Nurses providing good "service"?

[SoundofMusic]

Our manager now routinely posts emails in which she reiterates what the "customers" (meaning the patients) are saying about the "service" we provide, and how we can improve it.

Funny, I thought what I was supposed to provide was HEALTHCARE/nursing care to the patient!

If I wanted to provide service, I could go be a waitress in a restaurant somewhere, or perhaps go be a bank teller, or a retail provider.

I'm not even sure that this "service" requires a nursing degree anymore. If I am only judged by how quickly I can answer a call bell, or how great I can "get along" with a patient/client -- then what did I get this BSN for??

It just gets more ridiculous every day.

[flightnurse2b, LPN]

Sometimes it seems like it doesn't matter if you give good patient care or not. If the patient/family/administration's butts are kissed, and the correct forms and boxes are checked, who cares if someone dies? Yes, seriously, this is how it is at times.

For example, the other night we worked our butts off trying to save a 48-year-old who kept coding. Someone who was restocking the code cart took note that we accidentally left a spiked (but unused) amp of epi in the cart when we closed it up. Keep in mind there is no needle on this syringe. They took their precious time to take a picture of said syringe and sent it to our manager. Instead of a gentle reminder which could have been prefaced with "I know you had a rough night working to save so and so, but could you please remember to take open items off the code cart?"... nope we got a nastygram because apparently it's more important to please someone else in another department than save the patient. *sigh*

i had a patient last time i worked that when i came in had a blood glucose of 696.

i called the doc and got orders for more insulin and was checking the pt's accucheck every hour.

pt's mom comes in and brings the patient a freaking coffee coolata, which he proceeds to guzzle.

i walk in the room, educate mom on the coffee coolata and explain to the patient that it is not a very good choice to have that right now since his blood glucose is dangerously high.

mom says its important he drinks the whole thing because we are overdosing him on insulin and he needs to keep his glucose levels up. she tells me to stop interfering with her judgement because she has been taking care of him for almost 50 years (guy has IDDM, mom never treated it when he was a child, now he is on dialysis and dying of renal failure).

i get e-mail from director saying that mom said i was rude and i need to remember the patients are the customers.

rude, no. i did probably sound a little miffed since the blood glucose ended up reminaing over 500 and i kept having to call the doctor back to try and control this sugar in the middle of the night.

hmph.

[Batman24]

We call them patients and it will be a cold day in hell before I call them customers. They are patients in the hospital needing 24 hour care. And while I want everyone to love their meals and the pillows it's not my top priority nor should it be.

[PICNICRN, BSN, RN]

i had a patient last time i worked that when i came in had a blood glucose of 696.

i called the doc and got orders for more insulin and was checking the pt's accucheck every hour.

pt's mom comes in and brings the patient a freaking coffee coolata, which he proceeds to guzzle.

i walk in the room, educate mom on the coffee coolata and explain to the patient that it is not a very good choice to have that right now since his blood glucose is dangerously high.

mom says its important he drinks the whole thing because we are overdosing him on insulin and he needs to keep his glucose levels up. she tells me to stop interfering with her judgement because she has been taking care of him for almost 50 years (guy has IDDM, mom never treated it when he was a child, now he is on dialysis and dying of renal failure).

i get e-mail from director saying that mom said i was rude and i need to remember the patients are the customers.

rude, no. i did probably sound a little miffed since the blood glucose ended up reminaing over 500 and i kept having to call the doctor back to try and control this sugar in the middle of the night.

hmph.

Isn't that great!?! Momma has such great judgement and knowlege of IDDM that he is a noncompliant dialysis pt! Perhaps she should just take care of him at home from now on since you obviously don't know what you are doing! How dare you deny that poor man of his coolata- I see some pretty low "customer satisfaction" scores comming your way:banghead:

oh, and sounds like some great support from your management team!

[Batman24]

Instead of introducing yourself as the nurse introduce yourself as the customer service rep and see how they respond to it. Let your employer know you are just trying to let the customer know you are there to service them. lol

If I am in customer service I hope they start tipping me for extra pillows and ice. lol

[86toronado, BSN, RN]

This is a 100% true story: I once walked into a patient's room to find her struggling to breath, blue lips, O2 sat in the low 70's. I helped her back into bed, got her nurse (I was a tech at the time), and stayed with her, monitoring her sats until she was maintaining in the 90's. Want to know what she said to me, the first words out of her mouth after I had literally just saved her life? "This place is terrible! Will you look at me? My gown is filthy, my bed sheets are a mess, and all you're doing is standing there not even helping me!" I wonder how our Press Ganey survey from her looked...

For the most part patients have absolutely no clue.

