customer satisfaction in the er

[ensense]

I have been an ER nurse for 22 years now and this has to be one of the hardest parts of my job, customer satisfaction and Press Ganey. I work in an ED that sees 135 patients daily with the highest volumne during my shift 7p-7a. The problem I am having as well as many of my co-workers is that the hospital has decided for the last two years to use the Press Ganey survey company to evaluate our hospital. That in its self isn't much of a problem but when they start staying on us to the point it is interfering with our jobs it gets to be quite a head ache.

We as an ER have an average wait time of 2 hours or so. I think that is very good considing there are only 5 nurses on each shift . We have 2 doctors during peak times with a fast track open on weekends for even higher volumne.

My question is if anyone else has similiar problems keeping patients happy while still covering the TRUE emergencies. Even when I have a great day and don't let anyone fluster me I still can't seem to make the majority of patients happy. They get mad about the wait time, the lab wait time, the doctor attitude and the list goes on. Has any one out there got any ideas that I can take back to my ED customer satisfaction comittee to improve our scores. This is getting so old and it definitely takes the little bit of fun out of a very demanding job.

Thanks for any help any one can provide.

[tlf91]

Or are there times when you could really give a rip how "satisfied" the "customer" was with his/her visit? :angryfire

I had a women bring her dd into the ER at nearly 11:30 pm one night because she had a lac to the upper part of her mouth. Now this in of itself wouldn't bother me; what did bother the snot out of me was that the kid was happy and smiling, had already been seen in the morning of that same day at another hospital and was told to follow up with an oral surgeon, and had been sent to our ER that late at night by an "Ask a Nurse" R/t continued bleeding from the mouth (which was not evident when she brought this happy, smiling child in at a time that the poor child should have been in bed.)

Did I care if I didn't act like I was just thrilled that she was gracing OUR ER with her presence and her medicaid card? NOPE! I really didn't. Guess it had been the end of a very long week and I had already worked 8 hours earlier in the day (7-3, then back in 11p-3a). I know that is no excuse but sometimes.........you just want to scream at these people! We have a new manager now that follows up on every complaint she gets (which is good, don't get me wrong) so if this bimbo idiot complains then I am going to get called on the carpet for not acting like I was thrilled and happy that she was there. I wasn't all out rude, but I wasn't friendly either. As I said, I'm glad that our manager is concientious, but sometimes I think the "powers that be" should look hard at the chart and consider the source of the complaint before fussing at someone. I guess that sounds stupid. Sorry.

I'm not a bad person, but we have had a horrendous week with so many people coming in that don't need to be there. It almost got to the point of being funny at one point. I was working triage and generally sucking as I must have turned on the free beer and pizza sign inadvertently. Anyway, it got so backed up that everytime someone walked up and said that they wanted/needed to see a doctor, I wanted to laugh in their face and tell them "yeah, you and the other 12 people ahead of you! :chuckle ) I didn't, but that is the kind of week we have had.

I get so tired of seeing stupid patients take ambulances out of service to give them a taxi ride to the ER and the worst patients walk in the front door! That has been the big contraversary in our county; do we need to increase the number of ambulances or not? One of our ER docs wrote a very good response to that and basically stated that if people would use common sense when calling an ambulance then there would be no need for any additional ambulances. Course, it seems like the ambulance loads haven't gotten worse since that letter came out.

But, I digress.........sorry this is long and brought up a long dead topic, but I just needed to vent. Only four shifts this week and then I'm on vacation for a little over two weeks!

Thanks for letting me vent!

Pam

Boy, you have had a long week........ I had to change the way I looked at these people to keep out of the homicidal side of my personality. Yes, I know it sounds silly but I turned it into a game. Sickest patient of the day. Most pitiful acting job of the day. Drama queen for the day. Biggest pain in the %#*&^$&* for the day. I was at least laughing more.

The only thing I can say about patients who really do not need to be there is that that they are job security and character builders. I do not ever see this problem going away. Just make an effort to try to find ways to make it fun and try not to let it get you down. Venting is good . Real good!!!! We are right here with ya!!!!

