Nurse Satisfaction comes before Patient Satisfaction
This Article is going to review and reference the article titled: Patient Satisfaction Must Start With Nursing Satisfaction. Why do these scores matter? Are you a dissatisfied nurse? How can we make nurses happier?
Are you in a unit where your patient satisfaction scores are always a struggle? Look around you, are the nurses satisfied with their job? Nurses go into a job to help care for others, but when staffing ratios are unsafe, documentation takes longer than patient care, and you haven't peed in 12 hours, it can become a daunting job.
Who's obsessed with these scores?
Have you been a nurse for a while and don't remember such a fuss in the past about patient satisfaction scores. You aren't daydreaming; it is a newer concept. Hospital administrators, or what many of the nurses refer to as the "bigwigs," or "higher ups" are overly obsessed with the patient satisfaction scores. Why? Hospitals are a business, and excellent scores mean better reimbursement from Medicaid. Reimbursement equals money, and as nurses, we often don't think of the hospital as a business because we are in a caregiver role, not a salesperson.
As nurses, we have to understand this. There is an abundant number of people on the Medicaid and Medicare system, and unfortunately, without reimbursement. Hospitals could not run. Many hospitals are shutting down across the nation because they cannot keep up with the demands.
It's not that we don't want patients to love us
Nurses love their patients, or they wouldn't be a nurse. I have a problem with the concept of the "best patient experience" for everyone. I'll tell you; I don't treat anyone different. I don't care if you are Donald Trump's son or a homeless woman on her 4th abortion, I will treat you the same and give you the best care. My vision is never the patient experience; it is "how would I treat this patient if she was my sister."
We have to take a look at why we do what we do. When nurses become happier, the vision isn't so cloudy. We want our patients to be more satisfied, pain controlled, teaching completed, but sometimes it isn't possible. When nurses are happy, patients will be as well.
Why can't we meet our goals
Hey, "bigwigs," listen up. You have to take care of your nurses, yeah, the little guys. Do you think patients can't tell when their nurse is overworked and underpaid? IF not, you need to be a patient. It is written all over the nurse's face. We have a hard time faking happiness, at least most the nurses I work with.
How to turn the frowns upside down
If you are a nurse manager, take a look at your staff. Do you have a high turnover? Ask you trusted charge nurses, see what they think the issue may be. Hand out a random survey to your staff:
What is your overall satisfaction working at our hospital?
What is the most stressful thing about your workday?
What can we do to improve your workday?
Do you feel rested? Do you have enough breaks?
Do you enjoy working with your colleagues? Is there anyone here who drives you down?
In conclusion, higher ups, stop spending so much money on national "experts" who think they can help us raise our scores. Take a look of the nurses. Are they happy? What can you do to change that? Hiring an extra nurse to be out of staffing to help give lunches and breaks is going to cost less than all the extra lectures and training. According to Hazen's article, happier people make fewer mistakes because they are more aware of their surroundings, making their workload doable.
How do you think we should fix nurse satisfaction rates? Do you agree that nurse satisfaction reflects patient satisfaction?
Oh, because hospitals really aren't hotels or spas
That's NOT why. Believe me, if they had the money they would give every patient their own PCA w/ unlimited Dilaudid, mini fridge with snacks and personal CNA...actually, and MORE if they had the money. As satisfaction scores are not about healthcare but about customer retention and profits. Not that there is anything wrong with but that is not how it is sold to the public--thus it titters on FRAUD! But that is another story.
I concur, healthcare is a business and how we pay for the mortgage. However, different from other industries, healthcare is a time-honored profession genuinely dedicated to helping others and OBLIGATED with saving lives and stomping out disease. Despite that heritage and DUTY healthcare has been cheapened, by any means necessary and at the cost of so much, into just another customer-driven service just to accommodate a few.
Again, healthcare is like no other industry, NONE! and
-the only industry with patients
-the only industry with OUR waiting room
-the only industry in which services are sought during some of the worse moments of our lives and during inconvenient times, for uncertain, unpredictable and volatile choices in places that are unknown, unpleasant and unforgiving
-the only industry where regardless of disposable income or time services are sought after and rendered
-the only industry whose workers maintain the public's confidence year after year as the public has recognizes us as the most honest profession and with the greatest ethical standard of any industry
-most notable, healthcare is the only industry where workers go to battle for every so-called customer and when so-called customers succumbs ”we cry for them as well as the overwhelming numbers of patient experiences are rewarding, for both healthcare workers and patients. However, because of their sheer volume those positive experiences become blurs of one another and unless they are remarkably extraordinary their details are consigned to oblivion.
