Seriously? A hospital is NOT a hotel.

[raianne]

So I work on a surgical oncology floor. We generally don't get medicine patients unless all the medicine floors are full. Last night we get a call that we're getting a patient...we're confused, because our floor was pretty empty, but so were all the other floors. This woman and her friend show up, SUPER LOUD at 3am, rowdy, laughing, talking, waking the other patients up. We find out that they were on a medicine floor but they weren't in a private room, and they made a big deal about it (although come to think of it, I do feel bad for whoever their roommate was) and complained that they wanted a private room so the AOD put them on our floor.

Really? I mean, I know they do customer satisfaction surveys now, but that seems a little ridiculous to me. And then to make things even more awesome, her nurse thought that the patient was pretending to take her pain meds but slipping them to her friend...AFTER they had been in her mouth and she acted like she swallowed them. What can you do about that, (without offending an already loud and entitled-acting patient) short of "lift up your tongue, say AHHH, let me make sure you swallowed your pills"? Sigh. My floor can be busy and hectic but our patients are generally a great bunch of people and it makes me happy that I don't have to deal with patients like this on a daily basis.

[llg, PhD, RN]

Certainly the patient was behaving inappropriately. I'm not going to defend her behavior.

But ... I see nothing wrong with requesting a private room. If I were in the hospital, I would not want to share a room with a strange sick person, have her visitors looking a me and wondering what was wrong with me, etc. I can't blame them for wanting a private room or your AOD for giving them one.

But her behavior was uncalled for and I wouldn't want to take care of them either. I'd be telling them they had to be quiet or the visitor would have to leave.

[That Guy, BSN, RN, EMT-B]

If I was the other pt I would have demanded a private room to away from that person. It blows me away how inconsiderate people can be when others are around. Sadly, this is only going to get worse with the emphasis on customer satisfaction.

[TheCommuter, BSN, RN]

I've said it before and I'll say it again that healthcare facilities are intended for patient care. Healthcare facilities are not intended for customer service, regardless of what hospital administrators would like the public to believe. Before anyone disputes what I have to say, I'll describe the differences between patient care and customer service below, so continue reading to see my viewpoints.

The chef at the Hilton will provide excellent customer service by preparing a steak and baked potato covered with artery-clogging butter for the coronary heart disease patient. The pastry chef at the Ritz-Carlton will display excellent customer service by baking a sugary red velvet cake for the morbidly obese diabetic patient. The bellhop at the Holiday Inn will provide excellent customer service by walking the COPD patient to a patio where (s)he can smoke.

As long as customers are paying for the services to be rendered, employees in the hotel, hospitality, and tourism industry will do these things for the sake of great customer service. After all, it is all about the almighty dollar bill. Moreover, they want the 'paying customer' to return someday. Thank you! Come again!

However, healthcare workers should not be forced to kiss the butts of unruly visitors who purposely behave like animals and verbally abusive patients who use staff as personal verbal punching bags. Hospitals, nursing homes, and other types of healthcare facilities have turned into Burger King restaurants where 'customers' can have it their way.

[Double-Helix, BSN, RN]

The number one rule of customer service: The customer is always right.

Unfortunately.

If they were being loud and disruptive then I would have no problem telling them that they need to quiet down. Kindly the first time, and then with the offer to have our security officer come up to explain the "quiet hours" policy. Doesn't sound like these two were that bad, though. Being loud and possibly giving half-swollowed medication to a friend? At least they weren't verbally or physically abusive, stealing supplies, demanding food, etc.

If you suspect the patient is slipping pain medicine to her friend, you have a few options: 1. Ask the visitor to step out for a moment while you are in the room. Explain that you have to perform an assessment/ask a question that requires privacy. Give them medication first, and then do your assessment. 2. Stay in the room after you give the medication. You can give the pill, have the patient drink some water, take vitals, do an assessment, straighten the bed, assess capillary refill in each toe... whatever you have to do to stall and give the medication enough time to dissolve. (Offer to give them with ginger ale, which causes them to dissolve quicker.)

Coming from someone who can't swallow pills well, narcotics taste terrible when they dissolve in your mouth. If you hang around the room for a few minutes, and the patient has the pill in their mouth, they are going to get such a disgusted look on their face and they will either drink more liquid to swallow the pill/wash out the taste, or they will spit it out.

[dudette10, MSN, RN]

When it comes to loud, rowdy visitors, I tend to think of room changes as patient care for the quiet roommate, rather than customer service for the loud ones. Although in this situation, the loud, rowdy ones requested the room change, so it does take on more of a customer service slant.

You were spot on in thinking of it this way. The quiet patient in the room probably wasn't too keen on the party goin' on in the next bed; he/she just didn't say anything. If you don't move the loud, rowdy ones, that's two dings on the survey, not just one.

While I don't enjoy having to do the customer service bit with some patients, I just keep saying to myself, "It's my paycheck. It's my paycheck," because with the changes to public reimbursement, that's exactly what it is.

[KelRN215, BSN, RN]

Everyone wants a private room. Not everyone can have one. That's just the way it is. I hated how we always accommodated to the rudest most demanding patients when I worked in the hospital. I specifically remember one time that a family cussed every one out and therefore Social Work came in and got them a hotel for free. Then the nicest people on the floor don't ask for anything and the dad sleeps in his truck because only one parent is allowed at the bedside and he doesn't want to go home because it's too far but he doesn't want to cause any trouble. I do not miss hospital nursing.

[Been there,done that, ASN, RN]

Get over it. Medicare is mandating customer satisfaction for reimbursement.

Nurses are now customer service representatives...

you will make the customer satisfied at any level. The "customers'" know this and will wring us dry.

[skinnymomi71]

my sentiments exactly. our hospital even added room service where patients can call a number and can order the food they wish to eat. On top of that we also offer warm gowns and blankets, toiletries, juice, crackers, cable TV with free movie channels, a self-rotating Hillrom bed in a private room with a private bath and shower. Admission is free. Well, technically no cause I pay taxes for the pleasure of the uninsured frequent fliers. All these for better customer satisfaction rating.

[merlee]

New hospitals are being built with all private rooms - the reason is mostly HIPAA and the need for more privacy in general. But then there is room for even more visitors!

You do have the right to remind patients and visitors that there are other people who need their sleep.

As for the pain pill issue, if there is even the slightest possibility that a patient is 'sharing' their meds then any meacap refill in evns to make sure that the patient is taking her own meds should be employed, as mentioned in an earlier post. I like the idea of checking cap refill in every toe!!

There are pros and cons with the private room issue, and I usually have not minded having a roommate. But I have appreciated a private room when I have had them.

[wooh, BSN, RN]

And basing reimbursement on this stupid crap is just going to make it worse...

[SHGR, MSN, RN, CNS]

Wait- what? The person had a loud friend there at 3am? Don't you have any kind of visiting hours or security? If you are comparing the hospital to a store, hotel, or restaurant, you better bet any of those customer-service places would have shown the "friend" the door, if not the customer as well.

Better: kick the visitor out. Move the patient at 8 or 9am. Would be awesome if every other patient on the floor turned in an awful Press Ganey rating based on this incident.

Based on my experience, I doubt the loud patient in this scenario is organized enough to complete and return a patient satisfaction survey.