Nursing: The Highly Skilled Customer Service Representative

This article discusses the role of the RN as a customer service agent. It gives an over view of how customer service scores impact and organization and how it impacts individual RNs. Nurses General Nursing Article

Nursing: The Highly Skilled Customer Service Representative

Over the course of my nursing career I have heard endless spiels about "customer service" and "patient satisfaction" and the importance of these two things. What no one really explained was how I fit into that equation or what the ramifications of those scores meant to the organization or me personally. With that in mind, I am going to address those things now for all of you.

First, let's define customer service. In healthcare it seems to be this vague, arbitrary term that is interpreted to mean whatever makes the patient happy. Let's be clear on what we're talking about and not taking about here. The phrase "customer service" is an umbrella term that refers to how a person or entity (healthcare facility, professional association, business, individual practitioner) treats the people they serve. By "serve" I mean tending to those who come to us for help, advice, medical care. The phrase "customer service" is not "waiting on people" like a waitress in a restaurant. Nor does it imply that those we serve must be called "customers" rather than "patients." It's the concept not the terminology that matters. The phrase is universal.

I frequently hear things like, "I just want to come to work and do my job" or "I am a nurse not a waitress" or my personal favorite, "Employee satisfaction is going to decrease if I am expected to worry about patient satisfaction." Let's be honest ... nursing is an educational degree that equipped all of us with a certain set of clinical skills and knowledge however, in today's healthcare world, having the degree and skills isn't enough. Healthcare is a customer service industry. Granted, we are a highly educated customer service provider but we still provide a service. Today, being a good nurse also includes being able to provide good customer service. Treating patients and families with courtesy and respect, empowering patients to participate in their decision making, making them feel safe and cared for, providing them with information...all of those skills are part of what used to be called "bedside manner." That was a basic nursing skill because most people went into nursing with the desire to help people.

I've heard nurses say that we do these things "only" for patient satisfaction scores. Of course the scores are tool to measure how well patients perceive their overall care and hospital experience. A patient's perception does play a role in his/her care because we all know that the happier, safer, and more cared for patients feel, the better their recovery; the fewer times they hit the call button; the less inclined they are to initiate a law suit; and the more inclined they are to have good feelings about the facility and it's staff overall. These things are all important to any nurse because it impacts our livelihood. It impacts our livelihood!! I will explain how that happens...

Healthcare reimbursement is decreasing and costs are going up. We can save money on supplies and try to find other cost savings measures, but that will not close the gap. Payroll is around 65% of a healthcare organization's operating budget. With healthcare reimbursement being tied to performance on patient satisfaction scores, of course it will have an impact on payroll and your paycheck. Many organizations have had to freeze wages, decrease educational support, or reduce benefits. Raises cannot be given if there is a decreasing amount of money coming in to the organization.

Every employee is responsible for their piece of "patient satisfaction." Nursing is the single largest work force in the organization and the closest to the patient. We can have a large impact on our patient's perceptions of their care here. That is how you personally fit into this equation and how the organization's reimbursement ultimately affects you personally. Like it or not, the care you give, the attitudes you display, the interactions you have with patients and families have an impact on the scores...the financial health of the organization, and ultimately on your own paycheck.

It's a give/take relationship. It may be one you are not fully invested in or believe you should have to participate in. Perhaps you are feeling like you shouldn't be held accountable for those patient satisfaction scores. I challenge you to find a nursing job anywhere where you are not held accountable. Coming to work to "just do your job" now includes doing a great job with customer service. It does not mean you are a highly educated waitress. It does not mean that you are going to make every encounter positive at the detriment of clinical outcomes. We are never going to make every person happy. It does mean that you need to come to work prepared to spend time with patients and their families communicating clearly and helping those patients and families feel empowered to participate in their care.

I am a Nursing Director in a Level 3 perinatal center with 13 years of experience. I have my Master's in Nursing Management and Organizational Leadership. I am also a Master Trainer in the TeamSTEPPS patient safety methodology.

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Specializes in Progressive Care.

All we want is better nurse to patient ratios so we can take the time to provide the care our patients need and deserve.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I have no problem with providing good service/service recovery. But for the love of God, give me the TOOLS to do so. Equipment that WORKS, sufficient staff for all my patients and the TIME to do it.

Specializes in Family Medicine.

Can't think of a nice response so I'll just say thanks...

Specializes in Public Health, TB.

Happy nurses, happy patients.

Specializes in Allergy/ENT, Occ Health, LTC/Skilled.
All we want is better nurse to patient ratios so we can take the time to provide the care our patients need and deserve.

Amen!! Give us doable ratios, your scores will sky rocket. This post sounds like the out of touch administrators who think of useless policies that never do anything but put more pressure on the floor staff.

Specializes in ICU.

Blah blah blah.

Train your NAs to be food and beverage servers and assist with ADLs instead of avoiding patient care.

Then professional nurses will actually have time to be strong pt advocates and be able to provide emotional support instead of being glorified waitresses.

Specializes in Cath/EP lab, CCU, Cardiac stepdown.

Unfortunately the patients believe that we are there to wait on them like servers and waiters/waitresses, their idea of customer service and satisfaction in the hospital is the same as if they were in a hotel. They think that we are to provide the same services while being in the medical field.

Yes we can tell them that this is not the case and yes we refuse to wipe their butts when they can do it themselves, but inevitably their surveys are marking us down. They are more likely to remember the one time that they were dissatisfied rather than the majority of time when we provided excellent care. Not to mention they tend to lump everything to nurses.

Oh the lab tech drew your blood and it took a few times because you're a hard stick? That's the nurses fault. Physical therapist was on your case for not walking? That's the nurses fault too.

Satisfaction surveys should just read: did you receive medical care? Yes no?

Did the hospital perform such care without being an ass? Yes no?

Done. No bs about excellent care, and all the other unrelated questions.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Inpatient hospital nursing has gone off the proverbial deep end with the push for superior 'customer service,' IMHO.

Superior patient care needs to live on. Superior outcomes need to be a predominant goal. But 'customer service'? Customer service has no place in healthcare.

Let patient care thrive. Let customer service die...

Specializes in LTC, assisted living, med-surg, psych.

Couldn't have said it any better myself, Commuter. :up:

Not surprised at all, OP, to read that you are a Nursing Director. I knew that before I finished your post. How?

Your voice is so out of touch with a nurses reality.

The disconnect hurts my head.

Specializes in ICU.

2015 Press Ganey recommendations on maximizing reimbursement. It is based on evidenced based NDNQI indicators, not opinion.

In a nutshell, it says that management needs to stop blaming the nursing staff for low HCAPS and start providing humane working conditions.

The condescending tone of this writing exercise is offensive to those of us who are well aware of how reimbursement works.

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