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

[eriksoln]

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.........."

[eriksoln, BSN, RN]

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!

What kills me..... (VENT)!!! - Nursing for Nurses

You should find posts 84 and 91 very enlightening.

[Cul2]

"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."

Completely true. But although the "customer" isn't always, right,

the question is -- does the patient have a right to be wrong. And

the answer is yes, assuming the situation has been explained to the

patient and he/she has the basic intelligence to understand as in

informed consent. That's what's so frustrating. How do you deal

with someone who doesn't have the will power or just doesn't seem

to care or is just to stubborn.

By the way, I think this thread so far has made it pretty clear

the difference between real customer service and the kind of nonsense

(like scripting) that some nurses are asked to perform. And I do say

"perform," because unless you're a great actor, most patients will

see through it. As a patient, I would want genuine care. I would want

caregivers to be honest with me even if it was hard for me fto take. To me,

the most important part of customer service is humane, kind, genuine,

yet completely honest care. I'd rather you tell me you don't have the

time but you'll do the best you can. I'd rather you tell me that, in all

good conscience, you can't do what I ask, even though I have the right

to do what will harm me if that's what I choose.

Honesty. Genuine, humane communication. That's the best kind

of customer service.

[eriksoln, BSN, RN]

"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."

Completely true. But although the "customer" isn't always, right,

the question is -- does the patient have a right to be wrong. And

the answer is yes, assuming the situation has been explained to the

patient and he/she has the basic intelligence to understand as in

informed consent. That's what's so frustrating. How do you deal

with someone who doesn't have the will power or just doesn't seem

to care or is just to stubborn.

By the way, I think this thread so far has made it pretty clear

the difference between real customer service and the kind of nonsense

(like scripting) that some nurses are asked to perform. And I do say

"perform," because unless you're a great actor, most patients will

see through it. As a patient, I would want genuine care. I would want

caregivers to be honest with me even if it was hard for me fto take. To me,

the most important part of customer service is humane, kind, genuine,

yet completely honest care. I'd rather you tell me you don't have the

time but you'll do the best you can. I'd rather you tell me that, in all

good conscience, you can't do what I ask, even though I have the right

to do what will harm me if that's what I choose.

Honesty. Genuine, humane communication. That's the best kind

of customer service.

I've had more than a few tell me they appreciate me being straight forward with them. I don't yell at the smokers or belittle the diabetics who ask me for ice cream (how'd it turn into cake in here anyway? We don't even have cake on our unit). I do follow through with my responsibilities as a nurse and perform pt. education.

Now, if they decide they don't care and don't want to hear it (and most don't), then it's a judgement call on weather to grant the request or not. In the case of the smoker..................ummm, NO. Can't smoke in here (and I work on a pulmonary unit, you'd think they'd know smoking was not going to go over well). In the case of the diabetic wanting ice cream..........well, if their sugars are not sky high then, it's a matter of "pt. autonomy" and they can do whatever they want.

Still, we often are in a no win situation. With management constantly preaching "strive for 5" but not following through on their end, it becomes quite daunting to tolerate.

[ImaWonderer]

okay ericsoln

I read the posts and those are fair statements.

Everyone needs to vent to someone in who is in a familiar position and has first hand knowledge of what goes on "behind the scenes" and not just what's in the brochure! I agree!

I'm not dismissing your experiences and frustrations at all. I'm sure they are 100 valid based on what you see and experience as a nurse.If I was a nurse and was chewed out specifically for things that I knew were not in the best interest of the patient I would be just as frustrated.A patient that just had a heart attack and is demanding that I deliver a double whopper with cheese would drive me up the wall.

Interesting thing about post 91 it mentions why a non-nurse would post and visit the board. The number ONE reason why i visit this board is because of past experiences that I had with medical care. There was always that feeling of what they say to the patient because its just "what they are supposed to say" and then hearing medical professionals (not just nurses)converse about how they really feel about things that are going on within medical care .Things they would almost never say to a patient and actually have their guard down.

