Nursing: The Highly Skilled Customer Service Representative

gleanns, ASN, MSN, RN

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.

Nursing: The Highly Skilled Customer Service Representative

About gleanns, ASN, MSN, RN

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