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.........."
Okay, where I work we don't get reamed for not giving a diabetic a piece of cake. Management doesn't get on us because we didn't give someone their pain meds three hours early. Or because the patient claimed poor pain management on the survey because we won't double the dose of Lortab without their doctor's order. Or the family got upset because we let the coffee pot run dry.
What management does get their panties in a wad about is the fact that a patient put in a COMPLAINT because we didn't do those things. That's where the customer service thing has gone wrong. We sometimes have to do things the patient doesn't like and make them happy we are doing it.
I liked your managements approach. Core measures and basic care (T+P etc) don't seem to have lost their focus with your leaders.
Then, you landed in the 99th percentile. I think thats a direct reflection of.............good leadership. That and having people willing to be lead.
OH! I misunderstood you! Sorry about that. I really like our current manager. She has been on the job less than a year and is really doing a great job. Very visible, very positive, but addresses what needs to be addressed. I've also seen her cover for a nurse who needed to go do something (a meeting, some training or something) for an hour or so. She'd most definately roll up her sleeves and jump in if necessary. I can't say that's true for all the NMs throughout the hospital, but I know it is true for her.
We do get the "scripting" the PG suggests. It's funny when you see the lines on this forum and you know it's a canned product..."I have time" "Very Good Care", etc. But management really does focus on good care, such as...
*We do bedside rounding. At first I was resistant, but now I do it and I like it. MGT insists we wake the patient up to do this. By asking the patient if there is anything I can do before I go on, I get a lot less calls over the call light during shift report. I can say, "OK, we have to report on 2 more patients, but I'll get your coffee, pain med, check on your test time, when we're done." It allows us to let the patient know we've heard their request and, more importantly, set expectations. This is good customer service.
*When you have the grumpy old man who doesn't want to turn, they tell us to not ask them if they want to turn, but to say, "We're here to turn you"....Educate on the importance of turning and if they still refuse, document, document. This is good nursing and good customer service and prevents skin breakdown.
*They want us to suggest we help someone to the bathroom everytime we go into the room. "Do you need to use the bathroom, I can help you now" (The dreaded "I have the time" line...LOL). This prevents falls and is also good customer service.
And we have "Service Recovery" as well. Flower arrangements, food vouchers, etc. And most of the time what we give that stuff for is something I'd complain about too! Horribly long wait in the ER before coming to the floor, an unreasonable delay in getting a test or procedure, a nasty, dirty toilet (it grossed me out...and housekeeping was called right away), a loud obnoxious roommate who kept someone up all night. And as corny as it seems, a lot of times addressing the complaint, apologizing, and following up with a small flower arrangement really does turn the patient's attitude around.
I have learned in my previous life before nursing, that managing expectations is the best way to have good customer service. Most people are rational and reasonable. If you just take a second to let them know what's going on and what to expect, they'll be OK. You always have those few looneys who are never happy or who are manipulative or controlling. My manager has actually said not to focus too much on those people. She'd say, "Do what you can and move on." Like the another poster said, don't focus on fixing the 1's, focus on turning the 4's to 5's. And I bet most of those people who gripe no matter what aren't going to turn the survey in to begin with.
OH! I misunderstood you! Sorry about that. I really like our current manager. She has been on the job less than a year and is really doing a great job. Very visible, very positive, but addresses what needs to be addressed. I've also seen her cover for a nurse who needed to go do something (a meeting, some training or something) for an hour or so. She'd most definately roll up her sleeves and jump in if necessary. I can't say that's true for all the NMs throughout the hospital, but I know it is true for her.
We do get the "scripting" the PG suggests. It's funny when you see the lines on this forum and you know it's a canned product..."I have time" "Very Good Care", etc. But management really does focus on good care, such as...
*We do bedside rounding. At first I was resistant, but now I do it and I like it. MGT insists we wake the patient up to do this. By asking the patient if there is anything I can do before I go on, I get a lot less calls over the call light during shift report. I can say, "OK, we have to report on 2 more patients, but I'll get your coffee, pain med, check on your test time, when we're done." It allows us to let the patient know we've heard their request and, more importantly, set expectations. This is good customer service.