Only thing is I don't believe the "general public" is as quite blind as you think. I'm basing my views on what I have seen and experienced YES as a patient and what I have seen family members go through dealing with healthcare and the conversations that have been raging for years.It's based on my experience having a facility try to talk me into a surgery I knew I did not need and when I asked why I was LITERALLY told....."Well you have insurance....... you might as well get it done." Wow she was to lazy to even try to make up any medical mumbo jumbo. It's based on a beyond humiliating experience at a hospital that i won't even go into right now.........that could have been totally avoided.

I see the points that you are making..........I'm willing to have a friendly debate,read ,post and listen to what others have to say!

[fiveofpeep]

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.

me too! I usually explain my prioritization to family/patients when they ask for something and I veto their request till later. IE "I want to get this heparin gtt started now so that can get cooking and then I will go grab you that extra blanket."

[eriksoln, BSN, RN]

me too! I usually explain my prioritization to family/patients when they ask for something and I veto their request till later. IE "I want to get this heparin gtt started now so that can get cooking and then I will go grab you that extra blanket."

This was my way of handling the situation. "Let me get your pain meds and put a call out to the doctor, then I'll check the fridge for a boxed lunch." It used to be more than enough, most patients were pleased to just be on your "to do list".

I've seen more and more though, patients get into this mood where they want it all, NOW. Don't you dare let them see you giving pain medication to anyone else or putting that confused grandmother back in bed before she falls. You should be getting their boxed lunch first. These are the people that I think are in for a bitter dose of reality.

To go along with the theme that admin. want's top notch care but only staffs for basic, generic needs would be: Have you noticed the push to teach us what to say to hide the fact that most units run short? Big meetings abound at my hospital on how we are all supposed to make each pt. feel like they are the only one's we are assigned to. DOH.

There is only one way to make someone feel like they are getting 1:1 care, and that is to give them 1:1 care. Primping up their expectations to the point of thinking they are entitled to 1:1 treatment when you know your staffing is going to fall very short of these expectations is foolhardy.

[BabyLady, BSN, RN]

It blows my mind, that people in healthcare, many whom have never worked another job OTHER than healthcare, think that the "customer service" trend is something new or novel.

Healthcare is a BUSINESS.

Let me repeat that...a BUSINESS.

Your hospital/facility may be listed as not-for-profit, but if it does not TURN a profit, it CANNOT expand, hire more employees, offer more services, etc.

McDonalds..sells hamburgers.

Banks...sell money.

General Motors...sells cars.

Hospitals..SELLS HEALTHCARE FOLKS!!!!

There is NO profession, where a profit needs to be realized in order for that organization to survive, no profession...where good customer service isn't needed...and healthcare is no exception.

Healthcare is just the last to come around.

The "trend" is not going to go away...to those like me, who have worked for the public my entire career, it was the EASIEST part of the job. I frequently volunteer to take patients with difficult family situations because others in my unit don't want to deal with them..but for me, it's not a problem...I just treat it the same way as I would any other situation...listen to their concerns, do what you can to fix it, pass it along to management if you don't have the power to address/correct their concerns..that is all you can do.

[eriksoln, BSN, RN]

It blows my mind, that people in healthcare, many whom have never worked another job OTHER than healthcare, think that the "customer service" trend is something new or novel.

Healthcare is a BUSINESS.

Let me repeat that...a BUSINESS.

Your hospital/facility may be listed as not-for-profit, but if it does not TURN a profit, it CANNOT expand, hire more employees, offer more services, etc.

McDonalds..sells hamburgers.

Banks...sell money.

General Motors...sells cars.

Hospitals..SELLS HEALTHCARE FOLKS!!!!

There is NO profession, where a profit needs to be realized in order for that organization to survive, no profession...where good customer service isn't needed...and healthcare is no exception.

