Please tell me how this is right?!?!

[L&DRNJenn]

I work for a large univeristy hospital that also has several branches throughout the metroplex. There has been a huge push for patient satisfaction over the past 9 months. Scores are based on surveys completed on discharge and then also a survey mailed to patients at home following discharge. Currently scores are in the low to mid 80's. The goal is greater than 95%. We had a presentation in March on what the expectations were of the staff to insure that patient satisfaction improves and we were expected to sign a form saying that we were committed to just that. The major push was to have the patients be rounded on each hour. The even hours by the nurses and the odd hours by the techs and the purpose of that was to anticipate the patient's needs. We were also to imply with our words, actions and attitude that "we have time". The patients are visited by the supervisors to evaluate how things are going (I'm not sure what all the patients are asked during this time).

On Tuesday we were presentated with a hospital wide program that ranks each staff member as a high, medium or low performer based on carrying out the commitment of improving patient satsfaction. This ranking has nothing to do with patient care, critical thinking and so on. Bad attitudes, gossiping and backstabbing are within consideration to the ranking. The superivsors will meet with each staff member. The order will be high, medium and low in the hope that by talking to the high performers first they will have a positive influence on the rest. The low performers will be given a choice to basically shape up or ship out. My manager says that even some of the most experienced nurses will be faced with that decision.

What do you think of this?

Here's what I think. I think that it is extremely childish and extreme. I can't believe that a group of educated adults put this program together. I feel like it doesn't value nurses and techs and recognize that we are human beings. I also am feeling like I don't even want to work for this healthcare system anymore.

I really enjoy the people that I work with and they types of patients that we have. I even sometimes enjoy the workload :) We as a whole work pretty well together. I'm just dissappointed that we have to go through this and it is an added stress to an already stressful job. I'm further upset that we do not have an advocate.

I'm going to try to let this blow over because I don't see how it is going to effectively work. But the list has already been determined and it is expected that each staff member will be spoken to before January. "Nothing says Happy Holidays more than You Are A Low Performer"

[NRSKarenRN, BSN, RN]

The problems with this Studer model ensue when facilities choose to leave pieces out - the staff satisfaction for example. The Studer model is an all or nothing - meaning that if the facility isnt going to deliver THEIR end of the bargain - keeping staff happy with the appropriate resources and tools to do their jobs - then patients aren't going to be happy either.

A facility cannot just adopt the patient satisfaction piece and expect that to work - they have to be willing to do the rest too.

:yeahthat:

Staff need to hold Senior Management accountable. If they are not proviing "customer service" to employees, employees have a right to request meetings to discuss their concerns. Many work issues resolve around "unfilled expectiations" just airing exactly what these expectations are on both sides helps clear the air. This is not about getting raises, but about building a culture where two way honest discussions of how to best improve work environment for employees and patients will move your organization forward.

[pannie]

I've now been in the position of having a long hospitalization. Prior to surgery, I was on the second floor while they tried to get the sepsis under control (walked around with a perforated colon for 5 days). I've never had a more miserable experience in my life. First, the assessment nurse had limited English skills. We were all frustrated and it would have been quicker and much easier to just give me the clipboard and I'd do it myself. She was so frustrated she started doing it herself. I heard "You no have that." Whoa! What don't I have? It turned out the question was about food allergeries. I do have a terrible allergy to citrus. I had rigours every evening at 7 pm. When those were over, high fever, the fever would break but I'd be soaking wet. I asked the RN if she could cover the IV site so I could get a shower. If was the FIRST thing I requested in 5 days. She told me she was too busy because I had so medication she needed to hang. Thank God, a tech heard my request and got me the shampoo cap and put a new mattress pad under me so I wasn't laying on a wet bed. Just that simple act of kindness (he wasn't assigned to me) made all the difference. I felt like my hair didn't stink and I wasn't freezing. The IV infiltrated and needed changed. Granted my veins had disappeared, but the nurse said "Do you think I can do this?" I believe she meant "I CAN do this." (language barrier again). I begged her just to let them do it in pre-op since I knew WHO would be doing it. Nope! off I go with a tenuous, wobbling, IV that needed taken out immediately. But gloriously, I went to the 3rd floor after surgery and the difference was night and day. The 3rd floor crew could not have been nicer. I developed a blood yeast infection and needed intense nursing care again but not one nurse said "I don't have time." for anything. In fact, they went out of their way to do things to make me much more comfortable. So, I reject the notion that the administration is always to blame. Some staff are just surly. Had the nurse who didn't have time, say "Let me get an aid to help you." it would have made all the difference in the world. I DID have a choice of what hospital to be admitted to (Dallas/Ft. Worth metroplex). If the situation ever arises again, I'll have to ask "Which floor?"

[prmenrs, RN]

The problems with this Studer model ensue when facilities choose to leave pieces out - the staff satisfaction for example. The Studer model is an all or nothing - meaning that if the facility isnt going to deliver THEIR end of the bargain - keeping staff happy with the appropriate resources and tools to do their jobs - then patients aren't going to be happy either.

A facility cannot just adopt the patient satisfaction piece and expect that to work - they have to be willing to do the rest too.

