Grr! "Customer Service" Nursing Gone Crazy!

Mudwoman · Dec 20, 2009

By the way, I don't see this changing because there are just too many nurses that do not want it to change. And no matter what anyone says I firmly believe that that is the real problem and that is the reason I can't see myself on the floor long , not because I am "above" the job which you hear all the time about new nurses that dont want to stay on the floor. But because I dont fit with nursing culture.
I went to school with a great group of people. But during a few of our presentations on nursing things I really realized that I was in the majority. One of the students, talking about working short being so prevalent actually compared it to parenting and said something in the effect of you know its like parenting it can get tough but just dont give up just push through it, take it without complaint cause your patients need you. Most of the presentations were about the "nursing shortage" and most everyone talked of soldiering on for the patients no matter what hit them or how abusive or bad the working environment. I was floored.

My co-workers and I do it because the hospital we work at is the only game in town. The next place to work is a long, long drive away. I already commute 32 miles one way. If I don't work here and put up with the "customer service" requirements, then I am putting myself in a situation to commute 90 miles one way. We are sick of it. We hate it. We are burned out. But many of us are the sole supports of our families right now and we have to keep soldiering on for our own families. We have to have a job.

Music in My Heart · Dec 20, 2009

Thats because nobody else would put up with it. I believe strongly that it is due to the codependent culture in nursing being the acceptable norm. Those of us that are not codependent are the ones that are not "stepping up", "devoted enough" etc etc. I always wanted to be a nurse when I was young and got my degree when I was older. I had been through lots of couseling by then and shed the codependency. I realize now that this job would have been a fit when I was young and could not say no to anything and had all the other little trademarks of codepency and growing up with an alcoholic parent. But as a person that is "codependent no more" its probably not a good match. Still trying to figure out if there is any way I can fit into the codependent culture without losing all the gains I have made. Anyone else with the same problem I would love to hear your solutions!

I believe that it's less about codependency than it is about powerlessness. Individual, at-will-employed nurses are vulnerable. With good management (and thankfully my new hospital has it), it's not a problem. With lousy management, though, making waves will just get you walked out the door. It's easy to say "I wouldn't..." but if you've never found yourself as the sole provider of income and insurance for a spouse and children and faced with unreasonable management demands in order to keep food on the table, heat for the house, and the MD's door open, you may find that you sing a different tune in such cases.

I've been there and believe me, while nobody would ever characterize me as a doormat, I made some very unpleasant compromises with myself because I really had no practical alternative. Of course I left as soon as I was able but those 18 months were very difficult. And they had no difficulty finding other folks to follow in my footsteps when I left.

Moogie · Dec 20, 2009

How about suggesting to administration, that if they want "customer service," and it is so important for them to have happy satisfied "customers", than tell them that they are shortchanging their "customers" by not providing them with full time "concierge". They are actually doing their "customers" a dis-service by not providng a full time "concierge" that is not distracted by unimportant things like keeping patients alive, on time medication administration, making sure that "guests", so not spend a long time in soiled undergaments, etc.
I did also suggest that the Board of Health might have a problem with "waitstaff", who are handling contamined bodily fluids, etc. I believe that their are public health rules and licensing issues that govern these subjects. I would approach this problem from that end with hospital admistration.

Linda,

In long-term care, one of the trends that administrators are touting is the "universal worker", someone who can toilet and clean residents, then go to the kitchen to help serve, and pitch in to help housekeeping when the shift is over. When an administrator shared this "brilliant" notion with me, I asked him if that meant someone was supposed to wear many hats during a shift (do direct care as well as working with food or housekeeping) or if it meant that some workers would be trained in many areas and, depending on the day of the week, they would work the floor OR the kitchen OR housekeeping. He said---with a smile---that the "universal worker" would work wherever he/she was needed and if that meant working in multiple areas in one day, so be it. Then I asked him about infection control and got some BS answer about how I shouldn't "worry" about that. :angryfire

Un-freaking-believable. Oh, BTW, I don't worry about that anymore. I shook the dust from that facility off my Crocs a long time ago.

Music in My Heart · Dec 20, 2009

...the "universal worker", someone who can toilet and clean residents, then go to the kitchen to help serve...

I shudder at the thought. "Would you like some C. diff with your potatoes, Mrs. Jones?"

Moogie · Dec 20, 2009

I have to admit I was outright shocked after a recent hospitalization and surgery when I ended up in the ER for a complication. I whined a little about getting an IV because my veins had pretty much been blown during my hospitalization and the doc looked at me and said, "Well, it's all about 'customer service' so if you REALLY don't want an IV...."

