Published
Eight years.
That is how long I’ve been in nursing. Just eight years. I haven’t been on AN in a while. I used to frequent the site a lot to vent with others, and help others with advice. Well, today is a ranting kind of day, so here it goes…
I hate what nursing is becoming. It is become overrun with elite folks who have forgotten what it’s like to just get through your shift. It’s being taken over by money hungry CEOs that are finding neat little ways to package “customer service” with healthcare. Our intelligence is being insulted here! What exactly do I mean by this? Well, what professional do you know gets “scripts” to regurgitate at patients? Why is it that we are not trusted to do our job or say the right thing?
I understand that healthcare is indeed a business. It has to be. If it weren’t, we’d all be working for free. I got that. I do my job. I put my all into my shift. I advocate for my patients. I’ve gone above and beyond…all without recognition.
But, I’m deeply saddened…Now I’m being told that isn’t good enough. All I see for the future of healthcare is walking into a patient’s room at the end of my shift saying, “My name is______, if you felt I gave excellent care call 888-tell-them, and rate me a 10.” Heaven forbid you score less than 10 three times…
Eight years ago, I felt so proud in my whites on graduation day. I felt professional, neat, knowledgeable, and respected. Now, I feel burned up, and abused. For now, I stay in nursing…patients still smile, and thank me at the end of my shift. They cannot detect how I feel under the surface.
But, I am seriously considering leaving healthcare altogether.
I have been a nurse for a really LONG time. I too am very disappointed on where the profession has landed.As the OP said It is become overrun with elite folks who have forgotten what it's like to just get through your shift. It's being taken over by money hungry CEOs that are finding neat little ways to package "customer service" with healthcare. We are no longer respected as professionals, even though there is more education, we at the are just the hired help. I think the utilization of the "business" model has damaged how we treat people and how we are treated by people.
As much as I love being a nurse.........my disappointment in where it has gone to and where it maybe going has prompted me to tell my daughter to be a veterinarian. It's cash up front, very little midnight oil, you are your own boss, they are always happy to see you, you can keep them on a short leash and you can muzzle them before they bite!!!!!!!..........
What caught my attention with your comment was that you felt prompted to "tell your daughter to be a veterinarian" instead of a nurse. The two jobs aren't even on the same planet as far as requirements, preparation, entry exams, etc.. Akin to saying "yeah, I told my daughter to be an M.D. Instead of an RN because all the corporate nonsense" Huh??? :)
I would hope that if your daughter breezes through calc, genetics, has a penchant for biochemistry and can score respectfully on the mcat (etc.) without sweating bullets and donating a year to prepare for that potentially life changing exam, that you would do so anyway since having what is considered a professional degree (in the context of higher education.. e.g. PharmD, J.D., MD, DVM, etc.) is far more financially fulfilling and viable- that I would encourage my children to reach for what requires the highest requirement(s) first, as they can always migrate to jobs that require (and pay) less but not the other way around.
It's not about what's just now happening to nursing, but obvious trends that have been happening in healthcare, aviation, advertising, photography, and countless other occupations over the years.
Keep in mind that corporations aren't in business to employ people, and although I think it's crummy how some operate, I see it all for what it is and have no delusions whatsoever about the realities of business. At the same time, employees should be cognizant that they *volunteered* to accept the *privilege* of working at a particular job and can always end the work-relationship if it's too much for them. I do not embrace degrading, abusive, and disrespectful corporate behavior- but it is what it will continue to be until enough people get fed up and put an end to it.
If my daughter was an RN... I'd encourage her to stay in the trenches just long enough to get into her school of choice (NP, CRNA or AA, etc..) in order to (generally speaking) command an overall better quality of life. Floor RN is along the same lines of being a Certified Flight Instructor (generally considered the armpit of flying jobs that pilots leave the first chance they get!)... except far more RN's actually stay in the job as opposed to clawing their way upward via education; RN, BSN, CCRN, CRNA or RN, BSN, MSN, DNP, teaching at University, etc., (just two examples).
