Price of Patient Satisfaction

Sparrow91 · Aug 29, 2015

This was the video that was emphasized in my orientation...

It drove me nuts the entire time of orientation that the patient was always referred to as the "customer". That really rubbed me the wrong way and gave me a sense of what I was to expect on the job. I do not feel like the professional I thought I was going to be. I feel more like a cruise director on a lido deck! The only difference is that instead of cocktails I bring dilaudid, and instead of warm towels I bring warm blankets, just replace my nurses cap with that of a sailors cap and we'll be all set.

Here.I.Stand, BSN, RN · Aug 29, 2015

This was the video that was emphasized in my orientation...
It drove me nuts the entire time of orientation that the patient was always referred to as the "customer". That really rubbed me the wrong way

I just threw up in my mouth. :barf02:

jadelpn, LPN, EMT-B · Aug 29, 2015

I had something happen today that really bothered me. l lost my voice. I lost it in the name of patient satisfaction.
I listened to a male patient yell at me for something completely out of my control and then demand a new nurse because he didn't like my attitude.
My attitude consisted of explaining to him a certain policy and why it couldn't be broken. I then asked him why he was so mad and not to raise his voice at me. I said it in the most even, professional tone possible.
The bottom line and what bothers me most is he can treat me however he chooses. He can yell at me and if I say one word I am replaced. I am disposable. Who sticks up for me?
In what world is it ok for a grown man to speak to a woman or anyone for that matter in such a way? I feel like I have no voice or rights as a nurse sometimes.

Right when a voice is remotely raised--"I am going to stop this conversation at present, and go and get my charge nurse. Please explain to her your complaint, and we can see if there is a plan we can come up with. Thanks and we shall be back shortly" then literally walk out, go get your charge nurse, and THEN go into this room. It not only will give a few minutes for a cool off period, it will bring into the equation someone who has the power to do something about it.

jadelpn, LPN, EMT-B · Aug 29, 2015

I work in an oncology inpatient unit. It's funny how the sickest of patient's and families hardly ever act in this demenor. My cancer patients are amazing. It's when we have empty beds and over flow for the one night stay post surgery.
This man had a parotidectomy and was angry from the get go. He questioned everything I said and did, especially wearing the jaw bra. Complaining is ok, agression is not. I felt like he was use to calling the shots and wanted me to jump at his every request.
He was mad over a new bed not being there fast enough. Of course his particular bed was not comfortable enough, I was waiting on house cleaning to have it cleaned and he insisted on me bringing it before it was sanitized. Anyway, in your face yelling.
My charge kind of put him in his place and also took over his care since it was two bourse before shift change. She also told me it was in no way my fault he was an a-hole. But he wasn't reprimanded and got his demands. I feel its unreasonable.
My main concern was that I was in my rights calmly saying to him what I did, because it feels as though all that matters is the patients happiness and satisfaction surverys.

Take your feelings out of it. The situation was diffused, the patient was safe, and be thankful you don't have to take this person home with you. Feel for the person who does.....

Emergent, RN · Aug 29, 2015

I actually thought the video wasn't bad. It's a general one aimed at all industries. I think, what he's saying has some validity. Small things done for our patients can make a big impact on their perceptions.

Patients do need TLC. An extra pillow, a warm blanket, these little things can be a big comfort. Each person has their sweet spot, and a sensitive, intuitive nurse can find it fairly quickly.

trinitymaster · Aug 29, 2015

I get paid >$30/hr (and will get $50/hr when I start traveling again). Most new RNs make around $25/hour in my community.

I know that the wage is for the skill and knowledge that nurses bring with them, but for that kind of money we Should attend to the small details.

Of course, there is always the alternative:

fast-food-restaurants.JPG?w=497&h=278

bunsterj · Aug 29, 2015

Way back in 1982, during my new grad orientation, "the suits" came in during the early days. They welcomed us to the family, went over the history of the hospital, and other things I do not remember. One thing I do remember though, was when they told us that doctors and patients bring in money, and nurses cost the hospital money. If there was a problem, guess who they were siding with? It was cold, but through the years it was the truth.

mc3, ASN, RN · Aug 29, 2015

This is hearsay...but I heard it from the person involved, so I call it probably pretty accurate hearsay.
We had a patient - not confused, perfectly oriented, and completely capable of controlling his actions - break a CNA's arm. Deliberately, because he was annoyed and he got his hands on her and he could. Our nurse manager not only did nothing at the time, but when this patient was readmitted, she did not support the nursing staff who wanted to bar him from our floor. He was allowed *back*. The CNA in question transferred jobs a short time after. Which is a serious shame, because she was one of the best we had.

OMG:mad: Why can't he be charged with assault and battery???

mc3:nurse:

NursesRmofun, ASN, RN · Aug 29, 2015

I have had employers that backed me up when patients were *not reasonable or were rude, but, recently...not so much the attitude at my place of employment. If a patient has a request that is more in the realm of the CNA, but I answer the call light...I had better not try to find a CNA and just better go ahead and spend 15 mins I don't have ambulating someone to the bathroom and cleaning them up afterward too. Not good....but it does have to do with patient satisfaction.

