"Do you wanna.......huh...........do you really wanna?"

Nurses General Nursing

Published

Ever see the movie Lethal Weapon, when Mel Gibson goes on the roof to talk down the guy threatening to jump? The guy insists he is going to do it blah blah blah..............so Mel looks him right in the eye, gets this "I'm not all there" glare in his eye and asks him "Do you wanna..................HUH.........do you really wanna?" Next thing you know, Mel is pulling him off the ledge, forcing him to make the "jump" he was threatening to do. The guy is so scared by the time its over, he is screaming to get away from Mel.

I think the next time someone tries to tell me customer service is the focus of healthcare is going to have a very similar incident with me.

I was talking to some friends who were (yes, the past tense is intentional) big proponents of the push to make the medical field more like the "customer service" industry. I pointed out to them why healthcare can never completely adopt "customer service" policies.

1. Healthcare is and forever will remain a business. In that aspect, yes, we are much like any other retail/food industry establishment. On the other hand, we have more than any other industry taken the role of public servants. We continuously admit people who we know have no ability to pay their bills because it is our duty to do so.

Consider for a moment going into McDonald's with the famous line "I'll gladly pay you tuesday for a burger today." Or simply consider going in and saying.............."I can't pay, but I am hungry and you are service oriented sooooo..........hop too with making my burger and don't forget to hold the onion."

Once the laughter stops, you will quickly find said McDonald's management showing you the door. This is Real Life customer service.

Is this how you really want your local ER operating? We continuously treat people despite their ability to pay. We do not have the option of turning away customers simply because they are low on funds. Ask the guy who, with no health insurance, who falls and breaks his leg if he likes the RL version of "customer service."

2. The healthcare field more than any of our "customer service" counterparts must have the ability to personalize our service. We exemplify "Have it your way" more than any Burger King will. Yes, the grocery store will bag your sale exactly how you wish, yes BK will add/subtract whatever condiments to your liking. But we go much further than this. Timing of medications, treatments given (PT/OT, Social Services etc), everything down to how much your legs should be elevated is personalized for the best results for each individual patient.

Other sevice industries have the luxury of offering a service and placing difinite, concrete parameters on how it can be received. If you don't like their way of offering the service, more than likely they are not the company for you and good luck with your search for someone who does w/e it is (eating out, shampooing carpets) better. Tell me how successful you are in getting the cable guy to come to your home at 11PM becasue "its what I am most comfortable with." Next time you wake up with an urge for a night snack at 2AM and want pizza, tell me how well it goes when you call the pizza joint that closes at 10PM.

Is a hospital that stops admitting between certain hours what you want? What would you think of a physician who writes med orders like the cable company makes appointments.........."Take one tablet daily until somewhere between April 9th and May 5th"?

Point is, "customer service" industries are able to set their own parameters of "service" so they don't over promise.

If you don't agree with their way of doing it, your only real option is to find someone who does it your way, and more than likely it will cost more. This is RL "customer service". In order to cater to many, there are policies in place that allow for a systematic approach to be used. We on the other hand don't have the freedom to go between systematic and personized.

3. Ever been to a restaraunt where you've been to 1000 times before and gotten.........extra special benefits because you're known as a good tipper? or.............Ever been to a restaraunt for the first time and gotten so/so service because the waitress doesn't know you and is busy with their familiar good tipping crowd?........or, Know of anyone who tends to get bad service at the local restaraunt because they are needy or don't tip?

Industries in the service industry put a lot of effort into keeping the "good customers" and freeing themselves of the less desireable ones. If you are one of the "less desireable" types, service industries will tell you to pack it up and take your high demands elsewhere. I used to work in the food service industry and have witnessed more than a few times "clients" being told they should probably seek another place for their next meal because they were too demanding.

Retail and service industries are allowed to draw the line in the sand when someone is out of line. We, as healthcare providers, are not so fortunate. We can be attacked, spit at, verbally abused and all sorts of demands made of our time are needlessly made (often by non-paying patients) but............"Ah well, they are sick so it is their right" is the general opinion of onlookers.

Do you really want a healthcare system that gives better care to the patients who "tip" best? How about a nurse who can't be bothered getting you pain meds because they are too busy fluffing the pillows of the big tipper? How does a nursing manager telling you to take your demands elsewhere because you have no shoes/shirt on when you need cardioverted sound? Thats RL "customer service".

