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.
Specializes in Critical Care, Capacity/Bed Management.
Motorcycle Mama, We as nurses, aides, and techs have a job to do and that includes documentation, patient care, blood testing, glucose testing, phone calls to make, etc.
If a family member is at the bedside I do not understand why he/she cannot get the patient something to drink or eat from the pantry. It is open to family members.
I find it super annoying when a family member is sitting reading a newspaper and asks me to bring their mom or dad some soda. If family members are present I do not see as to why they themselves cannot get the small things.
One time I had a family member follow me and enter another patients room as I was cleaning him to tell me that his mother wanted cranberry juice. I told him he needed to go back to his mothers room because this was a violation to the patients privacy.
Argh.. once again WE ARE NOT MAIDS!!! This is not the HILTON! We are here to make you better and send you home.. not pamper you and run to your every whim.
Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.
The administrators expect you to kiss hind end and I think you should do it. I've kissed plenty (to an extent). Pride is something I learned to put aside, sometimes.
I am polite and professional. But I do not nor will I, put my pride aside and kiss anyone's butt.
Patients (or their health insurance carriers, or more accurately their employers which contract for the health insurance) may pay $50K or whatever number you want to use ... for inpatient health care. They are paying for competent, knowledgeable, technically-skilled care, including psychosocial care which supports patients' healing. They are paying for technological resources unimaginable a generation ago.
The administrators expect you to kiss hind end and I think you should do it. I've kissed plenty (to an extent). Pride is something I learned to put aside, sometimes.
If you are okay with kissing butt as a part of your job, pucker up and kiss away. If you are okay with setting your pride aside and being treated like a servant rather than a professional, do so. If you expect the rest of us to do the same because YOU think it is what nurses should do, you are going to be very disappointed, because I'm not about to ditch my self respect and kiss anyone's butt for any job - there is simply not enough money in the world. Frankly, I'm disappointed that you don't have any more respect for your own profession, but that's not my problem, so I'm not going to worry about it.
BTW -- this has nothing to do with my pride. If I wanted to be a maid or personal assistant, I would seek out such a job and do it with pride. But it is my chosen profession to provide skilled nursing care for patients (see other post above). That is what I get paid for. I cannot be replaced by a maid/personal assistant -- without skilled care many of my patients would expire long before they got that cup of tea they may want to have. My time is filled with the things they have to have -- med regimens, treatments, consultations w/MDs, testing, education, and the benefit of my nursing judgement.
It is very disappointing to hear a nurse, who knows what goes into nursing care, still focus on smiles, comfort items, and graciousness as though acute care nursing was akin to hostessing. Very disappointing indeed.
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:
Pain control (very important...I am still amazed at the number of nurses who put this at the bottom of their to do list)
Patient advocacy between the patient, family and other healthcare providers
Treatment and discharge planning
Ensuring treatments and medications given are appropriate, correct and timely
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:
Providing the patient and family with everything they ask for as soon as possible
Focus is on getting good ratings...not good patient care
Caring for the patient and their family in a way that a hotel manager would
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.
I think that was a really good point.
Mama (84softailmommyhere) I can see where you are coming from. Your expectations were not unreasonable. What you are asking for is professional behavior and respect. The comments you referred to are coming from the fact that there are people that don't understand the difference between professional nursing care and expectations and a waitress or servant. I think that nurses have a right to not be considered servants or waitresses but they do need to be professional. With the hospitals focusing on customers and ratings, we have reached a point that there is nothing we can say no to in order to please the customer.
Some nurses are just generally nasty. That is another thing I have seen over the years while those of us try to show compassion get kicked to the curb because we didn't play some political game right. Those also tend to be the nurses that complain and tattle and drive good nurses out of the unit.
As a nurse, you know both sides and I think your perspective is fair.
As far as the guy that got pushed out of the room for 30 minutes. It can be very hard to get patients situated (especially small rooms) when you have to keep moving a family member, stepping over them or they are so protective that they are an interference. I still believe that it is appropriate to ask the family to step out when transferring a pt or getting them settled.
Also, nurses rarely know how or who is paying. I know I did not go out of my way to know about the persons finances as far as the hospital. To me it doesn't matter whether the person is paying for it themselves or the insurance is - both are "paying customers" as far as the hospital is concerned and both are "VIP" patients to me. See, I also don't care if the patient is some famous person or rich person. All of my patients are "VIP" to me and I am not going to treat people with money better.
I do get sick of indegent people being picky, nasty or knowing the system and what all they can get. But I focus on what their needs are and I provide professional nursing care based on that. I don't know their circumstances - only that they are a patient.
As nurses, we can see when the care sucks. Whenever I see that I always think to myself.....I hope I don't act like that or I'm going to try to make sure I don't act like that. But, catch me on a bad day and who knows what your interpretation would be.
I recently had an alcoholic pt that had a bowel obstruction from too many narcs (seeker) This guy was my healthiest patient but was my busiest crankiest and nastiest patient. He was rude and barked and bit. I finally closed the door and let him have it. I told him that I was bending over backwards to make him comfortable and provide care to him when he had done this to himself and I was plain sick and tired of the way he was treating the staff and me. I said I am stepping out of the door to a better environment and expect you to change the evironment in here before I return. I didn't even make it to the end of the hall and he sent the tech to get me to apologize. I accepted his apology and continued to give him care as if it never happened. He appreciated it. That whole thing could have turned and backfired. It does often.
