Jump to content

Patients as customers????

Posted
MJAJKJ MJAJKJ (New) New

I am in block 4/4 of nursing school and one of the themes throughout school has been patients being referred to as customers. Some test questions are written to reflect this, and we are told hospital philosophy is beginning to reflect the same. I work in medical records (boring as s***) and the hospital I'm at has endless patient satisfaction polls. I worry about patients starting to feel like customers and they are always right, which of course is not true. I fear that administration will look down on an RN giving a patient morphine despite the "customer" request for diluadid because 8 mg of morphine "just doesnt work for me." We are also taught to be patient advocates, but advocate for their best interest, not their every request. I really believe this is a dangerous position for hospitals and patients/customers alike.

Customers go to Sears.

I'd be interested to hear RN's point of views and if other hospitals are adopting this philosophy.

Edited by MJAJKJ

Sun0408, ASN, RN

Specializes in Trauma Surgical ICU. Has 4 years experience.

Yes, you are correct and yes hospitals are heading in that direction if they have not already done so..

It is a fine line that we walk to keep the pts safe as well as happy.. Will I give a DM pt with a FS of 450 a pepsi..NOPE and I stand behind it. Will I help a person do something they can not, absolutly. Will I do a simple task like wipe a behind on a pt that is a walkie talkie and CAN reach it, NOPE.. I am sorry but I am not a slave to a pt. I am there to HELP them get better, advocate for them and assist them in that journey. I do not and will not bend over backwards "just because".

brownbook

Has 35 years experience.

Good thoughts "the customer is always right," can not be the driving force in medicine.

Most of our evaluations are very generic, 'scale of 1 - 10 were you satisfied with......" Then room for two lines on the bottom of the evaluation for comments.

No one is going to think the patient should be telling the nurse or doctor what medication to give them. If they find a trend that a certain nurse's patients always state they didn't get their pain medication on time or didn't get good pain relief that might give administration tools to assess that nurse or doctor.

I enjoy patient evaluations. 99% are boring, all good or satisfactory with no comments. Some are funny. "I wasn't told I would have a nasal cannula for oxygen after surgery." (This was a complaint!) Some give us a needed reminder. "The nurse didn't wash her hands after such and such." "It was very noisy near the nurses station." "I could smell the food the nurses were heating for lunch."

So.... wash your hands, keep the noise level down, be aware of the odor of food you are heating up.

I think of it as constructive criticism.

well guess what- it is that way- they are the customer. they are always right. and their families too. ME ME ME. i have bitten my tongue so many times its amazing that I have one left at all.

welcome to the Disneyland model of health care.

Yes, it really is that way :-(

tyvin, BSN, RN

Specializes in Hospice / Psych / RNAC.

Moons ago when I was in school we were taught to refer to patients as clients. I do many times depending upon the situation. But I wouldn't refer to them as customers. Yes they are but the terminology reflects a retail atmosphere.

madwife2002, BSN, RN

Specializes in RN, BSN, CHDN. Has 26 years experience.

Well some of the customer service I have been recieving in stores isnt always a pleasant experience recently and i hope that pts recieve better treatment!

sameasalways, ASN, RN

Specializes in Med/Surg. Has 11 years experience.

We were taught to refer to them as "clients" but also upon being hired you are given a psychological test of some sort and some of the questions and some of the questions when hired or in interviews (I interviewed at a lot of places) were regarding "who are the customers at the hospital?" The answer really is "everyone". The doctors, the patients and your coworkers. If my patient doesn't do well with morphine, then I call the doctor and get them what works for them. Is that customer service? Or just good nursing care? There is a fine line, true. But the patient often knows what works best for them and when healthcare providers don't listen it isn't very helpful for anyone. On the other hand, there is a difference between the patient who knows what works for them and what doesn't versus the patient who thinks they are staying at the Hilton Plaza.

nurse2033, MSN, RN

Specializes in ER, ICU.

Patient as customer is not a new idea. I believe that "the customer is always right" is actually an outdated idea. If you can't give them what they want, for whatever reason, explain it to them so they understand. This is the customer service in saying no. It's like being a parent, saying no is appropriate and beneficial sometimes. Being passive aggressive and just ignoring their request is a bad idea, it will make anyone feel neglected.

After a recent hospitalization a family member drives me crazy when she says "they waited on me real good!"

We are making improvements (new carpets,wallpaper and more) in our facility that everyone says makes it look like 'a fancy hotel'. So it stands to reason that our customers, clients or whatever might just think that their nurses and cna's are their own personal maids!!!!!

MLMRN1120

Specializes in Med-Surg, Oncology, telemetry/stepdown.

I was recently at a job interview for a new hospital..they gave me their policy manual to look over while i waited, and it indeed was based around "customer service". Even though I see it all the time, it still seems funny to me.

We are supposed to provide care to patients, not ring them up at a cash register. In my experience at my previous job, the customer service element was just something that was constantly held over our heads; if the patient's family was unhappy that their 16 relatives could not stay overnight, they would demand a manager and tell us that we were there to keep them happy. It's kinda frustrating.

belgarion

Specializes in Med Surg.

