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?
If anyone was sincerely interested in research based patient care, then health care would be moving in a different direction.
Have you noticed how many posts on this board are coming from good people in a bad situation? It's not that the wrong people are in this profession - and yes, I do believe if you spend so much time in school it should be called a profession.
For me, it comes down to staffing and respect.
1. I would be able to do a backrub if I wasn't rushed off my feet. Doing a backrub for one patient would cause another patient to go south or die for a lot of us. We have too many patients at a much higher acuity than even 10 years ago.
2. Respect - I don't need the please and thank yous, but I don't need to be yelled at or belittled every time I show up for work. It's abuse. The reasons for the the yelling - see point no. 1. Yes, nurses should be doing a lot more for patients and there I agree with you. However, at sub acute level I have four minutes out of every hour for each patient. Good care aint gonna happen at that ratio.
I love the way that (the more difficult) patients and families are all about their "rights" but never seem to follow their "responsibilities". We actually used to have a placard in every patient's room with said "Patient's Rights and Responsibilities". When we remodeled the unit they disappeared. I have a copy from when I took our son to the ED at a hospital in the same system as I work in...
"Patients have the responsibility to...
Accept consequences for the outcomes if they do not follow the care, treatment, and service plan.
Follow the hospital's rules and regulations.
Respect the property, privacy, dignity, and confidentiality of other patients and others in the hospital.
Respect hospital staff and property and help control noise."
Some people, I really wish I could say "I will respect your rights if you will respect your responsibilities."
And then I had the patient who just got diagnosed with metastatic ca and her family who were "please" and "thank you" and "if you don't mind, when you get a chance, there's no hurry". It made me want to cry. Here's this patient and family who by rights should be getting more of my attention, and I can't give it to them b/c I have five crazy family members up my butt for the other patient. You just can't win.
And we have our day charge nurses rounding now to ask the patients if they are getting 5 out of 5 care. And writing on the board in the patient's room what needs to be done to get that 5 out of 5. I can understand the rationale behind this, but when I go into a room and see that a patient has rated us at a 3 b/c their breakfast tray met their diet restrictions or b/c they are on a fluid restriction, it makes me want to bang my head against the nearest wall.
Too bad they didn't keep that sign because it would be good for patients and visitors to see.
You've also touched on one of the reasons surveys are a joke. Nurses are held accountable for things they have no control of...meals, doctor's orders, quality of pillows, thin blankets, etc. We don't make the meals and we don't order the blankets so why we would be judged on that is absurd.
And you've also touched on why customer service doesn't belong in nursing but patient care does. The things we do...restricted diet and fluids, getting them out of bed after surgery, foleys, etc. don't make patients happy. They take it out on us because they have no one else to take it out on which I understand. What some facilities however don't get is when I do these things and keep patients healthy and on the road to recovery I am in fact providing excellent patient care which is my job. If I wanted to keep the "customer" happy i would throw all restrictions out the window and let them do what they want but that's not my job...helping the patient heal is what I do.
it makes me very afraid when a bedside nurse is not interested in finding out about research based nursing care. this is evidence based practice in action. if you don't think it is pertinent, you should contribute something that is.
truthfully, i can read all that is pertinent in the ajn in less then 5 minutes. the rest is fluff and advertisement. i truly find little substance to it. where in the past it used to be an excellent resource magazine. it changed about 10 to 12 years ago. very sad.
Nurse B) Was a good and efficient nurse but had also a very warm personality. Wasn't rude, wasn't over bearing, showed that she cared about you, called you by name, asked you more then just the standard question for her report. Took the time to ask if you were hungy, would like some more water, wanted her to take your tray and so on. Took that extra step to make sure that you were happy, it wasn't even ass kissing, it was simply human understanding and compassion. Was essential there to "nurse" you back to health, not just physically but emotionally. THIS is the kind of nurse I want to be! THIS is the type of nurse I think everyone should have. I can not tell you what a world of difference it makes to have a nurse like this. To me this is what nursing is all about. Absolutely it is customer service, but not because you want the customer to buy a product. It's because You have a genuwine care and concern for people and you want to help them get better in times where that extra effort takes away the fears and anxiety they are already dealing with.
