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?
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
adult patients don't need their families at the bedside 24/7, and the families do need to take care of themselves. any family member who tries to stay at the bedside 24/7 is going to suffer from sleep deprivation and become loony after a few days. it isn't necessary.
sometimes i think we should all band together and sue "redbook," "good housekeeping," "reader's digest," and any other magazine that has printed an article advising folks that if they love their family member they need to sit at the bedside and keep a notebook of all the care/caregivers to prevent the evil hospital from making a mistake that will kill their loved one. every time i read one of those articles, i get angry!
I am being to feel I should have gone into the business field, instead of nursing.
The administrators are always telling us " the customer is always right" Stop calling our patients "customers" It really gives the wrong impression of what a hospital setting is all about. I may be wrong but shouldn't we be trying to heal our patients and teach them how to take better care of themselves?
When I worked as a "disease manager" at Blue Cross, there was a lot of emphasis placed on their consideration that the employer is the customer/client, the employee/patient a necessary evil......... They're sick there!
""I am not a nurse yet, so probably shouldn't answer this, But I have volunteered and worked as an emt and at a hospital, so here is my $0.02. I don't mind kissing a little a$$, if it makes them more comfortable and helps them get better. I mean the milkshake thing was obviously just ridiculous, but if they want their family by their side at every hour, an extra blanket, the tv clicker or a coke I'm more than happy to help them out. Now that doesn't mean that they shouldn't ask nicely and be respectful, but as long as their request isn't just wayyy out of line, I'm more than happy to cowtail to their whims, I mean, they are paying and probably are already feeling miserable.""
Wait until up are the nurse and not the VOLUNTEER. Posted visiting hours have a purpose.. to allow the NURSE to so all the things that those 'customers' want us to do. Try bathing a patient after they had a bowel movement, and being told that it can wait by a family member until they leave, even tho its 1 hour past visiting hours. And dont think you will get support from your charge nurse. They abide by the brainwashing on 'customer care' as opposed to patient services. Its like a mantra over and over again.....
On my unit it is frequently the opposite,.......example: family member (daughter) spending the night with elderly father who was 4 days post surgery who had pulled his ng tube out day before, md had said leave it out and give him full liquids. Pt had complained of nausea and was given 4 mg zofran. Less than 1 hour later his 50 year old daughter comes out of the room, screaming, "help, help, HURRY PLEASE help my daddy. We all go running in, prepared to see he has fallen out of bed or stopped breathing, and he is setting up in the middle of the bed with barf all over him. Not a good thing but hardly a crisis. She has 4 RN's in the room. Another case in point, mother of a brain injured young man, calls out everytime her son passes gas for us to come change him. He is in hinged braces, so it takes a lot to roll him over and check him out, when I told her I was going to check him before I gathered a team to roll him over, she insisted I could not possibly check him without rolling him over. I explained to her how I was going to do it and she was none too happy. Thank goodness he didn't have diarrhea, we would have had to have kept a team at bedside costantly wiping him. As it was when he did have a bm, she didn't want us to let him have time to finish before we cleaned him up.
Those are the exception in my experience. Most of my family members have been very reasonable and appreciative,and some are extremely helpful. I often give them small jobs to do and increase it if the show interest and ability. I show them how to rotate podus boots, replace and hook up scd's, do mouth care and even suction if they are up to it. However some can freak out over the least things. I just explain what is going on, what I will do, comfort and support them, sometimes I have to set limits and do the best I can to care for the patient and my other pts at the same time. My first couple of weeks off orientation I had a couple of families ask not to have me again and it was because I was clumsey with the pumps, then a couple of patients have since asked not to have me because I wouldn't give prn narcs when HR was 45 or resp were 12. Fortunately my unit doesn't generally hold it against you, they just oblidge the patient/family by changing you and make sure the other nurse knows the gripes and quirks of the family. Most of the time I have families asking to have me back and many of them are considered the difficult families. I am sympathetic with lots of the "difficult" family members because my daughter was hospitalized 4 months with sepsis and was a horrible patient. We were all overtaxed to the max. We tried to be a "good family" but the situation was extremely stressful :banghead:and I am sure the nurses had to dread all of us and I was just in nursing school at the time.
