Nurse Satisfaction vs. Patient Satisfaction: Can the Two Go Hand in Hand?

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    A happy staff makes for a happy patient. A hospital system that invests in their staff is making a wise business decision.

    Nurse Satisfaction vs. Patient Satisfaction: Can the Two Go Hand in Hand?

    Demands of Nursing

    The demands of nursing are great and often the recognition for a job well done is minimal. Why do it? Why give the extra time or effort? Why go the extra mile for a patient or family? Have you become disengaged? resentful? apathetic? Burnout can be insidious and may not be recognized early enough to make a change to avoid the all too common pitfall of one of the most rewarding professions. The standard recommendation is to get more sleep, exercise, eat more healthily, learn something new, transfer to a new department and learn to say "no". There is another answer. Hospital systems have the ability to invest in their greatest resource, the frontline staff, and help to avoid and potentially remedy this difficult problem.

    Happy and Engaged Nursing


    A happy and engaged nurse leads to a happy, satisfied patient that will become a return customer. By investing in the front line staff, a hospital's bottom line will improve. The hospital is a business and wants a return on their investment. Patient satisfaction scores are an integral measure of how well a patient perceives a hospital is providing care. A hospital system that invests their resources and support in their clinical staff create an environment of support and respect. An environment of happy, satisfied employees is quickly sensed by the patient and family. This creates a quality experience for the patient and family. In the finding of "The Relationship Between Employee Satisfaction and Hospital Patient Experiences" by Jimmy Poltier, Andy Dahl and Frank Mulhern, a direct correlation was found between employee satisfaction and patient satisfaction. The quality of patient care improved with happier employees. "By viewing the employees as internal customers" the needs of the staff were met which led to higher patient satisfaction. So how does a hospital achieve this lofty goal?

    Some Suggestions

    Here is a partial list of suggestions made by bedside staff:
    > reward and recognition (Daisy Award, Patient First Award, Lifesaver Award)
    > reimbursement for educational programs
    > promotion from within, clinical ladder
    > tuition reimbursement for certifications and renewals, conventions
    > paid education days, additional paid education days for staff with advanced certifications
    > promotion of community events, volunteerism
    > compensation for additional skill sets (ECMO, chemo, precepting, PALS/NALS/ACLS instruction)
    > nurse involvement in decision making (interviews, department decisions, system and process changes)
    > transparency, keep employees informed of changes, future plans, successes, opportunities
    > fair and timely evaluations with a credible performance evaluation tool and biannual one-on-one conversation with direct manager
    > adequate staffing, aggressive recruiting for staff vacancies
    > self scheduling
    > employee assistance program
    > celebration of achievements (personal and professional)
    > support for personal tragedy
    > support through system and process changes
    > free flu immunization vaccines
    > privately counsel and publicly praise
    > provide team building exercises at monthly staff meetings
    > communicate with staff regarding errors and process improvements
    > listen to staff concerns and respond in timely fashion
    > recognize the day to day acts of kindness
    > manage up
    > be available
    > managers set the example (be respectful, pitch in)
    > provide safe working environment, convenient free parking in well-lit parking areas
    > discounted meals in hospital cafeteria
    > embrace family centered care
    > provide space for employee break room, staff meetings
    > keep facility clean/organized/stocked with needed supplies and current equipment
    > recognize and immediately deal with bullying, inappropriate behavior and negative attitudes
    > provide de-briefing after stressful events, deaths
    > daycare facilities

    Why Empower Nurses?

    This is just a short list of suggested ways to encourage and empower staff. A happy and engaged nurse is a loyal nurse and can directly affect a hospital's bottom line. Staff retention improves, patient satisfaction scores are higher and an overall culture of support is created. Patients will refer their friends and family to your facility. An investment in the front line staff is a wise business decision with a multifaceted return in the investment.
    Last edit by Joe V on Jun 17, '18
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    About Jb4564, BSN, RN

    I am an RN employed by a large not for profit hospital system. I have worked primarily in critical care for the past 30 years.

    Joined: Dec '13; Posts: 5; Likes: 15

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    21 Comments

  3. by   AuDDoc
    With how they rate patient satisfaction now? Not a snow ball's chance in hades.

    People think a hospital stay should be like a hotel stay. Sorry you aren't there to get a good night's sleep or a comfy bed. You are there because you are ill. When you're ill you are sensitive to everything. Seeing complaints like "I couldn't sleep because staff can't coming into my room all night!" or "Everytime I would fall asleep my thing on my arm would inflate (auto BP cuff)".

    I want to say to these people, "do you want a good night's rest or actually wake up from your sleep and eventually leave the hospital!?!?" It would make it a lot easier on night shift folks to just turn the lights out and let the patient lay in bed all night. woo hoo everybody wins!

    When you think along these lines and then combine that administrators (many of which have no direct patient care backgrounds in the medical field) are making staffing decisions and really just looking at overhead vs profit and how to do the most with the least and it just ends up being a losing game. It's no wonder people burn out in healthcare. They are overworked, often times underpaid. They only hear negative feedback, etc.
  4. by   FloridaBeagle
    My place of employment does most of those things listed, and I still can't wait to get out of bedside nursing. The workload itself is just too much. What I want more than anything is more nursing assistants and fewer patients. Or LPN's instead of CNA's so someone can help me pass meds and change dressings.
  5. by   ClaraRedheart
    Quote from AuDDoc
    With how they rate patient satisfaction now? Not a snow ball's chance in hades.