Would you believe I am a "Nurse B"? I don't equate this with "customer service", I equate it with "nursing". I think part of the problem with conflicting points of view in this thread comes down to no agreed upon definition of "customer service". Those of us that see the trend toward "customer satisfaction" as a measure of the quality of care provided by an institution as a detriment to professional nursing are not necessarily cold, uncaring, robot like, task oriented. I think this comparison is what I chafe at most in this thread.
See, I equate "customer service" with working retail, in fast food, waiting tables, that sort of thing. In those environments, one's job IS to make people happy. Nursing, IMO, is a profession, not just a job. Part of being a professional nurse *is* to care for the whole person, not just perform tasks, but making them happy is not the sole focus. Helping them to heal physically, emotionally, and spiritually is. However, this does not equate to "customer service" to me. It's nursing 101.
People want what they want when they want it. They don't like being told "No". Nurses are often in a position of having to say "No" and respectfully explaining why. The problem is when nurses, in the name of customer service, are not backed up in making the right nursing judgment call, a judgment call that is often based on evidence; i.e. evidence based practice. This is what the OP is about.
In acute care, we have to prioritize. Sometimes, a patient's warm blanket or request for Jello is NOT my priority because another patient is having chest pain or is in respiratory distress. Sometimes, a patient wants something that I cannot ethically, in my professional nursing judgment, let them have.
What I would like to see in this thread is that we stop equating nurses that are dissatisfied with the direction health care is going with being "surly", "cold and uncaring", or in the wrong profession. That has to stop. It is divisive and chips away at any sense of unity that nurses might have as colleagues.
If we didn't care about being good nurses, we'd just go along with what we see as destructive to our profession without a second thought.
Truthfully, I can read all that is pertinent in the AJN in less then 5 minutes. the rest is fluff and advertisement. I truly find little substance to it. Where in the past it used to be an excellent resource magazine. It changed about 10 to 12 years ago. Very sad.
i think i stopped reading closer to 20 yrs....very little bedside stuff, mostly politics...just not my cup of tea
i think i stopped reading closer to 20 yrs....very little bedside stuff, mostly politics...just not my cup of tea
until we all realize that the politics of nursing is important then nothing is going to change. the docs, the hospitals, the insurance companies have each had a powerful lobby in dc and the state capitols for years speaking for them and getting the public to see things their way. we nurses on the other hand have been at the bedside providing care, working our tails off, and then complaining about how no one gets it. if we don't all speak with one voice through our professional organizations no one ever will get it. only very recently have nurses gotten "a place at the table."
ajn is just one professional journal, one of several that i personally subscribe to from one of several professional organizations general and specific that i belong to. every one of us has the professional responsibility to stand up and be heard through our professional organizations to make things better for our patients and for all of us too!
until we all realize that the politics of nursing is important then nothing is going to change. the docs, the hospitals, the insurance companies have each had a powerful lobby in dc and the state capitols for years speaking for them and getting the public to see things their way. we nurses on the other hand have been at the bedside providing care, working our tails off, and then complaining about how no one gets it. if we don't all speak with one voice through our professional organizations no one ever will get it. only very recently have nurses gotten "a place at the table."
my opinion of washington is that is is not a place at the table but a place at the swilling trough. and those that are there to represent us are not necessarily nurses but professional swillers. and the nurses that are there have not nursed in a few decades, therefore how do they represent us.
my opinion of washington is that is is not a place at the table but a place at the swilling trough. and those that are there to represent us are not necessarily nurses but professional swillers. and the nurses that are there have not nursed in a few decades, therefore how do they represent us.
until we all realize that the politics of nursing is important then nothing is going to change. the docs, the hospitals, the insurance companies have each had a powerful lobby in dc and the state capitols for years speaking for them and getting the public to see things their way. we nurses on the other hand have been at the bedside providing care, working our tails off, and then complaining about how no one gets it. if we don't all speak with one voice through our professional organizations no one ever will get it. only very recently have nurses gotten "a place at the table."
