"Customer service" and nursing

[LilPeanut]

I've seen a lot of people talk about 'customer service' in a disparaging manner, as if that is not what nursing is about and it's making their lives harder to provide it.

Could someone explain that more for me?

Personally customer service is another way of saying good bedside manner. It doesn't matter what you know if you cannot present it in a way that encourages others to follow you. Many of the things I hear people complaining about for "customer service", could be solved by patient/family education and a less adversarial relationship between staff and family.

What are your thoughts?

[anonymurse]

Sometimes folks feel they're all alone with their worst fears in a strange place. Sure they whine, they're regressing. Sometimes they just need a little limit setting, sometimes comfort. Always they need an answer of some kind, and if a promise is made, which isn't a good idea, it must be honored.

When I was an aide, I did aide things. To me, the task of providing non-urgent amenities belonged to me. If I saw a RN going to get someone some water, I'd offer to do it myself if allowed. OK, sometimes that offer had to be "Hey, I can get that within 20 minutes." Aides have to prioritize, too.

So now if I get a request for an amenity and I'm not coming right back, or even if I'm coming right back but I sense the need with this pt to rigidly exclude servitude from their perception of my role, I'll say "I'll let your aide know" or "I'll ask your aide to help you with that" as I nod and back out the door, watching for their return nod.

See, you do want to give them a feeling of control. But there are plenty of other ways of doing that than making yourself into a servant, and much more effective. Like you can make them feel control by having them perceive you as a powerful person who is on their side.

Pts need a rock to lean on. Part of their limit testing is a hope they will eventually meet resistance and feel secure. Plus if you give up your authority and power, you can never get it back. Then when you need it to obtain compliance, you're hosed.

[CRNI-ICU20]

Dry Erase Boards???? ARE YOU KIDDING ME??

In the time it would take me to fill out yet another "form", my patient could exsanguinate, choke to death, blow a pupil, or yes...DIE!

I do not have time for such nonsense...this is a hospital, not a cruise ship activity calendar!

My patients' needs ARE met....they are breathing...they have a heart beat....they are warm/cold per their needs and preference....and depending on their diagnosis (yes...remember that???) they might get food, OR NOT!!

Maybe administrators have all kinds of time to go niggling around and think of one more way to tie up my hands, but I prefer to have them busy DOING FOR MY PATIENT....not writing it all down so I look good to the administrator...this is straight out of Office Space, but unfortunately, it isn't as funny, because it's real.

I wonder, if you fill in all the squares, do you get some sort of prize at the end of the day....like a candy bar or something???

ugh.

And....another thing!

What about HIPPA rules??? why is all this information out in plain site for the whole world to see....did the administration ever think about how they are divulging personal medical information to anyone who comes into the room and can read?? Like housekeepers, nosy family members, and neighbors who visit? What the heck are they thinking???

[rnin02]

Dry Erase Boards???? ARE YOU KIDDING ME??

In the time it would take me to fill out yet another "form", my patient could exsanguinate, choke to death, blow a pupil, or yes...DIE!

I do not have time for such nonsense...this is a hospital, not a cruise ship activity calendar!

My patients' needs ARE met....they are breathing...they have a heart beat....they are warm/cold per their needs and preference....and depending on their diagnosis (yes...remember that???) they might get food, OR NOT!!

Maybe administrators have all kinds of time to go niggling around and think of one more way to tie up my hands, but I prefer to have them busy DOING FOR MY PATIENT....not writing it all down so I look good to the administrator...this is straight out of Office Space, but unfortunately, it isn't as funny, because it's real.

I wonder, if you fill in all the squares, do you get some sort of prize at the end of the day....like a candy bar or something???

ugh.

And....another thing!

What about HIPPA rules??? why is all this information out in plain site for the whole world to see....did the administration ever think about how they are divulging personal medical information to anyone who comes into the room and can read?? Like housekeepers, nosy family members, and neighbors who visit? What the heck are they thinking???

