Patient Satisfaction Surveys

[MichelletheRN]

Do you think it is ever going to get better? Or will it just get more and more picky and petty?

I have long believed surveys are useful, but must be taken with a grain of salt instead of as gospel truth.

For one, frequently the ones filling out surveys are 1) people who are upset about something, and/or 2) people who are hoping to get something out of it, something free, special treatment, etc. I would also bet you that people who have nothing better to do are more heavily represented, as busy people are more likely to misplace or forget them.

To me, this is just common sense. I guess i don't have any proof. I guess i could say, 94% of statistics are just made up. Lol.

Another thing, my facility is SMALL. Like 12 to 15 bed critical access with a 2 bed ER. So of the patients we treat in a month, we are talking at most, several hundred....we may only get back 10 surveys. That isn't enough to draw any correlations from. So why do we get emails reaming us out because our "satisfaction" scores went from 98.3 to 97%? It's essentially THE SAME. Why would anyone be mad at getting a 97%? Well, because...it used to be 98%! Obviously, we are not trying enough.

And we get them emailed to us, so we can see just what was said, with additional notes telling us it is "unacceptable!" Or "explanations????????"

One of mine was, "there was too much noise from the street and i couldn't sleep". What am i supposed to do to fix this? Go flag down cars? Forget the fact we are in a town of 3000 on a residential street. About 4 cars go down it a night. Someone else got, "only had diet coke, need diet pepsi" *****!?!? I am sorry our free pop isn't right. There is, however, a pop machine where it's available for PURCHASE. I know, it's not fair.

Also, apparently it is commonly known, that no one ever lies on these. Like the patient who reported that her nurse, "just gave her the call light and said she was going to find something better to do." Yeah, that happened. Granted, i wasn't in there, but i would be willing to bet any sum that did not occur. For one, that lady was baked out of her mind on percocet and xanax. She probably thought the IV pole said that. But it was accepted as FACT, and that nurse got yelled at over it. If you can't trust your nurses, who CAN you trust?

We had a chick show up on a friday night wanting something for knee pain. She was already on norco and oxycodone. For a knee scope TWO YEARS EARLIER. A. Scope. But you know, some dilaudid or something. My friend who is a primary care physician saw her, and said, "no, let's try some toradol, and maybe getting ahold of the surgeon, you need to see an orthopedic surgeon..." and this chick tore my friend up and left AMA, cussing all the way. And you can bet, SHE filled out her survey, and the PCP got pulled in the ADMINISTRATOR'S office, about not helping the patient's pain adequately, and having a bad attitude (she did not have an attitude, i was standing right there when it happened). She denied it, but why would we believe her?

Will any sort of common sense ever return? Should we just set out bowls of percocet that say, "help yourself"?

[CrunchRN, ADN, RN]

Yep. Those surveys are completely unfair and BS. Everyone has an agenda that has nothing to do with your performance as a nurse usually.

[MichelletheRN]

I guess the part of it i find most offensive is the lack of even a pretense of respect, the "guilty until proven innocent" thing.

I don't understand why the actual floor nurses, PAs, and doctors can understand what a load of crap it is, but the administrative staff, who are supposedly our leaders and smarter than us, can"t or won't see it.

And the move away from "patients" to "customers" and "clients". And i am all about good customer service. All about it. I want to provide the best, most competent care, with the goal of helping people to get better. That is all. I enjoy direct, hands on patient care, and interacting with others. I want to assess, treat, think, comfort, encourage, and teach. I don't mind getting you a can of pop, or a pudding cup, or changing the channel because you were too weak to do so, and instead pressed the other button so i could come and do it lol. Up to a point. But you have to take it for what it is. It's not a spa, and you're in my territory. Don't be ridiculous.

This sounds terrible, but i honestly feel there is a direct correlation between innate IQ and being rude/fitting about everything. And the nicer i am, the harder they push. I will think, "But.....i let them use my cell phone/ipad/ipod/charger/ magazines/gave them $5". It doesn't matter, it's never enough.

