I'm sorry, but I didn't realize I signed up to please the customer. While the nurses go around reminding the patients this is a hospital, not a hotel, we get notices that we SHOULD make these people feel like they're in a hotel. Or "even if you know they're wrong, you should apologize and let them know that they're right" THIS IS AN ACTUAL MEMO THAT APPEARED IN MY MAILBOX.
... oh but it gets worse.
I got tapped on the shoulder by the "hospital customer service rep" telling me this patient (customer) really really wants a milkshake and would really make her day if she could have a milkshake. And I tell this rep this patient just had a bowel resection yesterday and not only can she NOT have a milkshake, but she probably can't even have water, even ice, for the next couple days. I spend all day listening to this patient whine and complain, and now the hospital has provided her a rep to follow me out in the hallway to whine and complain. And neither of them can admit that although a milkshake would make the patient really happy for about 15 mins, going back to surgery and prolonging the recovery would not. I know there's a lot of things in the medical field that seem downright cruel. But if we go by "the customer is always right" keep the patient/customer happy, there will be consequences.
Should customer service be #1 priority? Or am I just being delusional believing that patient safety is more important than patient satisfaction?
You didn't see "Sully" the US Air pilot lose it when his plane was crashing. He kept his cool and got the job done. That's first class professionalism.
Did you see passengers knocking on the cockpit door demanding that Sully interrupt the safe landing of the crashing plane to bring them extra pillows and blankets?
THEY (TPTB) APOLOGIZED!! WHATWHATWHAT?!? SO LAME!! The only apology necessary is hers; to me, and especially to my other pts. But she's the "customer", and the customer is always right..right? WRONG! And that is the problem I have with "customer service". Ridiculous.:icon_roll
And what they needed to do was say that you were not providing 1:1 patient care however, if she wanted to pay for that she was welcome to.
no, you are not delusional...you just don't understand the concept of patient care-or to use another term, "customer service". hmmm, wonder why your patient was cranky and whiney??? do you think it might have had something to do with the fact that he/she was physically, emotionally, psychologically and spiritually vulnerable as well as isolated? do you think it might have had something to do with the patient picking up on the the non-verbal messages you were conveying? do you think the patient might have been hurting...and i mean experiencing pain in a way that was new and frightening.
your handling of the customer service rep. made me wonder what are your expectations of your role as a healthcare professional. . regarding the cust. service rep...it's easy. using whatever verbal skills you posess, you might have thanked her for trying to make your patient more comfortable and at the same time educated her. then your next move would have been to let your charge nurse know that the customer serv. rep.'s mgr. needed to know what had happened. see, no one gets mad, it is an educational experience for you as well as for the serv. rep. and adds to the whole concept of patient safety. hmmm! nursing is a profession that requires advanced scientific and theoretical knowlege. in addition, it requires maturity, maturity and maturity. putting all of that together we then are able to provide safe, empathetic (look it up) and professional care.
lest you think i am a pollyanna...i have been an rn for 28 years, lpn for 10 years and was a "na" for 5 years. (that was before "cna".) i have worked in everything from a very,very rural hospital in the state of hawaii (one bed er, 50 miles from a community hospital)to managing the third largest level one trauma center (ed) in the state of california. i have worked med/surg, ccu/tele and every other kind of nursng except or. i have been a director of ed's and a nursing supervisor. i have worked with gang members who spent there time thinking up new names to call us (fresno, ca), different ethnic groups that initially didn't trust me because of the color of of my skin (hawaii), peers that initially didn't trust me because i have continued attending conferences on many subjects even though i have lived in states with no ceu requirements (hawaii, az, wa) for licensure.
i have spent the majority of my career dealing with issues that are caused by rn's that exhude your attitude. my suggestion is to move into another area of nursing rather than direct provision of patient care.
in my career i have worked with lots of staff and patients; nice people, scared people, angry people, happy people, grateful people, ungrateful people, getting well people and dying people. focusing on those folks who are/ were staff i have worked with passionate people, from all areas of the hospital...and it has been a privilige. catherine m. meadows rn
catherine-
brava, well said. i've been where you've been (na to rn, started as an na in '71) and you are right on! it is all about professionalism, something that seems to be in very short supply these days in many professions, nursing included. customer service, to our patients, families, and outside providers (external customers) and to our coworkers (internal customers) is not a new concept, just new language to nursing. formerly it was called common courtesy and respect for others. we would all benefit from more of it.