So, you have nothing in your patient's rooms where you at least put your name? I would think everyone knows the board is not the priority when you are busy with critical patients, but if you're not busy, it takes 5 seconds of your time to write your name, date, etc on a board as you make your intial rounds on a patient. And I don't think there is any sort of HIPPA violation going on...this board is in the patient room, not the hallways for everyone to see. I would assume personal information the patient does not want disclosed would not be put on such a board.

[softstorms]

As I read thru all of these I found that I totally agree with you CRNI. As my "customer service" I have found myself spending many minutes that turned into hours with complaints about food, phones,linens, snacks (she likes chocolate pudding, not banana) We also have a 24/7 visitation rule. We have an open switchboard that allows calls to rooms 24/7. I am beginning to feel like we have a hotel service instead of a health-care service. Just once I would like to say "It is 11 p.m. and our patients need to have undisturbed sleep,no you can't visit or call." And no, I do not have time to discuss your mom's bowel movements (that are large and healthy) for 20 minutes while I have 3 antibiotics running on PICC lines. Don't call me after you get home from work, just to check on dad (at 1 a.m.) Yes he is asleep and no he is not in trouble just because he did not pick up his phone. (after his pain meds and a sleeping pill, he is very comfortable and NO, I will not wake him) . I think we are so afraid of offending or losing "customers" that we no longer allow our staff to care for the patients that were brought to us for that very reason. I see no way to fix that.

[darrell]

Darrell - I don't believe she's trying to be 'silly' at all!! Just truthful about what some people's expectations were.

...

But these nice nurses put a burden on all of the rest of us - I remember one night this nurse who was FAMOUS for being a patient floormat, left the department to take a patient to her car. And didn't come back for 45 minutes - now, we were busy, patients coming out of anesthesia right and left, and all our other patients to take care of.

Found out the patient and her husband had asked to be taken to another part of the hospital to visit another family member - so she took them! You betcha she got 'brownie points' from this family - but she won no awards from her co-workers.:angryfire

This is what I meant by silly. Not the poster's description, but the incidents being described. I'll stack my service reputation up against any in the world, but I don't always say yes. I guess I just get along well enough with people that they respect my need to say no when it occurs.

Customer service isn't about always saying yes nor is it about servitude. It's about discovering what the customer wants and then either providing it or seeking an acceptable compromise when you can't.

I think it's often simply about caring and communication skills. I remember my EMT instructor once telling me that he had never heard of a patient suing an EMT the patient liked. True or not, there's a lesson there. And people, customers and family, can like you even if you can't deliver everything they ask for.

[CRNI-ICU20]

To rnin02: Most of my patients are in a drug induced coma or they are just waking up after a drug induced coma, or they are head injured, or they are so septic, that they cannot put a complete sentence together....THEY DON'T CARE WHAT MY NAME IS! This is the point I am making....that people in administrative positions often have some grandiose idea that THEY believe will illicit the illusion of 'customer service' and since they are not at the bedside, they are clueless as to what would be 'helpful' to my patients....often, they don't ask the ONE PERSON WHO KNOWS the answer to that question, and instead, make wrong assumptions about what should work....

In our unit, a dry erase board will be seen by as many as 10 outside individuals in a given day....I don't think it is prudent to put someone's pain tolerance levels along with the name of their pain medication being given on a board in their room for everyone to see....along with whether or not they like crossword puzzles!

In units where people are even more mobile, I would surmise the number of people who visit that room would increase even more....does a physical therapist, housekeeper, maintainence man, or visitor who may be visiting the patient in the adjoining bed need to know that information on the board? Not all hospitals have private rooms....many are semi-private.

I get along well with people, too. But like the above poster, I must prioritize as to what is most important vs. what isn't.

And there lies the rub. When you add families with unrealistic and delusional expectations into the mix, and you have an administration that believes that we are a day-spa-recreational-vacation-destination-hotel-hospital, THE NURSE, the one who is hired to care for the patient, is blamed when the pudding isn't chocolate, when the blankets are not provided for the three barnacle family members hanging out in the waiting room, and when the coffee pot runs dry....

This situation is completely out of control, because we have been groomed to believe this is part and parcel of patient care, when it isn't.