    People think a hospital stay should be like a hotel stay..
    I see your point, and I get frustrated as well. However... from their standpoint, the price that they will be paying for healthcare, even if it's just a deductible ENTITLES them to top notch care.

    Those that aren't paying... Eh... Excellent patient care is STILL my job, so I will deliver it indiscriminately.
  6. by   AuDDoc
    Quote from ClaraRedheart
    I see your point, and I get frustrated as well. However... from their standpoint, the price that they will be paying for healthcare, even if it's just a deductible ENTITLES them to top notch care.

    Those that aren't paying... Eh... Excellent patient care is STILL my job, so I will deliver it indiscriminately.
    I don't want to open the can of worms and side track this discussion of hijack this thread, but just because one is paying for their care does not mean they are entitled to anything except quality care. Quality care means my pain is controlled, protocols are followed to reduce accidents and infections, and I leave the hospital alive.

    Perhaps being a healthcare worker my bar is set much lower.

    My gripe is that those not paying are often the biggest complainers and lowest raters on the customer service surveys. I remember working the surgical step down floor for a unit where all the osteo cases went after surgery. We were one of the major Medicaid hospitals in a 5 county region. Our doctors would do hip and knee replacement on people who they knew would never follow a proper diet for weight loss and would never go to PT. They did the surgeries anyways. What happened? We ended up often with 300-400 lb patients with knee and hip replacements who refused their PT and OT every single day. Refused to ambulate at all. Refused to follow the diet restrictions, etc..

    They often would leave the hospital AMA. Then be re-admitted hours later back in the ER. The hospital ate those costs. They also rated us very low for patient care because we took their cigs, alcohol, recreational drugs, and didn't give them KFC, Arbys, and McDonalds for every meal.
  7. by   KatieMI
    The thing is, nurses satisfaction and patients satisfaction are two somewhat different animals nowadays.

    Nurses, being mostly at least somewhat rational persons, want things which are, after all said and done, achievable. Perhaps with quite some money spent, but achievable. Not spreading supplies all over the place just because "we always do it". Availability of the said supplies. More assistance, human and mechanical, with physically heavy tasks. More autonomy with decisions supported by education and evidence. Better communication (I find it totally ridiculous that I can instantly connect with people living right halfway around the world but have to use antiqie paging system to connect with a doctor in the room across the street). Less dealing with everyone else's business.

    Patients, on the other hand, want things which are not achievable in principle, with money or without them. They want to have a life full of instant pleasures, great and small, with pain, aging and death itself totally banished from their very existence. They are not satisfied with having the greatest achievent of the Western civilization - human freedom to make decisions about their own lives; instead, they want someone else to make just such decisions which would somehow satisfy their momentary whims. They want pills instantly correcting every conceivable problem, surgeries which will be not only painless but also pleasant and provide instant positive results, guaranteed 100% good outcomes and 5 star all-inclusive resort atmosphere in places which purpose is to keep them alive, not "completely satisfied".

    I wonder if someone ever got interested in fact that the wast majority of patients, paying or not, are not able to duscriminate between good and bad care. The doctor or nurse who enters the room, does quick and effective assessment, recognizes the problem, gets a plan, tells patient/family that the situation is escalating and then leads the team saves a life but, almost 100%, perseived as "rushed" and "not compassionate" unlike the one who holds hands and chats about church outside of the room (where he/she is afraid of entering for the reason of well-known lack of both skills and knowledge). On the same line, Dr. Feelgreat, M.D. distributing highly addictive meds like candy usually gets higher "satisfaction scores" than Dr. Workhard, M.D. advocating for evidence-proven things like PT/OT, diet and lifestyle changes.

    As I wrote not long before, the whole concept of "patient satisfaction" is going to fall down pretty soon, just like every other "health care fashion" did over the last 30 or so years. It is going to succumb by either massive and public investigation(s) linking high "patient satisfaction" scores to things like postoperative mortality, drug overdoses or readmissions, or, less probably, by mass exodus of providers including nurses driven to the point by impossibility to do their jobs as they see them. Early or later, it is gonna end; only one question is how many are going to pay for that with their lives.
    Last edit by KatieMI on Dec 11, '15
  8. by   MaudKennedy
    Quote from KatieMI