It is both. I too have many years in nursing starting as a Pinkie(we did pt. care-Candystripers were volunteers), Nurses Aide, Student Nurse, and a BSN grad in 1975. I have seen many changes over the years-good and bad. (when the Docs come on the floor, they now get their own charts!!!-good change). We do have much sicker patients and yes we have pts. and families who want to call the shots, who never appreciate anything AND we have cooperative and grateful ones also. What has been a great and ever growing divide is between Nsing. Administrators and the staff nurses who are "in the trenches". They need for us to get high patient satisfaction scores so they will look good to their non-nursing administrators. We are often understaffed for the complexity of the patients we get and trying to be "everything" to "everyone" is taking a toll on those of us giving direct pt. care.
The lady who whined for the milkshake, when we face situations like that, staff will comment, "there goes our pt. satisfaction score for the month". No administrator wants to hear about a grumpy ,unreasonable pt. but they are quick to point out if our scores went down. We can do everthing right AND with a good attitude, but if a pt. isn't happy b/c of unreasonable expectations, we can get a poor score b/c the pt. felt we weren't helpful. Thank goodness that these pts. are not in the majority! But maybe for some of you they are.
It is interesting to note that the majority of Docs in Administrative positions also have Clinical responsibilities in our Medical University Hospital and Teaching Center. They interact with Patients so they better understand our position as the bedside care givers Administrative Nurses do not . We were "drowning" one night, understaffed, no sec.at the desk to answer pt. call bells and no CNA(nurses aide) and I was DESPERATE!!! I decided to call the Nursing house supervisor to ask if SHE could please come and take some vitals on Q4hr. pts. as we were hanging Blood on 2 pts., plus assesments ,meds, treatments etc.(earlier we were told we could not get any extra staffing) so I thought, HECK, she could give some time to help us be safe plus maybe she would see how things play out on our unit on a reg basis. She said,"NO", she did not do that! (when our residents face difficult or emergent situations, they can call in the Attending and Faculty who respond And know how to help out).
So you take that plus some demanding patients and we wonder why we get stressed. Does that mean we don't have a calling? Or that we should leave nursing b/c we get frustrated? Does it mean we don't care about pt. satisfaction or we don't care if a patient gets upset about the the care we must give to make them well?. Just as grumpy, demanding pts. may be scared or have reasons for their behavior, behind our Professional face when communicating about the patients Plan of Care, we are scared too, because we see the storm and the sinking ship and we feel helpless. If some Nsing administrators don't have a shift or 2 a week on the floor or in a Unit, to help them understand what we face daily, their definition of Patient Satisfaction will conflict with our understanding that giving good, safe care is our top priority even if the pt. isn't always happy about it.
" I have also had patients families that say, "Mother will be needing her backrub around nine...please make sure your hands are warm"."
HA HA HA!!! This made me laugh for so many reasons!!! I remember a thousand years ago when we did PM care and gave backrubs. How we practiced the strokes in the skills lab to learn them. We made it all so professional but how I detested giving backrubs! It just seemed way too intimate for me. I am not a massage therapist. I am a NURSE. I would rather give an enema than a backrub. Weird? Maybe so, but unless you are immobile and vulnerable, you are not getting a backrub from me. What a waste of nursing time!!!
