Lack of "customer service" as beneficial factor for chronic disease process? - page 7

I observed the following clinical scenario several times over the last few months and wonder if it is just episodic events or something more. There is a type of patients who openly abuse acute... Read More

  1. by   Leader25
    "In addition, let's not forget that the patients and family members, along with their insurance companies (usually) are paying the bill, and that health care professionals jobs are dependent on patients seeking health care at the facilities they work at."

    Ding dong you're wrong!!You ARE paying the bill. It is a vicious cycle.
  2. by   trytounderstand
    I would have to say this customer service is not nonsense when you are being paid by the patient's insurance and from the patient's own pocket.
  3. by   LadysSolo
    If someone doesn't want to participate in their own health care to improve their health, it is much cheaper to go to a hotel to get customer service, room service, clean linens, room cleaned for you, etc. Then they can take what meds they want, whenever they want, and eat whatever they want.
  4. by   trytounderstand
    Bad Customer Service is also negative for patient's health. When you have patients who will not willing go for medical care because they know their dignity is going to be thrown to the winds by "professional" providers. Because as we know you have seen it all. Or to be offered something to help you relax when there is no reason for a benzodiazepine to be administered other than to make it easier on the nursing staff. Physicians and assistants who refuse to listen to patients questions or apprehensions about their care. Physicians or assistants who no longer actually discuss the options for a patient's care with the patient and expect the patient to just accept what they have memorized from the radiologist report. Physicians and assistants who act like it is imposition for a patient to request to see their actual xray and ct scans and have it visually explained what is going on. Family members who feel they have to worry about how the patient is being treated by staff when they cannot be with them. This is all bad customer service.

    I actually always try to treat a medical professional with the same respect that I expect back from them. In real life I even thank the Walmart checker for taking my money because that is the right thing to.
  5. by   LadysSolo
    And I try to treat my patients the way I would like to be treated, I show my patients their lab work and explain it to them, I explain how their bad choices are impacting their health, I explain what their meds are and the side effects and benefits, and am ignored regularly. I frequently think it is a shame I care more about my patents' health than they do, when they come in and expect me to "fix them in spite of themselves."
  6. by   KatieMI
    Quote from trytounderstand
    Bad Customer Service is also negative for patient's health. When you have patients who will not willing go for medical care because they know their dignity is going to be thrown to the winds by "professional" providers. Because as we know you have seen it all. Or to be offered something to help you relax when there is no reason for a benzodiazepine to be administered other than to make it easier on the nursing staff. Physicians and assistants who refuse to listen to patients questions or apprehensions about their care. Physicians or assistants who no longer actually discuss the options for a patient's care with the patient and expect the patient to just accept what they have memorized from the radiologist report. Physicians and assistants who act like it is imposition for a patient to request to see their actual xray and ct scans and have it visually explained what is going on. Family members who feel they have to worry about how the patient is being treated by staff when they cannot be with them. This is all bad customer service.

    I actually always try to treat a medical professional with the same respect that I expect back from them. In real life I even thank the Walmart checker for taking my money because that is the right thing to.
    I think that the part of the problem is that "customer service" paradigm makes it difficult for health care professionals to state the facts of life.

    It is true that speaking with patients about what wrong with them is difficult and best accomplished when there is at least some trust between patient and provider. The latter thing requires time, which is always short. But "customer service" paradigm, together with HIPAA, makes it even more complicated. I encountered many times patients who, despite of everyone's best efforts, refused to follow dietary recommendations because, first, they did not like the food done that way, and, second, because their doctors just let them know that they "had a little problem with their heart" (kidneys/liver). "Little problem" was something like LVEF of 25% or GFR of 30 - in other words, significant level of disfunction. Whom patients were supposed to believe if the doctor himself just let them know that they "only have a little problem" which, therefore, shouldn't be that serious?

    Telling people that everything is gonna be OK can be therapeutic, I have nothing totally against it. But telling them that everything can be "fixed" for life with no efforts from their side is not truthful.
  7. by   Ruby Vee
    Quote from trytounderstand
    I would have to say this customer service is not nonsense when you are being paid by the patient's insurance and from the patient's own pocket.
    If the patient doesn't understand that his/her healthcare dollars are paying for HEALTH CARE rather than a luxury accomodation, it IS nonsense.
  8. by   trytounderstand
    In watching how my parents treated their healthcare providers with respect, I learned to respect the person in the white coat and of course the nurses, who today, are usually in scrubs rather than the starched white dress I remember. But they in turn were treated with the same respect. When the doctor walked into the hospital room he sat on stool beside the bed and explained everything that was going to be happening for their care rather than standing at foot of bed or bedside with the attitude I am in charge and you do not have a choice in the decision I have made. The nurses treated both my parents with the utmost respect and understood when my father do not want another woman seeing him without at least his underwear on. That he preferred to have my mother perform whatever personal duties needed to be attended to for his care. My mother as well preferred to have one of her daughters to perform her personal care. Both of them felt it was disrespectful to expect a nurse to do any more personal care than was absolutely necessary. In today's nursing and hospital world it is as though all that has been thrown to the winds. In the past few years, it seems as if the patient's dignity does not matter. As a matter of fact it seems that they want to put patients in embarrassing situations and I have even noted that some female nurses seem to enjoy the embarrassing situations for both male and female patients. I have actually heard male nurses and males technicians apologizing while I have not heard that a female nurse in a long time. It is more I have seen it all so its is okay that I see yours and too bad, so sad.

