If they're paying 50k+ out of pocket maybe they *should* expect to be waited on...?

Published

Sometimes I stew over and study about things too much, but with my husband in the hospital and with some of the attitudes I've encountered lately I've been thinking about how expensive medical care can be and what people should expect at the hospital.

My husband hasn't been treated poorly, but some of the staff have been less than gracious. I often read about how "nurses are there to save your butt, not kiss it" and "this isn't the Hilton, it's a hospital!" While I understand this to a degree, I think responses like this are rather arrogant and make it sound more like the patients are an inconvenience and are there for the staff than the other way around. Having worked in LTC and home health I know how unreasonably high maintenance some people can be (and yes, these were usually-but not always- the Medicaid patients). Truly, though, this wasn't the norm. Most people were not unreasonable with their requests. Even the ones that put us out a little when they ask you to make a phone call for them or get them extra ice or extra blankets. I'm not talking about rude folks who think you should jump when they snap their fingers, but from the ICU to the med surg floor, I was hesitant to ask for anything at all because more than once I got exasperated looks and sometimes huffy responses to anything I mentioned. I'd say half of the nurses were very accomodating but the other half were like, I've got my job to do and you're keeping me from doing it.

I say, part of the job is customer relations and decent bedside manner, no matter how annoying someone is to us.

What about the people who, like my brother-in-law, shell out tens of thousands of dollars in out of pocket cash to pay for his own quadruple bypass surgery. Why shouldn't he be treated like the customer he is? My husband has insurance, but isn't he in a way, a customer too? I know the hospital and nursing home doesn't include private nurses, but by the same token, if you knew someone was paying A LOT of money to be there wouldn't the customer oriented approach everyone complains about the hospitals adopting these days make sense?

I will admit I was appalled when I learnedsome hospitals were referring to the patients as "customers." But now I'm not so sure this is far off.

While my husband was in surgery I met a man in the waiting room who had a wife in surgery at the same time, and his wife and my husband were transferred to the floor within an hour of each other. I could actually understand the man's frustration at being thrown out of the room for 30 minutes while the nurses were with his wife. He said (obviously po'ed) "I wonder who they think is paying the bill here?"

I am a believer that nurses should run the floor. Thing is, a little power goes to some peoples' heads and they forget what they are really there for.

I've started to look at things more from a patient's perspective lately, and not to sound wishy-washy (but this is a wishy-washy situation) but I've looked at it from both sides now and right or wrong I can't help it this is the way I see it.

Up Vote Up Vote ×
Specializes in Everytype of med-surg.

Wow, I am sorry you had a bad experience. It only takes one rude nurse to scare a patient and gave him a bad impression for any future hospitalizations. However, as you said hospital bills are OUTRAGEOUS, you would think they could cut a little fat out of the suits' bonuses and get a little better staffing so nurses would actually have time to make sure their patients are happy and comfortable.

Up Vote Up Vote ×
Specializes in ICU, Pedi, Education.

As a RN who has recently spent a lot of time on the patient side, I have a stong opinion about this. Nurses should be "patient-friendly" not "customer-friendly". Here is the difference between the two as I see it:

  • "Patient-Friendly" - The nurse is focused on providing the best possible nursing care to their patients. The things that are included in this are:

    1. Pain control (very important...I am still amazed at the number of nurses who put this at the bottom of their to do list)
    2. Patient advocacy between the patient, family and other healthcare providers
    3. Treatment and discharge planning
    4. Ensuring treatments and medications given are appropriate, correct and timely
    5. Caring for the patient and their family with the specialized knowledge you have as a nurse

    • "Customer-Friendly" - The nurse is focused on keeping the patient and family happy in a "hotel-like" environment. The things that are included in this are:

      1. Providing the patient and family with everything they ask for as soon as possible
      2. Focus is on getting good ratings...not good patient care
      3. Caring for the patient and their family in a way that a hotel manager would
      4. Nursing care gets put second.

      Now, before I get flamed by everyone, I want to remind you that I have had about 10 hospitalizations and 6 surgeries over the past 4 years. As nurses, we need to put our job as skilled nurses first (which does include patient comfort) and any additional time we have into being "customer-friendly". I hate seeing nursing playing Solitare when there are patients that truly need things.

      Up Vote Up Vote ×
      Specializes in Peds Critical Care, Dialysis, General.

      I so agree with you, mama.

      I've had family members on the receiving end of care - my youngest daughter and my late, precious mother-in-law. We've had excellent nursing care and not-so great care for both of them. DD was in a world famous clinic and my DMIL was in a local hospital. The only days I knew that DMIL was getting appropriate, good care was when she had a student nurse. She was not demanding, not complaining. We weren't either (I hope), but we really were upset with some attitudes. Same at world famous clinic for DD.

