PR in Nursing Has Taken the Front Seat in Patient Care

Or, objects in the mirror are closer than they appear. Lately, seems as if image in nursing or even PR in nursing has taken the front seat in what makes great patient care. Does it, really? Can facilities create an image through PR that make a difference in how a patient is cared for? Or perhaps just the perception of care?

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PR in Nursing Has Taken the Front Seat in Patient Care

PR is big business in nursing. In order to have positive PR, a facility has to have a positive image. It is sometimes a difficult thing to be a well respected nurse due to what the nurse knows, as opposed to how politically correct, positive company image a nurse portrays.

Nursing has had a great deal of images throughout the years. At one time, nurses were respected with the title that they held by their cap and starched white dress, pristine, a uniform that commanded a certain presence. Compassionate, firm with kindness, and never ending wealth of hands on care are some thoughts that come to mind when one remembers that swish/swish of a nurse's dress as she walked down the hall. Never a prouder moment when they would "earn their cap".

When nursing changed a bit--and even men entered the nursing profession, there was a period of time that the nursing was loyalty. A nurse would be so very proud to be where they were. Facilities were thrilled if a nurse was on top of patient care, every patient was where they should be, and there was time and boundless energy to fluff and buff and do extras. They may be in freshly ironed scrubs (which in some facilities didn't come along until the late 70's! And even into the early 80's it was still all white scrubs) but every patient was up and clean and meds were carefully crushed in medium of choice, and there were breaks and charting time.....and patient load was maybe 3 or 4 patients per nurse. 5-7 on a really, really busy day if someone was out sick. You had DON's who would round and help with patients, as the DON's were long time nurses.

Now, nursing image is seen through a carefully planned communication process that is meant to anticipate and exceed what the patient believes they would like. Ratios far outweigh what any one nurse could possibly accomplish in a day, and any extras are a thing of the long, long past. However, a nurse now needs to know how to make a patient believe they have hit payday with what is akin to a private duty nurse who only has them for a patient.

And here lies the disconnect. Nurses who are used to actually creating a plan of care that can be reasonably accomplished--warts and all--(and most elderly people dislike taking that drug that makes em pee all day) are instead discussing how they want to "exceed expectations". And newer nurses are shocked to realize that "fluffing and buffing" even existed at all.

At the end of the day we are all wrinkled. Some more than others. Patients are no longer people. They are measurements by which someone else gets paid, and it is not the nurses.

Those who come to the conclusion that nursing is no more than customer service with some meds added in---oh, ya and that pesky "let's keep em alive then we will REALLY get dinged" become jaded. And overwhelmed. And wondering where that "swish, swish" went.

jadelpn, LPN, EMT-B

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Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

Fantastic article!

Reminds me of "back in the day".

This is almost true of every job in the USA not just nursing, it is the image not substance that counts.

Specializes in ob, med surg.

Yes agreed! One of the worst things I was ever told was that I 'spend too much time with the patient'. If that means alleviating their fears, explaining their care and their meds, giving bed baths, and giving them hope, then yes, I am guilty. At the same time, administration wants us to say to the patient 'Is there anything else I can do for you? I have time.' Even if you don't. It's all smoke and mirrors. :(

Specializes in LTC Rehab Med/Surg.

jadelpn:

How did you get in my brain and write what I think?

I remember the swish, swish. I even remember LIKING my patients a long time ago.

Specializes in LTC Rehab Med/Surg.

We have bi-monthly to monthly staff meetings with our NM. Those meetings used to revolve around policy and nurse concerns.

I didn't notice a shift, it was so gradual, until reading this article.

We don't really talk about policy and procedure anymore. We talk about phone etiquette. Dress codes. Professionalism and appearance. Last and not least survey approval scores and customer satisfaction

I have also been told that I spend too much time with the patients. I work in a procedural area that is like an assembly line. The patients are usually nervous about the procedure, the anesthesia, or both. I spend a little extra time and joke around a little and, of course, answer questions and address concerns. I think some individual attention takes away from the assembly line feel. My boss quit telling me I spend too much time with the patients when a patient, who happened to be on the hospital board, emailed the CEO to tell him what a great experience he had, thanks to me!

