So, what's it gonna take for nursing to change and become what it's supposed to be?

Nurses General Nursing

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What's it gonna take for nursing to become what it should be, which is providing nursing care from a nursing and medicinal, and holistic model to achieve the best patient outcome instead of a retail-esque "the customer is always right" and if "we don't score 99 on this arbitrary survey, then you'll be penalized or terminated despite giving excellent medical, holistic and nursing care."

What has to happen so that nursing has defined boundaries and limitations? When will we be able to say "I don't have to take the trash out, that's housekeeping's job," "I don't have to start the nebulizer treatment, that's the RRT's job,"I don't have to do [something outside of my job description], that's [person is is designated to do that]'s job," etc...?

Will the accountability without authority model ever be changed?

When will management, other nurses and administration advocate their employees and protect them at all costs, so that other disciplines don't **** all over nursing? I mean why would you cut the Achilles tendon on the people you have to work with and maintain professional relationships with? What would doing that do for you?

When will nurses be placed in the same cohorts as doctors, lawyers, and businessmen minus APN's?

I mean eventually something has to happen right? How can a profession even manage to survive with conditions like these? I feel as though the nursing profession is gonna be redefined by outside forces and we can do nothing about it or there will be a massive reform that'll take many years to even begin to materialize in the healthcare setting. I mean people can talk about what should be done, but until any action is taken, it's pointless.

Specializes in Case Manager.

Yes patients are customers, but we're also healthcare PROVIDERS, not hospital customer service associates or servants. To me, putting too much emphasis on the customer service model devalues the profession and makes people take it less seriously. And you can't make retail synonymous with healthcare. I'm sorry, but standing behind a register and tallying items or telling someone where the dog food is doesn't make a huge difference in someone's life. On the other hand, saving that patient from aspirating or getting their pressure back up so they don't go into shock and code is.

For all that, if we are so customer based, we might as well get paid minimum wage and bend over backwards to make sure the 'customer's' coffee is hot and the pillows are fluffed. **** making sure they get their meds or procedures done on time, right?

I've considered management when I get outta school but anesthesia or critical care has always intrigued me so...

Specializes in NICU, Post-partum.

I'll be honest..I came from another career before entering nursing where I have always worked with the public. Learning to work with the public is a NEEDED SKILL in nursing. For me, I had zero problems with this transition when I changed careers, but I have witnessed other career nurses that have never worked in another profession that despite years of experience, have never learned to handle difficult patients/family members. I blame the facilities for failing to teach them.

I hear it all the time....I hear nurses bite the heads off of families all the time and barking orders rather than making suggestions...it comes across as arrogant and confrontational and that is what leads to complaints. I see it every day...I'll overhear a conversation between a mother and a nurse and I can tell it's going to end up in an argument before it even gets there.

It is NOT about making the patient or family member happy all the time...you can deliver bad news, there are just ways to go about it. No, it is not going to work 100% of the time, but it will work a vast majority of the time.

Customer service will ELEVATE the profession. Just because we are healthcare professionals doesn't mean we don't have to be tactful or learn to be respectful of patients or families.

It is not going away folks...so those that think it is, will be very disappointed. Like I said, it is a learned skill and those that have never worked another job other than nursing, don't understand, that it doesn't matter what profession you work in...customer service is in place in any job you have.

Specializes in NICU, Post-partum.
Yes patients are customers, but we're also healthcare PROVIDERS, not hospital customer service associates or servants. To me, putting too much emphasis on the customer service model devalues the profession and makes people take it less seriously. And you can't make retail synonymous with healthcare. I'm sorry, but standing behind a register and tallying items or telling someone where the dog food is doesn't make a huge difference in someone's life. On the other hand, saving that patient from aspirating or getting their pressure back up so they don't go into shock and code is.

For all that, if we are so customer based, we might as well get paid minimum wage and bend over backwards to make sure the 'customer's' coffee is hot and the pillows are fluffed. **** making sure they get their meds or procedures done on time, right?

I've considered management when I get outta school but anesthesia or critical care has always intrigued me so...

This is where you are wrong...it is EXACTLY the same model.

Contractors: Provide a service for a price...be it construction, plumbing, electrical, etc...would you hire a contractor who was rude to you or failed to accomodate your requests?

Retailers: Sell a tangible product for a price...would you continue to solicit a shop where the workers were rude to you or failed to accomodate your needs?

Food Service: Sell food and a dining experience for a price...would you continue to visit a restaurant where the service was bad and the food was worse? Where they would not meet your needs?