" i have also had patients families that say, "mother will be needing her backrub around nine...please make sure your hands are warm"."
ha ha ha!!! this made me laugh for so many reasons!!! i remember a thousand years ago when we did pm care and gave backrubs. how we practiced the strokes in the skills lab to learn them. we made it all so professional but how i detested giving backrubs! it just seemed way too intimate for me. i am not a massage therapist. i am a nurse. i would rather give an enema than a backrub. weird? maybe so, but unless you are immobile and vulnerable, you are not getting a backrub from me. what a waste of nursing time!!!
sorry, my personal gripe.
wow. i guess i am just some kind of dinosaur or something. i too remember doing pm care and giving backrubs but i remember it a bit differently. i remember how much all of my patients appreciated it. i remember how much more relaxed they were, how much better they seemed to sleep, how much better their pain meds worked. no, i'm not a massage therapist, i'm a nurse. on my license it says that i am a "registered professional nurse" and that's how i see myself. that includes doing whatever kind of personal care will help my patients get better...not just the high tech stuff though that is certainly important.
i'll share something else too: when i was a patient last summer i would have loved having one, just one, nurse who care enough about my wellbeing to even offer to do something simple like give me a backrub. unfortunately, the nurses who "cared" for me were much too busy looking after my iv pumps, etc. so busy in fact that they failed to ever assess my lungs adequately. they also managed to make several major medication errors and did not control my post-op pain. btw, this was in a hospital that is "one of the top 5 in the us" according to recent news reports.
I would LOVE to give my patients backrubs, listen to all their war stories, gain insight and advice for life from them, and basically just interact with them a whole lot more. But our hospital system does not allow this. It sets me up for failure. For the last two weeks, I've had six patients every day, each of which were either circling the drain or jump-out-the-window crazy. Now, I don't know about yall, but for me, it's hard enough trying to be in six places at once, because they are all needing something at the same time. It seems that on the days when we have the highest acuity patients, that's when they pull our aides to other floors. "No, I'm sorry, I haven't noticed the respiratory depression in pt A, because I've been cleaning poo on patient B for the last 30 minutes because every time I clean him up, he goes again. And we only have one aide today."
Maybe I'm just sensitive, but the unspoken message I think I am getting from mgmt is: "We don't care how intense the patients are, and in fact, if they are more intense, you will get less help. We don't care if you are safe at work. If you got stabbed, it would be a huge inconvenience to us. Don't ask for help, because you will get thrown under the bus for asking. Also, we don't care what you have to do to get those pt satisfaction scores, you get them, or we will have your job."
This is just my perception of how it feels. And as a new nurse, this is more stressful than I ever knew possible. Is it this way everywhere?
maybe it's different in smaller community hospitals, but in my large, inner city referral center hospital, family members camping out at the bedside are not only not helpful, many of them are downright menaces! some of them menace the nursing staff, others of them are detrimental to patient care and some truly colorful individuals manage both at the same time.
i've had family members shooting up the patients, threatening to shoot the patients and more than one attack or attempted attack with a sharp, pointy object. i've had family members threatening the nurse with knives, stealing our wallets, setting attack dogs on the nurse (great security we have here -- they let the dog in!), threatening nurses with guns and a good friend of mine was shot in the ass. (ok, the patient actually shot him, but his rocket scientist of a family member brought in the gun). i've had family members leaving their children with granny in the ccu for granny to watch while they went out and had their fun. (granny was actively infarcting at the time.) i've had agorophobic visitors who won't leave the bedside and require just as much care as the patient. i've had spouses of patients dumped at the bedside by their children because "mom has dementia and i can't watch her, so i'll leave her here with dad and the nurses can watch her". you'd be surprised how often that happens.
there are helpful and supportive family members, but they seem to be the exception rather than the rule -- at least here.
omg! all i could think, reading this post, is that your hospital needs metal detectors at each entrance and stairwell, security clearance like courts and airports have, and security guards at each corner. but would insurance companies pay more for hospitalization at high risk facilities? i doubt it!
