Are NPs expected to be happy and cheerful?

  1. Honest question. My experience at the bedside, it seemed like hospitals always tried to shove down our throats the need to have a smiling, servitude style "Is there anything else I can do for you?" demeanor. In a more independent and authority role, do you find that you are also required and expected (I'm sure it can help) to have this demeanor as well?
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    About Soliloquy, RN

    Joined: Nov '11; Posts: 460; Likes: 400
    RN; from US
    Specialty: 5 year(s) of experience

    41 Comments

  3. by   djmatte
    You have to remember to some degree, these are businesses and as such, hospitality is becoming a real thing. With reimbursement starting to be reflective of post-visit questionnaires, it is not surprising that hospitals want their employees to present this kind of demeanor. I wouldn't call this a new thing though. Your attitude and how you present yourself can have huge implications on how a patient does and could make or break a shift. No patient wants a nurse who is p***ed off at the world or so hurried/openly stressed to the point that they feel like an imposition. It isn't about "subservience" so much as setting the tone.

    I think the same thing goes for advance practice. The only "authority" you have is over the knowledge you've obtained. But you are still no more in charge of that patient in a clinic than you are as an RN in a hospital. That patient may or may not continue to be compliant with their meds...may or may not meet your expectations of weight loss...may or may not do anything you ask of them. Sure you can decide not to see them anymore and you will still deal with the ramifications when that patient inevitably writes some scathing online reviews of your practice. To some degree you are at even greater risk as an APRN as your name and face is often on that clinic billboard.

    IMO what it comes down to is your personal attitude and what you classify as being "subservient". We all should strive to be accommodating to our patients' needs so long as it is ethical and appropriate. It is at the least a decent thing to do and at best going above and beyond. Think about all of the complaints patients make about their MDs..."he/she seemed hurried...uninterested...not attentive...etc". Those are the interactions you want to avoid and sometimes your attitude can be the defining difference. I remember reading that emulating happiness (even if you aren't exactly happy) actually improves moods of both the person and the people around them. You are in the role of providing care. And sometimes that attitude can make the difference between a positive or negative outcome in that care.
  4. by   Soliloquy
    Ok. Thank you. I agree, being a receptive and present provider is important. But I do feel there is a difference between being that and having the expectation that one is to continuously cater to your patient's every demand without being penalized for setting proper boundaries with a patient.

    But I see your point and I guess, yes, similar repercussions can happen to a provider for doing just that.
  5. by   djmatte
    Quote from Soliloquy
    Ok. Thank you. I agree, being a receptive and present provider is important. But I do feel there is a difference between being that and having the expectation that one is to continuously cater to your patient's every demand without being penalized for setting proper boundaries with a patient.

    But I see your point and I guess, yes, similar repercussions can happen to a provider for doing just that.
    Boundaries are certainly appropriate and for the patient who feeds off of positive attitudes and interprets them as validation in doing negative things, you absolutely should be more real with them. Most of the time it comes down to the individual and the rapport you have with them. The hard part about the hospital is their stay us usually short lived and therefore the simplest misinterpreted interaction could be damning for the hospital. In a clinic, many of the patients you will begin to recognize and better gauge how each responds to different stimuli and treat the accordingly.
  6. by   wondern
    NP's...how about women in general? How about men? How about people?
    I agree a smile can be contagious. Funny movies are healing. Why just NP's? Oh I just reread, because of their 'independent and authoritative role'.

    In a customer service oriented business a smile is very calming and refreshing for me personally. Who wants a grumpy angry nurse even if they are an NP?

    Being constantly short staffed and jumping through bureaucratic hoops really helps with a sincere smile. Sometimes you just gotta fake it to make it in the smile dept. if you can but life is real and so are our emotions. Sometimes it's just so hard to do.

    On top of everything else the people we are caring for are sometimes dealing with the most horrific events of their loves involving them or their loved ones which can be sad for us too. Yes, a sincere caring smile could help from anyone at times like these.

    Nurses/people can become great actresses in the smile department and then sometimes we just can't do it any longer.
    Last edit by wondern on Jan 29
  7. by   SpankedInPittsburgh
    Yeah I suck at the whole fakey fake smile stuff as a nurse. It hasn't really hurt me and I do try to be genuine, friendly and business like but I'm not cheerleader material. I can't imagine that will change much when I change the initials behind my name
  8. by   babyNP.
    Of course you should be friendly, it is a business after all...on the up side, I have found that parents (I work in a NICU) are much more willing to listen to what I say and question me less when I tell them our treatment plan for their baby and why we are doing x and y including risks/benefits.

    In fact, I've had parents that refuse to listen to a senior nurse who has many years on me in terms of nursing experience but as soon as I say the same exact thing as in the role of a APRN, they listen to me. It's not right, but it is what it is. It sure makes my life easier...
  9. by   FullGlass
    What is your definition of "happy and cheerful?" I don't think anyone wants an NP or MD that is sad and cranky. During my NP clinical rotations, I had wonderful NP preceptors. They were calm, matter of fact, yet kind, and that worked very well. They were not "subservient."
  10. by   Oldmahubbard
    I attempt to be pleasant and kind, but also matter of fact where boundaries are needed. Not infrequently, I encounter patients who clearly don't wish to engage with me, and I minimize the interaction, and do my write up with what I have.

    I also attempt to discuss treatment options in a realistic, but optimistic way.
  11. by   traumaRUs
    Oh oh....my smiley face left me years ago.

    Like others have said, I am very polite, friendly but very businesslike. When I'm at work, I work. Its not where I go for entertainment. I am very no-nonsense shoot from the hip kinda person and that is usually just fine.

    I'll be honest too - I don't have time for chit chat. The bosses don't pay me to chit chat, they pay me to make them money.
  12. by   SpankedInPittsburgh
    YAY Trauma!!!! If the entirety of nursing looked at their jobs that way the profession would be better paying and taken a heck of a lot more seriously
  13. by   FLnurse1127
    Quote from djmatte
    You have to remember to some degree, these are businesses and as such, hospitality is becoming a real thing. With reimbursement starting to be reflective of post-visit questionnaires, it is not surprising that hospitals want their employees to present this kind of demeanor. I wouldn't call this a new thing though. Your attitude and how you present yourself can have huge implications on how a patient does and could make or break a shift. No patient wants a nurse who is p***ed off at the world or so hurried/openly stressed to the point that they feel like an imposition. It isn't about "subservience" so much as setting the tone.

    I think the same thing goes for advance practice. The only "authority" you have is over the knowledge you've obtained. But you are still no more in charge of that patient in a clinic than you are as an RN in a hospital. That patient may or may not continue to be compliant with their meds...may or may not meet your expectations of weight loss...may or may not do anything you ask of them. Sure you can decide not to see them anymore and you will still deal with the ramifications when that patient inevitably writes some scathing online reviews of your practice. To some degree you are at even greater risk as an APRN as your name and face is often on that clinic billboard.

    IMO what it comes down to is your personal attitude and what you classify as being "subservient". We all should strive to be accommodating to our patients' needs so long as it is ethical and appropriate. It is at the least a decent thing to do and at best going above and beyond. Think about all of the complaints patients make about their MDs..."he/she seemed hurried...uninterested...not attentive...etc". Those are the interactions you want to avoid and sometimes your attitude can be the defining difference. I remember reading that emulating happiness (even if you aren't exactly happy) actually improves moods of both the person and the people around them. You are in the role of providing care. And sometimes that attitude can make the difference between a positive or negative outcome in that care.
    If I could like this 10 times, I would. Very well put.
  14. by   Forest2
    Be kind. Be professional. That should be all that is required.

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