[needsmore$]

Today's society doesn't want to wait for anything. We feed this ourselves-Faster cars, faster computer connections, fast food, etc. I have been an ED nurse for 18 yrs and i know what it's like to work with no food, a full bladder, standing up all shift, only to be told by admin the next day "Mrs Smith complained that she didn't get lunch while she was here, or not enough pillows, etc. " Admin is concerned with the numbers, unfortunately. The best thing that happened to our dept recently was that we got an ED nurse as a department manager, and she sticks up for us when these complaints show up. We do try to smile alot and nod our heads when people complain. It's hard to be pleasant when you're at triage and you have a 2 hr wait time and people, who should have used their FMD office but came to the ED instead, come to you frequently and complain about the wait. Good luck. When you leave, leave them all behind--Walking is a great stress reliever.

[teeituptom, BSN, RN]

Today's society doesn't want to wait for anything. We feed this ourselves-Faster cars, faster computer connections, fast food, etc. I have been an ED nurse for 18 yrs and i know what it's like to work with no food, a full bladder, standing up all shift, only to be told by admin the next day "Mrs Smith complained that she didn't get lunch while she was here, or not enough pillows, etc. " Admin is concerned with the numbers, unfortunately. The best thing that happened to our dept recently was that we got an ED nurse as a department manager, and she sticks up for us when these complaints show up. We do try to smile alot and nod our heads when people complain. It's hard to be pleasant when you're at triage and you have a 2 hr wait time and people, who should have used their FMD office but came to the ED instead, come to you frequently and complain about the wait. Good luck. When you leave, leave them all behind--Walking is a great stress reliever.

I looked at one guy who was obnoxious and kept coming to me at the triage window. I looked him straight in the eye and said, "If you come to this window one more time with something less than to tell me someone died out there, I am personally going to take your chart and move to the very last in the to be brought back box."

He didnt bother me again

[stretch thin]

My question is, does anyone read the paper or watch the news. Everywhere in the united states the ER is used as a clinic, let alone an emergency room. We see the worst of people. One because their in pain, which would make anyone cranky. They give these surveys to these people on arrival. Common on, that's smart. I mean EMERGENCY doesn't mean FAST CARE. Where people get this idea, I have no clue. It takes time to find out why grandma , who is 90 years old and has extensive medical hx, has been constipated for a month. I have had people scream at me because I haven't gotten them back as soon as they check in. I had this guy scream at me one night because he had been waiting 2 hrs, because he hadn't seen a doctor.(He came in because of back pain, which he had and he was out of his Lortabs) He cursed at me till I had enough. I had given my same routine. Sir we are extremly busy, we are trying to move people has fast as we can. Still wouldn't stop. So I took him to the back to show him exactly what I had to deal with. All rooms full, halls full and 2 ambulance crews waiting in the hallway to place pts. You would think that would be an eye opener. Nope, he still continued to complain. I had a few chosen words for him. Face it, we do the best that we can! Surveys don't mean anything. Please feel free to print this and show this to your manager, because it's this way everywhere. And with so many people out of work, the ER is these people primary care. Wheather it's right or wrong, it is.:)

[veetach]

Sometimes it is necessary to educate our patients on what the term "emergency" means.

As I have stated before, at my hospital, we do not have a fast-track.. Sometimes we have to re-educate people on the defination of "triage" and "emergency".. :rotfl: :rotfl:

[MrsWampthang, BSN, RN]

Boy, you have had a long week........ I had to change the way I looked at these people to keep out of the homicidal side of my personality. Yes, I know it sounds silly but I turned it into a game. Sickest patient of the day. Most pitiful acting job of the day. Drama queen for the day. Biggest pain in the %#*&^$&* for the day. I was at least laughing more.

The only thing I can say about patients who really do not need to be there is that that they are job security and character builders. I do not ever see this problem going away. Just make an effort to try to find ways to make it fun and try not to let it get you down. Venting is good . Real good!!!! We are right here with ya!!!!

Thanks. I'm on vacation now and don't even want to go anywhere near the hospital! Just need to unwind. I'll remember your game though and use it next time I work. Sounds like a great stress reliever! Maybe I could also give them scores like they do in the Olympics! 10.0 for acting....1.0 for complaint! :chuckle

Anyway, thanks for the support. It helps to be able to vent and not be seen as an uncaring, mean person.