    I also know from having surgery and injuries that the best thing to do is listen to the nurses and doctors about getting your mobility back as soon as possible and at times they are going to ask you to do things that cause pain and discomfort but it will make things better in the long run.

    I also believe that over the years patients have come to expect that there will be no pain or discomfort and have actually come to rely too heavily on drugs to take care of that pain. This has resulted in doctors being expected to prescribe something that will instantly take the pain away rather than a more safe alternative that may not work as fast or will not give the patient the resulting euphoria so many have come to expect.

    My concern with customer service are simple things:
    If a patient has said "no" then it is "no"
    A patient should not be stripped in front of everyone whether they are caregivers or not....gown removed, blanket removed, underwear cut off, after they have said "no". Especially when there is no medical reasoning behind it all other than the admitting nurse was upset that she had to step up and do someone else's job. Only after she had performed a quick bath did she cover the patient. Uncalled for. If a two trauma teams did not feel this treatment was necessary then I think she should have backed off.
    Patients not being properly covered and exposed when visitors walk into a room
    Private rooms without bed curtains that provide much needed privacy for bed baths, bed side toilet, urinal or bedpan use, Although they may be private rooms does not mean that someone will not open the door and get full view of patient.
    Refusal to listen to the patient when they request second opinion and then getting Physician Assistant to administer a relaxing drug because they are noncompliant
    Physician Assistant or doctor not pulling up xrays ct scans mris to show a patient why they feel the course of action is needed.
    Assuring a patient that we are all girls or all guys so it is okay if I don't leave the room while you get dressed.
    While yes I am sure that it is irritating when a patient refuses a drug or treatment that they do not feel is right for them and again it is their body and their insurance or personal bank account that is paying the bill.
    At no time should a family member have to worry that when they have to leave a patient in icu, critical care, operating room, recovery room that their dignity will not be respected. Or that once sedated the patient will not be allowed to lay there exposed to housekeeping, janitors, it people, other visitors, even other healthcare professionals, none of that needs to be on display unless it is truly medically necessary
    Nurses not offering tear away shorts or scrub pants so patients do not have to lay in the bed without the lower body covered. Although I realize in some instances it is not prudent to supply the shorts or pants, I have myself have been in that position and left my jeans on because I did not want to have to get up and walk around exposing my backside to other patients, visitors, nurses.
    These are the type of customer service items I am talking about. Just normal everyday things that seem to have passed as time passes.

    The same goes for patients and family members respecting nurses. A nurse is not a maid that should be at your beck and call. While I appreciate them bringing me a pillow, cot, water, towels as a family member staying with the patient, I would go get it myself if they would show me where to find it rather than have them wait on me. I always try to remember to thank them for every kindness they show. I will try to make a point of talking to the ones who have treated me and the patient with respect and kindness before leaving the hospital if at all possible. The patient also has no right to request personal care that they are capable of performing or insist upon refusing gown or scrub pants when offered exposing the nursing staff to unnecessary body exposure.

    I prefer a doctor or nurse who treats me with respect and tells me the truth about my condition and is willing to show me on a screen that this is what has to be done. Then tells me exactly what to expect, not sugar coat it.
  9. by   TriciaJ
    Quote from trytounderstand
    Bad Customer Service is also negative for patient's health. When you have patients who will not willing go for medical care because they know their dignity is going to be thrown to the winds by "professional" providers. Because as we know you have seen it all. Or to be offered something to help you relax when there is no reason for a benzodiazepine to be administered other than to make it easier on the nursing staff. Physicians and assistants who refuse to listen to patients questions or apprehensions about their care. Physicians or assistants who no longer actually discuss the options for a patient's care with the patient and expect the patient to just accept what they have memorized from the radiologist report. Physicians and assistants who act like it is imposition for a patient to request to see their actual xray and ct scans and have it visually explained what is going on. Family members who feel they have to worry about how the patient is being treated by staff when they cannot be with them. This is all bad customer service.