My hats off to those who've spent years actually caring for patients, weathering corporate "stuff", and having the state of mind, strong will, and physical/emotional/psychological ability to keep at a job that is truly needed and mostly appreciated by anyone who's ever had to be hospitalized.
I often write matter-of-factly; not to be confused with disrespect.
Respectfully...
hi nyteshade,My proposal to you is to consider applying in a different hospital that can meet your needs. You are an experienced nurse with a lot to offer to our patients, for some reason the boss does not see vital ways to foster the team in your units. Nursing profession does not stop where you are, the door is open for opportunities to grow and care for others. We are needed and you have a place, move on.
CC
I am looking at other options besides floor nursing. I realize that the customer service craze is sweeping the nation, and there is no way to escape it
My direct boss is actually a very good one. I know she tries her best to fight for us as a team. It saddens me that upper management is twisting her arm to the point of breaking. I wouldn't want her job!
hi nyteshade,My proposal to you is to consider applying in a different hospital that can meet your needs. You are an experienced nurse with a lot to offer to our patients, for some reason the boss does not see vital ways to foster the team in your units. Nursing profession does not stop where you are, the door is open for opportunities to grow and care for others. We are needed and you have a place, move on.
CC
you forgot to say "hope you enjoyed your stay and have a nice day"!
I cannot believe that actual Customer Service erodes morale for the employee. Making a pt or family member feel better can only improve morale for the nurse, or any hospital staff member for that matter.
Then maybe we differ on the meaning of the terms. In my mind "customer service" is not what I would term what nurses are trained to do and have been doing for hundreds of years before nurses had to bake cookies and make toast, have little bulletin boards in the hallway where construction paper happyfaces were pinned next to each nurse's name for positive survey ratings that have little to do with actual competence (because patients rating nurses like waitresses rates them on the wrong things).
Heaven forbid a nurse get a "tone" when a post-op pt doesn't want to get out of bed or use their spirometry. And Medicare is reimbursing based on that as opposed to their rate of "never events" etc? It rewards the nurse who serves cold drinks to the family and avoids ******* off the patient encouraging them to do what they need to do to get healthy again? There is something very wrong with that picture.
Where I work our management encourages customer service. Massively. But that is what they do, 'encourage'. They set the cultural tone. They let us know what is expected of us but do not force-feed us methods, but rather give us ideas.
What kind of ideas? That is a serious question. If you are smart enough to make it through nursing school and get your license aren't you smart enough to know how to interact with your patients based on what appears to meet their needs at the time? It used to be that nurses were considered a voice of authority, gasp, which is not the same thing as being a rude jerk.
People who are in jobs with the least amount of autonomy are the most stressed out. If you go to the trouble of getting yourself educated to make professional and independent judgements and come to find out "ideas for better customer service" are what matters I don't know why your morale wouldn't be eroded.
The public is anything but dumb -- once they figure out what to say or not to say to get favorable treatment from anyone in the hospital they will demand more of the same. Already it appears that nurse managers are inclined to side with the patient/family when a complaint is made as well. That is another thing that would suck the life out of me - but I'm almost done with this - like Esme. It's out of my hands at this point.
They also are up front about the money issue, letting us know that Medicare reimburses us less if our customers are unhappy, affecting money for equipment, fun things, salaries, all of it.In fact, blame Medicare for much of this. Getting paid based on happiness when your customer is inherently unhappy seems just a little twisted to me.
If a person has a better idea for a method to reach a necessary goal (in this case, full reimbursement from Medicare) while maintaining a semblance of employment satisfaction, try bringing it up to management. If your management isn't receptive to such things, it may be time to start looking elsewhere?
I have a better idea! How about a method that rates you on how your patients do health-wise? Because you are in a hospital? Morbidities, complications, hospital acquired infections, length of stay, etc - up until now that's how I thought it did work.