Yet, the melodramas of the complaining minority are permanently etched in our memories, some physically scarred. It is that misery and frustration which drags us down, as we must navigate, ALONE, that exhausting minefield just to stay safe and/or keep our jobs. Reason enough as to why so many leave healthcare and not fatigue as no one fatigues from helping others.
So, yes, although I agree that healthcare is a business and like you agree that what matters are outcomes, and the safety of healthcare workers and patients I DO NOT agree that surveys should include whether "Your concerns were listened to" or any other subjective means. Healthcare has NOT benefitted, in any manner, from the rating of healthcare, although somewhere on this thread someone did mention rating healthcare has improved respect for patients and families from healthcare workers. Rating healthcare is ONLY about customer retention and profits, a business, and that is fine. However, ONE, that is NOT how it is sold to the public. TWO, all the money (BILLIONS), time and effort wasted chasing after satisfaction scores. THREE, it's not the rating that is the problem but the knee-jerk respond and sequel from administrators when a patient complains. And, FOUR, all the collateral damage left behind. Those are the problems, none new, well documented, and everyone is aware yet chose to look away.
As for customer satisfaction, in every industry, decade after decade, that needle has not moved either. The rating of customers, in ALL industries, is simply another industry that evolves without fixing the problem. It's like metabolic/respiratory compensation, it takes place but DOES NOT fix the problem.
Pardon the dissertation, just my passion.
You have this romanticized notion of healthcare and what it actually is. You want to go back to 100-150 years ago when the world was a 100% different place.
Do you think hospitals make money from ER visits or people on their medsurg floors? Nope. They usually lose money in that regard. They make their money from elective surgeries such a knee replacements, or hips. They make money from babies being delivered and from specialized care such as heart centers. Those are all people who have choices on where to go. In order to keep the ERs open to save lives, they have to draw in all the others. That is where patient satisfaction comes in. Think about it. When you say go shopping for food, you are looking at several things. Convenience, options, friendliness of staff, and say freshness of the food. Nobody wants expired food. It's kind if the same in healthcare. Can this hospital system meet all my needs, are they close to my house, are the nurses knowledgeable and friendly, and most important, can they fix my problem??
This isn't a cut and dry thing. There is so much that goes into those surveys and as I stated, they are asking the wrong questions and focusing on the wrong things. But in order for us to have jobs, hospitals must make money. And I can't tell you the amount of money that a hospital never sees I'm a year due to people with no insurance yet we give them the highest and best care possible as it should be. But in order to care for the less fortunate, money has to be made somewhere.
I'm a believer that if nurses are satisfied, enjoy their jobs and their colleagues, and have good leadership, then it will trickle down to patient care.
This a thousand times over.
Yay for me, I've used the quote button twice now and didn't blow it.
HCAHPS, if can believe it, began as an "incentive" to improve healthcare. A slippery slope, which healthcare administrators and pundits took the bait. I could go on, however, it would take some time to explain through this medium.
I will tell you this, the federal government saw the money they were saving on healthcare the federal government tried to impose similar consumer rating of colleges and universities only to be pushed back by college/university leaders, unlike healthcare, who pointed out the "misguided" consumer rating system was uncharacteristically clueless, quite wrongheaded, oversimplified to the point that it actually misleads and prioritized moneymaking.
If you ask me, ALL predictable and have been actualized in healthcare, not only with HCAHPS but with the private rating systems before, like Press Ganey, as well.
So, no, rating healthcare is NOT about healthcare. It is SOLELY about customer retention and profits. And that evidence, not conspiracy theories, is overwhelming. DON'T drink the Kool-Aide! Look me up and we can chat. The Knitted Brow.
Maybe you could say what you actually think is incorrect. The government does not pay out less in total due to HCHAPS, hospitals that fall in a broad average range don't have any change in their reimbursement, hospitals that fall well below average see a reduction in reimbursement by as much as 2%, and an equal number of hospitals that far exceed the average see an increase in reimbursement by as much as 2%.
It's possible to provide healthcare very well, and it's possible to provide it poorly, hospitals shouldn't be paid the same regardless of which of those two groups they are in, if that was the case then there would be no incentive to provide quality care or disincentive to provide bad care.
I would agree that the survey could use some work, but scanning through your posts I only noticed one example that you've provided of what you disagreed with, which was the question about whether or no staff listened to concerns. It's generally agreed that ignoring patient concerns potentially hinders their safety (I feel like my breathing is getting worse, I'm worried mom's going to get up without help and fall, etc).
The Knitted Brow
25 Posts
Did you hit the nail on the head or open a can of worms? A rhetorical question.
That said, customer satisfaction, or the lack thereof, in healthcare is my passion and I would enjoy having this conversation with you, if interested.