*When you have the grumpy old man who doesn't want to turn, they tell us to not ask them if they want to turn, but to say, "We're here to turn you"....Educate on the importance of turning and if they still refuse, document, document. This is good nursing and good customer service and prevents skin breakdown.
*They want us to suggest we help someone to the bathroom everytime we go into the room. "Do you need to use the bathroom, I can help you now" (The dreaded "I have the time" line...LOL). This prevents falls and is also good customer service.
And we have "Service Recovery" as well. Flower arrangements, food vouchers, etc. And most of the time what we give that stuff for is something I'd complain about too! Horribly long wait in the ER before coming to the floor, an unreasonable delay in getting a test or procedure, a nasty, dirty toilet (it grossed me out...and housekeeping was called right away), a loud obnoxious roommate who kept someone up all night. And as corny as it seems, a lot of times addressing the complaint, apologizing, and following up with a small flower arrangement really does turn the patient's attitude around.
I have learned in my previous life before nursing, that managing expectations is the best way to have good customer service. Most people are rational and reasonable. If you just take a second to let them know what's going on and what to expect, they'll be OK. You always have those few looneys who are never happy or who are manipulative or controlling. My manager has actually said not to focus too much on those people. She'd say, "Do what you can and move on." Like the another poster said, don't focus on fixing the 1's, focus on turning the 4's to 5's. And I bet most of those people who gripe no matter what aren't going to turn the survey in to begin with.
Never seen my manager take an assignment, but she could and she is very active on the unit going into rooms and helping. I've flagged her down because I have a modest female who needs T+P or something and having another female around makes them feel better. I like talking to her about nursing issues and how to approach things cause I think she combines the book knowledge with reality well.
We have service recovery too. I think ours is free TV most of the time lol. Which, at my place, actually matters. The TV options are terrible, so it should be free to begin with.
LOL. I started reading that sentence I made bold and was like "previous life? Oh, she believes she had a former life, and it helps her now in nursing. Interesting."
LOL...No, I went back to school when I was in my late 30's. I have a degree in Communications and Psych and worked as a business analyst and technical writer before nursing. That's my "previous life." Even thought I like to think I used to be Clara Barton.....
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.
i very much understand what you're talking about respectfully. my point stays the same. customer service is stressed in practically every single industry where you come in contact with people.i don't believe that medical care should be exempt.
surveys,follow up calls about satisfaction with "service",questionairres,strategically placed complaint...oops i mean comment boxes are extremely common in virtually every industry.
let me be clear i do not think a nurse should be chewed out,get in trouble etc for not granting the diabetic patient cake. actually it makes more sense if they get in trouble or chewed out if they do...i fully understand how troubling that could be...i'm not arguing that specific point here or in my previous post.. at the same time i wouldn't exactly equate a push for customer service type attitude in medical care to drilling a hole in the head to let the spirits out.
i'm not even saying that i fully disagree with several of the points that the original poster point out. i know nurses don't go into the medical field to get people's coffee.i was responding to the original posters question is the "customer service" push here to stay........and i believe it is.
So…where is the line between customer service and nursing care? I had a couple things happen last night and am wondering…
70 year old man in with a lap chole. He was concerned because the drip chamber on his IV was "too full" and he worried that he wasn't going to get the proper infusion. I told him that the IV was on a pump and it would work no matter how full the chamber was and that it would alarm if it wasn't infusing. I also turned the bag upside down and squeezed a bit of the fluid out of the chamber (as I had been shown to do in orientation). Then, he complained because the light on the pump was too bright. Apparently he puts foil over his bedroom windows to keep the light out and has the bedroom walls painted a dark blue because the wants a VERY dark room to sleep in. I tuned the pump so the light was facing the door and that wasn't enough. I took a paper towel and taped it to the front of the pump. All you had to do to see them pump was lift the paper towel.
The charge nurse wants a full report on what every patient wants and what you did for them every time you come out of a room. I told her the above and she started slapping the desk with her hand and said, "Don't you ever do anything like that again! You are here to save his butt, not kiss it! If you keep doing all sorts of things just to appease him, you will be in there all night!" So…a bit of an over reaction from her, in my opinion. I would much rather do what I did and be done with it than have him call me in a few more times because the drip chamber and the light were just driving him nuts for some reason.
