Customer Service? Maybe on your home planet.

[Art_Vandelay]

I usually have a high tolerance for rudeness and inappropriate behavior, but yesterday I reached my limit. This patient is always verbally abusive toward staff, speaking with an acid tongue and tone. He claims that the nurses write down the wrong time in the narc book. "No, she didn't give it to me at that time. Your clocks are all wrong; none of them say the same time."

The man has nothing nice to say, regardless of the issue.

Yesterday, I finally grew tired of apologizing for something I didn't do, and called him on his behavior, stating, "You are being rude. Do not speak to me that way."

He retorts, "I just give what I get. You nurses are always rude to me."

I reply, "I am never rude to you. In fact, I hardly say anything to you because you have nothing nice to say in return."

He says, "You were rude to me just now." "If I sense a sarcastic tone, I will be sarcastic right back."

I say, "I was not sarcastic toward you, and I do not deserve to be spoken to the way that you speak to people."

It turns into a bit of back and forth, and then I realize, what is the point? In no way do I want to be having an argument with this man, but I am tired of being treated like ****. Some people, sick or not, are just jerks. If I weren't in the professional atmosphere, I would have told this guy off. No joke. I have been around enough people that are verbally abusive to be able to put them in their place. However, I somehow do not defend myself in the professional atmosphere for fear of repercussions from management.

Now, I have never been written up nor do I want to be, but it was at the point with this patient that I was thinking, Oh well, if I get written up for refusing to be treated poorly, so be it. Then I realize, this guy was probably raised without any manners to begin with, and my "educating" him now is not going to change anything.

Funny thing is, later he winked and smiled at me. What the heck was that? Now he was being nicer to me? He still had the same verbally demanding and demeaning tone when asking for pain meds though from his PO med nurse.

Anyhow, I still haven't reached a "happy medium" when it comes to dealing with this issue. I know there has been ongoing debate on AN regarding the "customer service" attitude. Funny, the first thing this patient said when I refused to tolerate the behavior was, "The customer is always right." Wrong.

[Yiggs]

We have the same problem where I work, patients are sometime so disrespectful and "entitled." They think that because the healthcare system advocates for the highest level of customer service they can walk over us like door mats. I am very assertive and matter of fact when I am dealing with patients like these. Many of them have issues that we are not in a position to fix and they resent us for this, they resent the fact that we are not in the position they are in! I think you did well being firm with him; we all need to be consistent when dealing with patients like these. Yiggs

[caregiver1977]

I have had the same thing happen to me...and sometimes if you call them on their "BS" they respect you more...kind of fuuny:uhoh3:

You read my mind.

[caregiver1977]

On the contrary, I have worked in several other industries including sales, hotel reception, and also owned my own business, and I have never had someone treat me with such disrespect as in nursing. I do not feel the patient owes me anything, and I am very cognizant of the fact that these people are sick and in need of care and compassion. I never stated that I am not capable of "turning it around,"; I am just tired of being respectful and professional to someone who treats me like crap. Oftentimes, it is better to say nothing and provide brief yet thorough care, but then I end up harboring resentment for allowing someone to talk to me in that manner. It is indeed a slippery slope.

Nurses owe patients respect. Patients owe nurses respect. Customer service for patients should not come at the expense of making health professionals doormats. It is different if a person is sick and can't help acting that way, but to be intentionally rude to a nurse just because "the customer is always right" is unacceptable.

The clinic where I receive some of my health care has signs printed and hung all over the building that say "We do not tolerate disrespect to our patients. We do not tolerate disrespect from our patients." I think that is fair enough.

[steelydanfan]

This is what nurses that have never worked in another profession don't realize.

In EVERY profession where customer service is promoted, it doesn't matter how nasty, saracastic, etc., a "customer" is, you are expected to keep your cool and remain polite and courteous.

However, for some reasons, nurses don't think that they owe it to the patients that are rude, to try to turn the situation around, then wonder why they get into trouble with management. It doesn't matter, if you don't need a job...but this isn't going away folks, regardless of what realm of healthcare you choose to work in.

However, I do blame the facilities for providing zero training of teaching nurses how to handle difficult patients. At the same time, nurses seem to forget that people that enter the hospital don't feel well....that is why they are there. They are not having their best moment. Fear, frustration about your own health condition brings out all sorts of behavior...yet nurses think that patients "owe" them something.

No patient owes me anything, nor do I expect it.

However, learning how to deal with difficult people is A SKILL...it is a people skill that has to be learned and fine tuned. I have had family members yell at me, curse at me, etc. However, I have always been able to turn it around.

Do I laugh or do I cry?

I'm not handing out hotel room keys here, I am trying to keep people alive, and restore them to health. This situation is far too serious for me to have to spend masses of time placating idiots who think that good nursing care is being on speed dial to every one of thiier 40 family members who URGENTLY neeed to speak with me.

