Please tell me how this is right?!?!

[L&DRNJenn]

I work for a large univeristy hospital that also has several branches throughout the metroplex. There has been a huge push for patient satisfaction over the past 9 months. Scores are based on surveys completed on discharge and then also a survey mailed to patients at home following discharge. Currently scores are in the low to mid 80's. The goal is greater than 95%. We had a presentation in March on what the expectations were of the staff to insure that patient satisfaction improves and we were expected to sign a form saying that we were committed to just that. The major push was to have the patients be rounded on each hour. The even hours by the nurses and the odd hours by the techs and the purpose of that was to anticipate the patient's needs. We were also to imply with our words, actions and attitude that "we have time". The patients are visited by the supervisors to evaluate how things are going (I'm not sure what all the patients are asked during this time).

On Tuesday we were presentated with a hospital wide program that ranks each staff member as a high, medium or low performer based on carrying out the commitment of improving patient satsfaction. This ranking has nothing to do with patient care, critical thinking and so on. Bad attitudes, gossiping and backstabbing are within consideration to the ranking. The superivsors will meet with each staff member. The order will be high, medium and low in the hope that by talking to the high performers first they will have a positive influence on the rest. The low performers will be given a choice to basically shape up or ship out. My manager says that even some of the most experienced nurses will be faced with that decision.

What do you think of this?

Here's what I think. I think that it is extremely childish and extreme. I can't believe that a group of educated adults put this program together. I feel like it doesn't value nurses and techs and recognize that we are human beings. I also am feeling like I don't even want to work for this healthcare system anymore.

I really enjoy the people that I work with and they types of patients that we have. I even sometimes enjoy the workload :) We as a whole work pretty well together. I'm just dissappointed that we have to go through this and it is an added stress to an already stressful job. I'm further upset that we do not have an advocate.

I'm going to try to let this blow over because I don't see how it is going to effectively work. But the list has already been determined and it is expected that each staff member will be spoken to before January. "Nothing says Happy Holidays more than You Are A Low Performer"

[HappyJaxRN]

Here's what I think. I think that it is extremely childish and extreme. I can't believe that a group of educated adults put this program together. I feel like it doesn't value nurses and techs and recognize that we are human beings. I also am feeling like I don't even want to work for this healthcare system anymore.

I really enjoy the people that I work with and they types of patients that we have. I even sometimes enjoy the workload :) We as a whole work pretty well together. I'm just dissappointed that we have to go through this and it is an added stress to an already stressful job. I'm further upset that we do not have an advocate.

I'm going to try to let this blow over because I don't see how it is going to effectively work. But the list has already been determined and it is expected that each staff member will be spoken to before January. "Nothing says Happy Holidays more than You Are A Low Performer"

And here's what I think. This is hogwash. I can see where the person who came up with this means well....but it's also very obvious that the person who came up with this isn't very realistic and is a paper-pushing administrative personnel with little to no experience with floor nursing. I'm sure that this won't continue on forever. I bet that they will realize that this task is going to be harder to complete and and next to impossible to meet their own expectations as originally intended.

[Tweety, BSN, RN]

Whatever happened to customer service being about actually BEING the best facility for health care????? Please its not WALMART!!!!

YOu can have all the smiling little cookie cutters you want,, but that isnt going to bring in "customers" if they arent getting GOOD QUALITY healthcare.

Is it too much to ask for both. Quality nursing care without the battleaxe attitude? Perhaps the quality care at this faciity is a given. What's going to give this facility an edge over the next place?

What's wrong with "I'm very concerned about your pain." Instead of "You're not my only patient I'll get to you when I can."

Or "I'm concerned about your post-op risks which are......." instead of "I don't care if you get out of bed or not, you're just going to get pneumonia"

No one who is pushing customer service is talking about compromising patient care in the process.

Granted some battle axe nurses with bad attitudes, who care "competenet clinical nurses" may get fired. I say good riddance. These are the nurses that patients complain about when they are laying cold wet beds. Their's are the fires I have to put out when trying to build rapport with my patients.