If we are going to call ourselves a PROFESSION, then we have to assume a united front and educate the public, the hospital associations, and the administrative elements in health care about WHO WE REALLY ARE.

When nurses are being written up because they failed to cough up their own money for a newspaper, or on their evaluations, they are 'dinged' for not smiling more, not greeting each patient more, etc.

I ask you, would a BANKER be adjudicated this way? Would a LAWYER? how about a COLLEGE PROFESSOR?

WE have just as much life experience and hard core education as they do, and yet, we are held in subjugation by people who have less education and less life experience and are pretty much clueless what we do at the bedside....

Many of you know of nurses who went into administration, having NEVER worked at the bedside.....don't you think this jades their reality a bit?

People who make decisions for us, are either too removed and detatched to understand our reality, or they prefer to put their collective heads in the sand and pretend we don't exist and we don't have any problems...and that whatever problems there are, are because nurses aren't doing enough.

Just once I would like to have the tables turned and have the administrators have to follow their own idiotic ideas and then be judged on them via their own evalutaions....

for instance:

1) they must bring coffee and donuts to each and every waiting room in the hospital everyday without fail....with a morning paper....and a smile....and introduce themselves as the " Blah Blah Administrator"....they must do this out of their own pocket regularly, all as part of being a team, and 'customer service'....they must ask each and every waiting room occupant "how can I make your stay more comfortable" (eventhough, WE understand that THEY are not the patient!)....and then whatever that occupant asks for, the Blah Blah administrator should provide that at whatever cost to their day or their own agenda, because it's "customer service"; if they fail to do so, they will be written up.

In a heartbeat, the above way of thinking will change 180 degrees....

I have no problem telling my patient who I am....because I happen to be enough in tune with my patient, I don't have to write down on a dry erase board their pain needs, their preferences, their pain medications, or their penchant for crossword puzzles....the reason I know this about my patients, is because I AM AT THE BEDSIDE....

People who don't occupy that spot need to move out of the way, because there's no room for two of us at the bedside...that includes pushy family members who once read a Reader's Digest article and now consider themselves a medical authority, nosey neighbors, and ignorant administrators who just fell off the turnip truck and think they have discovered a new catchy phrase for health care delivery systems.

If the administration wants customer service perks to be provided for the patients, families, et al....then maybe they should be the ones to do so...and then let us nurses get on with what we are trained and educated to do....

okay...now I will put on my Kevalar underwear so I don't get my butt shot off!! hehehehe!

[pie123]

To rnin02: Most of my patients are in a drug induced coma or they are just waking up after a drug induced coma, or they are head injured, or they are so septic, that they cannot put a complete sentence together....THEY DON'T CARE WHAT MY NAME IS! This is the point I am making....that people in administrative positions often have some grandiose idea that THEY believe will illicit the illusion of 'customer service' and since they are not at the bedside, they are clueless as to what would be 'helpful' to my patients....often, they don't ask the ONE PERSON WHO KNOWS the answer to that question, and instead, make wrong assumptions about what should work....

In our unit, a dry erase board will be seen by as many as 10 outside individuals in a given day....I don't think it is prudent to put someone's pain tolerance levels along with the name of their pain medication being given on a board in their room for everyone to see....along with whether or not they like crossword puzzles!

In units where people are even more mobile, I would surmise the number of people who visit that room would increase even more....does a physical therapist, housekeeper, maintainence man, or visitor who may be visiting the patient in the adjoining bed need to know that information on the board? Not all hospitals have private rooms....many are semi-private.

I get along well with people, too. But like the above poster, I must prioritize as to what is most important vs. what isn't.

And there lies the rub. When you add families with unrealistic and delusional expectations into the mix, and you have an administration that believes that we are a day-spa-recreational-vacation-destination-hotel-hospital, THE NURSE, the one who is hired to care for the patient, is blamed when the pudding isn't chocolate, when the blankets are not provided for the three barnacle family members hanging out in the waiting room, and when the coffee pot runs dry....

This situation is completely out of control, because we have been groomed to believe this is part and parcel of patient care, when it isn't.

If we are going to call ourselves a PROFESSION, then we have to assume a united front and educate the public, the hospital associations, and the administrative elements in health care about WHO WE REALLY ARE.

