Customer Service and 24 hour visitation

grandee3 · Jun 29, 2008

Can you imagine, I can see it now. Call light goes on, or you get a IM on you computer screen, "I need a nurse to come in here" You're in the middle of med pass and an hour behind because you had to give a back rub, you go in the room and the pt ask " I'm have trouble accessing my email, can you help me"

This is total BS:angryfire

MAISY, RN-ER, BSN, RN · Jun 29, 2008

HORRIBLE IDEA! I am all for customer service, and even for family members staying with their sick loved one....but I believe in enabling them to be self-sufficient. This PG BS has got to stop!

Everyone needs rules....even administration! I think wireless is great, but if you want massages....make nurses have 1:3 ratios-then there will be tons of time. Somehow I don't believe that will happen. If ratios can't be changed-hire a massage therapist to work certain areas.

I am sorry nursing is out of control because of thiis BS!

Maisy

Batman24 · Jun 29, 2008

The massages just aren't going to happen here because there's no time. Nurses will be spending tons of time calling dietary to find out where that 2am chocolate shake is and why the Starbucks coffee wasn't what was ordered. After that they will be on the phone with someone technical because we're NURSES NOT IT and won't know how to fix things. It will be a hot mess. Patients and their families are going to complain non-stop because all their needs aren't met.

I would just keep providing NURSING care and the rest goes on the backburner for when I have the time to do it. I'm not going to risk my license over a freakin' email and cup of joe. Not happening.

locolorenzo22, BSN, RN · Jun 29, 2008

exactly...the hospital will wonder why their PG scores keep dropping...maybe it's due to the loud family members for a patient keeping their roommate up....I have no problem with someone who wants to stay(IF the patient is unstable, AND it's the first night post-op, etc...) Other than that, is there really any reason for someone to stay beyond 8PM?

I'll love to see what happens when some family members decide 3 of em are going to stay the night because "all 3 of us need to be here just in case she goes at a moment's notice...."

bethin · Jun 29, 2008

It does sound like hell.
I'm glad the hospital I work at is too cheap to do any of that.

Our hospital is cheap too. No internet access (except at nurse's station), no 24 hour dining, no dvd players, etc. We do have an ancient VCR and TV for educational purposes for diabetics and such.

This is an example of how cheap we are: we have vertical blinds in rooms. The slats keep falling off and the street lights inevitably shine right in pt's eyes. Guess what the NM's solution is?? Not buying new blinds. She designated the break room as spare parts. So now there are no slats in the break room because we use those to replace the ones in pt rooms. BUT the hospital can afford to do major upgrades to a floor that was built 3 years ago. Makes sense, right? Our med surg floor has seen NO upgrades since it was built in 1975. We have the same paint (lead?) and the bathrooms I kid you not, are no bigger than what you see on an airplane. You can only get 1 person in there with no IV pole.

How's that for cheap?

iluvivt, BSN, RN · Jun 29, 2008

Yes I know about this customer service hype but I think your hospital has gone to far. I could not get all this service even at a fine hotel. Why can they not do some customer service things that do not impede or delay the real purpose that people are there for. People that are sick enough do not really care about all that !. My employer does some really nice things that do not impact the flow of the work. We give the patient a carnation with a nice note wrapped around it on discharge...we give them phone cards so they can all loved ones......we have a hospatality cart with things to do ( ie.Play cards ...read books...listen to CDs). We also now let them select their own menus. We also have a little gift cart...so if there is any delay in treatment or even an upset patient we can sign out a little gift for them. One of the things I hate is multiple visitors in the room and I have limited time and cannot get to my patient. What about the other patient in the room, unless you have all private rooms. Waht about HIPPA,how can you talk to the other patient in the room and protect their privacy with a husband of the other patient on a cot just a curtain pull away. I would have a fit if I were the patient in the other bed. In situations like oncology patients or patients that are dying I would do everything possible to accomadate the familys needs. I say OK to the starbucks though. :loveya:

iluvivt, BSN, RN · Jun 29, 2008

I forgot the massages! I say do you want a massage or your antibiotics. You know what is going to happen nurses will and should triage the massage right out the window.

Vito Andolini · Jun 29, 2008

On August 5, 2008, My hospital is going to implement a new Customer Service master plan that will surely make every employee's life a living hell. Some of the new "Improvements" to this horrid design include: 24 Hour visitation, 24 hour room service, leatherbound menu's, DVD, WiFi internet, Massages (that we nurses are to do since we have soo much free time), flatscreen TV's, Starbucks coffee carts, Quiet time/Do Not Disturb time, Valet parking, and sleeper cots in the rooms. The last one I detest the most. Our room are VERY crowded (some with 3 beds) and the last thing we need is to break our backs trying to maneuver around a family member. Needless to say, I am very very anxious about all these changes. Now we will have administration barking at us for politely asking family members to step out of the room while we provide pericare. With all these new changes about to occur, somethings will remain the same - for example our old vital signs machines and telemetry equipment from 1980.

and probably your pay scale

Has anyone asked the nurses for input on these ideas?