""I am not a nurse yet, so probably shouldn't answer this, But I have volunteered and worked as an emt and at a hospital, so here is my $0.02. I don't mind kissing a little a$$, if it makes them more comfortable and helps them get better. I mean the milkshake thing was obviously just ridiculous, but if they want their family by their side at every hour, an extra blanket, the tv clicker or a coke I'm more than happy to help them out. Now that doesn't mean that they shouldn't ask nicely and be respectful, but as long as their request isn't just wayyy out of line, I'm more than happy to cowtail to their whims, I mean, they are paying and probably are already feeling miserable.""
Wait until up are the nurse and not the VOLUNTEER. Posted visiting hours have a purpose.. to allow the NURSE to so all the things that those 'customers' want us to do. Try bathing a patient after they had a bowel movement, and being told that it can wait by a family member until they leave, even tho its 1 hour past visiting hours. And dont think you will get support from your charge nurse. They abide by the brainwashing on 'customer care' as opposed to patient services. Its like a mantra over and over again.....
Yes, and Grey's Anatomy featuring the worst mistakes and staff conduct imaginable. (And the most random, remote possible outcomes are the status quo prognoses.) This show has become a dark comedy to me!
Re: Nursing a field of medicine or customer service. I think it is both as the quality of care given is decided by the client and client relatives. They want to be talked to in an assuring manner, need their interest to be protected, need to be carried along in the care-given while carrying out your responsibilities such as serving their medications, attending to their physical, psychologic and physiological needs and keeping all their transactions confidential.
I was told the other day by my director that healthcare is consumer driven and we WILL be doing handsprings to make the customer happy....!!!!! PERIOD!
Unfortunately, our area is loaded with good hospitals-our hospital is now seeing a huge influx from the inner city and the middle/upper classes are going elsewhere. They don't "want to be with those people" as I have heard maybe one hundred times or more during the past two years. I am not sure when the customer is always right became the patient is always right-but it has!
I suppose in the middle of nowhere or an area where you are the only game in town that hospital can practice the "right way", however like everywhere else in the country the consumer can make or break you. In our case that means losing insurance reimbursement and seeing medicaid, charity and self pays. Pretty scary.
Wow! Any one who has ever had a really sick family member in the hospital will feel differently. Yes, pts families can be a PITA, but you know what? They are scared! They need a little TLC. I must say that I have been really lucky about the way I have been treated when visiting. Luckily, I didn't have some of these posters as my family members nurse. As the visitor, I just want to make sure that my lived one is being well taken care of. I believe that the pts overall state of health should be considered when allowing visitors. Also, their culture. Some cultures, the daughter will not leave the side of the sick bed. That is their choice. The stress of being in the hospital can affect healing. If having a family member present helps alleviate some of this stress than good!
I don't think we should allow 10 people in the room at a time of course, and I limit them to 2...for the sake of other pts, and to allow me to get my work done.
I also let the of in during a code if they want. It helps them see that we are doing everything we can. It helps them change the code status if need be, and helps them move on. Of course they need to stay out of the way, and not be hysterical etc.
I guess my point is, I treat families and pts the way I would expect to be treated. I think other attitudes give nurses a bad rep! Oh, and if my son was in the hospital, there is NO WAY I'd leave his bed side! I wouldn't take my son somewhere that had a policy that didn't allow it!
Yeah my bil was in the ICU this week. Seriously my mil was mad that at the smaller hospital that they drew blood to find out why the hell he was bleeding everywhere. I had to explain, and her response was "He is bleeding and did they really have to take that much? That seems dumb since he is bleeding so much". I don't know how she expected the MD to treat when they had no clue what was going on. Were they supposed to guess his coags and treat?
I understand being scared, but there is a line between being concerned about making sure a loved one is cared for and being overbearing and unreasonable.
