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?
I am not a nurse, but I just spent the last 10 years caring for my elderly parents, which necessitated a lot of time with them in hospitals.
It really bothered me to read the posts about limiting visiting time. We tried to keep at least one member of our family with my parents at all times, because the quality of care they got from the nursing staff was often horrible!
Some examples: My mother had bypass surgery, and the next day she still could not even sit up in bed without assistance. Her lunch was brought up to her room by the dietitician, and was left by her bedside...out of reach. It sat there for two hours without a nurse even chacking on my mother to see if she needed assistance. Mopm hdn't eaten in almost two days and was very hungry, but had to lie there with the food out of reach. She rang for the nurse, but they were doing a shift change, and said that they couldn't help her for an hour, at minimum.
Another example. My mom (heart patient) was not allowed to get up without assistance, so she rang for the nurse to help her go to the restroom. It was 45 minutes before the nirse came, at which time my mother was sitting, wet, cold and miserable, in a pool of urine. How humiliating for her!
Another example. My mom is on blood thinnners. A lab tech came and drew blood, but did not apply pressure to the draw site. She left the room, and my mom had blood dripping from her arm. She rang for the nurse, and it was 30 minutes later before one came. There was a large puddle of blood on the bed, floor, and my mom's gown by that time. She's anemic, and this blood loss certainly didn't help her condition.
For patients on a heart ward, how can a nurse go hours without checking on their patients??? If family members weren't there to help my mom to the restroom, help her with her food, make sure her insulin arrived when the meal did, etc, my mom would had a horrible quality of life when in the hospital.
The nurses say that they are understaffed...but when you go to the nurses' station and see them standing around discussing a party they attended, it's obvious that their dedication is severely at question.
You're mom's tray was out of reach for 2 hours? And you did nothing? She was hungry and you didn't at least help feed her? So you just sat there and stared at the food along with her?
She was sitting in her own urine for 45 mins and you didn't at least walk out of the room and try to get help?
Your mother was bleeding for 30 mins? You didn't walk out of the room to get help?
WERE YOU REALLY THERE?
I took care of my sick grandmother when I wasn't even in nursing school. I visited her in the hospital, brought her toiletries and helped her if she needed it. I would even have dinner with her there so I make sure she ate.
My fiance was in the hospital for 5 days from surgery. I was already a nurse at the time. I helped clean him, walk him, encouraged him to eat, etc. I did these not because I'm a nurse, but because I'm a loving granddaughter and fiance. It's something that I could do for my family. I don't need to be calling the nurse, cna, physical therapist, or dietitician for something I can do for my family.
I had sick family members that I helped take care of even when I wasn't a nurse. I know how it was and is.
You are not a nurse so you couldn't possibly understand where we're coming from.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
no nurse should ever be seen dallying at the nurses' station, when they're expected to be meeting patients' needs. either supervision is lacking there, or they could have been discussing a patient's aberant reaction to a medication........ that could sound like a party, with staff volunteering information about previous occasions when that might have happened.
nurses usually have their patients' needs at heart, but if they've worked short staffed very long, and haven't had recognition of their own needs by the management of the hospital, they "burn out", appearing not to care at all.
that's when a family member should go to the head of nursing and administration to discuss accepted ratios of nurses: patients. by adopting an attitude that these elements in hospital experiences can be resolved is necessary. when everyone has the intention that it will be successful, it is.
whenever you wonder what the intention was, look at the situation as it exists.
i wasn't there; i didn't see what our "not a nurse" poster saw. but i've been at the bedside for three decades, and i can tell you that those nurses "dallying" at the nurse's station may have been waiting their turn to get into the med pyxis, on hold while waiting for a physician to come on the line, dropping off or picking up something from the pneumatic tube station, or merely exchanging greetings as they're bustling through. the "not a nurse" poster wouldn't know whether or not that's what she was seeing because she's not a nurse.
as for her other "observations", if she was there, why wasn't she helping her mother? and if she wasn't there, she has no idea what actually happened. we all know that patients' perception of time is off, sometimes they are mistaken about what is going on and sometimes they outright lie. who hasn't had the patient whose bedside they sat at most of the night trying to keep him from climbing over the siderails, who then tells the doctor or his family "i didn't see a nurse all night. they never even checked on me!"?
the big problem as i see it,,,,is that "customer service" is designed to make customers want to return for more. Were as good health care is designed to prevent the need to return.......this dichotomy is hard to resolve.