There IS (and i am going to figure out how to do a study on this someday) ABSOLUTELY a correlation between IQ and now well you protect an IV. Most people of average or above average intelligence know that even with the best of veins, getting an IV inserted isn't fun and causes at least mild, albeit temporary, discomfort. For that reason, a normal person will be cautious of the IV, and try not to pull on it or mess it up (unless they are confused or senile). You get an idiot, they can have such awful veins it takes 4 of you ten tries to get a 24 gauge IV inserted in their pinky or some ridiculous thing...takes 2 hours...lol. Five minutes later, they will have crawled out the side of the bed, pulling the IV and pole across the top of the rails by the tubing, and the room looks like a murder scene. That is when you know you have an idiot, so you better be in there every ten minutes, begging them to just stay in the damn bed, bribing them with ice cream (what, no chocolate sauce? You'll be hearing from my attorney!)

In the example of the lady wanting more and more narcs, what on earth should have been done? Really? Norco and Percocet wasn't cutting it for a 2 year old knee scope? I had my knee scoped before. I know how it feels. It DOES hurt...for a couple weeks. If i was having enough pain i wanted narcotics years later, i would be getting ahold of the surgeon who did it, and saying, "hey...idk what this is about, but it isn't right!" So did they REALLY want us to give her dilaudid or fentanyl for that? That's beyond ridiculous. If we actually did that, and something went wrong, can you imagine? I mean, we hadn't even had a chance to really look at it, or xray it. She wanted IV drugs, NOW. Nothing else was satisfacory. And why does SHE get the benefit of the doubt rather than my friend (whom has been there nearly ten years, vs this lady we have never seen before or since, and don't know from Adam)?

Why doesn't anyone stand up for us? I have been a bedside nurse for twenty years. If I was a manager, I feel like I would stand up for us. But honestly, after twenty years, if i was going to be a manager, i already would be. I don't feel like i would be a good manager, it's impossible for me to separate myself from the floor staff, or to tear them up. I feel like there is some part of my personality that wouldn't work in that role, and i would be bad at it. It's probably unfortunate as i am not getting any younger.

One of the surveys we got back last summer, the wife said her husband had been in there 3 days and never received a shower. That is not true. I admitted him. We showered him before we even put him in a room, because he had dried poop and pee all over himself. He may not have got a shower that next morning (8 hrs later), but i am pretty sure he did the next day. It is charted that he did, anyways.

What it amounts to, is he wasn't showered while she was there, it took place later at night and/or earlier in the morning, and he was too confused to remember.

But boy, did we get reamed. An email saying how this is "unacceptable", "ridiculous", "how would we like our family member to be treated this way", "consider this a warning", "there will be disciplanary action next time", blah, blah, blah.

What are they going to do, fire us? We are already short 4 or 5 RNs, and half of our staff is traveling nurses. We are skimming by on providers, but one MD or PA or NP away from utter chaos. We recently lost a great PA because she had a baby, and we refused to work around a reduced schedule for her. I don"t know why. She was very competant, sweet, and a hard worker. Why do we just let these people walk out the door?

We have lost several bright, hardworking RNs as well. I don't know why we are just like, "okay, bye!" Instead of "what can we do to make this work? We value you and want you to stay".

Obviously, i am developing a bad attitude, and i don't want to, but it seems so hard to stay positive. Despite how jaded i am becoming, i honestly do still like people and want to help them. It's just hard when no matter what you do, it's wrong. I am burned out, we are all burned out, and there is no end in sight. We are back to getting extra shifts again because some of the travel nurses' contracts are up. In my eval, apparently i have picked up 18 extra shifts in the past 6 months, completed God only knows how much continuing education, and attended over 80% of all the extra meetings (if you don't make 80%, you don't get your yearly merit raise). This earned me a score of "average". 3/5.

How do you get a 4? Does it involve sacrifice and the blood of a virgin? (Guess i am screwed then. Lol.)

