Enough is Enough

I understand that some places do take it to the extreme....baking cookies is a little too much overkill, what about the pts who are having nausea....I'd be puking in a heartbeat! If you want to throw back to "old school nursing" then the back rub is incorporated, every HS. Just breath, do what you do best.....be a nurse and all of the other stuff falls into place, take a vaca if you are having burnout. I sounds like you work noc shift....get enough sleep during the day...it improves the outlook on your job a lot if you are rested. But if all else fails.......

It's that way lots of places sadly! I think they need to staff better, and according to what degree of diff the pts are. So many places work the staff short. It's exhausting, and it is hard on everyone including the Pt's. A unit is only as good as the staff it has! When you have staff that work well together it is great. Know your job description and stick to it! Noone should be doing assignments if they are not qualified to do them; simple as that. CYA!

I never did understand the advertising angle of marketing hospitals to the public. Going to the hospital is a lot like going to Denny's at 3am - you don't want to go there, but you end up there because it is the only place to go. I am respectful and kind to my pts, BUT they are not there for me to wait on them as if the were on vacation. Most of them understand this, and quite a few apologize for "taking up my time". I tell them that this is not the case and that they are my responsibility. That being said, I have had it with hospital administration (BIG reason that I turned to agency nursing 9 months into my very first hospital job 15yrs ago..) and their marketing strategies for "customer satisfaction" And I will name names here.. St Peter Hospital in Olympia Washington "prides" itself with advertising a primary nursing model to their prospective "customers". They say that it promotes continuity of care because the nurse is the only caregiver for that pt. The way I see it is that because I am the "license", I can do everyone elses job. On the PCU, you can get up to 6 pts with no help - no one to help with ADL's, VS's and the myrid of other things CNA's do. You cannot really depend on other nurses on the floor because they are too swamped with their own pt load. It makes an already difficult and mostly thankless job totally unbearable - unwilling to do the impossible, I left.

Absolutely do not beat yourself up for leaving...my eyes were made WIDE OPEN when I went to level 1 Trauma Center which also is a teaching hospital. Med students are taught the "7 minute rule". It's dictated by insurance companies and Medicare/Medicaid and that is WHY doctors don't want to talk to other doctors they CAN'T...that is why it's easier to tele-medicine. The docs of the past 15+ yrs know nothing different...I saw it taught to them and like I've noted before, when I was told on my evaluation and at other times, that I spend too much time with my patients I wrote that maybe bunk beds was a good idea for a Level 1 Trauma Center. I wasn't going to just jam in cardiac meds IVP that were supposed to be watched and walk away to the other hall because they put me on the 'split hall'. I absolutely saw patients die that didn't need to and that is why I will not name names. They were not mine, but you all know how you see things happen and can't do a thing about them except CYA in your notes. I lost 35 lbs in 3 months and kept it off over the 2 yrs I was there. I actually was afraid to go eat...I knew that nobody was really watching my patients when I was gone. I cried driving home at night...thinking how poor people were paying the price. I meet prior patients all the time who hug me and ask me, Are you still a nurse at such and such? when I tell them no, I'm working for myself now, they tell me, You were one of the only ones who cared at that place. They knew it and I knew it and it's dictated by the insurance companies these days. I've never met one MD who went to med school to take short cuts and do half-orificed patient care. Like us, they want to do a good job and most are compassionate, but they are taught from day #1 about economics and insurance companies and lobbiests in Washington. Sad....so very sad.

I understand what you are saying, but I think that customer service is a good thing, IF you have the time! Our unit plans to have the nurses make hourly rounds to each of our pt.'s rooms and sign a board in each room that we were there. This is to insure that each pt.'s needs are met, including the customer service. This sounds good in theory, but our unit is a busy one( blood transfusions, cardiac drips, bladder irrigation...) and there will be plenty of times that this practice will be impossible!

I hear what you say and I know all about patient ratios and how busy things can get...I'm a lifetime ER RN, and was a ER Tech in HS, and a PARAMEDIC for 17yrs. I must say that 1hr check and sign thing looks great on paper, but is a huge waste of dry erase boards and the pens. That job...should be for the patient rep that is scheduled in our ERs in Charlotte 24/7. THEY round...they can do only certain specific tasks and mostly must run it pass that patient's RN because they looooove to give out blankets to patients with fevers, but I have to spend some time with my patients and it will be with assessment and teaching while I am doing. It really takes no more time, and I pick up all kinds of things in doing so. If I ever retire, I'm going to write a book. I agree to disagree with you, but thanks for the input! :cheers:

I worked in retail before entering nursing, and besides the stress of 'never being good enough', I loved my job. In retail, you always have to try and strive to be better, sell more, do more, more more more... However, I loved the customer service aspect of retail, and it was one of the main reasons I was inspired to pick nursing as a career.

I knew it would be very much customer service.

Nursing is a service job, not so different from a waitress, police officer, fireman, etc. I think its absurd for people to think they are staying at the 4 seasons, but I feel it is my job to smile, be courteous, and give my patients the extras. I've only ever had a few people demand I go out of my way to do things for them. Most of my patients are so thankful for a cup of coffee, how could I possibly deny them that?