I have weird humor like that but I kinda like the doctor's comment

Katie---

He wasn't joking. He was serious and did not mean in any way to be funny.

Look, I believe in patient's rights and knew I had every right to refuse an IV or any other treatment. But when I was sitting in an ER with a surgical wound that had dehisced and was draining heavily, I knew it would be necessary to have IV access in case I needed antibiotics or, as what happened, IV contrast medium for an abdominal CT scan. But---if I wasn't willing to have the necessary treatments or go through whatever procedures for an accurate diagnosis, why the heck would I have wasted six hours in the ER? For feces and giggles?

And if the doctor would have been trying to be funny, look, I have a sense of humor too, but considering I was in pain, draining from my incision and scared out of my mind that I had an infection, I would have made a complaint about inappropriate patient communication IF THE DOCTOR WAS JOKING. I RARELY complain when I am in a health care setting as a patient----or as a customer, for that matter of fact. But stupid joke at that particular time in that particular situation would have been inappropriate and unprofessional.

Moogie · Dec 21, 2009

I had a situation where I was running to grab the crash cart and a patients family yells "Excuse me......" I said "Unless it's an emergency I need to finish what I'm doing" as I proceeded to run down the hallway to my coding patient. After the ambulance left with the patient that we couldn't revive, she says to me "My mom would like to know if her fruit cake is still in the fridge".
Are you serious? That's really what you interrupted me for while I was running down the hallway? You've gotta be joking me. BUT WAIT--It gets better. I got reprimanded by management as the patients family complained that I wasn't prompt enough in checking the status of her mother's fruit cake as I was running a code. What a joke. Sometimes I wonder where these DON's and Supervisors came from--did you ever work as a nurse? Would you have checked the status of a fruit cake?
Needless to say, they now have put a sign up behind the nurses station, visible to all visitors that says "Customer service begins with a smile." I'd like to deliver my meds on a silver platter and put a tip cup out since I am providing customer service in a position that sometimes seems nothing more than a glamourized waitress.
Management is completely off the deep end on this one. I would like them to come take a walk in our shoes for just eight hours as they will be waving the white flag.

Frankly, I think the manager who reprimanded you has fruit cake for a brain.

Snark aside, I agree with the posts about nurses (as a group, not as individuals) being co-dependent and thus unwilling to challenge the outrageous demands of management and administration, particularly the ludicrous and asinine importance put on finding someone's fruit cake in the fridge, putting that on par with a CODE. It's also true that many nurses will put up with abusive work situations because they buy into this nonsense of nurses being all-sacrificing, all-caring, always there for the patient even if it means going without meal breaks or time to go to the bathroom---or working off the clock because management discourages overtime.

I hate to disagree with either Linda or Eleanor Roosevelt (no one can take advantage of you without your permission) but we need to keep in mind that, in spite of assertiveness training for nurses and motivational seminars encouraging us to take back our profession, we cannot change other people's behavior. Yes, we can change our reactions and that might mean occasionally saying "no" to an outrageous request or demanding to get a meal break---but there is no guarantee that our acting assertively will result in better treatment by management/administration. In a recession and at a time when there are more nurses than jobs, management and administration have more power than ever. Management always has the power to hire and fire and to make one's life a living hell if one does not conform or tries to challenge the status quo. Many institutions like keeping their employees powerless and they purposely promote people who will uphold the status quo, not make changes, not change the power structure, even if it means a decrease in efficacy of the nursing care. Institutions that have a long history of dysfunction and unequal power will terminate or push out the nurses who don't make waves, who follow all their dictates and who act like "good little girls and boys who should be seen but not heard." :angryfire

Administration is more concerned with the sizzle than the steak, which is why there's this total insanity in which "customer service" takes precedence over the unglamorous reality of providing care. Who cares about a fruit cake when someone is coding?

Utterly, completely ridiculous. It is high time nursing becomes unionized to stop this madness as well as many of the other atrocities our profession faces.

Batman25 · Dec 21, 2009

Anyone that reprimands a nurse who is prioritizing care and working to literally save someone's life versus checking a fruitcake should be fired no questions asked. That person has lost all sense of what nursing care should be about and doesn't belong in a supervisory position. Idiocy.

I am very grateful that I have good management who back us and have kept the proper perspective of what nurses should be doing. They know patients going downhill come before all else. You could stand there and scream until the cows come home but if a patient is working on dying we are working on keeping them alive.

I feel bad for the nurses that don't have this available to them. My advice would be to take small steps to change things while continuing to prioritize care. Don't get so worried about being written up that you cater to someone who doesn't need you over someone who does. Protect yourself and your license at all times because if you don't no one will.