Healthcare is just the last to come around.

The "trend" is not going to go away...to those like me, who have worked for the public my entire career, it was the EASIEST part of the job. I frequently volunteer to take patients with difficult family situations because others in my unit don't want to deal with them..but for me, it's not a problem...I just treat it the same way as I would any other situation...listen to their concerns, do what you can to fix it, pass it along to management if you don't have the power to address/correct their concerns..that is all you can do.

Nobody has a problem with having to be kind/compassionate or having to give good "customer service". But customer service is not the same in the medical field as it is in McD's.

What we are being lead to do by administration amounts to: Imagine going to McDs, and the grill cook is told to speed up cooking those burgers.......to the point of undercooking a lot of them. Now, for the most part, this makes everyone happy, they don't wait anywhere near as long for their food. That's what fast food is about, right? Wrong. That worker taking the patties off the grill one minute early is putting each customer at risk for food poisoning. Chances are, hundreds of people will eat there and never have an issue. Believe me though, if you are that one in a thousand who does get sick because of it, you'd wish they had let you wait a couple minutes and your food would have been cooked properly.

Same thing, but with medical issues. Nevermind that pt. who can't speak for himself, they can't fill out a survery so who cares. What is important is fetching the ice cream faster for someone who shouldn't have it anyway. They are the one's who will give you poor survery responses, not the near comatose hospice pt.

What excilates our frustration with the "customer service" trend too is not being expected to do it, but being the only ones accountable for it. Units a consistently staffed for nothing but the bare minimum, most generic care. It takes a superstar simply to avoid letting your confused pt's fall and to get your medications administered safely. Anything more is purely out of the question. But no one looks at the staffing and lack of supplies or the disorganized placement of patients and says "Gee, I'll put that on the survery." The nurse is who they see, its all they know, so they complain about things like the nurse not smiling MEANWHILE, you are a pt. with cardiac issues on a unit not for cardiac treatment and that fact slips everyone's mind when filling out the survey.

[belgarion]

Imagine that you are in a pt. room with someone whose O2 sat is 62%. Or maybe their BBG came up 37. Even better, you are in the middle of a code and the daughter of one of your other patients comes into the room demanding that you stop what you are doing right now to get her mother the blanket she asked for or the Tylenol she requested 20 minutes ago,or a fresh cup of coffee or snack or whatever. Won't happen you say? An awful lot of the nurses on this forum can tell stories about these very situations and worse. I've personally had one happen to me.

Imagine further that you try to tell the daughter that you will be happy to fulfill the request as soon as you are through saving this other patient's life. The daughter storms out and heads straight for the DON's office and makes a formal complaint against you for not meeting her mother's needs. You then get to spend a bunch of quality time with the DON, not because you didn't meet Mama's needs, but because you didn't make daughter happy about it. Sorry boss but I tend to get a little brusque when someone tries to interrupt me while I'm mashing someone's chest. Think this can't happen? Take a poll on this forum and see how many others have had this scenario play out at their facility.

I'm sure a lot of administrators are judging their managers job performance by their customer service satisfaction scores. The problem I have with this is that when you are dealing with lives customer service sometimes has to be sacrificed in order to avoid sacrificing those lives on the altar of "very good service"

[flashpoint]

Yeah, your charge nurse sounds like a grumpy old bat. Ignore her/him. A report every time you walk out of a room? Just you or everyone? That's crazy.

Yeah...a report on every call light. With our small patient load, it isn't that much of a pain, but she is a real piece of work in general. I know the people who work in the restaurants hate her...chronic complainer...demanding...loud mouth...LOL.

She probably would have kicked my butt yesterday...had a guy come in in respiratory arrest...ended up tubed and vented. I asked the wife what I could do for her and she said she really wanted / needed a Diet Pepsi. The Pepsi machine was out of diet, so when I got off I went to the gas station and got her one. Not a big deal to me, but it made a difference in her day.

