Customer Service...........yay or nay?

Nurses Relations

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Remember going to school and learning the older, crazy approaches to medicine that people used to practice:

Drilling holes in the head to relieve sickness, letting spirits out.

The belief that sickness was a punishment from God and was a direct result of sins.

Civil War doctors who removed limbs the second someone was shot/scrapped in the leg because it avoided infection.

Those are the one's I can recall right at this moment. I know there are more. Today, we are in a stage of major change within our health system. There is a push for "customer service" that was not there before. It is no longer simply something schools/administration talk about, it is expected. Surveys asking if the nurses fetched your AM coffee on time type questions abound. Doctors who talk down to or belittle patients are no longer tolerated by hospital administration. Compensation to facilities can be reduced despite properly caring for the illness because it was not done with a smile.

Do you think this is simply the "vogue" theory of today and will eventually be replaced, or is it truly a push towards a new future in healthcare?

I am undecided TBH. I don't agree with the degree in which the "customer satisfaction" is being made a priority. Its almost as if hospitals would fare better with the general public and the powers that be if we simply stopped treating illness and took on a Bed And Breakfast style of treatment. To this I say "Be careful what you wish for, you might get it." Already I see managers pushing "smile when you enter the room" when they should be concerned with possible med errors and pt's being transferred to their unit who are not appropriate for said unit.

Its almost as if there is this "We need to get paid, times are tough. Just give them what they want" surrender going on with hospitals and facilities. So, what you are telling me is, no problem if a pt. receives another patients meds or is aspirating their own meds..................so long as we smile and make everything happy.

Seems to me some patients should just save themselves the hassle and just to to Denny's or go on vacation. They could get all that at a quarter of the cost.

I don't know if good medical treatment always lends to good customer service. If you've ever worked on a M/S unit with the non-compliant diabetic you know what I mean. They want snacks that don't conform to their diet at all constantly, and are very upset if they are not granted. Then you have the smoker who insists he is SOB because the doctor doesn't know how to order the right inhaler................the COPD has nothing to do with smoking over a pack a day. And we have all seen the pt. who just refused to break out of the sickness "asking for help" role and start doing for themselves. They refuse PT/OT, want everything done for them and are going to end up in a nursing home if they don't get their bottoms out of bed. But, if you tell them they must start being more active in their own ADLs, you are a jaded/bad nurse and the survey scores reflect this.

We are, very frequently, in a position of having to tell the truth, even when said truth is not "nice" or lends itself to "customer service". What benefit are we giving our pt. when we stash the truth in order to earn better survey scores? Yes, in the short term they are very pleased with the quickness in which we fetch the third ice cream they request, but when their foot is amputated..........what do they think of our service to them then? Truth is, if "customer satisfaction" promoted healing, Denny's would have people walking after years of being wheelchair bound and Retail stores would be the place to go for that abd. pain. It doesn't work that way.

Customer service definitely has its place in the healthfield, but not to the degree it is being taken. Who amongst us doesn't know that grouchy, unhappy with EVERYTHING nurse who has been told to act differently with people..........and thinks it was long overdue. I know of two specific doctors who were mandated to take classes to improve their bedside manner (oh, how we all snickered at this). I don't think the expectation of respect and kindness are out of order. But is what we are doing now relative to this? Or are we going to read about ourselves in 20 years in some new nursing book "The customer satisfaction age of medical practice was dollar driven and lead to an increase in foot amputations blah blah.........."

Specializes in M/S, Travel Nursing, Pulmonary.
I agree with everything said. I have worked in many aspects and in many settings of healthcare for 35 years. Most recently I've been an LPN for the last 12 years and I have found that the "customers" have finally completely burned me out. I am suppose to renew my license in the next 5 days and quite frankly I don't want to. If I am going to give people what they want with a smile instead of what they need with understanding and caring, then I'll flip burgers. I have ALWAYS greeted my patients (yes patients) with a smile, a caring hand on the shoulder if they allow and carefully explained what, why, and how. Lately I leave a bedside with confidence that while not pleased with their situation, they are comfortable with it. An hour later I'm being called into the charge nurse's office being chewed out for being mean and/or rude to the patient and/or the family! I did my nursing duty, I brought them that extra helping of ice cream with a teaching that this may not be their best choice for a diabetic and perhaps they would do better with the apple slices or sugar free cake I also brought along. But how rude of me to suggest such things! The "client" knows what is best for them, I'm told. I have seen nurses lose their jobs for consistantly doing their job in just this way. I believe in doing everything and anything within the confines of the healthcare process to make a patient happy and comfortable but this customer satisfaction has come to a place where healthcare is no longer part of the process.

Actually, I said something when I worked as a CNA that still applies now.......heck, it applies more.