    I actually always try to treat a medical professional with the same respect that I expect back from them. In real life I even thank the Walmart checker for taking my money because that is the right thing to.
    There are bad actors in every profession and no one here is making excuses for them. The "customer service" referred to in this thread addresses a trend in hospitals that requires health care personnel to prioritize the wrong things. The question being posed here is whether patients are now having worse outcomes because the "customer service" model is actually detrimental.

    If your loved one was deathly ill and the emphasis seemed to be on providing a spa experience without any patient education or need for the patient to participate in his own well-being, would you consider that quality care?
  10. by   LoveMyRNlife
    Quote from trytounderstand
    As a matter of fact it seems that they want to put patients in embarrassing situations and I have even noted that some female nurses seem to enjoy the embarrassing situations for both male and female patients. I have actually heard male nurses and males technicians apologizing while I have not heard that a female nurse in a long time. It is more I have seen it all so its is okay that I see yours and too bad, so sad.



    I

    My concern with customer service are simple things:
    If a patient has said "no" then it is "no"
    A patient should not be stripped in front of everyone whether they are caregivers or not....gown removed, blanket removed, underwear cut off, after they have said "no". Especially when there is no medical reasoning behind it all other than the admitting nurse was upset that she had to step up and do someone else's job. Only after she had performed a quick bath did she cover the patient. Uncalled for. If a two trauma teams did not feel this treatment was necessary then I think she should have backed off.
    Patients not being properly covered and exposed when visitors walk into a room
    Private rooms without bed curtains that provide much needed privacy for bed baths, bed side toilet, urinal or bedpan use, Although they may be private rooms does not mean that someone will not open the door and get full view of patient.

    While yes I am sure that it is irritating when a patient refuses a drug or treatment that they do not feel is right for them and again it is their body and their insurance or personal bank account that is paying the bill.
    At no time should a family member have to worry that when they have to leave a patient in icu, critical care, operating room, recovery room that their dignity will not be respected. Or that once sedated the patient will not be allowed to lay there exposed to housekeeping, janitors, it people, other visitors, even other healthcare professionals, none of that needs to be on display unless it is truly medically necessary
    Nurses not offering tear away shorts or scrub pants so patients do not have to lay in the bed without the lower body covered. Although I realize in some instances it is not prudent to supply the shorts or pants, I have myself have been in that position and left my jeans on because I did not want to have to get up and walk around exposing my backside to other patients, visitors, nurses.
    These are the type of customer service items I am talking about. Just normal everyday things that seem to have passed as time passes.
    I just wanted to address a few of your statements. Where I work, the male and female RNs and PCAs take great care to respect a patient's privacy and dignity. I am not sure where you had such a negative experience but I would think that is not the norm. A few things you stated are easy fixes. We do not provide scrub pants for patients. If they want their backside covered you simply put another gown on backwards and it is like a robe. Secondly, on my unit we deal with a lot of incontinent patients and we do not want wet underwear or pants up against their skin which would allow skin breakdown. We quite frankly have the opposite problem with some patients where I work. We have people completely capable of wiping their own behind, pulling up their blankets, reaching for a cup, etc that become completely child like when they become an inpatient. Expecting an A & O patient to perform their own ADLs is not a lack of care on the staff but helping the patient to maintain independence if they expect to return back home instead of an ECF.

    These are not the issues the OP is addressing.
  11. by   trytounderstand
    First of all, I apologize if I have wandered from the gist of this thread.

    I am not sure what you consider spa experience. I expect to receive respect when I enter a hospital or doctors office. The same as I expect to show respect in return. I do not expect a nurse to be my maid or my family's maid. But I also do not expect a nurse to refuse to listen when a patient says "no" and to put them in an embarrassing situation or to walk into a room after I have trusted my family member to be treated with respect and see the look of devastation because their dignity was stripped from them for no medical reason. I do not expect a nurse or technician to refuse to leave the room while I am getting dressed because we are all girls or guys here so what does it matter. Actually had that said to me. I do not expect a spa experience I expect respect from all parties myself included.

    I know that sometimes patients will make a choice that may go against what the nurse or doctor think is in their best interest. But once they have listened to your advice and decided they want to go a different route it is their body, their choice. I expect to be able to make an informed choice and to be part of the "team" who is deciding my care. Again my body, my choice. Unless it is an emergency situation every patient should decide whether they are taking blood thinners, stool softeners, pain meds, benzos (by the way all effects of those drugs should be explained before administered as well), wishes for a second opinion should be respected. Actual xrays mri ct scans should be presented to the patient and all physician assistants, nurse practioners and doctors should be able to explain to the patient exactly what they are looking at and why they are suggesting the course of treatment. If the patient goes against what the team without his/her input decided, they should not be considered noncompliant/uncooperative. They and they alone know what some medications will do to them once it enters their body and if they do not want to take it someone should listen. It is still their body, their choice. Should just be recorded as patient refused treatment or medicine and move on and not affect how the patient is treated for the rest of the shift.