Brekka, ADN, RN · Aug 29, 2015

I work in a rehab/LTC facility, and the rights of employees is far outweighed by the rights of patients and families. We're told to refer to patients as guests, as if we're striving to achieve a 5 star resort rating. Anything they want, whether it's healthy, safe or correct, we're supposed to provide it, or at least try.

Our admin staff emphasizes customer service over everything else. I agree we need to be as tactful as possible, but we're still in healthcare, and sometimes people just need to hear the truth. One of my very aware, continually educated diabetic patients will routinely be mid 300s-400s by lunch, because he has cookies, candy and soda at his bedside. When I check his sugar and he's high, he'll always ask, "Well I don't understand why I'm so high." He'll have 2-3 empty soda cans at bedside between breakfast and lunch. I've educated him on how his habits and lifestyle are the ones effecting his glucose levels more times than I can count. When confronting admin staff about it, I was asked what I could do to minimize his desire to eat and drink between meals, and make healthier choices. They tell us (nursing staff) that the patient is never responsible for what happens - ever. How is this acceptable?

We are currently on semi-lockdown with an outbreak of noro. 15 people one side of the building have been diagnosed, and we're basically shut off from that side. We also ask sick family members not to visit, and it's a policy. We had a family member come in who was symptomatic with an elevated temp, who intended to sit in the dining room at lunch with their family member. Another nurse and I confronted him, stating our policy and making the suggestion not to visit at that time to keep their family member and others from getting sick. The family member had a very short fuse and started yelling and screaming at us, just in time for admin staff to come up and tell the family member that they could stay and eat with their family... in the dining room with 40 other patients. They then turned to us and said, "He gets mad easily, just let him stay. We'll make an exception."

We've also had a mentally ill family member come in drunk with a baseball bat and threaten the staff because their mother wasn't getting any better (80+), and he nearly hit one of the nurses across the face with the bat. It was a big deal, a lot of chaos and drama. In the end we were confronted by admin and asked what we did to provoke them - the facility didn't press charges. For months a topic of the monthly staff meetings addressed what we did wrong in that incident, and how we were to blame for it.

lindarn · Aug 29, 2015

This will continue until nurses start to bill for their services. As long as nursings' professional practice is rolled into the room rate, housekeeping, and the complimentary roll of toilet paper, nursings' professional practice will forever remain on the negative column of the financial balance sheet.

I have heard all of the comments, on why it is not practical for nurses to bill, but it is more of a refusal to work with the system, borrow from other departments, who do bill for their services, and implement this with the billing department.

For instance,a standard rate for med surg, would be $$$. This would include basic things like bathing,medication administration, vital signs, etc. Then you start to add things like, IV's, dressing changes, (simple or complicated), oxygen treatments, other treatments.

The charges would be for things like, ICU/ER, care, Swan Ganz catheters, Arterial lines, dialysis, CVVHD, hemodynamic drips and titration, etc. You can just look at the usual day, and go on from there. OB care- labor and delivery, surgery post op-pacu, etc. The charges would reflect the patient population, and patient care needs. Just like doctors do, and PT, RT, SP, etc.

I do not mean, that patients, insurance companies, would pay us directly, or that we would have to do be responsible for some complicated billing system. We would just fill in a customized billing sheet,(check off the boxes), and turn it in to the billing department-an in-box at the nurses station. RT fills out a charge slip when they did an arterial blood gas, but if nurses did it, it was part of the room rate. Nice?

Gone would be the days, that nurses in high acuity/intensive areas, receive the same rate of pay as units who care for standard med surg patients. Yes, you may have more patients to care for, but the patients are all receiving standard med surg care. More education and training deserve higher rates of pay for nurses, just like doctors do. A GP earns far less than a cardiac transplant surgeon. If you have more patients to care for, then you just have more patients to charge for their nursing care.

There is NO reason this cannot be accomplished. Again, there is no desire/push, in nursing to be autonomous, and get paid for what we do. With the more complicated hospitalization, the higher the charges, just like doctors receive, and all other departments do. There is also no desire/push from administration, because even though it would mean more income for the hospital, hospitals have NO desire to have to admit that the nursing staff has worth.

CEOs want the nursing profession to remain barefoot and pregnant. In other words, powerless, and invisible. Until we push to make the changes, we will forever remain on the negative side of the balance sheet.

JHMO and my NY $0.02

Lindarn, RN, BSN, CCRN, (ret )

Somewhere in the PACNW

SarahMaria, MSN, RN · Aug 29, 2015

I'm so glad I work in forensics. We don't worry about patient satisfaction. There are no surveys. Very rarely does a patient complaint go anywhere unless it alleges abuse by staff. If a patient doesn't like his food, room, or nurse, oh well, that's what he's getting. No special treatment.