When nurses are being written up because they failed to cough up their own money for a newspaper, or on their evaluations, they are 'dinged' for not smiling more, not greeting each patient more, etc.

I ask you, would a BANKER be adjudicated this way? Would a LAWYER? how about a COLLEGE PROFESSOR?

WE have just as much life experience and hard core education as they do, and yet, we are held in subjugation by people who have less education and less life experience and are pretty much clueless what we do at the bedside....

Many of you know of nurses who went into administration, having NEVER worked at the bedside.....don't you think this jades their reality a bit?

People who make decisions for us, are either too removed and detatched to understand our reality, or they prefer to put their collective heads in the sand and pretend we don't exist and we don't have any problems...and that whatever problems there are, are because nurses aren't doing enough.

Just once I would like to have the tables turned and have the administrators have to follow their own idiotic ideas and then be judged on them via their own evalutaions....

for instance:

1) they must bring coffee and donuts to each and every waiting room in the hospital everyday without fail....with a morning paper....and a smile....and introduce themselves as the " Blah Blah Administrator"....they must do this out of their own pocket regularly, all as part of being a team, and 'customer service'....they must ask each and every waiting room occupant "how can I make your stay more comfortable" (eventhough, WE understand that THEY are not the patient!)....and then whatever that occupant asks for, the Blah Blah administrator should provide that at whatever cost to their day or their own agenda, because it's "customer service"; if they fail to do so, they will be written up.

In a heartbeat, the above way of thinking will change 180 degrees....

I have no problem telling my patient who I am....because I happen to be enough in tune with my patient, I don't have to write down on a dry erase board their pain needs, their preferences, their pain medications, or their penchant for crossword puzzles....the reason I know this about my patients, is because I AM AT THE BEDSIDE....

People who don't occupy that spot need to move out of the way, because there's no room for two of us at the bedside...that includes pushy family members who once read a Reader's Digest article and now consider themselves a medical authority, nosey neighbors, and ignorant administrators who just fell off the turnip truck and think they have discovered a new catchy phrase for health care delivery systems.

If the administration wants customer service perks to be provided for the patients, families, et al....then maybe they should be the ones to do so...and then let us nurses get on with what we are trained and educated to do....

okay...now I will put on my Kevalar underwear so I don't get my butt shot off!! hehehehe!

I freakin' love you! You are right on!

One day administration chose to follow me and watch me do rounds on one of my patients. They commended me for my boards, but at the end, they said that I did not address "the 3 p's with my patient: positioning, potty, and pain". Before I leave the room, I always ask the patient, "Can I get you anything/do anything for you before I go?" This is exactly what I said that day. I think this is sufficient, and this is still my practice. They thought my statement was too broad. Ok....now we're splitting hairs. I have yet to have one patient say to me, "Could you be more specific? I don't know what you mean when you ask me if there's anything that I need."

[CRNI-ICU20]

I also want to add a side point and consequence that comes out of this kind of 'customer service' way of thinking.

My son works for a large restaurant chain that is well known....and it is well known that if you go to eat at this restaurant and make one little complaint...like the food is too hot/cold, undercooked/overcooked, large portioned/small portioned, the atmosphere is too noisy/quiet, the waiters/esses are too friendly/not friendly enough, the restaurant chain notoriously gives you a free voucher for another free dinner on them the next time you are in....

The idiocy of this is that management actually believes that this will keep a good customer base, and that they will continue to gain monetarily from this....ahem.

Nothing could be more delusional. What this does is that it teaches people that all they have to do is complain about something, and they will get a free meal....in fact, this is so consistent with this company, David Letterman actually commented on it on his show one night....

The motivating reason that the company does this is because they are so afraid of being sued????

Well, here's a novel idea!! What if you provided great food, great service, and people actually came in and ate and went home happy?? Of course, there will be the ones who nit pick over every speck of pepper on the steak, but, why cater to them....who needs that kind of customer base? Doesn't corporate understand that a whole base of these non-paying complainers will sooner or later cause the company to fold???