My point is, if you want "customer service" to be a part of healthcare, you have to take the good with the bad. It works for the service industries because they can implement it under their own terms. No government fines because the steak was Medium-rare instead of Medium, no being forced into catering to unrealistic demands, freedome to choose who the "good customers" and "bad customers" are and act accordingly.

The "customer service" approach works for retail and food service because they have liberties that will never be accepted in healthcare. Without said liberties, you can't have the other aspects.......not because I don't think they should be there but because they simply don't work without the balances or ying/yang in place.

So, to end, I will ask all the proponents of customer service out there:

":devil:Do you WANNA................huh................do you really wanna?"

Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
On the other hand, administration tells nurses to accept the public's deviant behaviors because the 'customers' are sick and not feeling well. Management demands that we coddle to rude visitors because they're 'under stress.' This mentality is wrong on so many levels.

It is time for abusive patients and menacing visitors to be made responsible for their socially unacceptable actions. There's no way that I would be able to come to another person's workplace, tell them how to do their job, hover over them all day like a helicopter, and curse at them when things are not going my way. This happens to bedside nurses daily.

There are ways to set limits. I do it all the time--I do not allow people to "trample" me because--in real life, they do not. If someone is rude, family, or whatever, I tell them. I don't allow it. I do, however, do it very, very assertively and my tone of voice is always in control.

It's learning how to do it, without becoming unprofessional or stooping to an ignorant's level.

:cool:

You should submit this in allnurses contest. I really enjoyed this :D

Specializes in M/S, Travel Nursing, Pulmonary.
Wow.

I think I :redbeathe you!

The only problem I see with the dilaudid tipping is - are you gonna give the big tippers a "generous" portion??? You will make the jack if you do - awesome!

Maybe you can start the "movement" - I would go back to the bedside, if (big IF) I could really treat "customers" as "customers"!

Practice SAFE!

:angel:

<_>

:o

>_>

Specializes in M/S, Travel Nursing, Pulmonary.
There are ways to set limits. I do it all the time--I do not allow people to "trample" me because--in real life, they do not. If someone is rude, family, or whatever, I tell them. I don't allow it. I do, however, do it very, very assertively and my tone of voice is always in control.

It's learning how to do it, without becoming unprofessional or stooping to an ignorant's level.

:cool:

I'm 90% there with ya. I believe having an assertive and in-control personality/mentality is a big part of nursing these days. The ability to talk down/calm family members and make people who are very afraid feel safe is an attribute one can not ignore if they wish to be a truly effective nurse. In short, charisma separates the avg. nurses from the great nurses often times.

I think though, the person you quoted and myself are talking about conditions that go well beyond what can be expected of........even a great nurse.

I can handle my irritated/agitated patients without a hitch for the most part. What I have a problem with is when I walk onto the unit and pick up an assignment in which EVERY SINGLE patient is verbally abusive and some are close to becoming physical. I've been nursing over 5 years and its worse now that I've ever seen it. Patients are going to new heights with their threats and verbal abuse now that they feel empowered by this new push for "customer service". How good customer service came to be interpreted as allowing ETOH withdraw patients to beat on you or allowing drug seekers to take up all your time so that non-verbal/unable to reposition herself grandma gets ignored.............is beyond me.

And yes, I do, for the most part, blame the new/vogue attitude about customer service for this. As should you actually, according to your post. The new vogue/popular attitude about customer service has robbed powers that be of their will/desire/ability to be assertive. What do you do when a calm voice and assertive approach are not enough? That's when the things I talked about come into play: "If you are so unhappy here, perhaps you should seek your next meal at another establishment." RL "customer service". We can't do that though.

Anyway, my point is, there are more than a few times where even the great nurse's assertiveness is not enough. Patients know we are up against it as far as having to deal with their demands, regardless of how unrealistic they are. If we don't dig the ditch exactly where they want it, as deep as they want it and fast enough to satisfy them..........all "1's" on the survey and you don't get paid.

It is as if, we are a McDonald's that has been told by the powers that be: "You are obligated to satisfy w/e demands are put upon you. If the patient demands prime rib cooked to perfection with all you can eat lobster tails on the side...............you better find a way to serve it or you don't get paid." Now tell me, what McD's would stay open for even one full day under these circumstances.

