Nursing a service industry?

Tweety, BSN, RN · Jul 13, 2005

We are definately a service oriented society, compared to say a farming society.

But I agree with you, to me service implies payment at the time of the service.

We do provide a "service" to the community though. As you said, it's prescribed, not bought and sold. It does get a little blurry as more and more choice is being offered and the patient is being thought of as a client collaborating in their own care.

I always thought nursing was under the "health care industry" umbrella and not the "service industry".

PMHNP10 · Jul 13, 2005

I saw a brief reference to nursing being a service industry in another thread and didn't want to hijack . This is not to judge or put down other jobs. I'm of the opinion that nursing is *not* a service industry. That implies that the "customer" (patient) pays x amount in expectation of getting x good or service. We give patients what they need, which is not always the same thing as what they want. I.E., the patient may want us to give them the bedpan, but if it's time to get up and be moving post-surgery, we're going to encourage that.
I see the docs get that kind of attitude from patients sometimes as well ("I paid you and I want my antibiotics because *I* think I need them.")
Thoughts on this attitude as it seems more and more jobs are falling into the service category?

In the service industry, the customer is always right. If that were the case, there'd be little need for dialysis units, cardiac units, ortho, neuro, etc. I suspect most people are in those units because they didn't do a few things right. IMHO that is enough to eliminate nursing as a service industry.

**RosesrReder, BSN, MSN, RN** · Jul 13, 2005

Very interesting point. Many people think that money moves mountains and that with it you can and will have anything you want. By this I don't mean just the wealthy or course. When I was a pharmacy tech, I saw this all the time with patients who had just had their narcotics fille somewhere else and would bring another Rx to our pharmacy (and when it showed in our computer that is was recently filled or ready to pick up somewhere else), they would enfuriate and demand it filled stat! Of course that did not happen, but I even had a gentleman attack me (flew over the counter) and called me this and that because I told him I couldn't process it :stone next would come the threats etc. No matter how much support we got from management it was still frightening (considering it was a small town and most people knew each other) and the odds of finding each other on the street were considerably high.

Anyhow, I agree that nurses and all other healthcare professionals are to provide care and only what the person needs. Like with everything else excess is not a good thing.

Nice post by the way :)

Trauma Columnist · Jul 13, 2005

While I agree that we serve our patients/clients/customers, I think the difference between nursing and the service industry is the level of education and autonomy that we have.

Works2xs · Jul 13, 2005

I think that it is a service industry, i.e., we aren't "producing" any product. Make no mistake, when people show up, they are looking for subject matter experts in the field of the human condition. The service that is provided is knowledge based. Speaking as a patient, while I may not know how to differentiate one diagnosis from another, I sure as hell expect those I seek help from to provide the information needed for me to make an informed decision. I also expect that information to be delivered in the same thoughtful, curteous manner that I'd expect from any paid professional. When I'm shelling out sums of money that's second only to my mortgage, you'd better believe that I expect to be treated with least a modicum of respect. Nothing irritates me more than providers that insist on behaving as though their license equates to intelligence and that because I don't have one, I'm stupid.

I think that part of the dynamic is caused by the changes in the profession over the last 50 or so years. Previously, the system was paternally based. The physician was a walking storehouse of common-sense coupled with expansive experience. Like a parent, you didn't argue with them.

Now, as the level of care and the ability to intervene has increased, so has the need for hyper-specialization. You feel bad, see your PCP, and off you go to a specialist. When you arrive there, you expect (demand) that the specialist perfrom the duty for which they were referred. The role of the paternalistic health care provider has shifted more toward that of expert consultant. This is especially true since it's a rarity that a person has the same doctor from cradle to grave. These specialists are not holistically focused. If you want to make sure all your health care "dots" are "connected," you'd better take an active roll in coordinating and understanding what's going on.

nursemike, ASN, RN · Jul 13, 2005

As much as I resist the idea of patients as "clients," I do have to agree that nursing is definitely in the service sector. We don't manufacture health, we do things for (and hopefully with) the people who pay us.

The problem, I think, is that "service" gets confused with "servitude." The "server" who brings my food at a restaurant is not my servant. My patronage pays for their wages, but they don't really work for me. If they put my meal on the table without spilling it and refill my coffee a couple of times, they've fulfilled their part of the transaction, and if my car needs washed, that's my problem.

Even at the "lofty" wages I now make, I can't afford a servant to attend to my every need in life, but a fair amount of my income does go to services of one sort or another.

P.S. I was a bit startled to see how large a chunk goes to having my internal revenue serviced. Gee, I didn't even know I needed that. Still, on the whole, I think I'm going to like being on this side of the poverty line, for a change.

andrecle · Jul 13, 2005

I definentely believe that nursing is a part of the service industry. "Service" simply means that you are not manufacturing a good or product. For this reason, nurses, doctors, lawyers, insurance salespeople, cashiers and most other occupations in our society today belong to the service sector. It has nothing to do with someone's level of education or skill.

fergus51 · Jul 13, 2005

I don't consider it part of the service industry either. Teachers don't manufacture anything, but I've never heard anyone say they are part of the service industry.

Frankly I think the whole customer mentality in healthcare is sick. Patients don't deserve to be treated with respect because they are paying for healthcare (let's ignore the fact that many of them aren't anyways). That's an argument to be made at MacDonalds. They deserve to be treated with respect because that's our responsibility to them as professionals. Our responsibility to them is deeper than a waitresses'.