Hospitals are different....our 'product' is different....our delivery system is different....you cannot offer a family a voucher to come back in a week and have their gall bladder removed for free!! for crying out loud!

So, I say, don't play that game in the first place...

I say, give good, safe, excellent care.....and let the whiners eat their chocolate pudding somewhere else....we don't need a base of 'customers' that only find fault....nor do we need a base of administrators that only find fault...

Nurses are soon going to burn out with this kind of thinking....

We can do 20 things right, but if some clip board carrying administrator trots up and whines about the ONE THING we aren't able to do, nurses will soon leave in droves....and who then, will take care of the sick and injured??? They need to wake up.

[NurseShelly]

To rnin02: Most of my patients are in a drug induced coma or they are just waking up after a drug induced coma, or they are head injured, or they are so septic, that they cannot put a complete sentence together....THEY DON'T CARE WHAT MY NAME IS! This is the point I am making....that people in administrative positions often have some grandiose idea that THEY believe will illicit the illusion of 'customer service' and since they are not at the bedside, they are clueless as to what would be 'helpful' to my patients....often, they don't ask the ONE PERSON WHO KNOWS the answer to that question, and instead, make wrong assumptions about what should work....

In our unit, a dry erase board will be seen by as many as 10 outside individuals in a given day....I don't think it is prudent to put someone's pain tolerance levels along with the name of their pain medication being given on a board in their room for everyone to see....along with whether or not they like crossword puzzles!

In units where people are even more mobile, I would surmise the number of people who visit that room would increase even more....does a physical therapist, housekeeper, maintainence man, or visitor who may be visiting the patient in the adjoining bed need to know that information on the board? Not all hospitals have private rooms....many are semi-private.

I get along well with people, too. But like the above poster, I must prioritize as to what is most important vs. what isn't.

And there lies the rub. When you add families with unrealistic and delusional expectations into the mix, and you have an administration that believes that we are a day-spa-recreational-vacation-destination-hotel-hospital, THE NURSE, the one who is hired to care for the patient, is blamed when the pudding isn't chocolate, when the blankets are not provided for the three barnacle family members hanging out in the waiting room, and when the coffee pot runs dry....

This situation is completely out of control, because we have been groomed to believe this is part and parcel of patient care, when it isn't.

If we are going to call ourselves a PROFESSION, then we have to assume a united front and educate the public, the hospital associations, and the administrative elements in health care about WHO WE REALLY ARE.

When nurses are being written up because they failed to cough up their own money for a newspaper, or on their evaluations, they are 'dinged' for not smiling more, not greeting each patient more, etc.

I ask you, would a BANKER be adjudicated this way? Would a LAWYER? how about a COLLEGE PROFESSOR?

WE have just as much life experience and hard core education as they do, and yet, we are held in subjugation by people who have less education and less life experience and are pretty much clueless what we do at the bedside....

Many of you know of nurses who went into administration, having NEVER worked at the bedside.....don't you think this jades their reality a bit?

People who make decisions for us, are either too removed and detatched to understand our reality, or they prefer to put their collective heads in the sand and pretend we don't exist and we don't have any problems...and that whatever problems there are, are because nurses aren't doing enough.

Just once I would like to have the tables turned and have the administrators have to follow their own idiotic ideas and then be judged on them via their own evalutaions....

for instance:

1) they must bring coffee and donuts to each and every waiting room in the hospital everyday without fail....with a morning paper....and a smile....and introduce themselves as the " Blah Blah Administrator"....they must do this out of their own pocket regularly, all as part of being a team, and 'customer service'....they must ask each and every waiting room occupant "how can I make your stay more comfortable" (eventhough, WE understand that THEY are not the patient!)....and then whatever that occupant asks for, the Blah Blah administrator should provide that at whatever cost to their day or their own agenda, because it's "customer service"; if they fail to do so, they will be written up.

In a heartbeat, the above way of thinking will change 180 degrees....

I have no problem telling my patient who I am....because I happen to be enough in tune with my patient, I don't have to write down on a dry erase board their pain needs, their preferences, their pain medications, or their penchant for crossword puzzles....the reason I know this about my patients, is because I AM AT THE BEDSIDE....