[SoundofMusic]

I don't think they realize how much mental energy this takes all day long, especially with 4 or more patients. It's mental time and energy spent that SHOULD be spent thinking about the patient's labs, orders, condition, assessment, etc. Those things you just seem to "squeeze in" nowadays, while the customer service portion gobbles up the entire focus.

It's all our manager cares about, it seems. We don't discuss anything clinical. It's all about rounding, treating the patient "like your own family member," (which, I'm sorry -- they are not), about using "key" words -- I mean, it's really silly if you start to think about it.

I had a lady the other morning who was livid that I was waking her up to take her 6 a.m. meds. Every single day she'd go off on me -- "I don't get this place . . . why are you DOING this to me? she'd snarl as I'd give her scheduled heparin shots and synthroid. I mean -- sorry, lady, YOU showed up here, wanting to be treated. What did you expect?? What do any of them expect?

[*ac*]

Sometimes I want to scream at the top of my lungs, There is NOTHING, NOTHING I can do about the food!!

And I really, really wish I did not have call dietary every single time I work and suck up in a high pitched voice to convince them to pretty-please send up a tray THEY missed. WHY is this a nursing responsibility??

[flightnurse2b, LPN]

I don't think they realize how much mental energy this takes all day long, especially with 4 or more patients. It's mental time and energy spent that SHOULD be spent thinking about the patient's labs, orders, condition, assessment, etc. Those things you just seem to "squeeze in" nowadays, while the customer service portion gobbles up the entire focus.

It's all our manager cares about, it seems. We don't discuss anything clinical. It's all about rounding, treating the patient "like your own family member," (which, I'm sorry -- they are not), about using "key" words -- I mean, it's really silly if you start to think about it.

I had a lady the other morning who was livid that I was waking her up to take her 6 a.m. meds. Every single day she'd go off on me -- "I don't get this place . . . why are you DOING this to me? she'd snarl as I'd give her scheduled heparin shots and synthroid. I mean -- sorry, lady, YOU showed up here, wanting to be treated. What did you expect?? What do any of them expect?

if i were to treat them like my own family member, i would tell them to comply with their treatment, not eat a bunch of crap, take their pills, and be nice to their nurses. last time my grandma was in the hospital she hollared at the nurse and was really mean to her. i wasn't there, but she called me to tell me about it right away, she told me the nurse treated her badly. i went up there and asked her why she was so mad and she said it's because the nurse put in an new IV and it hurt and she didn't need it because she already had one. OK, granny, the IV you had was 4 days old, you're on IVF, your BP is low, and your nurse didn't do it to hurt you. i found the nurse and personally apologized for her behavior.

if i wasn't a nurse though, and got this tearful phone call from my poor granny, i would have probably been like "oh that mean nurse! why did she do that to you!"... like so many of our patients and their family members do.

education is key, i think. not butt kissing.

[SoundofMusic]

Now that I think about it, I feel it's really just coddling patients and not asking them to take responsibility of any kind for their own welfare or care. It fits in with the push in our society to allow the irresponsible to be rewarded.

We constantly get drug users who do themselves almost to death, then come in, are put "on the protocol" and waited on hand and foot for a week. That is a REWARD for drug abuse!! To wait on a non-compliant diabetic for a week is a REWARD for non-compliance and a lack of personal responsibility.

A customer service focus really takes any sort of responsibility off the patient. It's all on us. We "fail" and they get to complain if things aren't right. It really is a total, total CROCK.

This sort of system is good for no one, except the corporate types who must be reaping profits of some kind. Not that national healthcare is going to fix this -- that is going to usher in all sorts of other problems, I'm afraid.

Don't know the answers, but it needs to stop. It's good for no one.

[sicushells, RN]

Our facility has a had a really big push for required educational "offerings" (read: non-clinical nurses who want to keep their jobs so they're making busy work for the rest of us). One class was about customer satisfaction, keeping people happy, blah blah blah. The educator said that, maybe ten years ago, we had managers for dietary that would round on each floor and make sure everything was okay, and pharmacy would round, and make sure they didn't miss any meds, and managers from housekeeping would make sure everything was cleaned. Then hospitals started becoming more 'cost-conscious' (translation: the nurse can do it!) and eliminated those positions because it's more effective to have the nurse do everything. So now we're responsible for trays being on time, rooms being cleaned appropriately, meds being delivered on time. The bottom-line of the class?

We're also responsible to make sure that the customer... oops, I meant patient, since they have healthcare needs and all, gets whatever they want. The stellar example from the "nurse" educator? ... "The patient wanted a Pepsi, and I asked the charge nurse what the chances of her getting that Pepsi were. The response was "It depends on the nurse", but People, it shouldn't! We should all be giving great care!!"

Umm.... hello? My hospital only serves Coca-Cola.