It sounds like the nurse you descriped was a prude. I've told nurses their burnout was not welcome in my daughter's room when she was a patient. That changed their attitude (well at least in the room).
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.
Your $50,000 was not enough to cover this. That is right the budgets are cut to the bone. $50,000 may sound like a lot to you but it in reality is a small potatoes when it comes to what many of us pay for a single hospital stay. I was in over night no surgeries, and it was $45,000.
The administrators expect you to kiss hind end and I think you should do it. I've kissed plenty (to an extent). Pride is something I learned to put aside, sometimes.
Nurses that have this type of attitude are the reason why administration thinks they can treat us so badly. They forget that NURSES are the ones that are needed, not them and management.
I really feel badly for you that you feel this way. Whatever would make you think that you have to disregard your personal pride just to do your job?
Nursing is JUST a job - nothing more, nothing less. I am certainly not going to sell myself down the river to make a few bucks. I wasn't raised that way. Not only that, but I am really tired of this attitude that my employer is doing me a favor by employing me. Guess what? THEY AREN'T. I have been called and asked to come in every night this week and over the past weekend because we are so short. I certainly haven't seen the need to call any PATIENTS to come in and get in a bed. People aren't knocking down the doors to get jobs at any of the facilities in my area, either. I know because I am job hunting and the same jobs sit posted and unfilled.
Just something to keep in mind when you think that nurses should be stuck kissing hind end. Sounds like a few someones better start kissing our disgruntled rears, stat.:chuckle
You sound like you are on a mission to bring nurses "down a peg or two." It was a wise decision you made leaving a group of professionals whom you clearly have no respect for.
Yea, I guess I was on a mission to bring them down a few notches, but only the nasty ones.
As for it being "rare thing having all your patients go down the tubes at once."I do not know from where you draw this conclusion. It is not that rare depending on the setting where you work. Why does it take "all" your patients doing this before you would consider cutting some slack?
Regarding the nurses I'm talking about, I don't think it would matter if they were working at a day spa. I've worked in the nursing home and know what it's like when things are busy and it looks like Christmas with all the lights going off. I'll just have to leave it at that...I'm very tired.
You are quick to criticize nurses "attitude" Did you realize that your own attitude has a greater impact on your happiness with a situation than anyone elses?
I guess you have never taken exception at being treated like you-know-what.
But no matter, the old man came home yesterday. Coming close to death didn't change him at all, and right now I wish he was back at that hospital, with a big, mean 300 pound Nurse Olga taking care of him.
Nurses that have this type of attitude are the reason why administration thinks they can treat us so badly. They forget that NURSES are the ones that are needed, not them and management.
I really feel badly for you that you feel this way. Whatever would make you think that you have to disregard your personal pride just to do your job?
Nursing is JUST a job - nothing more, nothing less. I am certainly not going to sell myself down the river to make a few bucks. I wasn't raised that way. Not only that, but I am really tired of this attitude that my employer is doing me a favor by employing me. Guess what? THEY AREN'T. I have been called and asked to come in every night this week and over the past weekend because we are so short. I certainly haven't seen the need to call any PATIENTS to come in and get in a bed. People aren't knocking down the doors to get jobs at any of the facilities in my area, either. I know because I am job hunting and the same jobs sit posted and unfilled.
Just something to keep in mind when you think that nurses should be stuck kissing hind end. Sounds like a few someones better start kissing our disgruntled rears, stat.:chuckle
I know, but the employers hire us to suit their needs, not the other way around. And the patients are paying for it, so yes, it should be like Burger King. There needs to be customer relations people on every floor. I wouldn't even go to administration about this because ultimately it isn't up to them. There are higher ups that really make the decisions. Administrators are just another brick in the wall. A small cog in a big wheel. How do you get to the ones who really have the ability to make decisions?
I used to be all puffed up and a take no you-know-what kind of person. But now I'm getting old and I don't have the fight in me anymore, and even if I did it wouldn't change anything, anyhow. It never did before.
The taste is too much for me to bear, though, which is why I'm living for the day I can have a career where I work alone and don't have to deal with the public at all.
Your $50,000 was not enough to cover this. That is right the budgets are cut to the bone. $50,000 may sound like a lot to you but it in reality is a small potatoes when it comes to what many of us pay for a single hospital stay. I was in over night no surgeries, and it was $45,000.
That was an arbitrary figure I threw up there.
I actually don't know what, say, a quad bypass would cost. But I know my bro-in-law paid cash for it. I know that my husband was going to be charged 47k up front (I don't know what the total bill would have been) if his insurance had not covered it. No, that isn't a lot of the money in the bigger scheme of things but it isn't chump change, either.
Still, without the "customers" there would be no business. It is not like they are getting it for free.
Okami_CCRN, BSN, RN
949 Posts
Motorcycle Mama, We as nurses, aides, and techs have a job to do and that includes documentation, patient care, blood testing, glucose testing, phone calls to make, etc.
If a family member is at the bedside I do not understand why he/she cannot get the patient something to drink or eat from the pantry. It is open to family members.
I find it super annoying when a family member is sitting reading a newspaper and asks me to bring their mom or dad some soda. If family members are present I do not see as to why they themselves cannot get the small things.
One time I had a family member follow me and enter another patients room as I was cleaning him to tell me that his mother wanted cranberry juice. I told him he needed to go back to his mothers room because this was a violation to the patients privacy.
Argh.. once again WE ARE NOT MAIDS!!! This is not the HILTON! We are here to make you better and send you home.. not pamper you and run to your every whim.