Enough is Enough

[abbaking]

I have HAD IT with customer service and press-gayney. ENOUGH IS ENOUGH! Lately at work , I do the basics and make a nice introduction but anything else I refuse (the backrubs promised in the brochure, the menu seletion, the encouragement of 24 hour visiting). All i want to do is do my job, and go home. This Customer is alway right and Healthy Patients are Happy Patients has burned me out to the point of tears. I snapped at my boss a few weeks ago when she told me of a complaint that I was not Happy enough - I said "Who on EARTH is happy and manic with energy at 4am?"

Patients are PATIENTS! They are not our guests! This is not a hotel. Personally, I would rather the hospital be old school style - that would be encouragement enough for early ambulation post surgery and even quicker d/c.

I have had enough of this customer service mentality - staff deserve better.

[diane227, LPN, RN]

Dear RN Randy: I agree with you. Today I was the patient. Having some back problems and was having a nerve stimulation exam. In any case, my neurologist who ordered the exam is leaving our area (near Seattle) and moving to the eastern part of the state. The EEG lab at our hospital will close after he leaves because he is the only person who uses it any more. All the other neurologist have moved all their EEG needs into their own offices or to off site contract areas so they can make the money. There is no physician that I know of that will do anything "for free" anymore. For example: we have to pay the cardiologist to read an echo and an EKG. If the doctors have not contacted a cardiologist before they order an echo we can't do one.

Nurses always get blamed for every delay that occurs. When I can't get a doctor to come see the patient, can't get a test done, can't get anyone to tell the patient when they are going to get to go home etc, we get the blame. I am now giving the phone numbers to the patients and telling them to call the physicians themselves when I cannot get them to call me back. I can't make a doctor order pain medicine. I can't make the doctor not give you an infection every time he operates on you (he has operated on you 6 times now and each time you get an infection... why don't you get a new doctor). I don't cook the food.

I refuse to refer to a patient as a "customer" or a "client". That is for the lawyers and the hairdresser.

This health care debate is going no where and it won't because you have 4 lobby groups that are at odds with each other and they are the: AMA, American Hospital Association, Trial Lawyers Association and what ever association covers the drug makers. They all have an agenda and it has to do with MONEY not with patient care or lowering the cost of health care.

If you sent us, the nurses working on the units of these hospitals, some of these people in the middle of this health care debate to spend about 6 weeks with us, we could teach them a few things about what sick people have to go through and about what this "customer service" stuff is doing to the way we try to take care of patients, especially in those hospitals where they are cutting staff to the bone. And better yet, let's let them pretend to be sick, give them a few lines and a foley. Give them an NG tube and then let them have the pleasure of dealing with their insurance company when they won't pay the bill. Let them wait 10 hours in the emergency room and see how they like it.

Let's see how they do when the drunks come in at the triage desk and start cussing at them or vomit onto their shoes. Or they have to chase the psychotic patient around the ER waiting room. These people do not have a CLUE as to what goes on in a hospital.

I will continue to try to do the best that I can to help people and to make them comfortable and happy while they are in the hospital. I want then to know what is going on with their care and what the plan is for their care. I want them to know what to expect and when to expect it. But I can't be all things to all people. Like I told my manager the other day, as the charge nurse, I am the janitor. I am at the desk at the front, and making these rounds and all I do is clean up the messes left by someone else. I fix the stuff dumped on us by other units and fix the screw up's by the doctors when they write orders for the wrong medications, wrong doses, on the wrong patients who then get ****** when you call them to correct it. I provide for "service recovery" when someone has made a patient or a visitor angry or has given them either no or incorrect information. But I guess that is my job. I have been doing this or something like it for 31 years. What else can I do.

[bigredrn57]

As the charge nurse, I try to find time to do the follow up phone calls and I do try to make rounds on all the patients. It does help them feel better. I help answer their questions etc and I think it makes them feel better and it gives me a better idea of what is going on with them and what they need. We, as charge nurses have business cards and I use mine up handing them out and they really seem to respond to that. I wear a starched white lab coat and I fix problems as soon as I find out about them. It is usually small stuff. But I don't think of it as "customer service" I just think of it as good patient care. Medical care is so complicated these days that I find people are more and more confused. Then they see stuff on TV and read the news and they get lots of impressions that are not correct. Plus, most of the physicians are not very good at explaining things. I take the time to print off information for them and explain the diagnosis to them in words they understand. It makes it easier for me and for them. Then they understand what we are doing and why. The only thing that I have repeat complaints about is the food. The food at our hospital is so bad that even the staff won't eat it. Just horrible.

Really? Where do you find the time? I have a full team of five CABG's. I am primary and I am charge.

[diane227, LPN, RN]

I have a different situation than you do. My unit is actually a combination of two for a total of 34 beds. Orthopedics on one side and med surg on the other. I do not take a patient load so I have time most days to make at least some rounds and make a few phone calls. I have a lot of staff to supervise and I spend some of my time going to other units evaluating patients before they come to my unit. I do not always get the correct story regarding the condition of the patient so sometimes I go evaluate the patient myself before I will give them a bed assignment. I also have to review all labs, x-rays and on certain days have to call report to certain orthopedic surgeons around 9 pm with regard to the condition of their fresh post ops. I review, make correction and additions to the mars, and sign off all orders for all patients and correct/clarify any orders that are not correct before handing off the charts to the nurses. I do all incident reports and am primary or secondary for all patients who take a turn for the worst. So it keeps me busy. I do have to take a patient every now and then, but not very often. Our nurse patient ratio is 1:4 or 1:5 but we try to keep it 1:4. We get really sick pts on our floor. Lots of isolation, dialysis, and heavy ortho cases.