    I do believe that some patients think they should be waited on hand and foot and that is wrong. I also believe that in trying to prevent patients from experiencing pain the pendulum has swung too far as not considering alternative methods to opiates or benzodiazepines to control pain and anxiety. I can remember years ago being in a hospital for surgery as the night wore on and I could not sleep the nurse who was checking on me said you should be asleep and I have given everything the doctor ordered. Then he said let me get the floor nurse. She came in and we talked she then took me for a walk up and down the hall. Yes it hurt. Yes I had to have help from two nurses to make sure I could make that first trip up and back to my room. But after that the pain subsided and I was able to sleep. Forever I will be grateful to that nurse for realizing I did not need more sedation I just needed a simple walk for my body to relax and take over and let me sleep.
  12. by   LoveMyRNlife
    Quote from trytounderstand
    First of all, I apologize if I have wandered from the gist of this thread.

    I am not sure what you consider spa experience. I expect to receive respect when I enter a hospital or doctors office. The same as I expect to show respect in return. I do not expect a nurse to be my maid or my family's maid. But I also do not expect a nurse to refuse to listen when a patient says "no" and to put them in an embarrassing situation or to walk into a room after I have trusted my family member to be treated with respect and see the look of devastation because their dignity was stripped from them for no medical reason. I do not expect a nurse or technician to refuse to leave the room while I am getting dressed because we are all girls or guys here so what does it matter. Actually had that said to me. I do not expect a spa experience I expect respect from all parties myself included.

    I know that sometimes patients will make a choice that may go against what the nurse or doctor think is in their best interest. But once they have listened to your advice and decided they want to go a different route it is their body, their choice. I expect to be able to make an informed choice and to be part of the "team" who is deciding my care. Again my body, my choice. Unless it is an emergency situation every patient should decide whether they are taking blood thinners, stool softeners, pain meds, benzos (by the way all effects of those drugs should be explained before administered as well), wishes for a second opinion should be respected. Actual xrays mri ct scans should be presented to the patient and all physician assistants, nurse practioners and doctors should be able to explain to the patient exactly what they are looking at and why they are suggesting the course of treatment. If the patient goes against what the team without his/her input decided, they should not be considered noncompliant/uncooperative. They and they alone know what some medications will do to them once it enters their body and if they do not want to take it someone should listen. It is still their body, their choice. Should just be recorded as patient refused treatment or medicine and move on and not affect how the patient is treated for the rest of the shift.

    I do believe that some patients think they should be waited on hand and foot and that is wrong. I also believe that in trying to prevent patients from experiencing pain the pendulum has swung too far as not considering alternative methods to opiates or benzodiazepines to control pain and anxiety. I can remember years ago being in a hospital for surgery as the night wore on and I could not sleep the nurse who was checking on me said you should be asleep and I have given everything the doctor ordered. Then he said let me get the floor nurse. She came in and we talked she then took me for a walk up and down the hall. Yes it hurt. Yes I had to have help from two nurses to make sure I could make that first trip up and back to my room. But after that the pain subsided and I was able to sleep. Forever I will be grateful to that nurse for realizing I did not need more sedation I just needed a simple walk for my body to relax and take over and let me sleep.
    I would recommend that you re-read the thread. Not one response that I read expects the patient to follow exactly what is recommended by the physician. We all recognize that people have choices. The problem with some people is that they do not recognize the consequences of their choices and want to blame the entire healthcare team. We are not in the business of forcing people to take care of themselves, we can only educate.
    It is not disrespectful of the RN or MD to tell the pt with COPD,CHF,DM, and CKD, on their 5th admission in a year, that they may want to start following the diet recommended and stop smoking. The pt has every right not to follow the recommendations but then do not complain endlessly that you feel like crap because it is the MDs fault for not "fixing you".
    Again, this is not the OPs question/thought so I will not hijack the thread anymore. Sorry you or your family member had such a negative experience. I work with excellent people that love what we do most days and would never treat people in the manner you have described.
  13. by   trytounderstand
    Again I apologize for getting off the subject. I more than appreciate when a healthcare provider gives me the information that I need and allows me to take this information and help make an informed decision on my healthcare. But in this case it was more like we are the "team" and we have made the decision. It was truly one of the longest days of my life watching what was happening and feeling that I could not stop it or being afraid to overstep because I did not know how that patient would be treated after I had to leave the area.

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