My SCHOOLING went into great depths as far as handling difficult people (2 semesters of pyschology and sociology each, as well as psychiatric training and role playing in leadership skills classes; thank you very much).

As for the statement that "nurses think that patients 'owe' them something", your thinking is so out of the ball park as to be ludicrous.

I have done this for a VERY long time, and I know for a fact that there are no "ALWAYS". Your statement just says that you have been VERY lucky so far.

You WILL be faced with the pt./family from hell; you will be abased, humiliated and frustrated in all that you try; and then you will remember this post.

Best of luck to you.

[eriksoln, BSN, RN]

This is what nurses that have never worked in another profession don't realize.

In EVERY profession where customer service is promoted, it doesn't matter how nasty, saracastic, etc., a "customer" is, you are expected to keep your cool and remain polite and courteous.

However, for some reasons, nurses don't think that they owe it to the patients that are rude, to try to turn the situation around, then wonder why they get into trouble with management. It doesn't matter, if you don't need a job...but this isn't going away folks, regardless of what realm of healthcare you choose to work in.

However, I do blame the facilities for providing zero training of teaching nurses how to handle difficult patients. At the same time, nurses seem to forget that people that enter the hospital don't feel well....that is why they are there. They are not having their best moment. Fear, frustration about your own health condition brings out all sorts of behavior...yet nurses think that patients "owe" them something.

No patient owes me anything, nor do I expect it.

However, learning how to deal with difficult people is A SKILL...it is a people skill that has to be learned and fine tuned. I have had family members yell at me, curse at me, etc. However, I have always been able to turn it around.

Eh, yes and no. Dealing with difficult people certainly separates good and great nurses...........I think an awful lot of patients go beyond the accepted difinition of simply being "difficult".

https://allnurses.com/nursing-articles/healthcare-customer-service-585705.html

Thats the truth about "customer service". It doesn't work in healthcare, and for a reason. Ever since this fad (yes, that's what it is, the flavor of the week attitude about "how it should be", next week it'll be back to paper reduction or medication error reduction) of "customer service" started, patient care and the nursing/patient relationship has gone so far down hill...........neither is being accomplished (neither customer service nor pt. care).

[BabyLady, BSN, RN]

Eh, yes and no. Dealing with difficult people certainly separates good and great nurses...........I think an awful lot of patients go beyond the accepted difinition of simply being "difficult".

https://allnurses.com/nursing-articles/healthcare-customer-service-585705.html

Thats the truth about "customer service". It doesn't work in healthcare, and for a reason. Ever since this fad (yes, that's what it is, the flavor of the week attitude about "how it should be", next week it'll be back to paper reduction or medication error reduction) of "customer service" started, patient care and the nursing/patient relationship has gone so far down hill...........neither is being accomplished (neither customer service nor pt. care).

It's not a fad and it isn't going away.

I can see it going away if we ever go to a universal healthcare system.

However, I hope to never see that nightmare in my lifetime.

[BabyLady, BSN, RN]

Do I laugh or do I cry?

I'm not handing out hotel room keys here, I am trying to keep people alive, and restore them to health. This situation is far too serious for me to have to spend masses of time placating idiots who think that good nursing care is being on speed dial to every one of thiier 40 family members who URGENTLY neeed to speak with me.

My SCHOOLING went into great depths as far as handling difficult people (2 semesters of pyschology and sociology each, as well as psychiatric training and role playing in leadership skills classes; thank you very much).

As for the statement that "nurses think that patients 'owe' them something", your thinking is so out of the ball park as to be ludicrous.

I have done this for a VERY long time, and I know for a fact that there are no "ALWAYS". Your statement just says that you have been VERY lucky so far.

You WILL be faced with the pt./family from hell; you will be abased, humiliated and frustrated in all that you try; and then you will remember this post.

Best of luck to you.

Uh, you are assuming a lot, aren't you?

That I have never been confronted by a "family from hell"? You are incorrectly assuming that just because I have the people skills to diffuse a situation that it was never "really that bad" to start with?

I worked another career before nursing, between the two... I have been stalked, had death threats, I have been hit (yes, HIT), I have been screamed at, cursed at, had things thrown across the room, had to call security on one that slapped her child across the face out of frustration when all she asked for was to go to the bathroom, I have had parents to scream to the top of their lungs that parents had better get their babies out of here because we were incompetent, a major domestic altercation, etc.

No, I have not been lucky....at all. Can you share with me, other than probably getting beat up in the parking lot, what else I have to experience to be unlucky? In fact, I usually get assigned the difficult parents because other nurses that are far more senior than me, don't seem to know how to deal with the difficult parents or just make the situation worse. Is that fair to me?