Specializes in M/S, Travel Nursing, Pulmonary.
You should submit this in allnurses contest. I really enjoyed this :D

What contest? There is a contest going on? I wanna play :clown:.

I actually could write this better if it were for a contest.

Specializes in M/S, Travel Nursing, Pulmonary.

Oh. :o

Wonder if I'm allowed to rewrite this and submit it? Hmmmm, does this actually fall into the category of "ethics" though? A little bit of a stretch maybe, but not totally foreign to "ethics" I guess.

What contest? There is a contest going on? I wanna play :clown:.

I actually could write this better if it were for a contest.

Great post Eriksoln!!!!!!!!!!! You have a natural ability for nursing issues communication!

Your post has my vote to win! :balloons::balloons::balloons::balloons:

Disclaimer- When Eriksoln wins and starts his own healthcare network,

I am working there! :D

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

maybe the next contest could be about customer service -- seems we all have plenty to say about that!

Specializes in M/S, Travel Nursing, Pulmonary.
Great post Eriksoln!!!!!!!!!!! You have a natural ability for nursing issues communication!

Your post has my vote to win! :balloons::balloons::balloons::balloons:

Disclaimer- When Eriksoln wins and starts his own healthcare network,

I am working there! :D

My MSN is going to be in Informatics. If I own a company, it'd be geared towards that. Probably involve going around the country teaching hospitals how to better implement their systems.

I'm going to take a lot of assignments in Hawaii. Hawaii will become the the Informatics capital of the world.

Well, maybe not...............I'll be on the beach drinking "Blue Maui" too much to be that successful, but I'll still do well enough. Wanna come?

Specializes in med/surg, cardiology, advanced care.

i started nursing about the same time managed care came along. i remember when the pbx operator announced the end of visiting hrs at 8pm, visitors left. imagine what would happen if that was done today! let's face it, healthcare is an industry/business where the #1 priority is the bottom line so that hospital ceo's can collect a 7 figure salary plus bonus for "managing costs", meanwhile the nursing dept has a wage/hiring freeze. the ceos of the largest insurance companies make 8 figures while their "enterprise" policy makers and corporate attorneys create loopholes to deny coverage. the health insurance lobby is one of the most active and powerful groups in dc, hard to believe, right?

The focus on customer satisfaction has had an ever increasing negative effect on the ability of direct pt caregivers to do just that, give care to the pt. how many times have we all seen groups of visitors camped out in a pts room and had to squeeze through to hang fluids, pass meds, tried to assess breath sounds in the middle of the pizza party? Of course not all pts do this, but the ones who do make our jobs harder than necessary. i've even seen this happen in critical care units, which would have been unheard of 20 yrs ago. This type of behavior continues because it is tolerated and encouraged by hospital administration who use press gainey scores as a marketing tool.

Hospitals will continue to recruit customers by building new facilities, that look more and more like hotels, providing VIP suites with flat screens on the wall, mini fridge and microwave, laminate wood flooring, custom art. The brand new hospital in my area also has a grand piano in the lobby.

Specializes in M/S, Travel Nursing, Pulmonary.
and mcdonald's will sell you a milkshake even if you're lactose intolerant. long john silver's will sell you a shrimp basket even if you're allergic to shellfish. you can get a coke at any restaurant in town even though you have surgery scheduled in two hours and they'll sell you a steak even though you have no teeth to chew it with. there's a big difference between customer service and patient care. long live patient care.

i like using the term "patient care" as our description of "customer service". while patient care does implement some of the common approaches of customer service, it is much more than that too.

tbh, idk why more academia types are not on fire over this customer service fad. it cheapens the art of nursing, devalues what our goals are and, not accidentally, gives the impression that anyone who can joyfully run a cash register has what it takes to be a nurse. smile, anticipate what people want, look clean and healthy, display some assertiveness.................these are are qualities of a great nurse...................and a car salesman.

is that to say anyone who has spent a year or two in car sales should be allowed to have an honorary license in nursing? no, certainly not. why? because there is more to healthcare than sales. we have to do what they do and so much more. that is what separates "patient care" from "customer service".

if you are one who considers nursing a profession, this customer service stuff should have your panties in such a bunch that you are unable to walk a straight line or pass a sobriety test.

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