Only retail marketing folks have the "return for more" goal.
In medical settings, the "low recivicism" goal is the most important one.
I haven't worked in any hospital that didn't have clocks in patients' rooms...... yet I know they may not look at the clock, and time goes very slowly for them, unless they're asleep. Time goes very quickly when we're busy, so for me when I worked on the units, a shift was a blur as far as time went, and I couldn't believe the shift was almost over, and I hadn't accomplished many things that had to be done, yet.
The perception of how much time goes by is usually over and under estimated, according to the viewpoint/pain of the perceiver and the amount of things they're doing.
I'd hate to think that the majority of prople lie, and don't care if the veracity of their story harms another's retention of employment. I know that patients regress because they're ill, so I give them that edge, if they misinterpret time, what I say, or what they think is appropriate nursing care.
The important thing to accomplish, is a sense of working together with them, for the same goal - their return to health. Laughter is a great aid to healing, so I've tried to turn around the "I needed something you should have been here to provide" blues, with stories about other situations (without violating HIPPA), wherein something funny happened to a patient who experienced the same thing..... like the visitor who didn't want to wake up his/her hospitalised friend, and ate the meal that languished beyond his/her reach, while he/she was sleeping, so food wouldn't be wasted. Then I ask the patient what they'd like to have (from the kitchen on the unit, or the dietary dept. if it's open) and get it.
There's no point in disagreeing with their account of how much time went by without patients' need(s) being met. When we buy the criticism of patients, it's easy to become defensive, want to blame it on him/her, staffing and anything else that comes to mind. It's very important to revise their opinion, by correcting it through our actions - not words. Just get them food, if they're hungry, and check to see if they liked it, ate it, or fell asleep with it uneaten, because they pushed the tray out of reach themselves, again.
By the way, my sister who's 80 years old had her laminectomy and spinal fusions 2 days ago, at a hospital in Toronto, Canada. Her adult children weren't great at letting me know how she was, and I had to let the vague reports of their adult children suffice, while worrying about everything that could go wrong.
I was very relieved when my cousin who visited her at the hospital today emailed me to report specifically about her progress, and most importantly said, ".....and she has a great nurse". Knowing how critrical of most people my cousin is, and that her big sister was a nurse administrator, I knew her viewpoint could be trusted. I just hope that the one on the next shift is also great.
My brother-in-law was the kind of patient nurses love to hate, and his impatience and temper is legend in our family. He got terribly threatened by the thought that he could be left alone, if anything untoward happened to his wife, my sister.
One of their sons (they have 4) is always there when he's at the hospital, to neutralize his lack of understanding, (read that fury) and give him what he needs (he's 85 going on 100, but fit, with knee replacements). One son is married to a physician who is a specialist in pain relief, so I know that end is covered, so I'm not as anxious as I was, here in CA.
After miraculously reading through all of the responses to the original question I am just speechless! With that being said, I believe nursing is a collaboration of both medicine and customer service. I am there to promote wellness and healing in addition to keeping my PATIENT comfortable and pleased as much as can be achieved. In no way am I there to kiss up to anyone or anything...the patient satisfaction scores aren't even on my mind. If my patient dies due to neglect because I was down the hall fetching pillows and water for able bodied healthy non-patients, then I am up the creek without a paddle! Get ready for a lawsuit or the hospital firing brigade.
No matter how I look at it, here lately I have noticed that if my patient isn't "happy", they make my night at work a long living HELL and they don't apologize for it either. I usually don't have patients or family members that cause too much trouble, yet I will elaborate why I usually don't have too many problems...Usually.
When I get to work and get my patient assignment and report I typically go see my patients and give intros and find out who the people are that are hovering around the patient. I inform the patient(and ask pt if I can also share with family) of the plan of care for the night. I let them all know that I am there to take care of the patient and if I have time I will cater to all of those extra necessities the family may throw out there. In no way am I there to play maid and I am not their loved one's personal 1:1 nurse, unless otherwise specified. I will go above and beyond the call of duty to care for both my patient and family members if I have the time and resources, yet the patient comes first. I will explain a procedure and medicines to be given, let the pt and family ask questions, and let them know when I will do my next rounds. If I get really busy or if I know I am going to be tied up with one patient for awhile I let my other patient's know and keep their call light near by...the units I work on typically work together as a team and can help them if they aren't busy with their own patients.