TO REENSI; You can be steamed all you want because this forum is for nurses to safely vent their frustrations and you, as a student nurse, cannot possibly understand how the nursing profession has changed for the worse. A "smile" will not get you or your patients through a very stressful day - it will be hard work with time constraints and leaving, knowing you were unable to provide optimal care.
I agree customer service has sucked the life blood out of nursing. My family and I went to a restaurant that is part of a well-known chain last night. The waitress introduced herself as "your seafood specialist" and informed us that her colleague, also "a seafood specialist", Joe, would be assisting her in giving us "an outstanding dining experience." Joe turned out to be the busboy, and we had a nice meal but nothing to write home about. But we got what we came for, we left a nice tip, and really what's so wrong with that? I felt sorry for the poor waitress and thought about complaining to the management for forcing her into such a phony script, but I was afraid she would just get into trouble for not pulling it off. It's a joke in a restaurant; it can mean the difference between life and death to tie nurses up in such nonsense. No-one will save us and our patients but we nurses ourselves. If we don't stick together and quit blaming each other and being afraid of losing our jobs, in the end we as a profession deserve what we get. But our patients don't. We need to tell the public the truth!!! If we all say it together, it will get through. What do people really want from nurses and hospitals? To enjoy the ride or to get home and be healthy or at least as functional as possible?
What caught my attention with your comment was that you felt prompted to "tell your daughter to be a veterinarian" instead of a nurse(a statement about being treated better in the animal world than the human one). The two jobs aren't even on the same planet as far as requirements, preparation, entry exams, etc..(it seems you are saying that a nurses education and an advanced degree is less acedemic than other professions or the entry level is less challenging for the nurse vs the vet)) Akin to saying "yeah, I told my daughter to be an M.D. Instead of an RN because all the corporate nonsense" Huh??? :)I would hope that if your daughter breezes through calc, genetics, has a penchant for biochemistry and can score respectfully on the mcat (etc.) HA! I hope so too!! without sweating bullets and donating a year to prepare for that potentially life changing exam ( like boards?), that you would do so anyway since having what is considered a professional degree (in the context of higher education.. e.g. PharmD, J.D., MD, DVM, etc.) is far more financially fulfilling and viable- that I would encourage my children to reach for what requires the highest requirement(s) first, as they can always migrate to jobs that require (and pay) less but not the other way around. I believe my daughter will accel in whatever she chooses as her profession and I have no doubts as to her IQ and her capacity to learn.
It's not about what's just now happening to nursing, but obvious trends that have been happening in healthcare, aviation, advertising, photography, and countless other occupations over the years.
Keep in mind that corporations aren't in business to employ people, and although I think it's crummy how some operate, I see it all for what it is and have no delusions whatsoever about the realities of business. At the same time, employees should be cognizant that they *volunteered* to accept the *privilege* of working at a particular job and can always end the work-relationship if it's too much for them. I do not embrace degrading, abusive, and disrespectful corporate behavior- but it is what it will continue to be until enough people get fed up and put an end to it. Whether it is hospitals, Enron, The Banks, Wallstreet, Bernie Madoff, BCBS 11 million severance package to the CEO they FIRED! or the government........the behavior IS ALL deplorable, I would rather she work for herself around living things that are actually happy to see you and appreciate what is done for them.
If my daughter was an RN... I'd encourage her to stay in the trenches just long enough to get into her school of choice (NP, CRNA or AA, etc..) in order to (generally speaking) command an overall better quality of life. Floor RN is along the same lines of being a Certified Flight Instructor (generally considered the armpit of flying jobs that pilots leave the first chance they get!) RN's at the bedside the armpit of nursing? kind of my point all along about the disrespect to the profession, that without an advanced degree you no longer are valued. To me the floor nurse is the real nurse... except far more RN's actually stay in the job as opposed to clawing their way upward via education; RN, BSN, CCRN, CRNA or RN, BSN, MSN, DNP, teaching at University, etc., (just two examples).