I can't believe how long I went to college and how hard I try, to end up being a complete peon, who is one "diet coke instead of pepsi, and i prefer CRUSHED ice to cubed" away from some kind of "disciplinary action". I don't know what the disciplinary action is, some kind of vague horror that is threatened when i don't put miracle whip on a sandwich, or forget to lock the little drawer in the room that holds bandaids, alcohol swabs, and tape, because we must prevent the stealing of bandaids that is apparently an issue.

[Davey Do]

EXCELLENT thread MichelletheRN!

I could sense your frustration, but reading your posts caused me to laugh out loud a several times. Yours is probably the most interesting and entertaining vent I've ever read on AN.com.

[Toastedpeanut]

Your posts precisely reflect my mindset pretty much all shift. I couldn't have said it any better. And I feel like I too am getting a bad attitude about my profession... but you're 100% right - it's ridiculous!

[Princess Bubblegum]

I get surveys whenever I see my PCP, whose clinic is part of the medical group where I work. I send them back with over-the-top glowing reviews, because I think they're terribly unfair. One survey had questions about the clinic's decor. It's totally hideous. But I hate to think that my doctor and her staff could be penalized because of that, when they are providing excellent care, regardless of the mauve vinyl furniture. If I wanted to relax inside a Pottery Barn store, I would go to a Pottery Barn store.

[Skippingtowork]

I absolutely agree with all the posters. When I get surveys I always give good reviews. If I have an issue with care or service I address it on the spot and it's over. It seems that nowadays, everyone wants to evaluate or review everyone else; however, the most negative reviews come from people who are talking about nonsense. Hospitals are trying so hard to make their "customers/clients" happy that they are actually doing them a disservice. Hospitals should be pleasant, but not a place to drop in for a good time. Most of the grumblers probably are not paying their way and have a lot of time on their hands. They cannot tell you their medical history coherently, but they can sure take the time to fill out a survey. To be reprimanded about comments on a survey without proper investigations, is not professional and definitely not respectful of the professional staff. Everywhere you look now, hospitals are bragging about their ranking and patient satisfactions scores. I have seen nurses brought to tears over alledged complaints from patients. if you stopped to think for just a split second, the situation was impossible! But what can we do?

[Here.I.Stand, BSN, RN]

Just delete those reaming emails. As soon as you see it's survey related, don't read further, just delete. Seriously. YOU know you give your pts good nursing care (I'm assuming based on your posts you give good care). The shellacking from management serves no purpose really, except to pollute your head space.

I do think eventually common sense will prevail. I just hope it won't take a bunch of sentinel events stemming from the Burj Al Arab Jumeirah mentality. (like the wife in that thread who refused neuro assessments on her husband postop).

[TriciaJ, RN]

A strong and well-supported union would nip this crap in the bud. But if you're not already unionized, it's hard to get one up and running. I like the idea of just ignoring the stupidity and carrying on. Fired over diet pepsi? Might turn out to be a gift from the Universe.

[db2xs]

I think most managers/administrators don't know how to communicate. Instead of asking, "What happened?" they go straight to the blaming, "This is unacceptable! I can't believe you did this!" I had an assistant manager do that to me more than once--to a lot of people. We complained to the union and got it straightened out.

[MichelletheRN]

I believe (and i could be wrong, but i don't think so) that nurses and doctors are not allowed to unionize in our state. This may include more health care workers, but i am almost certain at least these folks cannot.

I guess i understand managers who have zero experience in healthcare as not getting it. But like our director....she was a staff nurse before she took over as director. She actually is slightly younger than and has slightly less experience than i do. Regardless, she has worked the floor and SHOULD understand how people are. The department head is also an RN, who has a masters in nursing and an mba, but has never worked the floor. Ever. Since nursing school. Why??

These guys need to work the floor at least once every 6 weeks, to keep up with how we are doing things and remain skilled.

I haven't heard **** about bonuses this year, either, i suppose we are doing away with those, maybe to save money to buy stamps to send survery.