      I learned much from the excellent, customer service oriented RNs and even more of the kind of RN I truly did not want to be from the ones who treated us as inconveniences.

      Unfortunately, there will always be those families who can't be pleased. I refer these quickly to my management team. Quite often, I get assigned some of our more difficult families.

      BTW - my DMIL got the best care at a SNF she went to after her hospitalizations. They were responsive to her needs and to us. She adored her PCTs and they pampered her, as did the RNs & LPNS there. They cried with us when she passed.

      {{{{{{{{{{{{{hugs}}}}}}}}}}}}}}}}}}

      Up Vote Up Vote ×
      Wow, I am sorry you had a bad experience. It only takes one rude nurse to scare a patient and gave him a bad impression for any future hospitalizations. However, as you said hospital bills are OUTRAGEOUS, you would think they could cut a little fat out of the suits' bonuses and get a little better staffing so nurses would actually have time to make sure their patients are happy and comfortable.

      Thing is, I think the attitudes I encountered just happened to be part of the dispositions of the offenders. The other nurses were tired and overworked too but they didn't take it out on the patients, er, customers.

      I say, if you think you have a reason to be rude go be rude to the source. When they call another mandatory inservice or tell you to do something else will anyone step up and give them the same irritated look and impatiently tell them they are busy?

      Up Vote Up Vote ×
      Specializes in Peds Critical Care, Dialysis, General.

      [i hate seeing nursing playing Solitare when there are patients that truly need things.

      Ain't that the truth - that's time that not could be, but should be, spent with patients doing the little extras or perhaps helping out your co-workers!

      Wish I had written what you did!

      Up Vote Up Vote ×

      One thing I haven't seen at the hospital yet: a nurse's aide!

      What happened to these? A few of those on a floor could make things a lot better for everyone.

      Up Vote Up Vote ×
      Specializes in Peds Critical Care, Dialysis, General.

      We've just gotten nurse's aides for our unit. A good bit of their job in our ICU is to help keep our in-room supply carts stocked (this is immensely helpful). They do help us with turning, baths & such. Our NM has low tolerance for people sitting around, so aides know when they come to us, they will work. We have one male nursing student who is absolutely awesome! Always ready to help and learn. A good NA is worth the weight in gold, a great one is absolutely priceless!

      Up Vote Up Vote ×
      Specializes in ICU, telemetry, LTAC.

      I say, if you think you have a reason to be rude go be rude to the source. When they call another mandatory inservice or tell you to do something else will anyone step up and give them the same irritated look and impatiently tell them they are busy?

      Yeah, I'll do that, if what I'm doing is either direct patient care or related to it. It makes people mad sometimes too.

      Up Vote Up Vote ×
      Specializes in LTC, assisted living, med-surg, psych.

      I was just about to say the same thing, but you beat me to it.

      Up Vote Up Vote ×
      Specializes in Cardiac Telemetry, ED.

      If all four of my patients are paying $50K, and one of them expects me to bring them warm blankets and fresh water while another one is in agonizing pain and needs pain meds, another has a blood pressure of 70/40, and another is having frequent runs of V Tach, then which one do you expect me to "wait on"?

      The vast majority of patients and family members have absolutely no inkling of all that I am juggling in any given moment. I must prioritize my work according to what is going to kill my patients the quickest. While I am happy to get an extra pillow or refill your water pitcher if I have time, these things are not likely to kill you any time soon if I do not get to them right away.

      I know you do not want to poop in your bed, I don't want that either, but if it's a choice between you pooping in your bed because I couldn't get there soon enough to help you to the bathroom, and the guy next door going into V Fib because I didn't get that magnesium drip going quickly enough, guess which one I'm going to pick? Would I rather clean up a bit of poop, or have to put the paddles on someone?

      I try very hard to be patient, kind, and pleasant in the face of all of this, but there are days when I am not a robot, but a human being, and my human side does show (particularly when I've been running since I hit the floor four hours ago, have not peed, have not eaten, and it looks like I won't be eating any time soon, my blood sugar is crashing, and my aides have gone to dinner, and my charge nurse has just handed me another admission slip, while the family member is sitting there stuffing their face with takeout and asking me to bring water for their loved one). I may not always provide service with a smile, but I will do my best to keep Granny from dying on my watch.

      Up Vote Up Vote ×
      Specializes in Cardiac Telemetry, ED.

      I just want to add, MM, that I am very sorry for what you are going through, and I mean no disrespect for that. Thinking good thoughts for you and your family.

      Up Vote Up Vote ×
      + Join the Discussion