90 year old female, in with a CVA…unconscious, not expected to make it through the night. Her son came from some town about six hours away to stay with her. Her son asked if we could find him a more comfortable char and a blanket so her could try to sleep. I moved the procedure chair (portable, on wheels, reclines, no procedures planned for at least a week) into her room, so he could use it. Same nurse came got upset again. "There is no reason he can't sit in the chair that is already in there! (hard, straight back chair) You have got to quit doing things like that! You are a nurse, not a waitress, not a hotel maid, not a slave!"
Well…I would much rather spend a few minutes taking care of the little things than spend half the night in and out of the room because I didn't. I'm not going to give a diabetic cake and potato chips and soda, nor am I going to give someone my lunch or buy them a latte. But…I think a lot of little things can really make the patient (or their family) more comfortable and if my other patients are not suffering or lacking care, why not do them? I'm not a big pillow fluffer or straw bender, but my patient needs something that he or she cannot take care of by on their own, then I need to do it! And…sometimes, silly unimportant things can make a huge difference. So there!
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.
i very much understand what you're talking about respectfully. my point stays the same. customer service is stressed in practically every single industry where you come in contact with people.i don't believe that medical care should be exempt.
surveys,follow up calls about satisfaction with "service",questionairres,strategically placed complaint...oops i mean comment boxes are extremely common in virtually every industry.
let me be clear i do not think a nurse should be chewed out,get in trouble etc for not granting the diabetic patient cake. actually it makes more sense if they get in trouble or chewed out if they do...i fully understand how troubling that could be...i'm not arguing that specific point here or in my previous post.. at the same time i wouldn't exactly equate a push for customer service type attitude in medical care to drilling a hole in the head to let the spirits out.
i'm not even saying that i fully disagree with several of the points that the original poster point out. i know nurses don't go into the medical field to get people's coffee.i was responding to the original posters question is the "customer service" push here to stay........and i believe it is.
and neither do we. problem is, the abuses of the new obsession with what is referred to as "customer service". maybe you missed the cynical nature of my use of the term "customer service" or don't catch my sarcasm. i am not talking about the usual everyday motions of respect that every person in every industry must do. i'm talking about the twisted version of "customer service" many patients come in with. as i said before, most of these people would save themselves a lot of hassle and money by simply going to the local denny's. what they are looking for is there, not in the hospital. there are bigger fish to fry for the avg. nurse than making sure you get your am coffee on time.
it's the general public like yourself that make this so frustrating to boot. they fall for the smoke and mirrors act put on by administration/management, begin to think they are top priority and that all measures necessary to give top "customer service" will be made.
what you don't seem to put together is how much of a mask that is. hospital administration is not in the least bit concerned with weather you are happy with your stay or not. couldn't care less if you are smiled at, spoken to in a respectful manner or if all your needs were met as opposed to only your medical needs. they only care to the point of getting high ratings on surveys. unfortunately, the avg. citizen is not educated enough on what is good medical treatment and what is bad. do you prefer a nurse who smiles all the time, brings you your ginger ale right on time but also gives you your room mates pills or the one who maybe always seems to be in a rush, but catches that the doctor did not order your home medications properly and keeps you safe? the general public falls for the car salesman act that we are being told to sell to our patients, falls in love with the nurse who hugs them and fetches the blanket they wanted right on time.................but can't put it together that they are in the hospital an extra three days because everyone is busy playing salesman instead of attending to medical needs.
like i said, administration could not care less if your experience with the hospital is good or bad. if they did, the staffing ratios would be entirely different and they would never even dream of performing half the cutbacks that occur. a handful of what you do outweighs a truck load of what you say. administration and management continuously make decisions that detract from your care. supplies are hard to find (my hospital runs out of cpap/bipap and continuous pulse ox. machines frequently, won't pay to get the broken ones re-calibrated), units frequently run short, we are told we can not stay a single minute late no matter what occurred during our shift and the acuity of pt's on general floors continues to rise but the ratios are not adjusted to meet "customer service" standards. then, when the customer complains (like you), the same administration and management who run the floors in such a manner that only the most generic care is possible.............go into your room and apologize and the impetus is on us to make things right. and you guys fall for it.
and after all this, the general public falls for the smoke and mirrors tactics performed by administration and believes their bad experiences are because the nurse doesn't understand "customer service":eek:. hence we find people like yourself, imposing upon nursing boards, trying to explain it to us. pathetic.