Pam

[CHATSDALE]

i was in er in december....md does not work on fridays usually will tell pts to go to er for eval on any day instead of trying to work u in at office...anyway i had plursey (my dx) and i felt like i was going to die...pair was unbelievable i could not even drive...got there about noon and it was after 6p when i got out/ i will admit that they did have to do scans etc but much of the time was just waiting for before anything was ordered.... i guess that they are use to people wanting drugs but i was anything but satisfied with service

[teeituptom, BSN, RN]

i was in er in december....md does not work on fridays usually will tell pts to go to er for eval on any day instead of trying to work u in at office...anyway i had plursey (my dx) and i felt like i was going to die...pair was unbelievable i could not even drive...got there about noon and it was after 6p when i got out/ i will admit that they did have to do scans etc but much of the time was just waiting for before anything was ordered.... i guess that they are use to people wanting drugs but i was anything but satisfied with service

You were expecting the drive through at MacDonalds

[babynurselsa, RN]

I am sure as the only patient in the ER that possibly needed any tests or scans we can all appreciate your unhappiness with the poor service you recieved.

Six hours total in an ER doesn't sound too bad.

[Medic946RN]

I am sure as the only patient in the ER that possibly needed any tests or scans we can all appreciate your unhappiness with the poor service you recieved.

Six hours total in an ER doesn't sound too bad.

In some ED's in my area it's a standard 6 hour wait before you even go back to the core or fast track, let alone see a RN/MD/PA.

I'm about fed up with our fast food, fix-it-right-now, no patience, society. You came to Emergency Room for help, you will get some kind of help, it may not be what you wanted (we are not going to be able to find out why you've heard a cracking noise in ear for the last six years when your primary doc and his referred specialist's couldn't) We are not a drive-thru version of your MD's office. And we are not here to feed you, take personal phone messages for you or give you free stuff to take home. I believe in being a caring and responsible medical professional. If you hurt, I'll do my best to take away your pain, if you're vomiting, I'll get you something to make it stop, if you need psychiatric help, I will do my best to see that you get it. But it's time people understood the Emergency Room is for true medical emergencies and not for things you should see you MD/Local clinic for. It may sound harsh but if we dumped EMTALA and started turning away people who don't need to be in the ED and referred them to he proper channel for their problem it might make a dent in spiraling healthcare costs.

[teeituptom, BSN, RN]

since you brought up fast foos, I went to Macdonalds today on an sudden urge, needed some food fast for some reason, just needed it. Went through the drive through, made me mad as can be I couldnt understand the guy taking orders he couldnt understand me due to cultural differences. I couldnt even understand the guy who was collecting the money his ebonics accent was too much for me, finally got to a point of understanding took time though, even fasr food isnt fast anymore.

And Chatsdale I became more appreciative of your feelings, I actually thought about what you said. maybe there is a moral here.

[babynurselsa, RN]

In some ED's in my area it's a standard 6 hour wait before you even go back to the core or fast track, let alone see a RN/MD/PA.

I'm about fed up with our fast food, fix-it-right-now, no patience, society. You came to Emergency Room for help, you will get some kind of help, it may not be what you wanted (we are not going to be able to find out why you've heard a cracking noise in ear for the last six years when your primary doc and his referred specialist's couldn't) We are not a drive-thru version of your MD's office. And we are not here to feed you, take personal phone messages for you or give you free stuff to take home. I believe in being a caring and responsible medical professional. If you hurt, I'll do my best to take away your pain, if you're vomiting, I'll get you something to make it stop, if you need psychiatric help, I will do my best to see that you get it. But it's time people understood the Emergency Room is for true medical emergencies and not for things you should see you MD/Local clinic for. It may sound harsh but if we dumped EMTALA and started turning away people who don't need to be in the ED and referred them to he proper channel for their problem it might make a dent in spiraling healthcare costs.

Amen!!!!!!

The other night I passed through the triage booth to room a patient and overheard the patient in the booth, "I got a tetnus shot a couple of days ago and now my arm hurts from here to here." These are typically the folks who do the most complaining about wait times in the ER.

It seems like the genuinely sick people are so glad for help and care that they find far less to pitch a fit about.

Yes if we could send out those folks that are there for non emregent or even non existent reasons then the wait times would sure be cut down.