The type of pt. I have NO patience for is: The one who can't have anything any way except "their way". Refuses this or that test, won't take this or that med, wants all these acomodations and couldn't care less about the education they need to hear. BUT.........when "their way" does not work.......such as with the diabetic who eventually gets their foot amputated.......its everyone else's fault. Can't have it any way except their way, but if their way don't work, its your fault.

Specializes in ICU./CCU/SICU.

I think it's another instance of good idea gone bad {ie: sexual harrassment laws, political correctness}. 50 years ago, you'd have a boss chasing his secretary around the desk. Nowadays, if you make an off-color joke, you face the HR firing squad. There's nothing wrong with trying to keep patients happy, but when that comes at the expense of taking care of sicker patients, or giving doing things for them that aren't in their best interest, a line needs to be drawn. If someone comes into the ED c/o 100/10 abdominal pain, they should NOT be getting a house tray. If someone comes into the ED in DKA with a blood sugar of 600, they should not be getting milkshakes. And my last and final comment- If the powers that be want to have someone fluffing pillows and bringing warm blankets and ice-cold Cokes to the family/patients, THEN HIRE SOMEONE EXTRA TO DO IT, who's only job is "customer service". :twocents:

Specializes in LTC,Altzhiemer's,Family practice, rehab.

And that is why I believe I'll go back to being a CNA....then I can call the nurse to address the client's "concerns".:spbox:

Why is this an either or situation?

Doesn't EVERY industry aside from the post office and the DMV where you come in contact with other people have an element of customer service? If the teen flipping burgers for minimum wage is expected to smile and bring a certain level of customer service then shouldn't why can't the (nurse/doctor/technician etc....) who is asking you about your last bowel movement?

The patient upon entering the door has to drop trou,share very personal intimate details about their health and body to an entire group of strangers and any interns/students/observers who feel like waltzing in. Why is it wrong for patients to want a certain level of customer service? I'm not implying you should be treated like or doormat or be required to put a mint on their pillow. But customer service is a part of basically EVERY SERVICE/BUSINESS I can think of..............

I'm not at all in favor of medical staff being viewed as a maids,butlers or servers from IHOP in a nursing uniform. But what I've noticed with the encounters Ive had personally with medical care is that if you are a patient youre basically on the medical staffs "territory." This type of view leads to people being "cared" for but it's like oh well we didn't get your meds screwed up so we can post your ass on Facebook, invite the janitor in to watch your pelvic exam all while propping the door open to not miss the Chinese Delivery Guy with the beef chow mein!!!!

Again why is it either or? If a doctor smiles, if a CNA says good morning, if an intern asks a patient if its okay to observe, if the lady at the admission desk turns off her personal cell phone is the whole hospital going to collapse in on itself? Will hospital staff spontaneously combust? Will patients resort to cannibalism?

I just don't get it?

I don't care if you work in the medical field I don't care if you walk dogs for a living....... i"m just saying every service/industry/business I can think of has a customer service aspect to it.

"It is no longer simply something schools/administration talk about, it is expected."

UHM....yeah.........why shouldn't it be expected? This tells me this is something that should have been happening for years but staff for their own reasons ignored it....now its shocking because management is actually following through.......now its the freaking apocolypse:eek:

The funny part is I've read several posts on here (various threads)where medical people think they should be celebrated and have a street named in their honor simply when they manage to not LAUGH in the patients face about a particular situation or conditon..........now to have to actually smile when you walk in the room....."A doctor who belittles a patient will not be tolerated"?!?!?!?!?!......crap like that should have NEVER been tolerated!!!!!..OH THE HUMANITY!!!!!!!

Specializes in LTC,Altzhiemer's,Family practice, rehab.

Oh the humanity indeed! I am not talking about providing common kindness to those in our care, and I don't want my name in lights. I want TO BE THE NURSE! I am just so very upset right now that my childhood dream has turned into my worst nightmare. And management dosen't care.

I'm very sorry that you are having such a hard time.......limpingaway.I can tell the frustration and hurt from your post. The healthcare field is just crazy right and is going through a lot of changes for various reasons.(some for the better.some for the worse) When I read about your childhood dream turning into a nightmare I was able to understand it from another point of view that I didnt see before.

To respond to the original post I do believe the customer service aspect of healthcare is here to stay!

I don't work in the medical field so from the patients point of view I know first hand MANY of the frustrations that come along with that paper gown but at the same time being the nurse to so many people needing you to management who just push papers around all day must be ALOT to deal with!!!!

Anyway best of luck to you and I hope you make the best decision for yourself and your sanity!!!!!

I work in LTC and I just had an inservice in Customer Service. We are not allowed to say "your well come" We have to say "Is there anything that I can do for you? I have time" I feel bad saying that because that is a lie I really do not have time. I have 29 residents waiting for their meds, treatments, complaints,.......... etc.