I don't think it's asking much of an organization that payers me nearly $30.00/hr to be both clinically competent and customer service savy.

[Tweety, BSN, RN]

What I think is so weird is that the big Customer Service push is happening at the same time we have the nursing shortage.

Which is precisely why there are so many uncaring, rude nurses. The old "there's a nursing shortage....what are they going to do? Fire me? hahahahah....I can get a job in two minutes if they do.".

[Tweety, BSN, RN]

Although, as one can see, I am pro-customer service. I wish there was a movement toward patients and family members reciprocating.

Sometimes I feel I derserve combat pay the patients and families are so dreadful acting, despite my excellent customer service skills. :)

[SmilingBluEyes]

I see what Tweety is saying, too. Oftentimes, It's all about approach. There are better answers than "I am too busy and you are not my only patient" or "she/he is not my patient". Just a change in words can make a difference, e.g. "I will get your nurse for you" or "is there anything I can do for you while you wait?" etc.

Yes, It is important not to invalidate or minimize patient or his/her concerns. We all know nurses who do just that and not all of them are "old battle axes", either. I see a good measure of young, new nurses who have started this early in their career. It's indeed wrong to treat people this way. So no---Good customer service need not be a huge deal---it's something we can incorporate no matter how busy we are.

But like I said, I would like to see those administrators spending big $$$ to hire consultants to teach us all to be better agents of customer service, be accountable to the SAME standards. We as staff, are THEIR customers, too. If they are held to it, we are in a win-win situation. The patient wins, the staff wins and so does Admin. It would work if we all are held to this Studer standard!

Unfortunately, there is not much we can do about rude patients or family members---and they are not our customers, anyhow.

[Tweety, BSN, RN]

I agree Deb. When we had our customer service push, there was this "employee as a customer"survey. We still take it every year. There are many questions about our managers and they are held accountable for the surveys and to improve their scores the next year. Although I don't think anyones been fired.

It is well understood that an unhappy crew is not going to provide good customer service, so that needs to be addressed.

But I do buy into the idea of personal responsibility for effective patient/nurse relationships. And management having a tool to deal with that.

Didn't mean to use "old" when talking of battlesaxes, they can be any age or gender. I do see as many young people saying things like "you're not my only patient" and "because the doctor ordered it" as I do older ones.

[pannie]

Tweedy GOT it. It's exactly what I meant - ATTITUDE. I think there are some "misconceptions" here. I DID have a formal appointment with the CEO because my surgeon suggested it. I sent three huge gift baskets from Mary of Puddin' Hill to the 3rd floor nurses station and sent a letter telling of the exceptional care I received there. I nominated one ICU nurse for a Gold Star, one physical therapy tech and of course the tech. I KNOW my husband and children were not the family from hell.

I am NOT ashamed of being a nurse at all. Why would you get that idea? I don't have to work so just do volunteer nursing. It's just easier for the staff not to think I'd be critical, second guess them or know something that I don't know. Do other nurses go in and say "I'm an RN."? None of my friends do.

I haven't been a floor nurse for many years and things change rapidly. I can't learn it all in continuing education, so never assume I know more than the floor nurse. I only stated the ATTITUDE not the nursing care bothered me. Although, having a patient cold, wet and feeling "stinky" is nursing care, isn't it?

[SmilingBluEyes]

You sound still very upset/emotional over your situation, so I won't belabor any argument with you. I am not looking for a fight here, Pannie. I am sorry if I mistook your "not saying your are a nurse" for shame---I guess you meant something else.

From a patient's standpoint, I have never made much of a thing out being a nurse or not when hospitalized. Most of the time, I, too, chose not to tell, just so I would be treated like anyone else. I wanted certainly no better than the next one......maybe that was what you were eluding to? Not telling staff you are a nurse for a given reason? Anyhow I admit, I can't read your mind....

From an employee standpoint, I have a lot to say. The whole concept of customer service is certainly not new and it disgusts me that millions of much-needed dollars/monies have to be spent on "consultants" and "firms" to teach simple concepts to us; to me, it's preaching to a choir when done to nurses--I have heard these things since nursing school and certainly in my prior military career........it seems so self-evident. Certainly it is something that can be discussed in employee orientation and yearly competencies/education.