A lot of times I have seen families anxiety increase solely due to lack of information being shared regarding the patient's updated health status, lack of awareness and education pertaining to the patient's diagnosis, and as many posters have reflected on...the false perceptions regarding what really goes on in a hospital and what medical care is required to care for their loved one. TV has made families and patients think that nurses and doctors spend all of their time cuddling up in closets and gossiping about their social lives. Families only see part of the picture of what is going on with nurses and patient care . They see what they see when they are there and the rest is what the patient tells them.
My remedy: Visiting hours need to be reinstated to allow the patient to receive unhindered care(exceptions do apply), families need to find ONE person to relay their loved ones health status and updates(tired of spending tons of time on the phone answering the same questions I answered for the 6-7 other siblings on mom/dad's contact list), the doctors and other pertinent medical staff need to find a way to update the family members about the patient because I can't call the doctor every time you don't understand something or when you need a doctor's note because you decided to sit at the pt's bedside because you were scared to leave mom alone. Staff/People who aren't providing direct patient care to the patient should consult the nurse or the doctor before making idle promises(milkshakes, medicine, time and care) to families and patients
Ultimately, I am rendering services(health care interventions, nursing care) to a patient population and teaching the family how to care for the patient when the patient leaves the hospital. There are a lot of inconveniences when customer service turns into me adopting the perception of "the customer is always right", yet I aim to do a few things: 1. go to work and do my job, 2. provide the best care I can for my patients, 3. lift the weights of customer service off my shoulders as I walk out the door of my job and go home. I am a nurse, I can't please everyone.
I actually had a patient in one room going down hill in respiratory distress and another one complaining because I didn't get her pepsi in a timely manner. This actually happens to me all the time. Very frustrating.
I had one patient call my hospital-assigned cell phone while I'm with my other patient who was short of breath and may have been fluid overloaded. I answered the phone thinking it was the MD I paged. I get a blaring "I WANT MY 3 PACKS OF EQUAL AND MY EXTRA MEAL TRAY WITH CHOCOLATE SHAKE AND STRAWBERRY BOOST...." Didn't let him finish and I hung up the phone. I should have told him "I'm trying to keep someone alive right now, your food will just have to wait." This man was notorious for calling for specific type of foods--specific type of TEMPERATURE for the food. I was just thinking SOMEBODY SHOOT ME! Our luck too--he's a frequent flyer. So at that time, I say "screw the patient satisfaction, I'm trying to save someone."
Specializes in Emergency Dept. Trauma. Pediatrics.
Just from what I have seen in my limited hospital experience as a student nurse, I would be in favor of visiting hours, (not super strict like 6 p.m or something) because some family members can't visit until after work. But I would say 8-9 would be reasonable. I can see the benefits to having family there, IF they are family members willing to help in the care. I mean in the earlier vent, it was said they had to make sure someone was with mom the whole time, well then why did this someone not feed mom and make mom sit there with a visitor and her food tray out of reach??? Pick up the spoon and start helping your family. Help them to the bathroom but make sure you leave it for the nurse or aide to measure and what not. So far the families I have encountered have mostly been helpful.
We are nicely staffed as well though with low patient nurse ratios and enough aides that can handle their tasks pretty much on their own unless all the patients they care for decided to have diarrhea at the same time. Plus with all us student nurses on shift the aides get a lot of extra help which helps as well. So it would be hard pressed to find a pt. not getting suitable care when it comes to regular food and hygiene matters where I am at. Dietary also handles passing out the food and that as well. There are meal times that they try to go by but pt's can also order food whenever they want.
Our hospital is very big on customer service though, we even have Valet parking and concierge services :|
Although for the most part I have only seen the good of this and not the bad I read about, but I am have not had a lot of hospital experience yet so I am sure it's there, I just have been fortunate that the evenings I have been on have been pretty mellow and there has been a lot of free time and even for an evening shift my co nurses haven't had more then 3 patients.
I would say though that parents or a close family member be allowed to stay in Peds cases.
".............. find out who the people are that are hovering around the patient. I inform the patient(and ask pt if I can also share with family) of the plan of care for the night. I let them all know that I am there to take care of the patient and if I have time I will cater to all of those extra necessities the family may throw out there."