You nurses all need to get together and come up with your position on these things that you are expected to live with. Massages? We haven't had time to do those for many years. Yes, they're nice but lifesaving, charting, your own survival - these all come first.

As far as getting people to step out while you do intimate care, I'd ask once, after that I'd just do it. If anyone doesn't get the hint, if anyone is mortified, oh well. I feel sorry for the poor patient who has to use a bedpan or commode with a roomful of visitors present, shielded only by a curtain. It's bad enough with a roommate present, let alone 3 patients' visitors. Doesn't anyone think of this stuff?

You nurses need to present a united front to those suits who think these things are good ideas. And you must make them understand that room service, cots, etc. might actually be good things but that, given how crowded the rooms are and how many patients you have, given that you are probably already not getting meal or pee breaks, you are not going to be able to start caring for family members on top of the patients. You guys just really need to get united and let your bosses know that you are there for patient care, not care of visitors. Also, show them by having them crawl over cots themselves how crowded the rooms are going to be. At the very least, require that they inform families that the nurses will determine actual visiting times (ha!) and that emergencies will determine when and where cots can be. Where is your Nursing Admin on this? Your manager/director?

Next, I'd start looking for a new job, as this will all likely fall on deaf ears.

Is your hospital hurting financially and they are doing this to be competitive? How are they doing on morbidity and mortality? Nosocomial infections, lab errors, med errors, having sufficient supplies conveniently located, physician behavior, things that really matter? These are vital to patient health. Yeah, a lot of us want to be pampered and so do our families but surviving is what matters most in a hospital.

Another issue: what about privacy of a nurse and patient conversing? It's already an issue in a semi-private room but when a bunch of visitors are present, I think it's next to impossible to speak confidentially.

Vito Andolini · Jun 29, 2008

Even with family members stepping out, I think this could possibly lead to a HIPA violation. What if the family member who spends the night is male and the patients are female? That's a BIG no-no where I work. Family members may stay if they're loved one is in a room by him/herself. We try not to admit to that room, but if there are no more beds we will and the visitor must leave. We tell this to them upfront and we haven't had a problem yet.
I have been a pt many many times with roommates. I can't tell you how annoying it is to be very sick (I have Crohn's and it is very painful), receive pain meds and phenergan wanting to sleep and have a roommate's visitor show up at MN yacking like it's social hour in the local pub. I find it rude. The hospital is for SICK people who need their rest. We do have visiting hours from 9-9 and it is paged when they are over but people think it doesn't apply to them.
I do have a problem with family members spending the night, but they need to understand that we have a job to do and they need to get out of the way to do care. I know I'm only an aide, but it's a pain in the butt to trip over blankets on the floor family has thrown around, getting them coffee when it's just down the hall. I stopped taking visitors vital signs because I consider it a liability to me - I cannot diagnose nor treat high or low bp.
I'll never forget a few months ago - my charge nurse wanted me to put a family member who was bound to a WC in a bed so I could change his depends. I said no way. He was not a pt and while I felt bad I did not have time with 29 pts on the floor, 4 nurses and me as the only aide. I could barely provide the most basic care to the pts I had.
Sorry for the rant but this really frosts my crack!

You should never wait on or serve family members, as there is liability in doing so. :no: Your manager sounds like she belongs on a Psych ward. I'm so glad you stood your ground.

Frosted cracks. Wow, that is a new concept for me! :chuckle

Vito Andolini · Jun 29, 2008

One of my friends told me about a hospital where he used to live who heavily advertised all the amenities in the OB unit - dinner for mom and dad, a bag of toys, a personalized picture frame - that probably cost about $100 total but it cost more than $2,000 extra to have a baby there.
It gets better.
When epidurals started to really take off as a popular option for L&D, one hospital in Des Moines had this big advertising blitz "IF YOU DELIVER HERE, YOU CAN GET AN EPIDURAL" :imbar

Of course, what if the doc determined that the patient was not a candidate for an Epidural????

Vito Andolini · Jun 29, 2008

We have 24 hour visitation in all areas except for ICU and our acute rehab. We also have room service available from 0630-1830. We have wireless internet, dvd players in all rooms, dvds available at no charge and sofas that pull out to beds in all our rooms and showers. All our rooms have recliners as well and all our rooms are private. We are expected to jump for every pt or family members whim. There are signs posted in every room with the directors direct line printed on it in case the pts wants, needs or expecations are not met.
I wanted to be a nurse caring for pts not a waitress or gopher waiting on every whim you might actually think of.

At least you have private rooms and recliners, not the cots.

Woodenpug, BSN · Jun 29, 2008

We have continuously talked about a "new" concept - patient outcomes. Several measurable and objective systems have been available for many years. If one hospital, without amenities, could brag that you will recover faster and more completely, that hospital would attract more patients.

I'd like to see a slogan along the lines of "Sorry, no Starbucks, just better health care."