting sued for one misstep. Please don't compare these lines of work to Nursing.
    :yeahthat: :yeahthat: :yeahthat:
  12. by   brendamyheart
    Quote from nrsang97
    I do not think that "Customer Service" has a place in nursing. I believe everyone in entitled to good nursing care. I am sorry if I offend the original poster but sometimes I am so sick of bending over backward to make some patients family happy.

    Sometimes I think we go WAY beyond common sense and have to bend over backward to please someone we will NEVER make happy.

    We had a experience recently on our ICU. We had a pt who was admitted Jan 26,07. Still inpatient. All problems started one night when the nurse asked the family to please go to the waiting room because the pt needed to be stabalized. The family was pissed that they were asked to leave at this time. So they put in a complaint to the manager and demanded that she not take the pt again. This was agreed upon by mgt. Another nurse had this pt and in the succeeding time let family stay and as did I except for bathing and changing. No issue with me at this time, but with the other nurse they had issues (I am not sure what). Again put in complaint to mgt. (not about me) and this nurse not allowed to have this pt. As time went on more and more staff were put onto this list for "frivilous" complaints. Like "Too many people to turn him making me feel like he was fat." The pt was a large man about 6'5" and 350 pounds. On nights took 2-3 staff to turn due to male staff able to help. On days many of the women are pettite so it would take more to turn him. We also had her complain that while cleaning him a RN lifted his leg and he winced. He was getting stiff so he was probably sore but we had to lift his leg so we could make sure we got all the stool off of him. Staff explained that and a complaint was written that she "Threw his leg up in the air and hurt him". We had it so one nurse couldn't work one whole side of the unit. The pt wife would say "nurse jane is looking at me and laughing at me" This would occur even when she wasn't on duty. Eventually mgt was getting pages from this woman at home. She was so "Out of control" due to our inability to set limits with her due to "Customer service". Her son threatened a nurse that answered a call light saying "You have abused my father by having his trach too tight and he can't defend himself but I can defend him. I have taken on guys bigger than you." Due to all the problems with the family we had to transfer the pt to another ICU. I didn't have a problem taking care of this pt, but I was never sure what would put me on the "List". At one point half the floor was on the list. I understand that the family was having control and coping issues. I am empatheic and sympathetic to that. But we definately needed to set limits. It was to the point that no one wanted to have this pt but becasue of the family.

    The OP works in a different department than most. Most of us on this thread work with adults. Adults as patients and family aren't always reasonable when it comes to explaining that someone else needs me more at the moment. I have also had to explain to famlies that I couldn't get to them right away, there was a emergency with another pt. Sometimes they understand and sometimes they don't. Usually they do, but there are going to be the unreasonable ones that we run into. I had a pt that I was late with her pain meds and was there to give them. I came in and said "I am here with your pain meds. I am sorry I had tried to get in here a few minutes ago and I had to go see a pt having a emergency." I was told by the pt "I am having a emergency I HAVE ABD PAIN". She was pissed that I was taking care of someone with chest pain and not her belly pain from a skin abscess.

    I am so fed up with customer service and the customer is always right crap. Not true in the hospital. You are there to GET BETTER not have a blast. People need to remember that the hospital is just what it is, a hospital not a hotel.

    I am all about making the paitnet comfortable and quality care. I should not have to worry about the fact someones soup isn't warm enough when I am caring for a critical pt.

    I have been on the other side of the bed and no it wasn't a good experience. I had to wait 1 1/2 hours to see a RN when I was having chest pain since the RN who was assigned to me was in a STAFF MEETING. I am sorry but I should have been the priority. Was I pissed? Yes I was. I didn't make some huge fromal complaint though I could have.

    Yeah this customer service bull cakka gets to me. A patient is a patinet not a customer/consumer.
    That squeaky wheel gets the grease. What happens to the one's that do not complain? Were I work we a so consumed with customer care, not nursing care to the point were those whom do not complain get less attention.W are a business and customer care is important, however to what what extreme do we provide it?
  13. by   brendamyheart
    Quote from wooh
    Not being able to say you were busy, that's just management's way of passing the buck. If we can't say we were busy, then the patients can blame it on lazy nurses rather than the real problem, which is inadequate staffing (or even if adequate, the fact that we aren't private duty nurses!)
    :yeahthat:

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