[Scarlette Wings]

imagine that you are in a pt. room with someone whose o2 sat is 62%. or maybe their bbg came up 37. even better, you are in the middle of a code and the daughter of one of your other patients comes into the room demanding that you stop what you are doing right now to get her mother the blanket she asked for or the tylenol she requested 20 minutes ago,or a fresh cup of coffee or snack or whatever. won't happen you say? an awful lot of the nurses on this forum can tell stories about these very situations and worse. i've personally had one happen to me.

imagine further that you try to tell the daughter that you will be happy to fulfill the request as soon as you are through saving this other patient's life. the daughter storms out and heads straight for the don's office and makes a formal complaint against you for not meeting her mother's needs. you then get to spend a bunch of quality time with the don, not because you didn't meet mama's needs, but because you didn't make daughter happy about it. sorry boss but i tend to get a little brusque when someone tries to interrupt me while i'm mashing someone's chest. think this can't happen? take a poll on this forum and see how many others have had this scenario play out at their facility.

i'm sure a lot of administrators are judging their managers job performance by their customer service satisfaction scores. the problem i have with this is that when you are dealing with lives customer service sometimes has to be sacrificed in order to avoid sacrificing those lives on the altar of "very good service"

omg can i ever say "been there, done that." lol.

i don't think that it is customer service that sticks in my craw as much as this insane selfishness and "sense of entitlement" that so many patients and family members are coming in with the last few years.

i have seen family members follow nurses into another patients room and demand that the nurse stop what she was doing and come set up their momma's food tray.(i swear this is no lie!) i have watched a nurse open her mouth to answer a question and before she could get the words out her mouth to explain the doctor has been called the family member slapped the nurse's face and knock her eye glasses off. (i swear!)

it has gone beyond a caring attitude, i think we all care and most of us will go above and beyond to help and do little extras, it is this new patient attitude and threats they are so quick to throw out. i have heard so many "you better do it or i'll report you" regardless of how important or non important the request.

i mean, there seems to be no "balance" in the customer service debate.

[steelydanfan]

okay ericsoln

I read the posts and those are fair statements.

Everyone needs to vent to someone in who is in a familiar position and has first hand knowledge of what goes on "behind the scenes" and not just what's in the brochure! I agree!

I'm not dismissing your experiences and frustrations at all. I'm sure they are 100 valid based on what you see and experience as a nurse.If I was a nurse and was chewed out specifically for things that I knew were not in the best interest of the patient I would be just as frustrated.A patient that just had a heart attack and is demanding that I deliver a double whopper with cheese would drive me up the wall.

Interesting thing about post 91 it mentions why a non-nurse would post and visit the board. The number ONE reason why i visit this board is because of past experiences that I had with medical care. There was always that feeling of what they say to the patient because its just "what they are supposed to say" and then hearing medical professionals (not just nurses)converse about how they really feel about things that are going on within medical care .Things they would almost never say to a patient and actually have their guard down.

Only thing is I don't believe the "general public" is as quite blind as you think. I'm basing my views on what I have seen and experienced YES as a patient and what I have seen family members go through dealing with healthcare and the conversations that have been raging for years.It's based on my experience having a facility try to talk me into a surgery I knew I did not need and when I asked why I was LITERALLY told....."Well you have insurance....... you might as well get it done." Wow she was to lazy to even try to make up any medical mumbo jumbo. It's based on a beyond humiliating experience at a hospital that i won't even go into right now.........that could have been totally avoided.

I see the points that you are making..........I'm willing to have a friendly debate,read ,post and listen to what others have to say!

I still don't get or see your point. I really would like it if ALLNURSES was somehow closed to the general public; so that we don't have to hear about this...experience.. "that I don't want to go into right now"...

with a lot of non-attributed "what I have seen..", without examples, not that they would be true. Enough sob stories, all.nurses; can we get back to talking about our jobs?