Enough is Enough

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.

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.

"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!

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?

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:

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

:clphnds::rcgtku:

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

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."

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.

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.

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!

And what of that wafting scent of fresh baked cookies? Am I supposed to offer them to my non-diabetic patients & tell the diabetics "sorry, you can't have any?" (that should fly like a lead balloon).

Or, am I to bake regular & sugar free cookies? Do I serve them with milk, coffee, tea? (Where is the fine china, I saw it just the other day.....)

Good God, what happened to the business of saving lives?

Heck, what about the poor patients that are NPO?!! That's torture, IMHO, to have the scent of chocolate chip cookies everywhere.

I think if I had to bake these cookies, I'd make a special batch for administration, with a healthy dose of Ex-Lax in there.