People who don't occupy that spot need to move out of the way, because there's no room for two of us at the bedside...that includes pushy family members who once read a Reader's Digest article and now consider themselves a medical authority, nosey neighbors, and ignorant administrators who just fell off the turnip truck and think they have discovered a new catchy phrase for health care delivery systems.

If the administration wants customer service perks to be provided for the patients, families, et al....then maybe they should be the ones to do so...and then let us nurses get on with what we are trained and educated to do....

okay...now I will put on my Kevalar underwear so I don't get my butt shot off!! hehehehe!

Well said!

[fmwf]

To rnin02: Most of my patients are in a drug induced coma or they are just waking up after a drug induced coma, or they are head injured, or they are so septic, that they cannot put a complete sentence together....THEY DON'T CARE WHAT MY NAME IS! This is the point I am making....that people in administrative positions often have some grandiose idea that THEY believe will illicit the illusion of 'customer service' and since they are not at the bedside, they are clueless as to what would be 'helpful' to my patients....often, they don't ask the ONE PERSON WHO KNOWS the answer to that question, and instead, make wrong assumptions about what should work....

In our unit, a dry erase board will be seen by as many as 10 outside individuals in a given day....I don't think it is prudent to put someone's pain tolerance levels along with the name of their pain medication being given on a board in their room for everyone to see....along with whether or not they like crossword puzzles!

In units where people are even more mobile, I would surmise the number of people who visit that room would increase even more....does a physical therapist, housekeeper, maintainence man, or visitor who may be visiting the patient in the adjoining bed need to know that information on the board? Not all hospitals have private rooms....many are semi-private.

I get along well with people, too. But like the above poster, I must prioritize as to what is most important vs. what isn't.

And there lies the rub. When you add families with unrealistic and delusional expectations into the mix, and you have an administration that believes that we are a day-spa-recreational-vacation-destination-hotel-hospital, THE NURSE, the one who is hired to care for the patient, is blamed when the pudding isn't chocolate, when the blankets are not provided for the three barnacle family members hanging out in the waiting room, and when the coffee pot runs dry....

This situation is completely out of control, because we have been groomed to believe this is part and parcel of patient care, when it isn't.

If we are going to call ourselves a PROFESSION, then we have to assume a united front and educate the public, the hospital associations, and the administrative elements in health care about WHO WE REALLY ARE.

When nurses are being written up because they failed to cough up their own money for a newspaper, or on their evaluations, they are 'dinged' for not smiling more, not greeting each patient more, etc.

I ask you, would a BANKER be adjudicated this way? Would a LAWYER? how about a COLLEGE PROFESSOR?

WE have just as much life experience and hard core education as they do, and yet, we are held in subjugation by people who have less education and less life experience and are pretty much clueless what we do at the bedside....

Many of you know of nurses who went into administration, having NEVER worked at the bedside.....don't you think this jades their reality a bit?

People who make decisions for us, are either too removed and detatched to understand our reality, or they prefer to put their collective heads in the sand and pretend we don't exist and we don't have any problems...and that whatever problems there are, are because nurses aren't doing enough.

Just once I would like to have the tables turned and have the administrators have to follow their own idiotic ideas and then be judged on them via their own evalutaions....

for instance:

1) they must bring coffee and donuts to each and every waiting room in the hospital everyday without fail....with a morning paper....and a smile....and introduce themselves as the " Blah Blah Administrator"....they must do this out of their own pocket regularly, all as part of being a team, and 'customer service'....they must ask each and every waiting room occupant "how can I make your stay more comfortable" (eventhough, WE understand that THEY are not the patient!)....and then whatever that occupant asks for, the Blah Blah administrator should provide that at whatever cost to their day or their own agenda, because it's "customer service"; if they fail to do so, they will be written up.

In a heartbeat, the above way of thinking will change 180 degrees....

I have no problem telling my patient who I am....because I happen to be enough in tune with my patient, I don't have to write down on a dry erase board their pain needs, their preferences, their pain medications, or their penchant for crossword puzzles....the reason I know this about my patients, is because I AM AT THE BEDSIDE....