I know where I am working, customer service is certainly drummed to us in all our yearly competencies-------At least customer service for OTHERS is------however---- try and find that same sense of "service" when we as nurses need something from our HR or payroll departments, for example. Just getting a live human being to help at the office or answer phones is a nightmare---they are out on break, doing bake sales, or what-not. They all take lunch at the same time-----why not leave one person in there to help out and answer phones for the few hours we can get help? Their offices are closed as much as they are open. And their hours stink for those roughly 1/3 of employees working nightshift; what about customer service for them????

Another thing that has disturbed me a long time, I have heard of (and TALKED TO) potential hires who went elsewhere for employment because they could never get clear whether their resumes were even received or reviewed. HR either did not return calls or was out doing bake sales when they called. SERIOUSLY! I am not making this stuff up.

And another area of customer service lacking: there is no meal service at all for the night shift or patients at night, either. None. After 6p, too bad, so sad. They stock the patient fridge with some sandwich and salad trays and yogurt, and that is it. And NO staff may not touch any of it. I guess cold sandwiches and salads is better than nothing for the patients, but staff get hungry in 12 hour shifts, where is our food? No meal service for anyone after 6, to me, is not customer service, either.

So I have to ask: WHERE IS THE CUSTOMER SERVICE FOR US as employees?????

That is what I mean by customer service being a concept we all have to adapt.

It's a great concept, the Studer Program, but again, I say, it must be implemented from the top to the bottom, not just the bottom (staff) and out. Managers and Admin MUST be on board and customer-service oriented for it to really work. Ok enough from me.

[pannie]

It IS difficult to understand through the written word sometimes. (I always forget to use smilies) My (and my friends') reasoning for not disclosing is as I stated. Your "ashamed" set me back on my heels for a few seconds. It was an interpretation I hadn't even considered.

[Tweety, BSN, RN]

It IS difficult to understand through the written word sometimes. (I always forget to use smilies) My (and my friends') reasoning for not disclosing is as I stated. Your "ashamed" set me back on my heels for a few seconds. It was an interpretation I hadn't even considered.

I'm not sure when if/when I go into a hospital I'm going to say "I'm a nurse". It might be moot point because insurance dictates I go where I work.

If I have to deal with my family members in the hospital I will disclose my being a nurse if it's relavent. "I'm a nurse, so I understand the importance of......".

Many nurses use the fact that their a nurse as a tool to harras staff, heaping unrealistic expectations on us. "I'm a nurse and why hasn't my dad been bathed yet, it's 9:00AM, blah blah blah." So sometimes when you say you're a nurse, you get a nurse automatically on the defensive.

[Tweety, BSN, RN]

...........that millions of much-needed dollars/monies have to be spent on "consultants" and "firms" to teach simple concepts to us....... So I have to ask: WHERE IS THE CUSTOMER SERVICE FOR US as employees?????

Quote shortened for space considerations.

It should be self-evident that adults know who to treat patients. Unfortunately, when you get survey results that state "the nurses were uncaring and unresponsive to my needs", something needs to be done. I agree, it's very disheartening the amount of many these consultants get paid for telling people to be nice.

I think good customer service is part of my job description. Part of me getting paid, getting benefits and vacation, etc. is providing care in a matter that makes people feel like their being cared for.......in addition to competent clinical skill and knowledge. It's not contingent on whether I get customer service from management, in my work ethic it's because I'm earning a paycheck.

I know you weren't saying that nurses customer service is contingent upon the organizations customers service. You brought up some excellent points there that I agree with.

[pannie]

Ah, Tweedy, we're on the same wave length. Defensive, is exactly the word I should use. I never want anyone to feel defensive or uneasy. And I hated "tattling" but the surgeon is a dear friend and he'd had some frustrations over that med floor before my experience. He thought the administration MIGHT listen to a "consumer", I guess.

I have no idea if it helped or not. I'll ask him. I only told him because of the complete difference between the two floors.