Personally, I am just so thankful to have a job in this difficult economic time, that I try to count my blessings. I understand that some nurses feel that they are not a waitress, but truly you are. Perhaps it is different where you work, but I've had so few patients that expect me to do cartwheels for them that it makes me want to do back flips for those who are thankful for the bare minimum.

I have been in health care since 1976. I began my career as a nurses aid, (this was prior to having to be certified) I gave many back rubs and comforted many patients. I worked in assisted living as a caregiver and became a night shift supervisor, still giving back rubs and comforting patients, then I went to nursing school and became an LVN. I worked in skilled nursing still giving back rubs and then on to hospice more back rubs. I now manage a rural FQHC, I feel it is a privlege and an honor to provide my patients with whatever comfort I can give them. If you are not there for a total commitment to the patient and their needs, no matter what they are, then perhaps caring for people wasn't what you should be doing. I hope I will always be able to make a difference for each patient I have the privlege to care for. I would suggest reading the book What's Right in Health Care. It is inspiring and enlightening. :heartbeat

I am an older nurse in the ER and have worked in a couple of ER,s.in one job we were all dropping like flies because we were so busy and short staffed,we could not eat or go to the bathroom and got dehydrated.I get chest pains after 4pm on a 12hour shift when they are rushing us to get patients admitted,discharged and have new patients outside the curtain.Then they write you up for forgetting to write a response in the computer after a pain med.We never used to be so rushed to doing everything,it,s not fair to the nurses or the patients and it is inhuman.

In one place one of the nurses had an MI!

I see nothing wrong with trying to humanize the hospital experience for patients, because from a patient's point of view it can be stressful and dehumanizing in many ways. Because we say "a patient is a patient" we sometimes forget they are a human beings.

We now have servers serving meals, taking their orders, and coming by with a coffee cart. At first I thought "this is rediculous, this is a hospital, not a hotel"....but then it's such a huge hit with the patients, and I like happy patients, I've come around to the dark side. But no, I will not give back rubs....unless you're a total care and I'm doing a bed bath anyway.

I think in many ways "customer service" is overkill, but some of us needed a wake up call in how we treat "patients".....not just nurses, because nurses have always been patient focused, but the entire experience from beginning to end.

I have to say that customer service is indeed an overkill, based on the fact that as mentioned before, people expect too much from anyone, or any agency, all the time. Not just hospitals.

People who live 'normal/average' lives demand special/above average treatment in all things from not paying a lot for a new muffler, to healthcare. As someone else said "We're spoiled".

This society has become so complacent and dull-minded that we watch TV shows like "Survivorman" and think that guy is "crazy" and doing "insane" things. Kids think meat comes from Wal-Mart or IGA, and that milk is made just like any other commercial beverage.

To kill a turkey or chicken for dinner is ghastly and risking the wrath of PETA.

If the technological world fell apart, people would be found lying in fields of grain and grazing cows, having starved to death.

It seems the *demands* of the average person can be somewhat selfish and unrealistic.

If we only had people in the hospital that *needed* to be there, healthcare would not be so lucrative a career.

It's a hospital, not a hotel.

You don't need 24hr observation for your hangnail, and you don't need dilaudid for your headache. But since your lawyer can prove that you *do* need these things, we all get to enjoy higher costs, higher taxes and the list goes on.

It's the way things are. Changing them would require teamwork on an impossible scale, attempting mission impossible, and the end result would be lower costs, lower incomes, quality health care, and just enough money for corporate kings to live an expensive, posh life, but without all the world travel and private jets.

So as you can see, it's a nice thought, but find better uses for your time.

I've no trouble being kind, diligent, responsible, ethical, honest, advocate, etc. But I draw the line at pampering for the sake of ego and corporate America's fear of it's own subjects. To submit to that is to say I am willing to be an indentured servant to the masters of money.

I'd rather volunteer in a third-world country and let them support my needs. It would be a better deal in the end.

Sorry for the rant... lol...

I work in the ER & we were told to do 30 min rounds on our pts ( to inform then of progress- serve coffee, Coke food).....the triage nurse was to go to the waiting room every little bit ( forgot the time frame) & let everyone know about wait time :chuckle.....we were told to treat them all like they were at the "Hilton"....make them feel "warm & fuzzy". I might mention we are do do this even though we short staffed EVERY shift. We do not ever get to take a supper break or our other breaks either for that matter!

I have pts & their families that will ask for a sandwich, chips, drink & a warm blanket while you are trying to assess them! Give me a break! I just refuse. I will take care of my pts to the best of my ability, I will treat them with respect & compassion ( the ones I can) but the rest of this crap they can forget!

If you are sick enough (not your back pain x 5 yrs, or I want a pregnancy test pts) to be in the ER ...I think food & drink would not be a priority. I would like to see just one of the suits be warm & fuzzy" while someone is spitting in your face, kicking you in the stomach, trying to bite & caling you every name in the book........yeah buddy that really put me in "warm & fuzzy" mode.

The pts that are truly sick & in need.....never ask for anything....they are sick....these are the people I will bend over backwards for!

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.