Hospitals will never pay enough to have a nurse to patient ratio that would allow the nurse to actually be able to do their job at the high standard we are held to. Such a ratio would be so ridiculous that administrators would laugh.
Last week I somehow ended up having only 4 patients on my med surg night shift. Usually we have 5-6. At around 02:00, I was taking an elderly post op patient to the restroom who kept apologizing, "I am so sorry you have to help me, I don't want to be a bother, I know you are busy". As I reassured the patient that I had the time, was not busy, and was doing my job ("this is what I am here for"), I had a realization- I actually DIDN'T have anything else to do for once! No patients waiting for pain medication, antibiotics to hang, no assessments to chart, no one else ringing... I was completely caught up. It was a wonderful moment because I was able to truly attend to this patient without having to rush with fifteen other things on my mind.
I can't remember least time I have said, "is there anything else you need? I have the time!" without having been lying through my teeth. I said it to this patient, I meant it, and I left that room feeling fabulous. That night I did my job and in my heart knew I did it well.
1:4 as a standard would never happen on med surg, ever.
I won't list all of the examples for which "patient satisfaction recovery" is impossible. At least 1/5 of my patients are completely impossible to satisfy, with unrealistic expectations. These could be the drug seekers (for whom the only dose of narcotics to satisfy them would also be lethal), the manipulative personalities (admitted each month), or the CEO's daughter (VIP's), ect... There are always going to be patients who you can't please, no matter how above and beyond you try. Kiss their press ganey goodbye as soon as their room is assigned to your unit.
Some of our press ganey results are completely laughable and ridiculous. I will share one- poor ratings, and the expectation that "we need to invent wireless pulse oximetry monitoring and oxygen tubing, because in this day and age with technology it's unacceptable to have all these lines and wires attached". WIRELESS oxygen tubing!!! I would be a billionaire if I could figure that one out.
This whole topic is depressing. The only real solution is better staffing, to the point that it's a fools dream.
I am going to continue to do what I do- which is to truly give 100%, to the point that there is nothing left in me.
Any administrator needs to work four weeks on the floor (now, not ten years ago) before I would believe any single thing they say about "customer service". You are paid a lot more than me, you are certainly higher educated than I am, but you are ignorant of what I have to do on any given shift for twelve hours. Research all you want and put together an article with lots of action phrases and cheerleader optimism, but it means nothing to me unless you have worked the floor recently.