People who don't occupy that spot need to move out of the way, because there's no room for two of us at the bedside...that includes pushy family members who once read a Reader's Digest article and now consider themselves a medical authority, nosey neighbors, and ignorant administrators who just fell off the turnip truck and think they have discovered a new catchy phrase for health care delivery systems.

If the administration wants customer service perks to be provided for the patients, families, et al....then maybe they should be the ones to do so...and then let us nurses get on with what we are trained and educated to do....

okay...now I will put on my Kevalar underwear so I don't get my butt shot off!! hehehehe!

Dear CRNI,

I am a new new new nurse and even newer to these boards. If I might say you are the first one to address this aspect of this thing. Indeed! We are a PROFESSION! To be repetitive, we have no more profressional capital to give up on this thing. (I want a refund on my nursing education.)

After one crazy year where I felt like I learned nothing but was harrassed aplenty, I interviewed last week for a job and was asked nothing but CUSTOMER SERVICE questions. Oh my goodness. I was so ill prepared. After the fifth question I could not fake it anymore. Needless to say, I was told that I would not be given a second interview.

Next time I will go into my waitress character and not come out...if I want a JOB.

I am a altruistic,conscientious, articulate, athletic, polite, quick-thinking person of high ethic. I was an ill-paid ($9.00/h) community health worker b/f nursing. TB exposure and the whole bit.

Often I do not think that I will be able to learn what is necessary in 2007 to make it as a nurse.

What can we do proactively? What can I do? I found this part of my first year truly nerve-racking.

Anybody?

[fmwf]

I also want to add a side point and consequence that comes out of this kind of 'customer service' way of thinking.

My son works for a large restaurant chain that is well known....and it is well known that if you go to eat at this restaurant and make one little complaint...like the food is too hot/cold, undercooked/overcooked, large portioned/small portioned, the atmosphere is too noisy/quiet, the waiters/esses are too friendly/not friendly enough, the restaurant chain notoriously gives you a free voucher for another free dinner on them the next time you are in....

The idiocy of this is that management actually believes that this will keep a good customer base, and that they will continue to gain monetarily from this....ahem.

Nothing could be more delusional. What this does is that it teaches people that all they have to do is complain about something, and they will get a free meal....in fact, this is so consistent with this company, David Letterman actually commented on it on his show one night....

The motivating reason that the company does this is because they are so afraid of being sued????

Well, here's a novel idea!! What if you provided great food, great service, and people actually came in and ate and went home happy?? Of course, there will be the ones who nit pick over every speck of pepper on the steak, but, why cater to them....who needs that kind of customer base? Doesn't corporate understand that a whole base of these non-paying complainers will sooner or later cause the company to fold???

Hospitals are different....our 'product' is different....our delivery system is different....you cannot offer a family a voucher to come back in a week and have their gall bladder removed for free!! for crying out loud!

So, I say, don't play that game in the first place...

I say, give good, safe, excellent care.....and let the whiners eat their chocolate pudding somewhere else....we don't need a base of 'customers' that only find fault....nor do we need a base of administrators that only find fault...

Nurses are soon going to burn out with this kind of thinking....

We can do 20 things right, but if some clip board carrying administrator trots up and whines about the ONE THING we aren't able to do, nurses will soon leave in droves....and who then, will take care of the sick and injured??? They need to wake up.

I am just one year in. Don't think that I want to be driven neurotic while being liable for pt lives. While nurses do what they do best: assume the passive role. Starting my own business. Praying that I can keep my job long enough to get it going. I think we might lose the house, nothing to say about the student loans.

[rnin02]

To rnin02: Most of my patients are in a drug induced coma or they are just waking up after a drug induced coma, or they are head injured, or they are so septic, that they cannot put a complete sentence together....THEY DON'T CARE WHAT MY NAME IS! This is the point I am making....that people in administrative positions often have some grandiose idea that THEY believe will illicit the illusion of 'customer service' and since they are not at the bedside, they are clueless as to what would be 'helpful' to my patients....often, they don't ask the ONE PERSON WHO KNOWS the answer to that question, and instead, make wrong assumptions about what should work....