    I wonder if someone ever got interested in fact that the wast majority of patients, paying or not, are not able to duscriminate between good and bad care. The doctor or nurse who enters the room, does quick and effective assessment, recognizes the problem, gets a plan, tells patient/family that the situation is escalating and then leads the team saves a life but, almost 100%, perseived as "rushed" and "not compassionate" unlike the one who holds hands and chats about church outside of the room (where he/she is afraid of entering for the reason of well-known lack of both skills and knowledge)
    Why always dissociate being technically skilled and being compassionate? Is that really impossible to be both?
    I don't say it's the case in the example you gave but some doctors are pretty great to make people feel like from the moment they become a patient,they become a body part or a pathology and not a person anymore.
    When I was a kid,my family had a primary doctor who was known to be a stellar doctor. Yet,when I had my period for the 1st time,I was 11 and my mother told the doctor the next time I went to see him. He didn't make any comment but yanked my underwear down(what's traumatizing in itself) and without explaining me a thing,he did a pelvic exam and once finished and once again without a warning or an explanation palpated my breast.
    Even now I still don't know why he did those exams but what I know is I'm still traumatized and refuse to go to the gynecologist or even see my primary doctor for a gynecologist exam. I absolutely can't.
    I don't say the holding hands part is necessary to make people feel like they're still human beings time constraints exist and not all doctors are like that but yet their patients still feel dehumanized because they're emotional. That's a possibility. However,some doctors act like human body mechanics. I agree at the end of the day being alive is what matters but when you deal with human beings and that's more important when you deal with sick or injured human beings,you can't treat them like cars(like not listening to them,not answering to their questions,being careless about modesty like it happened to me etc...)
  9. by   Pythinia
    Nurses see patients in various vulnerable positions, I've seen patients humble themselves towards nurses in the hope that they will be well treated as patients do realise the power the nursing staff have over them. Patients can be difficult especially those with dementia - one poor old lady screamed her head off for five hours, unnerving for the rest of the patients but nurses took it in their stride. .
  10. by   vbarger28
    I don't think it's possible with the way the system is set up. NO WAY. In urgent care, pt staisfaction means refilling endless narc scripts, refilling alllllll meds when a primary hasn't been seen in 4 years, and getting ABX treatment for virus infections.

    Unfortunately pt's are not educated enough to make descisions about their medical care more than 50% of the time, and I wish they would stop cramming the 'I'm the patient and I want THIS not that.." down our throats. There is a reason why health in other countries is better than the United States, here pt's control the staff, the medications, and the doctors. And if they don't get what they want, you get a "2" out of 5 on your yearly eval for not giving them penicillin for a 1 day old cough..

    tisk tisk..
  11. by   Susie2310
    Quote from ClaraRedheart
    I see your point, and I get frustrated as well. However... from their standpoint, the price that they will be paying for healthcare, even if it's just a deductible ENTITLES them to top notch care.

    Those that aren't paying... Eh... Excellent patient care is STILL my job, so I will deliver it indiscriminately.
    Patients are entitled to quality care regardless of whether they are paying nothing, or paying the entire amount out of pocket. And, you, the nurse, are getting paid regardless of how much the patient is actually paying out of their own pocket for their care.
  12. by   martymoose
    I have only one request out of that whole list.

    If we had adequate or better staffing, techs , to do what needed to be done with out running around like an idiot, I bet some of those scores would be better.

    Why? Oh , because a person actually was able to answer a call light quickly. A person was asked if they needed anything before they put the light on. Staff would be happier.

    But it will never happen.
  13. by   coffeetalker
    On another thread ( I fear for the future of nursing)- someone posted that nursing started going downhill when pts became 'customers'. And as long as patients are customers, we do not upset them by stating that a pound of bacon a day and maybe they need some exercise is forbidden (unless of course the pt specifically asks what they can do to improve their health). And if a nurse does mention true things (like lifestyle or diet changes) that the pt gets upset about, it's the nurse who gets the reprimand. Until the healthcare industry realizes that our 'customers' aren't always right and that medications and treatments cannot be decided by a well meaning but uninformed family member/family friend who did an internet search, nothing with nursing will change. And sadly, people will continue to think that the hospital is the Magic Factory.
  14. by   sweetie13
    I just have to respond to this article. I was a bedside RN for 30 years. I always went far beyond what I had to do for patients. nursing changed for the worse when PCT 's were dreamed up. no longer could nurses depend on their assistants to do their job correctly. the majority of PCT's I worked with believed their knowledge was equal to the RN. yet RN's has no power over the pct's but we are responsible for what they do or don't do. and patients being customers is ridiculous. the last hospital I worked at would call nurses into the "office" to respond to "not satisfied" complaints . and we would have this held against us on our yearly review. I was called in because a patient said he was thirsty and I did nothing about it. that jerk was npo, after a full breakfast for an ultrasound. I printed out the ultra sound instructions and explained he would get his lunch as soon as he returned. this man was 30 years old and was to be npo for 6 hours. so how was I at fault???????? ridiculous !!!!!!!!!!! and I had called his doc 4 times with the patients complaints , the doc refused to speak with the patient on the phone and called him a jerk. but , the RN was blamed. this kind of stuff made me so furious and very glad I am not a nurse anymore. on the other hand I became very ill and cannot even begin to explain how nurses appear to patients. the majority were ok but some were so bad and could not get out of the room fast enough. and one hospital had the nurses and techs wearing a small communication transmitter pinned to uniform so I never knew if they were talking to me or someone else. just crazy. I am an old nurse who enjoyed so many years of bedside nursing ...........but not anymore. no nurse satisfaction and patient satisfaction cannot go hand in hand. not when patients are customers and not patients.

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