Customer Service at any cost and its effect on burn out and safety??

Nurses Relations

Updated:   Published

SO... Things are more different every day than when I started nursing over ten years ago. The advances and technology I can flow with. Some other things not so well. I have worked ICU, LTAC, Med/Surg, Peds, Oncology, Float, and PACU. No matter what the area, this customer service push follows you every where!

I have always understood that the patient is your customer, and you just cant be flat out rude or nasty, however, when did it become routine every day acceptable for the patient, their wife, and their aunts third cousin to be rude, and right out nasty to the nurse?! People more and more feel like they can do or say whatever they want in the hospital. Like basic rules of courtesy do not apply if you are their healthcare professional.

My hospital had a big customer service push with classes a few years ago, which basically was all about how to lie and be fake. This is above and beyond keeping your personal troubles at home, and giving your best to your patients. I currently have two jobs, PACU (because i love it), and LTAC for the money. If there is a problem or any type of complaint no matter where you are, you are done for.

Recently in our PACU a comment card from a patient angry that he was aroused and told to breath was taken seriously and a discussion was had with the management. At what point does this junk stop? At what point does customer satisfaction overpower safety? At what point will someone understand that the impression this junk is giving nurses is that we dont matter, and if someone spits on me I should thank them for it?? HCAPS = Burnout!

I was kicked by an a & o pt last week. I had it, and politely told him i wouldnt go to where he works and kick him, and expected the same level of respect in my work environment. Did not go over well.

HCAPS and the government and the Joint stressing the satisfaction issues simply makes this worse. People making decisions about this stuff arent the ones getting screamed at, insulted, and belittled. Politely educating your patient family member who read how to flush a line on the internet and doesnt know what they are talking about will get you fried. Telling an alert pacu patient they cant scream and curse when there is a 3 yr old in the next bay will get you fried. Telling a family member in the waiting room they cant come to recovery while you are extubating their wife will get you in trouble. Following pplicy will get you in trouble as soon as someone decides to complain they dont like the policy.

Anyways, can you tell I am frustrated? I like patient education, rights, and good customer service, but how ridiculous will this continue to get? I just need to hurry up and hit the Mega Millions. . . .:mad:

Specializes in Mental health, substance abuse, geriatrics, PCU.

Out of curiosity, are hospitals where nurses are unionized experiencing the same psychotic customer service jamboree others are facing?

Specializes in ICU/CCU, Med Surg.

This customer service issue in healthcare really ticks me off...like everyone else has said here, I too am all about providing care with a smile and helping out pts and their families however I can during the worst time of their lives. But I'm also new to nursing, having worked in retail and customer service for (too) many years...and I just want to burn it into the mgrs' heads that THE CUSTOMER IS NOT ALWAYS RIGHT! In the food service industry, you do everything you can to make the customer happy, even when they act like craptacular d-bags. Even when they are not "right", which is often. But the food industry never involves life/death situations. It's much easier to swallow one's pride and offer the customer an alternative that suits them. It's just not as translatable with healthcare. I would maintain that patients are NOT customers! :no: The fact that they are considered consumers, customers or whatever the buzzword is today, is seriously counterproductive, in my opinion. And not at all why I went into nursing...

Ugh, what to do, what to do...

Is anyone on here a manager? Can/should we pose this question in the managers' forum here on allnurses? I just want to hear some perspectives from current managers who also have extensive bedside experience...

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
rngolfer53 said:

Yes, people are stressed (though the level of stress in our society is ludicrously small compared to previous generations and other places in today's world) but that does not give them license to forget they're adults.

It may be ok to let an adult in a department store act like a child, because the mission of the store doesn't include providing healing.

Adults behaving like toddlers in safeway would be ejected. If someone kicked the mcdonald's server because his fries were too cold, he'd be arrested. As nurses, we're supposed to shut up and take it because if we'd done our jobs better, they wouldn't be so upset.

Specializes in ICU/CCU, Med Surg.
TheMoonisMyLantern said:
Out of curiosity, are hospitals where nurses are unionized experiencing the same psychotic customer service jamboree others are facing?

"Psychotic customer service jamboree"...hahahaha!

Specializes in Med surg, LTC, Administration.
roseycortes said:
It is SO nice to see that I am not the only one struggling over this. I love the Press ganeys that say things like, "my roommate puked all night" or The nurse wouldnt go down to the lobby and get me a sandwich from McDonalds" Really?!

Its just killer how YOU are somehow responsible for all this crap. I give good care. My fellow nurses do as well, but the comments you see have nothing to do with care, they are basically about how they did not get to do whatever they wanted, or how they didnt like what the MD ordered, and then blame the nurse.

We chart by exception at my facility, but I have stopped doing that and started writing every time I get the vibe that Mr Smith is angry his pillow is plastic to cover myself and illustrate the patients ridiculousness. Sometimes that helps when my manager pulls and reviews the charts.

It is crazy and maddening, makes me want out of nursing, you cant do your job, you cant convince people to do their stuff, and you cant say anything back when getting abused.

Comfort in others experiencing the same thing.

This is actually, my biggest peeve. No longer charting by exception, but charting solely to cya. All this writing to avoid suits, that have absolutely nothing to do with nursing care, only the impulse/whim of a certain family or individual. Hours are wasted weekly from this practice. Something got to give...