In our unit, a dry erase board will be seen by as many as 10 outside individuals in a given day....I don't think it is prudent to put someone's pain tolerance levels along with the name of their pain medication being given on a board in their room for everyone to see....along with whether or not they like crossword puzzles!

In units where people are even more mobile, I would surmise the number of people who visit that room would increase even more....does a physical therapist, housekeeper, maintainence man, or visitor who may be visiting the patient in the adjoining bed need to know that information on the board? Not all hospitals have private rooms....many are semi-private.

I get along well with people, too. But like the above poster, I must prioritize as to what is most important vs. what isn't.

And there lies the rub. When you add families with unrealistic and delusional expectations into the mix, and you have an administration that believes that we are a day-spa-recreational-vacation-destination-hotel-hospital, THE NURSE, the one who is hired to care for the patient, is blamed when the pudding isn't chocolate, when the blankets are not provided for the three barnacle family members hanging out in the waiting room, and when the coffee pot runs dry....

This situation is completely out of control, because we have been groomed to believe this is part and parcel of patient care, when it isn't.

If we are going to call ourselves a PROFESSION, then we have to assume a united front and educate the public, the hospital associations, and the administrative elements in health care about WHO WE REALLY ARE.

When nurses are being written up because they failed to cough up their own money for a newspaper, or on their evaluations, they are 'dinged' for not smiling more, not greeting each patient more, etc.

I ask you, would a BANKER be adjudicated this way? Would a LAWYER? how about a COLLEGE PROFESSOR?

WE have just as much life experience and hard core education as they do, and yet, we are held in subjugation by people who have less education and less life experience and are pretty much clueless what we do at the bedside....

Many of you know of nurses who went into administration, having NEVER worked at the bedside.....don't you think this jades their reality a bit?

People who make decisions for us, are either too removed and detatched to understand our reality, or they prefer to put their collective heads in the sand and pretend we don't exist and we don't have any problems...and that whatever problems there are, are because nurses aren't doing enough.

Just once I would like to have the tables turned and have the administrators have to follow their own idiotic ideas and then be judged on them via their own evalutaions....

for instance:

1) they must bring coffee and donuts to each and every waiting room in the hospital everyday without fail....with a morning paper....and a smile....and introduce themselves as the " Blah Blah Administrator"....they must do this out of their own pocket regularly, all as part of being a team, and 'customer service'....they must ask each and every waiting room occupant "how can I make your stay more comfortable" (eventhough, WE understand that THEY are not the patient!)....and then whatever that occupant asks for, the Blah Blah administrator should provide that at whatever cost to their day or their own agenda, because it's "customer service"; if they fail to do so, they will be written up.

In a heartbeat, the above way of thinking will change 180 degrees....

I have no problem telling my patient who I am....because I happen to be enough in tune with my patient, I don't have to write down on a dry erase board their pain needs, their preferences, their pain medications, or their penchant for crossword puzzles....the reason I know this about my patients, is because I AM AT THE BEDSIDE....

People who don't occupy that spot need to move out of the way, because there's no room for two of us at the bedside...that includes pushy family members who once read a Reader's Digest article and now consider themselves a medical authority, nosey neighbors, and ignorant administrators who just fell off the turnip truck and think they have discovered a new catchy phrase for health care delivery systems.

If the administration wants customer service perks to be provided for the patients, families, et al....then maybe they should be the ones to do so...and then let us nurses get on with what we are trained and educated to do....

okay...now I will put on my Kevalar underwear so I don't get my butt shot off!! hehehehe!

You made a few good points. I especially like the idea of administrators bringing in coffee and donuts to the waiting rooms. I don't understand how writing your name and the date on a dry erase board is causing you to YELL at me however. I think that huge dry erase board someone a couple pages back has to do is a little over the top, maybe too much stuff on it and some stuff that should be kept private. But your name, as the nurse, and the date? Not a huge deal, doesn't take long. I understand the thought of "what's the point" for your "drug induced coma patients", but for the with it ones...its a great little move that takes 5 seconds away from your bedside time.