You are absolutely wrong if you think that I or general public falls for as you say the smoke and mirrors of any sort of administration/management that happens in healthcare. Now that's pathetic. Policies/Issues/Concerns/DEBATE YES I SAID DEBATE concerning healthcare are daily conversations people are having in their homes,hospitals and on the news and everywhere in between!!!! Just because I choose to not change bedpans for a living doesn't mean I shouldn't be allowed to respond to a post.
I can agree/disagree with anyone about any topic and be respectful.....If you can't or choose not to then that's a sign of your character AND NOT MINE!
Hmm.... something tells me you rated seriously low on many-o-surveys .
What is your problem with anyone stating their view? You can post on a board but if anyone at anytime says as much as a syllable that you disagree with you start foaming at the mouth?
I made it a point to say that I DIDN'T EVEN DISAGREE with many of the points made in the original post. Perhaps if you would have read what I wrote instead of throwing a tantrum and ripping your shirt open as you turned into the Hulk you would have realized that.
DO YOU REALLY THINK THAT NURSES ARE THE ONLY PEOPLE WHO DEAL WITH RED TAPE,BEAURACRACY,MANAGEMENT ISSUES.Your martyr routine isn't working.
Oh and as for your comment about me IMPOSING on this board.....uhm okay..yeah... the thread is only posted on THE FREAKING WORLD WIDE WEB!!!!!!!! UHM THE INTERNET!!!!! GET OVER YOURSELF!
I'm worried about giving good patient care not customer service. Do I think we should be polite and caring? Absolutely but that isn't where customer service in hospitals is really at for most in healthcare these days. Pleasing the customer can come at a cost to the custumer in a hospital setting where we are dealing with actual patients.. I don't refer to my patients as customers and never will. We aren't talking about people getting a broken DVD or a poorly cooked burger but people that are in need of 24/7 nursing care. There is a world of difference between the two.
Most in hospitals are stressed, cranky, ill, injured, sad, etc. As nurses we often have to ask them to do things that cause them more pain i.e. walk after surgery. We have them eat things they don't want and avoid things they do want. Their urine can be monitored along with their BP, weight, etc. We are trying to help them but are often seen as an annoyance. There is no way you are going to get a good customer service score from a patient who wants their smokes in the room and doesn't understand why they can't have two Big Macs along with a few beers post heart surgery.
This is a field where the "customer" isn't always right. Their idea of right could kill them and it's our job to prevent that. They might not like us, give us good scores, etc. but that is secondary to keeping them alive and getting them on the road to recovery. Patients that are smart understand and appreciate that. Many of the others will be back after their next heart attack after not listening the first time.
quote] Just because I choose to not change bedpans for a living doesn't mean I shouldn't be allowed to respond to a post.
Actually, ImAWonderer, that's exactly what it means, the website is "allnurses.com", you're not a nurse, nor a "bedpan changer", so why are you here?
This simply made me laugh......now nurses are dictating who can visit what websites from their own computer?This is a site on the web folks it's not the ark of the covenant.
"previous life? Oh, she believes she had a former life, and it helps her now in nursing. Interesting."
belgarion
697 Posts
Okay, where I work we don't get reamed for not giving a diabetic a piece of cake. Management doesn't get on us because we didn't give someone their pain meds three hours early. Or because the patient claimed poor pain management on the survey because we won't double the dose of Lortab without their doctor's order. Or the family got upset because we let the coffee pot run dry.
What management does get their panties in a wad about is the fact that a patient put in a COMPLAINT because we didn't do those things. That's where the customer service thing has gone wrong. We sometimes have to do things the patient doesn't like and make them happy we are doing it.