It's so sad that so many have turned from patient care to customer service. The focus should always be on helping keep our patients safe and on the road to comfort and wanting applause not for getting the patient's neighbor's friend's daughter a soda but for wonderful quality of patient care. The focus is in the wrong place.

Music in My Heart · Dec 21, 2009

"Hey nurse, could you get me a soda?"

"Sorry, I'm dreadfully busy at the moment but the machine's right down the hall. Wait a sec, here's 6 bits, grab me one while you're down there. Thanks a million."

If management's so into customer service, they should make the soda and snack machines free... the customers would LOVE that.

Moogie · Dec 21, 2009

"Hey nurse, could you get me a soda?"
"Sorry, I'm dreadfully busy at the moment but the machine's right down the hall. Wait a sec, here's 6 bits, grab me one while you're down there. Thanks a million."
If management's so into customer service, they should make the soda and snack machines free... the customers would LOVE that.

Yes, and place the machines right next to the diabetes education department.

Bad, bad Moogie!!!

abbaking · Dec 21, 2009

I just had a terrible thought - AFter 4 years of hard-work, full time classes, Debt beyond belief, and general exhaustion - You find a great paying job as an RN. You are an educated professional and have expertise. Now, after all you have had to go through just to get here - Management tells you that you have "Customers to Wait on". EVERYONE STAND UP AND SAY NO MORE ENOUGH IS ENOUGH!!!

A 90 year old lady with a stage 4 decubitis ulcer and an active MRSA infection is not what i think of when I go to the Hilton.

I was a patient recently at the hospital I work at for intensive surgery. I had my mother with me helping me with the hospitalization. All the nurses that I had caring for me were pleasent and kind - and educated and knowledgeable. I did not utilize my complimentray hand towels, or the room service. I could have cared less about the home-like decor and flat-screen TV's.....none of that is at all important when you are sick or in pain. All i cared about was getting my morphine and going to lala land.

In a nutshell, It is al a giant waste of money - customer service is a waste. Management has got to know this by now!!!

ephiemarie · Dec 21, 2009

As a CNA in an ICU, I've certainly seen my share of families who expect too much and abuse the generosity of the institution. However, I've also learned that sometimes all it takes to make someone happy (whether it's a patient or their needy family members) is a creature comfort like ice cream, coffee, or a warm blanket. I've found that when I take the extra few minutes to tidy up the patient's room and offer kindnesses to their loved ones, my shift ends up going much more smoothly. Making a patient or family feel "special" equals fewer call lights for me to answer. It's a win-win situation most of the time. We all know that when a whole family is crowded into a room trying to help their mother/father/child/etc. die, they don't take the time to grab a drink or a bite to eat. Ordering a family cart from the kitchen--or putting together something simple after hours--doesn't take all that long and the family is always very grateful for the gesture.

However, I do feel that these tasks should be delegated to support staff, and only if time allows. Nurses need to focus on the important, life-saving stuff. While families can be a royal pain sometimes, I think having a good team of CNAs, HUCs, etc. can also lighten the load on nurses.

allnurses Guide · Dec 21, 2009

Linda,
In long-term care, one of the trends that administrators are touting is the "universal worker", someone who can toilet and clean residents, then go to the kitchen to help serve, and pitch in to help housekeeping when the shift is over. When an administrator shared this "brilliant" notion with me, I asked him if that meant someone was supposed to wear many hats during a shift (do direct care as well as working with food or housekeeping) or if it meant that some workers would be trained in many areas and, depending on the day of the week, they would work the floor OR the kitchen OR housekeeping. He said---with a smile---that the "universal worker" would work wherever he/she was needed and if that meant working in multiple areas in one day, so be it. Then I asked him about infection control and got some BS answer about how I shouldn't "worry" about that. :angryfire
Un-freaking-believable. Oh, BTW, I don't worry about that anymore. I shook the dust from that facility off my Crocs a long time ago.

Seriously? :uhoh21: On the face of it-- seems impractical due to training-logistics-budgeting-and pay scale issues, but it almost sounds like there was a gleeful air about it as he daydreamed about all the control that would give him as an administrator. Creepy.

Here's what I don't understand. At least some of those clipboard people from the carpeted hall worked on the floors as staff at some point in their career- what happens to them? :confused: I'm the same age as alot of them so it can't be just that. I don't see how they would "forget" what it's like to be on the floors because I remember exactly how I felt when I was a student, first job, etc. Is it a strange mist emitted by conference rooms? Sigh.