wow. i guess i am just some kind of dinosaur or something. i too remember doing pm care and giving backrubs but i remember it a bit differently. i remember how much all of my patients appreciated it. i remember how much more relaxed they were, how much better they seemed to sleep, how much better their pain meds worked. no, i'm not a massage therapist, i'm a nurse. on my license it says that i am a "registered professional nurse" and that's how i see myself. that includes doing whatever kind of personal care will help my patients get better...not just the high tech stuff though that is certainly important.
i'll share something else too: when i was a patient last summer i would have loved having one, just one, nurse who care enough about my wellbeing to even offer to do something simple like give me a backrub. unfortunately, the nurses who "cared" for me were much too busy looking after my iv pumps, etc. so busy in fact that they failed to ever assess my lungs adequately. they also managed to make several major medication errors and did not control my post-op pain. btw, this was in a hospital that is "one of the top 5 in the us" according to recent news reports.
now that's what family members could do - back rubs! however, they'd probably complain that it's what we're being paid to do, if we suggested it..........
Well, it's not the field of medicine or customer service...it's nursing. Like Whispera said, it is a caring profession, but that doesn't mean we have to wait on people hand & foot. Sometimes a little "tough love" is better for the patient, like the super needy patient that calls you in to the room to ask you to cover them up with the blanket that is at the foot of their bed. Unless they have a legitamite reason for not being able to reach down to their feet and get that blanket (or do whatever it is they are asking), I explain to them that they need to get their independence back and must be an active participant in their healthcare. I encourage them to do as much for themselves within the realm of patient safety, because when they get out of my unit (a typical med/surg unit) they will be on their own at home. They don't often like my answer, but I am a nurse, not a maid or a waitress, even though I do those things when my job requires it.
That is OBSURD that your management has been telling you that even if the patient is wrong you should tell them they are right. What about being tactfully honest with the patient! Isn't it our responsiblity to be honest with the patient, even if they don't like it. My last patient admitted for "atypical chest pain" did not like the lecture I gave him about his current Atkins diet. I also printed some research off the internet for him that I'm sure he didn't like, but it's at least in the best interest of the patient!
That's how it feels at my hospital too! We recently have been getting more high acuity patients and lots of staff has been leaving. The more the nurses speak out about the high risk we are putting patient's in and other poor processes we have here, the more we seem to get shut out by our own management!
wow. i guess i am just some kind of dinosaur or something. i too remember doing pm care and giving backrubs but i remember it a bit differently. i remember how much all of my patients appreciated it. i remember how much more relaxed they were, how much better they seemed to sleep, how much better their pain meds worked. no, i'm not a massage therapist, i'm a nurse. on my license it says that i am a "registered professional nurse" and that's how i see myself. that includes doing whatever kind of personal care will help my patients get better...not just the high tech stuff though that is certainly important.
i'll share something else too: when i was a patient last summer i would have loved having one, just one, nurse who care enough about my wellbeing to even offer to do something simple like give me a backrub. unfortunately, the nurses who "cared" for me were much too busy looking after my iv pumps, etc. so busy in fact that they failed to ever assess my lungs adequately. they also managed to make several major medication errors and did not control my post-op pain. btw, this was in a hospital that is "one of the top 5 in the us" according to recent news reports.
not sure where you work, but if you can adequately provide safe nursing care, medication administrations (usually 150 meds or so a shift), treatments like peritoneal dialysis, heparin drips, dopamine drips, handle acute mis and give backrubs on nine telemetry patients, a big fat kudos to you.
in my world, i can't. and backrubs is the only thing i can cut out and not have someone die.
SO LAME!! The only apology necessary is hers; to me, and especially to my other pts. But she's the "customer", and the customer is always right..right? WRONG! And that is the problem I have with "customer service". Ridiculous.:icon_roll
Virgo_RN, BSN, RN
3,543 Posts
Did you see passengers knocking on the cockpit door demanding that Sully interrupt the safe landing of the crashing plane to bring them extra pillows and blankets?