I replied to your post but it ended up under "imintrouble"'s post below!

Specializes in ICU, APHERESIS, IV THERAPY, ONCOLOGY, BC.

A thought provoking and insightful piece. Thanks jadepln for this. PR and politics go hand in hand, however how compatible or appropriate are these two issues to competence and nursing when compared to the level of real skills and knowledge which is needed for all patients today. This is rather like putting peanut butter over old, moldy bread in the hopes that no one will really notice and all will be fine. !! The reality is that Public relations in healthcare, particularly nursing is dependent on not only how professional we appear and represent our institution on the job., ie uniform, clean scrubs, proper shoes with a demeanor which will inspire confidence and reassurance to those who are ill and in need nursing. There is also the aspect which is ignored, deliberately or not, which is how does the institution treat its team, its staff members. It is difficult to hide poor management and lack of support to health team members and pretend that a positive PR approach is being practiced, in the hopes that management gaps can be conveniently ignored.

PR at the present time presents a form of stop-gap just-in-time policy because restructuring with increasing financial restraints impacts the greatest source of an organisation, its staff. Without considering in-depth restructuring as to maintain quality and excellence and to promote trust, teamwork and mutual respect, politics and pr become like balloons which have been inflated too long- they collapse, ( helium meets the same fate) While no one is denying the cruel realities of economic downturn, we still have an option to use our smarts for better outcomes with humility for humanity.

A thought provoking and insightful piece. Thanks jadepln for this. PR and politics go hand in hand, however how compatible or appropriate are these two issues to competence and nursing when compared to the level of real skills and knowledge which is needed for all patients today. This is rather like putting peanut butter over old, moldy bread in the hopes that no one will really notice and all will be fine. !! The reality is that Public relations in healthcare, particularly nursing is dependent on not only how professional we appear and represent our institution on the job., ie uniform, clean scrubs, proper shoes with a demeanor which will inspire confidence and reassurance to those who are ill and in need nursing. There is also the aspect which is ignored, deliberately or not, which is how does the institution treat its team, its staff members. It is difficult to hide poor management and lack of support to health team members and pretend that a positive PR approach is being practiced, in the hopes that management gaps can be conveniently ignored.

PR at the present time presents a form of stop-gap just-in-time policy because restructuring with increasing financial restraints impacts the greatest source of an organisation, its staff. Without considering in-depth restructuring as to maintain quality and excellence and to promote trust, teamwork and mutual respect, politics and pr become like balloons which have been inflated too long- they collapse, ( helium meets the same fate) While no one is denying the cruel realities of economic downturn, we still have an option to use our smarts for better outcomes with humility for humanity.

It may in fact be difficult to hide poor managment, however a nurse's idea of poor management and the expectation of big business are like night and day.

It is difficult to have a rah-rah we are all in this together attitude when we are losing nurses who are not replaced, we are churning out managers, manager's managers, and manager's manager's managers more than Carter has liver pills.

It is a study in opposites those who enjoy the clinical aspect of the job, and those who prefer the business end of things--both of which happen at the bedside.

Specializes in Family Nurse Practitioner.
Yes agreed! One of the worst things I was ever told was that I 'spend too much time with the patient'. If that means alleviating their fears, explaining their care and their meds, giving bed baths, and giving them hope, then yes, I am guilty. At the same time, administration wants us to say to the patient 'Is there anything else I can do for you? I have time.' Even if you don't. It's all smoke and mirrors. :(

Hey! I wonder if we work at the same hospital. That is line for my facility. I'm not a two faced lier so I will not say it if I really don't have time.

I will not call a patient a "customer" or "member". I will uphold the standards of nursing as defined my my nursing license. There is a balance of being able to get all of the priorities of patient care done first, then maybe Ill get that family member a soda... I think we can put a better face on Nursing: put away your phones, answer call lights, make your patients pretty in bed...

I very recently has a patient tell me that she wasn't receiving good customer service; I explained to her I was a Registered Nurse who was there to give her excellent patient care- she didn't complain after that.