I feel like I am working at Walmart...The customer is always right!

Enfermera85, BSN, MSN, NP · Dec 29, 2009

My facility definitely kisses butt EVEN if the patient or the family is wrong.... it makes us nurses sick BUT unfortunately we are working in a take-it or leave-it society so it is up to us to decide what we will take or leave as nurses, if we do this then maybe one day we WILL get the respect we deserve (especially from management who themselves we're once staff nurses but seem to forget that). :twocents:

StNeotser, ASN, RN · Dec 29, 2009

Share the love! Do what you can, the best that you can, but get your charge nurse, and/or nurse manager, and/or house supervisor involved ASAP. This takes some of the responsibility off of you. Let them see the patient first-hand.
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One method I employ sometimes is to bring my charge nurse in, and introduce them as "Mary who is coming to help me move you up in bed" or whatever but I do not let on they are in authority - of course your supervisor has to be in on this. Otherwise if you say "This is Mrs Smith, my supervisor" the patient very often changes their behaviour and tries to come off as a victim of you, the awful nurse.

martymoose, BSN, RN · Dec 29, 2009

people at wal mart dont even get treated like this. I don't understand these people who come in , yet don't want to be treated.The normal avg person would not be making this decision. It has come up a few times if a person is this beligerant regarding treatment, well, there are some options- like , are they competant? maybe psych eval is needed(make sure ALL behaviors have been documented- ive been known to fill two or three pages worth of progress notes when someone behaves like this- yes- i will write every single thing down. The other option is to have the Doc ask the patient if they dpn't want to be treated, then maybe they would like a hospice evaluation. If you are sick enough to be on a dopamine gtt, you are sick enough that if you refuse tx, that you may die. Maybe a family meeting was in order. Definitly some intervention was required- and it stinks that the op supervision was no help at all. Yes, it may be time to find another place of employment.

The trouble is, as long as the admins. keep this customer service thing going, the more tis is going to happen. I'm sure some of these people (pts) feel entitled because they are sick. I would love to make them feel better. But they cant even see that their behavior isnt helping. Thing is , they can get away with it , because the pt complain to someone in admin, and Lord knows- admin would never take the risk of losing a pt to a competitor from lack of service- oh noooo.

This is one of those challenges they didnt teach you in nursing school!

mamason · Dec 29, 2009

I think the best thing you could do in a situation like that would be to document fully what the pt, family, doc, and nurse manager said...I gave up fighting a useless battle a long time ago.. I now cover my butt as best as possible. I also make sure that the pt is safe to the best of my ability. That's all you can really do when no one else cares about what is actually going on at the beside. My facility has turned into a HOliday Inn. Press gainey scores out weigh everything else as of late. So it seems. My philosophey is this....I go in, give the best care I can and then be done with it. I am the one who has to live with myself. So, I know that if I gave 110% with my pts...then, that's all I can do. We are not whipping boys to be treated poorly so the pencil pushers can make a buck...It's really a shame that nursing has come to this because there are many of us out there who still actually give $hit about what we do and how we give care to these sick people... :smokin:

mamason · Dec 29, 2009

i was suspended once because i told the daughter of a dying patient that her mother was dying and there was nothing more we could do. she had been demanding that we basically "cure" her mother. her mother did die a few hours later. afterwards she sent a letter to administration about how she couldnt believe they had a supervisor as rude and intimidating as me. i had over 6 witnesses that were present when i talked with her AND it was on camera. the administration did not speak with ONE staff member about the incident. they simply suspended me and told me i was lucky i didnt get fired.

That's inappropriate. Getting suspended for telling the truth...What did they want you to do? Tell them you could save her? Crazy!

CaLLaCoDe, BSN, RN · Dec 29, 2009

Good Thread OP!! I was fired for a customer service related concern; whenever your coworker wants you fired, he/she can just go around from room to room and ask if the deranged patient, the confused patient, the demanding family member is happy with the nurse and document the response and management will follow with a termination letter! This is nursing at its worst!

I believe one cannot please every Tom Dick and Harry all of the time, sometimes some of the time is good enough when it comes to patient care in the hospital. I'd rather be saving lives than to be concerned the patient doesn't think my hospital is "the happiest place in the world." Sheeesh!