[dbscandy]

"But no, I will not give back rubs....unless you're a total care and I'm doing a bed bath anyway."

Whoa, whoa, whoa!!! Since when did giving a back rub get relegated to customer service??

Maybe I'm too old in this business, but to me, a back rub is a comfort measure. If I am a patient, lying in this bed day in and day out, then a back rub might do more for me than that pain shot!

There might be little less b****ing and moaning from the 'customers' if they are sleeping off a good back rub!

[dbscandy]

I also have to review all labs, x-rays and on certain days have to call report to certain orthopedic surgeons around 9 pm with regard to the condition of their fresh post ops. I review, make correction and additions to the mars, and sign off all orders for all patients and correct/clarify any orders that are not correct before handing off the charts to the nurses. I do all incident reports and am primary or secondary for all patients who take a turn for the worst.

What is your job title exactly? Unless you're the NP for this unit, why do you have to review all xrays/labs, etc? Why do you have to sign off all orders for all patients? And aren't the nurses responsible for any of this? Also, why would you do all incident reports unless you were the one involved?

Just curious. Seems you take a lot on yourself. Or is that your hospital's requirement of your position?

[1bigmedicRN]

I totally agree about this customer thing is crap . Working at an inner-city hospital in Michigan administration wants me bow down and kiss people's feet. I will support you, hold your hand, do what I can to make the patient comfortable, but don't ask me about mixed vegetables on the menu when your mother is intubated (true story). If people are so *&@# bent on customer service. Well then like any other business please pay up front for the service(s) or there is no service; otherwise become a patient and I will take care of you no matter if you have insurance or not and if you can pay or not. :spbox:

[1bigmedicRN]

I refuse to refer to a patient as a "customer" or a "client". That is for the lawyers and the hairdresser.

:clphnds::rcgtku:

[paddlelady, BSN, RN]

I think "professionalism" is a better term than customer service or some places use consumer.

We as nurses shouldnt even be serving cookies they have too much darn sugar in them anyway. I have been practising nursing since the late 60's and there were always the snack carts in the evening. Juices , crackers and jellos were passed out along with fresh water and fresh linens such as a turn sheet or x-tra blanket. The reason for the snackes as we needed to make sure the diabetics had their pm snack. The patients were hydrated with water so maybe we could d/c the IV. Then we could monitor the patients I&O's. Some patients got a back rub and would actually use less analgesics. This was the standards of care and there was a reason for all of this. It just wasnt customer service. I think if we act professional then the customer service is a by product. You can do your job and be professional and shouldnt have to feel that you need to practise nursing out of your comfort level. There is a thing as personal boundaries. Sounds like some of this stuff is beyond your boundaries. Back in the day they would call it "attitude." We are all different people and we cannot all walk around like the Stepford Wives. The patients are ill and deserve to be comfortable and not in pain, have their meds given to them safely and keep them from getting nonscomical infections and all the other things we need to think about. I think some hospitals are doing some of these things as marketing tools. Think about how you feel and how you want to practise your nursing profession. This particular institution may not be the place that fosters your mission statement and values.

Time for a change?

Good luck

Paddlelady

[PeachPie]

Oh, I'd go as far to say that healthcare customer service is killing people! In this country's hospitals, the mentality is that the customer is always right and never responsible. That means patients on contact isolation for C. diff have their families come in without washing up or donning PPE. When you try to tell them about the dangers of the disease and why they should not bring their newborns to the hospital, they'll call you a mean nurse and that, "We ain't keepin' her granddaughter from her." I had a guy on contact isolation who was insulted that we donned PPE ("I feel like a leper!"), and was allowed to roam around the hospital with his festering MRSA wound and use the employee bathrooms because he didn't like his bathroom. This is why we have epidemics: crowds of visitors galumph in, let their kids play on the filthy floors, don't wash up, and spread it around the community like bubonic plague rats. People also make unhealthy choices that we are expected to bail them out of time and again, such as diabetics who almost put themselves into comas on our shifts, but gosh darn it it's their right and they're paying our salaries so we'd better bail them out yet again! We nurses are suffering from patients who know that they can act like hooligans. If a patient threatens a nurse, management will go in and try to calm them down, and then tell the nurse that she should be more patient and how to avoid this in the future. All these factors are some of the main reasons why I'm going back to school for a non-nursing related field.

These feelings of entitlement are widespread. They expect full out service with a smile, they expect to get their way, and they become livid when you refuse to enable their requests that would land you in hot water. No wonder people think that Americans are lazy spoiled brats! Whatever happened to the days when visiting hours were enforced, nurses were nurses and doctors could tell noncompliant patients, "Either shape up or find another doctor."

[cherrybreeze, ADN, RN]

I think "professionalism" is a better term than customer service or some places use consumer.

I don't think the term "professionalism" is anything even CLOSE to this customer service crap being spewed. I can be an utmost professional performing my NURSING tasks and not getting flogged for not filling a water pitcher during a code situation. Professionalism has NOTHING to do that, IMO.

[ChaeF]

They would be awfully sorry the day I am assigned to do anything more than boil water...the darned place would be burned down so quick that no one...staff or patients would have a place to rest their heads.

LMAO!! omg. i agree with you 100 on that one.

[MuzzleSnuzzler]

I don't have a problem with "customer service". I do have a problem with my raise being based on the opinions of frequent flyers, drug seekers, and patients/familes with unreasonable expectations of what an ER should provide. To add insult to injury, my facility has announced that in an effort to avoid layoffs, they will be drastically cutting our retirement benefits -- to offset the costs of the write offs. The write offs would include the uninsured / Medicaid ER visitors that come in for nasal congestion, constipation x1 day, yeast infection, pregnancy test, etc.

Trying to keep a smile on my face!