my opinion of washington is that is is not a place at the table but a place at the swilling trough. and those that are there to represent us are not necessarily nurses but professional swillers. and the nurses that are there have not nursed in a few decades, therefore how do they represent us.
i was going to respond, but i see you have done a very adequate job of it!!!
it appears that effie has to right, and i dont think there is anyway she is going to see what most other persons are posting about......
until we all realize that the politics of nursing is important then nothing is going to change. the docs, the hospitals, the insurance companies have each had a powerful lobby in dc and the state capitols for years speaking for them and getting the public to see things their way. we nurses on the other hand have been at the bedside providing care, working our tails off, and then complaining about how no one gets it. if we don't all speak with one voice through our professional organizations no one ever will get it. only very recently have nurses gotten "a place at the table."
i see what you're saying, but a huge part of the problem is the whole "one voice" part. as you can see, evidenced by this thread, there is a huge chasm among nurses as a profession. we have an entire camp that states that those here chafing at a "customer service" role for nurses are "bitter" and "should find a new profession". well, i take exception. i can only speak for myself, but i am a kind, caring, and professional nurse. i do my best to treat each of my patients with the respect and dignity they deserve. i'd bet you could say the same of almost every other nurse here who has a problem with this. my role being what it is, sometimes will lead to people not liking what i am asking of them, or the things that i have to do. the very nature of good customer service, is that the customer is always right. well, in healthcare, that is an impossibility. so to try and meld them is ludicrous. so until we can try to find a common ground about these types of issues, our voice will continue to be weak. in addition to that, not a single policymaker in my hospital (read-nurse management) has been at the bedside in more that 10-20 years. they are out of touch, and don't speak for me. there are a couple that sympathize, but their job is to look after the bottom line,so they won't do anything for fear of losing their own jobs-much easier to go with the flow, and let the bean counters make the decisions. i imagine it's the same way in washington. so i don't feel too hopeful.
I see what you're saying, but a huge part of the problem is the whole "one voice" part. As you can see, evidenced by this thread, there is a huge chasm among nurses as a profession. We have an entire camp that states that those here chafing at a "customer service" role for nurses are "bitter" and "should find a new profession". Well, I take exception. I can only speak for myself, but I am a kind, caring, and professional nurse. I do my best to treat each of my patients with the respect and dignity they deserve. I'd bet you could say the same of almost every other nurse here who has a problem with this. My role being what it is, sometimes will lead to people not liking what I am asking of them, or the things that I have to do. The very nature of good customer service, is that the customer is always right. Well, in healthcare, that is an impossibility. So to try and meld them is ludicrous. So until we can try to find a common ground about these types of issues, our voice will continue to be weak. In addition to that, not a single policymaker in my hospital (read-nurse management) has been at the bedside in more that 10-20 years. They are out of touch, and don't speak for me. There are a couple that sympathize, but their job is to look after the bottom line,so they won't do anything for fear of losing their own jobs-much easier to go with the flow, and let the bean counters make the decisions. I imagine it's the same way in Washington. So I don't feel too hopeful.
StNeotser, ASN, RN
963 Posts
If anyone was sincerely interested in research based patient care, then health care would be moving in a different direction.
Have you noticed how many posts on this board are coming from good people in a bad situation? It's not that the wrong people are in this profession - and yes, I do believe if you spend so much time in school it should be called a profession.
For me, it comes down to staffing and respect.
1. I would be able to do a backrub if I wasn't rushed off my feet. Doing a backrub for one patient would cause another patient to go south or die for a lot of us. We have too many patients at a much higher acuity than even 10 years ago.
2. Respect - I don't need the please and thank yous, but I don't need to be yelled at or belittled every time I show up for work. It's abuse. The reasons for the the yelling - see point no. 1. Yes, nurses should be doing a lot more for patients and there I agree with you. However, at sub acute level I have four minutes out of every hour for each patient. Good care aint gonna happen at that ratio.