Was at Wally World the other day. There were only three people working check-out and about a dozen customers in line. After standing in line for about 20 minutes it was finally time to unload my basket. You guessed it! A "customer service" manager came and informed me that line was shutting down and I would have to go to another one and start waiting all over again.

Point is, if this is what passes for "customer service" these days, do we really want to refer to patient care as "customer service?"

Ruby Vee, BSN

Specializes in CCU, SICU, CVSICU, Precepting & Teaching. Has 40 years experience.

"customer service" is a trend. it's a bad trend as far as health care goes, and will probably last about as long as any of the other trends . . .

there are times you just cannot make a patient happy, nor can you explain it to their satisfaction. in those cases it may be passive-aggressive, but ignoring constant and unreasonable demands is a choice, too. i actually had a patient complain to my manager that i kept her awake all night by drawing her hourly blood sugars, doing her every 15 minute vital signs and basically just not leaving her bedside until she stopped bleeding, had a stable glucose and was weaned off the pressors. and yesterday a patient complained about poor customer service (actually used that phrase) because i was trying to explain to her why coughing and deep breathing after surgery, though uncomfortable, are a good idea. the surgeon, overhearing that conversation, intervened by explaining to the patient again why pulmonary toilet is so important, concluding by saying "if you don't do it, you'll get pneumonia." the patient's response? "i don't care." and she was alert and oriented!

GoodNP

Specializes in Cardiology, Research, Family Practice.

Ahhh, customer service, or the general lack thereof. One of the few things I wish I could change about nursing (along with wrinkled scrubs and those bacteria-magnet cartoonish stethoscope covers).

Guess what, the patient IS a customer, and the only reason we all have jobs. As nurses, I think we often forget that, or perhaps it never crosses any of our minds. Of course the customer-as-patient can't always be right, but let's be real, nobody is going to expect a nurse to kowtow to a patients demands for dilaudid when morphine is written. However, since my days in nursing school, I have noticed an overwhelming amount of complacency in healthcare. I've made this observation as a nurse and also as a patient.

Nurses (even though this really applies to all staff working with patients and their families, I say nurses b/c that's the forum we're on) need to smile more, speak politely, learn basic customer service phrases such as "my pleasure" "I'll be happy to" "let me see what I can do about that" or, when necessary, "I'm very sorry Mr./Mrs. so-and-so, but ." Let's manage our patients' expectations on wait times. Night shift, try to be as quiet as possible. Appear as if you are happy to do your job (b/c these days we are all lucky to have one).

It's been said that every person should work in retail at some point in his/her life. That's b/c of the invaluable customer service lessons you learn, both as a provider and as the consumer. I would love to see a customer service elective in nursing school. Patient safety may be our number one priority, but why can't a positive patient experience be high on the list too?

nursel56

Specializes in Peds/outpatient FP,derm,allergy/private duty. Has 33 years experience.

Was at Wally World the other day. There were only three people working check-out and about a dozen customers in line. After standing in line for about 20 minutes it was finally time to unload my basket. You guessed it! A "customer service" manager came and informed me that line was shutting down and I would have to go to another one and start waiting all over again.

Point is, if this is what passes for "customer service" these days, do we really want to refer to patient care as "customer service?"

I agree! "Customer service seems to be the first thing on the chopping block when a business decides to cut costs and why?? My cable company used to have dream customer service! So did my bank! I stayed loyal to both for that reason alone, and now dealing with both of them is a nightmare of telephone trees, conflicting information and people who cannot utter a syllable "off script" even if you beg them to! Yikes!

Ahhh, customer service, or the general lack thereof. One of the few things I wish I could change about nursing (along with wrinkled scrubs and those bacteria-magnet cartoonish stethoscope covers).

Guess what, the patient IS a customer, and the only reason we all have jobs. As nurses, I think we often forget that, or perhaps it never crosses any of our minds. Of course the customer-as-patient can't always be right, but let's be real, nobody is going to expect a nurse to kowtow to a patients demands for dilaudid when morphine is written.

I disagree. The patient should be aware of and an active participant in his/her healthcare choices, but they are not a "customer" as one would be at a restaurant or other retail establishment. If the customer can't always be right, but they've picked up on the notion that they are a "customer" in a traditional sense, when do they stop being right? How much harm are we to allow them to do to themselves before we step in and say "you aren't right anymore, I'm going to take over now"?

These boards are replete with stories of patients demanding and getting Dilaudid over morphine, refusing to wear their TED stockings, get up and walk after surgery, follow restricted diets and on and on ad nauseum. One ED doc actually set up a station in the waiting room so that drug-seekers wouldn't need to be seen before they got their fix and out the door. Nurses are disciplined all the time for not kowtowing to the patient and their visiting families with iced soft drinks and snacks even if the nurse has a much sicker patient next door.

However, since my days in nursing school, I have noticed an overwhelming amount of complacency in healthcare. I've made this observation as a nurse and also as a patient.