Specializes in Med surg, LTC, Administration.
opossum said:
"Psychotic customer service jamboree"...hahahaha!

Lmao!

Specializes in Family Medicine.
jrwest said:
As wierd as this comment may be- we need another Noah's Ark- the world has gone to Hades. People are evil. not all, but a large percentage.There is no repect anymore. The mgmt only encourages this horse bleep. Which gets around to others that it's ok to be violent and rude. I bet if the op had called police to report assault- i Guarantee that she would be canned- how DARE we accuse our CUSTOMER of such a thing. Why this crap is allowed in nursing makes no sense'

I feel the frustration OP. Mgmt KNOWS how desparate we are to even HAVE a job in this current society. They are just as abusive to us as much as the rude patients. All this patient satisfaction stuff can take a flying leap. These "customers" aren't stupid- they KNOW they will get THEIR way. welcome to burgerking.

Great post.

Last week, I actually had a dream another Noah's Ark occurred. The only living things saved were Labrador Retrievers (yellows only).

Specializes in Mental Health, Medical Research, Periop.
lalalalexi said:
What really gets me is how we as nurses are often held accountable for EVERYTHING. Any bad experience or complaint is a nurses fault. My manager leaves press ganeys out for us to read sometimes, and tells us "Be sure to read them. They can help us improve as a floor and see where our weaknesses are". So I go through them. Some of them are complementary, but a lot of them contain what I consider to be trivial complaints (that apparently also seem to ruin their whole hospital stay), or are things that nurses are not responsible for/can't do anything about.

Some of them had vague comments with no basis, like "The nurses all seemed like complete idiots". Or "the nurses had no idea what was going on". That isnt very helpful, IMO. Give us some examples.

And far and away the most complaints are about the food. Like I can do anything about the food...We get a lot of bowel surgeries on our floor and we hear all the time "they didn't let me eat for THREE days!". Well yes, that's the way it works when you have your bowel operated on.

Other complaints "They made we walk a few hours after I just had surgery", "they had to put a tube down my nose and it was AWFUL!" So you want to keep throwing up a liter an hour because you're obstructed? "They woke me up all night" "My room wasn't cleaned one day". And a really great one "I didn't get any extra amenities. I saw other patients had combs, lotion, mouthwash etc and I NEVER got any. This made me very angry". Uh, last I checked all you had to do was ask for those things!

And the question that asks about the skill of the nurse caring for them, most of the time the people comment about IVs. "They had to poke me TWICE to get an IV started". Or "they poked me every morning to draw blood." Or "my IV pump kept beeping". I think it's funny how when asked about technical skills of the nurse all they think about are IVs. Like that's the only technical thing we do. And like I can change the fact that you have small veins, or that the doctor ordered labs for you (because they are actually important) or that your IV pump beeps when the bag is out.

Management is always about Press Ganeys or HCAHPs and how can we improve them. Well after reading the survey results, I usually have no good ideas. After reading this last batch I'm like, so in order to get a good Press Ganey we should basically let the patient do whatever they want...let them eat whenever, avoid any procedure that might be uncomfortable or painful, avoid waking them up during the night and above all else "not be an idiot". Great.

Almost makes you wonder if people want a hospital stay or a hotel stay? Whats this look like, the Hilton?

Specializes in Mental Health, Medical Research, Periop.
blueheaven said:
At nurseconnect.com there is an excellent article called "Is it the nurse's job to keep patients happy"

We do a survey that is like PG and some of the things written are RIDICULOUS!! Many things that OPs have written about and more. One that really gets me is, "I couldn't rest because the alarms were always going off and the nurses kept coming in the room and waking me up. (note they didn't mention the 400 or so fellows, residents, sub Is, attendings etc etc) Ummm, you were in an ICU and you had 5 different specialties taking care of you and you were very close to pushing up daisies. And they complain about the alarms, the food and the nurses!

The script that is coming down the line at my facility includes "Is there anything else I can do for you? I have the time." I will give my best put-on smile and run to get a ginger ale while my other patient on 3 pressors etc is trying to crump...NOT.

OMG! A hospital here has the nurses using this line, "Is there anything else I can do for you? I have the time." what a bunch of ********!!!

ruby vee said:
I love that line: "The ultimate customer service is a healthy outcome"! May I use it?

Thanks! I'd love to have you pass it on!

Specializes in Emergency Care.

Dear lord, HOW do you guys in the US not go stir crazy and kill everyone? I'm in the UK, we have (at least on paper) a ZERO TOLERANCE approach to staff abuse. We just won't have it! My most recent example is a patient who screamed verbal abuse at me while I tried to assess her. I called the police, had her removed, then had our yellow/red card process started. She's on a warning now, if there's another incident during a future visit, she'll be red-carded and will only be allowed onto the premises for life or limb saving treatment. If a patient is being demanding, rude, abusive (not due to illness/injury, obviously), we TELL THEM their behaviour is unacceptable, and as long as we're not abusive, unreasonable or threatening ourselves, management will back us. Hats off to US nurses, I would've been struck off several times over by now!

I can't believe you were assaulted by a patient and you ended up in trouble! If someone kicked you anywhere else they could be arrested, and you could go off on them.

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