If I had time to say all that to assigned patients, it would mean that I didn't have enough patients.
If asking a patient in front of family/friends, if private info about them could be shared with same, and gave it, I'd be guilty of not keeping confidentiality. Doing that coerces a patient to say "Yes", yet I got a sense that you would go on disclosing stuff about the patient without hearing or seeing a response. The angst toward family/friends visiting is palpable throughout your post.
It would behoove any nurse to avoid conflict from the getgo, when coming on duty. The attitude projected was reminiscent of teachers commanding good behavior from a class. Patients don't need to hear about others' with greater priority over your time, which takes that away from their care! Most have anxiety about being there in the first place, and what you said about them needing to trust that if you're not with them when they may need you, gives them increased stress. Please stop that, it's not consistant with providing good nursing care.
Specializes in Adult Critical Care, Cardiothoracic Surgery.
I work in a 32-bed ICU and we recently moved into a beautiful new facility next door to the old facility. Along with the new unit came new visitation policies. First, there is a definitive "24/7" visitation policy allowing any visitors including small children. Naturally, the complaints have been pouring in to which management replies, "ICU's all over the state are doing it and so are we."
The new unit is set up as two very long hallways instead of a square like the old unit. We no longer can sit at the nurses station and see all the rooms, all the time.
So here's the beef...If a room is not being monitored at all times, anyone can walk into a room at the end of the hallway at anytime and draw up sedatives and analgesics from a bag hanging on a patient, take them home and OD. I guarantee it will be a closed unit then!
I fear for my patient's safety and my license at this new hospital.
I work in a 32-bed ICU and we recently moved into a beautiful new facility next door to the old facility. Along with the new unit came new visitation policies. First, there is a definitive "24/7" visitation policy allowing any visitors including small children. Naturally, the complaints have been pouring in to which management replies, "ICU's all over the state are doing it and so are we."
The new unit is set up as two very long hallways instead of a square like the old unit. We no longer can sit at the nurses station and see all the rooms, all the time.
So here's the beef...If a room is not being monitored at all times, anyone can walk into a room at the end of the hallway at anytime and draw up sedatives and analgesics from a bag hanging on a patient, take them home and OD. I guarantee it will be a closed unit then!
I fear for my patient's safety and my license at this new hospital.
Most ICUs in most states have locked doors at all possible entrances, to prevent access by visitors without the nurses' knowledge. To get in, you have to speak to a nurse or the clerk.
Your license isn't at peril, since the decision wasn't yours; and visitors can be kicked out. If they won't leave, call security.
I have too many times been asked to compromise my nursing care in the interest of marketed customer service. A number of areas of the nursing process directly contradict customer service algorhythms. I do understand the larger picture of HMO market competition and the impacts that truly poor "service" can have. However, my understanding of my own practice is that Good Care already includes important elements of customer service, Good Customer service, however, does not guarantee good nursing care. The whole HMO industry feeds the pharmaceutical industry, it would be interesting to see these two industries try to live without competant nurses and with nurses that were only Customer Service agents. True health care reform, if it included all Americans covered somehow to receive health care would clearly reduce the competetive market aspect and we may not be bothered by marketing depts so much...
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HeatwaveRN
77 Posts
You're mom's tray was out of reach for 2 hours? And you did nothing? She was hungry and you didn't at least help feed her? So you just sat there and stared at the food along with her?
She was sitting in her own urine for 45 mins and you didn't at least walk out of the room and try to get help?
Your mother was bleeding for 30 mins? You didn't walk out of the room to get help?
WERE YOU REALLY THERE?
I took care of my sick grandmother when I wasn't even in nursing school. I visited her in the hospital, brought her toiletries and helped her if she needed it. I would even have dinner with her there so I make sure she ate.
My fiance was in the hospital for 5 days from surgery. I was already a nurse at the time. I helped clean him, walk him, encouraged him to eat, etc. I did these not because I'm a nurse, but because I'm a loving granddaughter and fiance. It's something that I could do for my family. I don't need to be calling the nurse, cna, physical therapist, or dietitician for something I can do for my family.
I had sick family members that I helped take care of even when I wasn't a nurse. I know how it was and is.
You are not a nurse so you couldn't possibly understand where we're coming from.