ABSOLUTELY :yeahthat: Customer service is a 2 way street!!! Unless Management views staff as "customers" along w/the pts, they're doomed! Of course, on the way to doom, jobs/lives/business will be lost. Not nice.

I suggest, respectfully, for the OP to do some 'homework' on this "Quint Studder" thing, and start asking the suits why they don't seem to be doing their part of it, and what [and where] the positive pieces are?

So far, from what the OP is saying, management has created a very adversarial and hostile environment. Not one in which I would like to work. Fertile ground, too, for a union to enter! The fun's just getting started!

Meanwhile, about all I have to offer is sympathy.

[LydiaNN]

The "I Have the Time" concept is a very nice one, indeed, provided your facility's staffing is such that it actually allows you to have that time. When push comes to shove, nurses have to prioritize, and if that means some customer service scores fall, then so be it. I hope this process is going to allow for that.

[Tweety, BSN, RN]

Thanks Daytonite and Karen for great information.

It's really not all that difficult to provide good customer service, even when you're short staffed and busy, and even when you really don't "have the time".

[KacyLynnRN]

My workplace is jumping on the customer service bandwagon as well...which wouldn't be a bad thing, except they tend to have the attitude that the customer is ALWAYS right. A few weeks ago, a patient's family member was very verbally abusive to me for most of my shift. This man was a mean, evil tyrant who openly yelled at me in the nurses station (because he said his mother had her call light on for several minutes...the unit secretary later checked and found she had had it on for less than 2 minutes, and I was right in the middle of something I couldn't stop at the time) and yelled at me several times in the patient's room. It was SO bad that the roommate in the other bed's family was complaining about how mean he was being to me!! To make a long story short, I was in tears all day and went to the charge nurse, intermmediate supervisor, and my boss. No one went into the room to stand up for me and tell him this was an inappropriate way to treat me. Instead, I was told to go into the room and apologize for anything they were upset about, and offer them a private room to make him happy. You know, I know the 'customer is always right', but there comes a time when you have to put your foot down and say, OK, this is not an appropriate way to treat a staff person and ask them to calm down or leave. I am still angry about this!! :angryfire :angryfire :angryfire

[SmilingBluEyes]

That is my fear about such programs, conveniently leaving out administrative accountability is very common.........the customer is EVERYONE BUT the employee. In the long run this does not work. Unhappy employees can't provide good customer service for long....

[meownsmile, BSN, RN]

I agree, and again that is the problem with these "getaways" to sit at conferences for this stuff. Management will walk away and twist and accomodate their own philosphies even when wrong. The whole program isnt utilized, just the parts they want. IF in fact it was instituted as it was modeled, maybe there would be increases in satisfation surveys. But im tellin ya,, when management doesnt even bother to follow up on a write up now, this too will walk in the halls of comedy.

How on earth can management exemplify the attitudes they want staff to take when they only come to the floors to 1 either chew on someone because they didnt smile, or 2 survey patients who are so sick their nurse could be attilla the hun and they wouldnt care as long as they got their pain med, or something to eat, etc.

So maybe patient satisfaction means let the patient dictate their own care. They do have the right to refuse. They dont want their incentive spirometer, ok yes sir,, dont want to get up and walk,, ok yes sir,, sure, but then i have to go in,, make them get up and walk in the hall wether they want to or not,, "with a smile". Im not sure Mr. patient really wants a smile on my face as i tell him hes gonna get pneumonia and have to stay 5 more days, or hes headed for a DVT, if he doesnt getup and walk or use his spirometer. Is he gonna see this as me thinking his discomfort is funny?,, or is he gonna see this as good customer service? Hmmm, they may be very very smart, in business, but i dont know that they took the time to think much about patiet/nurse interactions.

[Town & Country]

What I think is so weird is that the big Customer Service push is happening at the same time we have the nursing shortage.

[meownsmile, BSN, RN]

Whatever happened to customer service being about actually BEING the best facility for health care????? Please its not WALMART!!!!

YOu can have all the smiling little cookie cutters you want,, but that isnt going to bring in "customers" if they arent getting GOOD QUALITY healthcare.

[pannie]

I didn't want a "smiling little cookie cutter"! I wanted NOT to be laying in a cold, wet bed feeling like my hair stunk and being told someone was too busy. I hope to God I've never treated a patient like that no matter how busy I was. I NEVER tell anyone I'm a nurse and most of my friends don't either.

Not ALL problems originate with admin.

[SmilingBluEyes]

Pannie you are right. No not all problems begin and end with administation, but if your care is that shoddy, you have a recourse that can begin there.....did you write any letters to the CEO and DON regarding your lousy care? Conversely, did you tell them of the person who did the right thing? (on the bad unit)

I am sorry to hear you are ashamed to admit you are a nurse. Personally, I am proud to be a nurse and never ashamed to tell others--- and, I have been a patient quite a few times in the past 2 years and have received horrendous to amazing care (the whole gamut). However, I can see between the lines----the harried and overworked staff find it impossible to do all the things they should/could. I understand that. It did not stop me from writing letters both of complaint and PRAISE (as appropriate) for my situations.

I am particularly interested: Did you write a letter of praise for those that DID make you feel better? I sure hope so. Positive feedback is hard to come by for many of us anymore---and people who make a difference deserve to be recognized.