Nurses (even though this really applies to all staff working with patients and their families, I say nurses b/c that's the forum we're on) need to smile more, speak politely, learn basic customer service phrases such as "my pleasure" "I'll be happy to" "let me see what I can do about that" or, when necessary, "I'm very sorry Mr./Mrs. so-and-so, but ." Let's manage our patients' expectations on wait times. Night shift, try to be as quiet as possible. Appear as if you are happy to do your job (b/c these days we are all lucky to have one).

Sorry - but I have never needed a sheet of canned phrases or a "service with a smile" sign on the wall to know how to talk to patients and what you're saying is pretty condescending to all of us who've been around interacting with patients for decades before the customer service trend started. Maybe you live in a part of the country where all the nurses just happen to be rude, I don't know.

It's been said that every person should work in retail at some point in his/her life. That's b/c of the invaluable customer service lessons you learn, both as a provider and as the consumer. I would love to see a customer service elective in nursing school. Patient safety may be our number one priority, but why can't a positive patient experience be high on the list too?

Actually, I've never heard anyone say that but I've worked as a salesperson, a waitress, a restaurant hostess and assistant manager of a clothing store all before I went to nursing school. The two things are miles apart. I don't know very many nurses who have not developed a communication/pt education style that is unique to her or him that in fact may sound gruff to an outsider but are beloved because of how they get what they know into the other person's head. It would be patently ridiculous to force them to say dumb, out-of-character and cheesy phrases like that. I guess I have a higher opinion of nurses in general than you do. I trust them to say the right thing the right way in most cases.

ChristaRN

Specializes in PICU now, Peds and med-surg in the past. Has 7 years experience.

Ah, the customer thing, one of my biggest pet peeves. I've got to say in Peds the child is usually pretty easy to deal with but the FAMILY! Here's some customer service complaints I have seen on my unit:

1. Parents should NOT have to sleep on a cot or a recliner chair apparently. I have had numerous parents state that it is our job to make sure THEY are comfortable so we should make sure actual BEDS are available for them to sleep in

2. Courtesy meal trays should be given to ALL visitors (we do give them to breastfeeding mom's but that's it). It's not enough that at our facility the cafe will take visitor orders over the phone along with a credit card for payment and then deliver it to the patient's room - these meals should be free for everyone.

3. Nurse's should not be coming into the child's room when they and the parents are sleeping, the parents should be able to call when it's convenient for meds and vitals to be done. Lord knows that better be convenient for you or they cry "my nurse is never in the room". I flat out refuse this request most of the time.

4. Providing accomidations for parents to stay in the room is not enough - I have had a family yell at us for not having accomidations IN THE PATIENT'S ROOM for the patient, both parents, grandma who won't drive at night and the patient's three siblings who can't get home because neither parent will leave and Grandma is afraid to drive at night.

5. Patient snacks should be regularly offered to visitors and to tell them that they are for patient's only is rude.

I could go on and on.......... I'm not a parent yet but I still feel like I would live on water and sleep on a wooden chair if it meant being with my sick child. We have many wonderful parents who are like that and I do try to go above and beyond for those people. Some are just unrealistic though.

kmmRN,BSN

Specializes in Medical, Surgical, Pediatrics.

I feel that the patient is definitely a "customer" of the hospital, they are paying the hospital to provide medical service. With that being said, there are also rules that must be followed, no matter what. When you are a customer in a store or restaurant, it is just the same. You can't order something not on the menu, you can't smoke somewhere that is a no smoking establishment, you can't tell a cashier that you only want to pay $2 for milk when it costs $3, that is because every establishment has rules that must be followed or they would ultimately end up going under for some reason or another. The patient is still a customer! We are working for them! I tell my patients when I admit them, that we are there working for them to get them well again, and with that they have the right to question any treatment or plan of care that they are concerned about. Yeah, it might just set us up for a billion questions, but, after reading a different post about some of the horrendous things nurses and docs have done to patients, I don't think it hurts for our patients, or customers, to question things we do.

nursel56

Specializes in Peds/outpatient FP,derm,allergy/private duty. Has 33 years experience.

I think a more apt comparison would be if you were a customer in a restaurant and wanted to go back to the kitchen and tell the chef how to cook.

As for who is paying for someone's healthcare, rarely is the patient paying for the service. If the person who calls the shots is the person paying for the care, it would be the taxpayers and private employer provided insurance. When a patient is admitted to the hospital, the hospital calls the insurance company/Medicare/Medicaid or whatever. Those things are shared risk. People who underutilize are paying for those who overutilize benefits. So technically some will pay for others - it isn't a simple a+b=c transaction.

Medicare tax from my check goes right straight into the kitty for the "customer". In fact, intrusive laws such as helmets, seatbelts, and mandatory immunizations recognize the reality that the pool is the customer and it's trying to cut costs in trauma treatment and the treatment of acute illnesses.

Educating patients about their rights is not synonymous with "customer service". It sounds to me like you think there is something above and beyond the call of duty to tell patients to ask questions about their treatment and that if you are not a customer service nurse you will attempt to shut questions down to avoid answering too many of them? What you are describing as customer service are things intrinsic to nursing already.