Absolutely not...but I am the type of nurse that never complains about my assigment, I don't care which assignement I get...sometimes you get an easy one, sometimes you get a hard one...there are other battles that I would like to pick rather than some of the senior nurses that are calling two hours before their shift with a "list" of which babies they do and don't want that night because they don't like the families.

No, my view is not laughable...it is a PEOPLE SKILL. When the customer service approach rolled out in healthcare, facilities did nurses a grave disservice by expecting them to handle patients as customers without giving them any training at all in how to handle difficult people. Other industries do this all the time...how to handle a heated phone call, how to handle threats of lawsuits, how to handle people cursing, etc....in healthcare? NOPE..not one class, nothing.

I was very fortunate to have those skills and 20 years of experience working it before I ever became a nurse. To me, it was the easiest part of the job...but tons of my more-senior co-workers and the new grads? ARE PULLING THEIR HAIR OUT when they encounter difficult families.

However, ironically...I have noticed, that those, like me, that have a long history of working with the public prior to nursing...are able to diffuse a situation to where everyone can come up with a compromise.

BY THE WAY: I'll be honest...by you claiming your "education" entitles you to not have to cater to anyone because you are "not handing out hotel keys"...I can understand why management is beating their heads against the wall when nurses have this attitude...talk about a sense of entitlement!!!

[eriksoln, BSN, RN]

It's not a fad and it isn't going away.

I can see it going away if we ever go to a universal healthcare system.

However, I hope to never see that nightmare in my lifetime.

Yep. It's a fad.

Before this, it was pain management and all of its accompanying baggage (don't judge, be sure you reassess pain).........but you don't hear much about that anymore. When I started nursing, it was so taboo to label someone a drug seeker. Now, I can't go ten minutes without hearing the phrase.........and it's the supervisors and management a lot of times.

Before that, it was reducing paperwork and double documentation. To this one, we made great strides, but the second the "pain management" fad kicked in........it was forgotten and it was back to ten different forms for the same thing.

Before that, it was eliminating overuse of restraints. I've worked at hospitals where they were not allowed at all. Now......eh, they cost less than sitters so.............go ahead.

When w/e the next fad is starts picking up steam, "customer service" will go into the grave like the fads mentioned above.

Once the powers that be (politicians, insurances, people on the business side of healthcare) realize its not working and in fact has cause us to take two steps back and one forward.............the craze will wear off.

[eriksoln, BSN, RN]

I worked another career before nursing, between the two... I have been stalked, had death threats, I have been hit (yes, HIT), I have been screamed at, cursed at, had things thrown across the room, had to call security on one that slapped her child across the face out of frustration when all she asked for was to go to the bathroom, I have had parents to scream to the top of their lungs that parents had better get their babies out of here because we were incompetent, a major domestic altercation, etc.

Why'd you call security instead of "Dealing with the problem using theraputic communication and people skills"?

Because this person crossed the point in which "the customer is always right" no longer applies and the baby's best interest had to be taken into account. That is "patient care" at it's finest.

On the other hand, as so often happens today, had you called security and been told what I said above...........and told you should have handled it in some way as to not make the situation worse by upsetting the mother............well? That is "customer service".

[BabyLady, BSN, RN]

Why'd you call security instead of "Dealing with the problem using theraputic communication and people skills"?

Because this person crossed the point in which "the customer is always right" no longer applies and the baby's best interest had to be taken into account. That is "patient care" at it's finest.

On the other hand, as so often happens today, had you called security and been told what I said above...........and told you should have handled it in some way as to not make the situation worse by upsetting the mother............well? That is "customer service".

Seriously....I can detect the sarcasm.

Child abuse needs to be brought to the attention of security and that mother was also reported to social services.

Or didn't you know that?

Glad I could in-service!!!!

[Art_Vandelay]

I was very fortunate to have those skills and 20 years of experience working it before I ever became a nurse. To me, it was the easiest part of the job...but tons of my more-senior co-workers and the new grads? ARE PULLING THEIR HAIR OUT when they encounter difficult families.

However, ironically...I have noticed, that those, like me, that have a long history of working with the public prior to nursing...are able to diffuse a situation to where everyone can come up with a compromise.

BY THE WAY: I'll be honest...by you claiming your "education" entitles you to not have to cater to anyone because you are "not handing out hotel keys"...I can understand why management is beating their heads against the wall when nurses have this attitude...talk about a sense of entitlement!!!

This is not irony. One would expect someone that had a long history of working with the public to be able to resolve a conflict. Furthermore, one would expect a new grad to encounter difficultly in handling new patients and families. However, it would be ironic if a new grad with no customer relations experience was able to diffuse a situation easily.

The irony is this: some patients have a sense of entitlement, and act accordingly.

[caregiver1977]

I would rather see mutual respect rather then "customer service" any day in health care. But I am probably just spitting in the wind on that one.

*exits stage left to go cut fresh herbs (legal ones)*