I don't think that just because someone is in the hospital that they need someone at their side 24/7. The patient needs a break too. There are pts that have expressed that to me at times and I try to explain to family that they need a break and they wont budge. Even when the pt tells them to go away.
I work in a neuro ICU and don't need family at the bedside 24/7 telling the pt to show 2 fingers and trying to arouse them. Those patients need rest and I do my best to explain that fact. They also need low stimulation to prevent ICP from rising and to keep it down, I need all the cooperation I can get and if that means kicking out visitors then so be it. I am not mean about it, but after the third time I have told you to leave your loved one alone that you can sit quitely, but talking and touching raises their ICP to dangerous levels I will make you leave to keep your loved one safe.
Family need to go home and take care of themselves too. I find that if they don't do that then they start becomming unreasonable and hard to deal with since they are so sleep deprived. You can't make the best decisions for your loved one when you are so sleep deprived.
I will let family stay when the patient is critical, but not sleep at the bedside. I will also let family stay with minor children, because I believe that having mom or dad there is a huge help. In the ICU we don't have the room to let a family member sleep at the bedside. When I worked the GPU I would let the family stay if minor child, the patient was confused and needed to be watched and the family was helping, the pt was dying, or if just wanted to and in a private room (not all rooms are private and if there was a visitor then no sorry they can't stay in room all night but can to go waiting room and in and out every hour or two as desired.).
We have 24 hour visitation in the ICU so there isn't really a need to campout at the bedside. If they go home for awhile and then comeback later then they will be allowed in as long as we aren't doing a procedure that requires privacy.
I hate to break it to you and all the others, but medicine, nursing, phlebotomy, et al, IS CUSTOMER SERVICE. (It has to be said!)
However, the patient is a team member, not the captain of the healthcare team. We are also members of the team, and if antagonism occurs, no one wins. Family members aren't so much spectators, as much as bench sitters. You're darn right they're scared - scared of being left on this not so friendly earth, without their loved one, and hoping decisions made in their cases are right. When they trust the caregivers, it all goes better.
And like it or not, their doctor is the captain, administration umpires, and extended family are there for the drama, and to support the nearest and dearest. They're kind of like the Greek chorus. They lose the right key when sleep deprived; and are driven to stay, in case they were home sleeping (as if they could) when something defining happened.
I agree with limiting the number of warm (?sweaty) bodies in the close vicinity of the patient, and depending on their backgrounds, families can be a strange bunch, yet they, you, everyone has one thing in common - caring about the patient and investing in the right thing being done. I agree that the patient shouldn't be "aroused" (see "grammar" thread), as there's nothing appropriate to do with that. It's too bad we don't have to fold dressings anymore, or we could give families that to do.
Most CCU/ICUs have a waiting area with coffee and tea available, near the door of the unit, for families of unstable patients to crash, and that can be where they sleep, instead of the bedside. They need to know that within an instant of being called, they can be at the side of their relative; and they need repeated explanations, because high emotions tend to do something nasty to perception.
With you using your "inside voice" saying you understand their concern and assurance that they'll be told of any good or bad change in condition, using earnest eye contact, things will even out. Your tone and calm will spread to them. They may even tell administration how wonderful you were to them.........
Patients are invested in their family's well being, and intuitively sense upset in their loved ones - hearing being the last thing to go. When they hear calm return to the voices of those they love, they don't have to understand the words. They know everyone is in good hands, and their "supreme being" is there.
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Ruby Vee, BSN
17 Articles; 14,051 Posts
adult patients don't need their families at the bedside 24/7, and the families do need to take care of themselves. any family member who tries to stay at the bedside 24/7 is going to suffer from sleep deprivation and become loony after a few days. it isn't necessary.
sometimes i think we should all band together and sue "redbook," "good housekeeping," "reader's digest," and any other magazine that has printed an article advising folks that if they love their family member they need to sit at the bedside and keep a notebook of all the care/caregivers to prevent the evil hospital from making a mistake that will kill their loved one. every time i read one of those articles, i get angry!