My hats off to those who've spent years actually caring for patients (32 years thank you all bedside), weathering corporate "stuff", and having the state of mind, strong will, and physical/emotional/psychological ability to keep at a job that is truly needed and mostly appreciated by anyone who's ever had to be hospitalized. Why would I encourage my daughter to follow a path in a profession that I feel is degrading and falling apart?
I often write matter-of-factly; not to be confused with disrespect. As do I
Respectfully...
After being a nurse for 32 years I do not like where the profession is directed nor the treatment of the nurses themselves. Are you saying that a doctorate in nursing is less challenging than a doctorate in anything else? My daughter has the "I need to help" and "hands on"gene.........a curse as well as a blessing.
As "caring profession" (tongue in cheek) a vet can work for herself, help as many as she likes, get paid what she is worth and get cash up front, muzzle the patient before it bites and be appreciated by the famlies (unlike our human patients). People are better to their animals than their families (for the most part). WHat I said was slightly tongue in cheek........ but If my daughter (actually me) is going to spend thousands of dollars getting a doctorate in nursing (and be a NP)..........I'd rather her get a doctorate in vet medicine, be self employed, not deal with the healthcare/government payor system, have better treatment of her by her patients and their families; than go into a profession that for right now.......for it largest population the bedside nurse.......leaves a lot to be desired. Just my 2:twocents: IMHO
The whole 'customer service' thing bothers me to a degree. I do believe a nurse should strive to give the best care possible but I think it crosses the line when they want you reading from a script and asking for a '10 star' rating. I'm not putting my blood, sweat, tears and money into a BSN degree to rattle off scripts cheesier than the 'Hi! Welcome to McDonalds, would you like to try our hot chocolate today?" If I wanted to work in that capacity, I'd have chosen to forgo getting my degree and applied to a retail or food related job.. or would be majoring in Hotel and Restaurant Management.If nurses don't start standing up for themselves and refusing to be treated like this, it's only going to get worse.
I am so with you on that. No way am I getting my BSN. If I have a chance to go back to school (probably when my son is in college), it will be to get a degree in a field I will enjoy. I am in an abusive environment going to work as a nurse. Why in the world would I spend a dime to increase my degree, for most likely a pay cut. That's next folks.
I have been nursing for a while. I, like many others, find the whole customer-service aspect of hospital nursing ludicrous. All one has to do is Google "medicare reimbursement and patient satisfaction" to get a disturbing preview of the numerous companies and conferences that cater to this real-world concept. I was sickened by the absurd concepts and tricks of the trade to "enhance the patient's satisfaction" or the "Know Me, Serve Me" mantra. Perhaps, even more disturbing is the quote, "and the financial pressure to improve patient experience is nothing short of mission critical.” I guess we disagree on exactly what "patient experience" means.
It makes me sad that it is all about money. We are not stupid. We realize that hospital's are a business and they need to make a profit. We know that there needs to be a reasonable amount of customer service involved. But what I don't get is how this spin on comparing hospitals to 5-star hotels came to be?
We are all customers in some shape or form. (Heck, even nurses are customers of the hospital but they seem to forget that). The idea that a customer is a customer doesn't fly with me. Every customer is not created equal. A hospital customer (I prefer the term "patient" but whatever..I'll play along) is different than a restaurant, banking, dry cleaning customer. Apples and oranges.
I have put my foot down refused the scripting lines. I... just..cannot..make..myself...say it. I do say something to that effect before leaving the room, "Let me know if you need anything or push your call light, etc..." I just refuse to regurgitate their words. I am not a stepford nurse. I am not a child. It is bad enough that we have to endure daily emails about "getting your customer service scores up!" complete with annoying bobbing cartoon graphics and loud colors sent out by Administration's secretary. Reminds me of when my daughter was in Kindergarten and was graded on behavior by changing colors. How would mgmt feel if we were allowed to grade them on a daily basis?