Note: "happiest place in the world" is a quoted slogan from Disneyland, a corporate wunderkind not a hospital, sheesh!

new_oldRN · Dec 29, 2009

In our hospital, administration has embraced the Studer philosophy, which makes the nurse the bad guy in all situations! :cry: Our manager has even stated that she will believe the patient no matter what the truth is. So we are screwed no matter what.

I have no idea what you could have done in your situation to make things better; even the doctor wrote off this patient. I'm not sure why people come in to the hospital and then refuse all attempts to make them better. My husband is an ER charge nurse and for years he has said "I'm here to save your a**, not kiss it!"

I really want to care for my patients and see them get better; I resent having to be fakey sweet and follow a script to please them.:bowingpur If you aren't familiar with Studer and Aidet, look it up. We are encouraging needy behavior and allowing patients to abuse us while we have to smile and say thank you. I think Walmart might treat their employees better!

new_oldRN · Dec 29, 2009

You summed it up perfectly. I'm glad I'm not the only one feeling this way about nursing; it's a shame it's come to this.

FLmomof5 · Dec 29, 2009

The customer is always right AND NEVER RESPONSIBLE. This is why I'm leaving nursing to go into IT.

I would suggest another field. I am leaving IT after 18 years. The reasons: (1) layoffs every 2 or 3 years (due to outsourcing, downsizing, economy, whatever)... (2) hard to find another job in the same strain of IT in the same town forcing multiple relocations (3) My pay began at $XX,XXX.XX at job 1...raise, raise, layoff, job 2 started me at the same $XX,XXX.XX.....for the past 15 years! My pay has been stagnant.

To each his own..

PMFB-RN, RN · Dec 29, 2009

I am just wondering how your facility responds when there is a conflict with a patient or their family especially when they are wrong. Will they back you up or will they kiss butt and appease them. I had an issue the other day where a patient refused EVERYTHING! This included an OR procedure which angered the MD so much that he refuses to see her again, she refused to have nursing assess her, physicians assess her, to eat, pain medications, v/s, chem sticks, and to be turned (she had many wounds some of which were to the bone!), and her dressing changes. And more so while trying to convice and help her she attacked me drawing blood and biting and spiting. So I documented everything fully. The following day the patients family member comes in and verbally attacks us saying that we give horrible care and she doesnt care what she refuses we should do it anyway and that she is reporting us to the BON, I explained fully that she refused everything, she basically said I dont believe you and who cares if this MRSA infected patient drew blood on you its in your job description to get attacked. I knew I was right in the situation and the woman had me angry, however what really had me angry was my manager who did the whole I am sorry, I understand what your saying BS and validated this womans accusations instead of saying your wrong and you are not the POA so I can not discuss this with you any furthur. I had the MD come down and vouch for this womans behavior and it still did not make much difference. SO my question is what is a way to professionally handle this without allowing yourself to be a doormat and what would have your manager done?

*** My manager would have called the police when the patient attacked you and the patient would have been charged with battery. The management at your facility sucks. I recommend you get another job as fast as you can. Too bad you can tell us what hospital and unit this is (you can't) so the rest of us would know to avoid ever working there.

Virgo_RN, BSN, RN · Dec 29, 2009

To the OP, I would document each and every refusal, using the patient's own words whenever possible, and document your continued efforts to explain the importance of each intervention, as well as the patient's verbal/observable responses to your efforts.

As far as the angry family member, the moment you recognize what is happening, you need to step back and detach. Do not allow yourself to become angry or in any way emotionally invested in this interaction. Let the person vent their frustration, acknowledge their frustration, then calmly, rationally, explain the situation. If they continue, then ask your charge nurse/nurse manager/whoever is next on the chain of command to come talk to this person.

PMFB-RN, RN · Dec 29, 2009

Example: Dialysis pt who because she didnt think the pct was getting her on the machine "fast" enough jumped out of the chair and physically shoved my pct into the wall.

*** Why did you not call the police and have the patient charged with assault and or battery or whatever else would be applicable?