Specializes in Trauma ICU, Peds ICU.

I more or less group my priorities in three categories. Things that will kill my patients quickly, things that will kill them slowly, and things that won't kill them. "Customer Service" falls in the third category, and I'll worry about that after I address the first two.

"why is this an either or situation?

doesn't every industry aside from the post office and the dmv where you come in contact with other people have an element of customer service? if the teen flipping burgers for minimum wage is expected to smile and bring a certain level of customer service then shouldn't why can't the (nurse/doctor/technician etc....) who is asking you about your last bowel movement?

the patient upon entering the door has to drop trou,share very personal intimate details about their health and body to an entire group of strangers and any interns/students/observers who feel like waltzing in. why is it wrong for patients to want a certain level of customer service? i'm not implying you should be treated like or doormat or be required to put a mint on their pillow. but customer service is a part of basically every service/business i can think of..............

i'm not at all in favor of medical staff being viewed as a maids,butlers or servers from ihop in a nursing uniform. but what i've noticed with the encounters ive had personally with medical care is that if you are a patient youre basically on the medical staffs "territory." this type of view leads to people being "cared" for but it's like oh well we didn't get your meds screwed up so we can post your ass on facebook, invite the janitor in to watch your pelvic exam all while propping the door open to not miss the chinese delivery guy with the beef chow mein!!!!

again why is it either or? if a doctor smiles, if a cna says good morning, if an intern asks a patient if its okay to observe, if the lady at the admission desk turns off her personal cell phone is the whole hospital going to collapse in on itself? will hospital staff spontaneously combust? will patients resort to cannibalism?

i just don't get it?

i don't care if you work in the medical field i don't care if you walk dogs for a living....... i"m just saying every service/industry/business i can think of has a customer service aspect to it.

"it is no longer simply something schools/administration talk about, it is expected."

uhm....yeah.........why shouldn't it be expected? this tells me this is something that should have been happening for years but staff for their own reasons ignored it....now its shocking because management is actually following through.......now its the freaking apocolypse:eek:

the funny part is i've read several posts on here (various threads)where medical people think they should be celebrated and have a street named in their honor simply when they manage to not laugh in the patients face about a particular situation or conditon..........now to have to actually smile when you walk in the room....."a doctor who belittles a patient will not be tolerated"?!?!?!?!?!......crap like that should have never been tolerated!!!!!..oh the humanity!!!!!!!"

ima, if you were a nurse, you would understand what we are talking about. we are not talking about just smiling or showing common courtsey. of course we do that. (well most of us) we are talking about the fact that we are being asked to do things for the patient that go against good nursing judgement so they will be happy, and fill out a survey saying how great the place is.

do you understand that it goes against every fiber in a nurses being to give diabetic patients with blood sugars in the 300's a large piece of cake? but they want it, and get mad when they dont get it. and they whine and they say you are a mean nurse. and we get in trouble if we don't get the damn cake.

furthermore, laughing or making fun of a patient on a nursing website for nurses does not mean we are mean, bad people. we come here to vent so we can go back out there and deal with the diabetic woman who wants cake in a professional way.

Specializes in ER, Trauma.

A co-worker in the ER had a coffee mug that summed it up. I'm here to save your asterisk, not kiss it. He and I both cared in all senses of the word. We provided good nursing care, and we also cared that the patient was having the worst, and possibly last, day of their lives, and we addressed that too. This isn't Wal Mart of Burger king. If a patient complains that we didn't smile or that the beds were uncomfortable, they belong at home, not in a hospital. The "customer care" model? It's my deepest desire that this too shall pass. The designer was clueless about health CARING.

Specializes in Emergency.

The customer service mindset is here to stay. The hospitals are pushing us to get 5's because that does influence people who can choose where they go. Especially for elective procedures, which bring in the bg bucks.

I am one of those people who smiles a lot. I'm basically happy cause i woke up and got out of bed under my own power. I do try to make my pts stay in the er as pleasant as i can.

However, if the pt is hindering my ability to care for them by refusing aspects of that care or demanding services as if they were in a restaurant, then i'm not going to bend over backwards to make them happy.

On a side note, it seems to me the nit-picking demanding pts fall into 2 general categories:

- those people who are used to having their own way all the time.

- those people who have little to no control in their day to day existence and now can order someone around.

Jmho

I would say I do pretty well at the customer service side of care, however I have to say that am I ever glad that in Canada our hospitals are pretty well all public and making money is not the focus...our management is concerned with efficiencies and good patient outcomes, not the outcomes of patient surveys. While there are and always will be those nasty nurses that could use a lesson or two in customer service I am so happy that as a new grad I am allowed to worry more about patient care than fetching ice or whatever for my patients right away rather than worry about my patient with chest pains...

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