It is hard to care for a critically ill patients for 12+ long hours, titrating gtts, drawing labs, calling doctors, and replacing electrolytes. Hard but satisfying. I made a difference. I am part of the reason that patient is still there at shift change. That satisfaction is short-lived, however, when you return to work to find out that "your scores" just weren't good enough.
The patient lived, but so what?
I have been nursing for a while. I, like many others, find the whole customer-service aspect of hospital nursing ludicrous. All one has to do is Google "medicare reimbursement and patient satisfaction" to get a disturbing preview of the numerous companies and conferences that cater to this real-world concept. I was sickened by the absurd concepts and tricks of the trade to "enhance the patient's satisfaction" or the "Know Me, Serve Me" mantra. Perhaps, even more disturbing is the quote, "and the financial pressure to improve patient experience is nothing short of mission critical." I guess we disagree on exactly what "patient experience" means.It makes me sad that it is all about money. We are not stupid. We realize that hospital's are a business and they need to make a profit. We know that there needs to be a reasonable amount of customer service involved. But what I don't get is how this spin on comparing hospitals to 5-star hotels came to be?
We are all customers in some shape or form. (Heck, even nurses are customers of the hospital but they seem to forget that). The idea that a customer is a customer doesn't fly with me. Every customer is not created equal. A hospital customer (I prefer the term "patient" but whatever..I'll play along) is different than a restaurant, banking, dry cleaning customer. Apples and oranges.
I have put my foot down refused the scripting lines. I... just..cannot..make..myself...say it. I do say something to that effect before leaving the room, "Let me know if you need anything or push your call light, etc..." I just refuse to regurgitate their words. I am not a stepford nurse. I am not a child. It is bad enough that we have to endure daily emails about "getting your customer service scores up!" complete with annoying bobbing cartoon graphics and loud colors sent out by Administration's secretary. Reminds me of when my daughter was in Kindergarten and was graded on behavior by changing colors. How would mgmt feel if we were allowed to grade them on a daily basis?
It is hard to care for a critically ill patients for 12+ long hours, titrating gtts, drawing labs, calling doctors, and replacing electrolytes. Hard but satisfying. I made a difference. I am part of the reason that patient is still there at shift change. That satisfaction is short-lived, however, when you return to work to find out that "your scores" just weren't good enough.
The patient lived, but so what?
I wish I could give you more than one "kudo" for that post. How about this?
+10
iyqyqr
57 Posts
I work in a NICU, the 13th over my 27 year career. Despite years in the field of nursing my work ethic, high standards, and love of caring for my patients and their families has remained high. However, each year the last 4-5 management has added tasks to my role, such as we now do all our lab on our patients, we work with one less RT, so we have to do more and more of the respiratory care, we have private rooms so parents can stay all night if they choose and then you are caring for them as well as your pt, computer charting, so we are now data entry people, on w/ends we have to stock our carts. We are not staffed by acuity, rather by a number matrix. I try to find ways to be more efficient, but with the heavy assignments I often feel defeated by the time report is over. I have many 12 hour shifts when a 20 min lunch break is the only break of the night. I am still trying to deliver the care I take pride in, but around me I see many staff just giving up and picking and choosing what they will fit in on any given shift. They still take their breaks and hang out on their I-phones and if their pt hasn't had a linen change in a week, or a bath in two, the excuse is " I don't have time for fluff with my heavy assignment." Because the work load is so heavy, each staff member picks and chooses what she'll fit in to her shift. I dread going in many nights and even when I get it all done and really make a difference to a baby's outcome or the famly, there is absolutely no recognition from management or our doctors. Night shift staff is viewed as babysitters. "Just keep them alive till 7:05." I have 4 years to go till I can possibly retire and NEVER thought I would end my career feeling this way. I still LOVE what I do, I just hate how and where I have to practice my craft.