HEALTHCARE IS ULTIMATELY A BUSINESS, THAT IS WHY THE CEO'S OF MOST HOSPITALS ARE NOT PHYSICIANS.

What do we sell?

Healthcare!!!!! We provide a place for you to come, a team to tend to your needs. You have a choice whether to accept that care or not.

Most people with insurance cards have a CHOICE of which facility to go to and which physicians to choose...so there is competition, just like with any other service that is provided to the public. Even people on welfare benefits can typically choose their physician from a list of approved providers, so even to the free sector, there is competition.

The ones that are going to survive long term in this business, are going to "get" this connection..the ones that don't, will forever be frustrated.

Specializes in ED, Informatics, Clinical Analyst.

I don't understand the "that's not my job attitude". Good patient care is the result of teamwork. Maybe the nurse isn't primarily responsible for taking out the trash but if it needs to get done you do it. After all, It's not housekeeping's job to tell me a patient fell out of bed or is choking on their food and can't breathe or has eloped from the unit but I'd really appreciate them letting me know those things. When the s*** hits the fan and you fall behind wouldn't you want someone to be there to help you?

Specializes in Trauma/Critical Care.
What's it gonna take for nursing to become what it should be, which is providing nursing care from a nursing and medicinal, and holistic model to achieve the best patient outcome instead of a retail-esque "the customer is always right" and if "we don't score 99 on this arbitrary survey, then you'll be penalized or terminated despite giving excellent medical, holistic and nursing care."

What has to happen so that nursing has defined boundaries and limitations? When will we be able to say "I don't have to take the trash out, that's housekeeping's job," "I don't have to start the nebulizer treatment, that's the RRT's job,"I don't have to do [something outside of my job description], that's [person is is designated to do that]'s job," etc...?

Will the accountability without authority model ever be changed?

When will management, other nurses and administration advocate their employees and protect them at all costs, so that other disciplines don't **** all over nursing? I mean why would you cut the Achilles tendon on the people you have to work with and maintain professional relationships with? What would doing that do for you?

When will nurses be placed in the same cohorts as doctors, lawyers, and businessmen minus APN's?

I mean eventually something has to happen right? How can a profession even manage to survive with conditions like these? I feel as though the nursing profession is gonna be redefined by outside forces and we can do nothing about it or there will be a massive reform that'll take many years to even begin to materialize in the healthcare setting. I mean people can talk about what should be done, but until any action is taken, it's pointless.

When we get more men in the profession and make advanced education mandatory.

I'll be honest..I came from another career before entering nursing where I have always worked with the public. Learning to work with the public is a NEEDED SKILL in nursing. For me, I had zero problems with this transition when I changed careers, but I have witnessed other career nurses that have never worked in another profession that despite years of experience, have never learned to handle difficult patients/family members. I blame the facilities for failing to teach them.

I hear it all the time....I hear nurses bite the heads off of families all the time and barking orders rather than making suggestions...it comes across as arrogant and confrontational and that is what leads to complaints. I see it every day...I'll overhear a conversation between a mother and a nurse and I can tell it's going to end up in an argument before it even gets there.

It is NOT about making the patient or family member happy all the time...you can deliver bad news, there are just ways to go about it. No, it is not going to work 100% of the time, but it will work a vast majority of the time.

Customer service will ELEVATE the profession. Just because we are healthcare professionals doesn't mean we don't have to be tactful or learn to be respectful of patients or families.

It is not going away folks...so those that think it is, will be very disappointed. Like I said, it is a learned skill and those that have never worked another job other than nursing, don't understand, that it doesn't matter what profession you work in...customer service is in place in any job you have.

Well said! I come from 15 years customer service management experience, and there are truly right and wrong ways to handle any situation even in the field of nursing. Even during my clinical rotations, I close my eyes saying to myself "I just did not see/hear that!" (something I saw nurse doing or saying, which could have TOTALLY been handled differently). It truly takes one of a kind, one - of - a - kind!

Specializes in NICU, Post-partum.
Well said! I come from 15 years customer service management experience, and there are truly right and wrong ways to handle any situation even in the field of nursing. Even during my clinical rotations, I close my eyes saying to myself "I just did not see/hear that!" (something I saw nurse doing or saying, which could have TOTALLY been handled differently). It truly takes one of a kind, one - of - a - kind!

...thanks...then you understand completely, what I am talking about.

You, like me, probably found the transition to working with the public probably a very natural part of the job, in fact, probably the easiest part of the job while many very young new nurses that have not worked other jobs, really struggle with this aspect and many of the senior nurses have convinced them that it is a "phase" with healthcare.

But we know...it is not a phase...it is just very late in coming to healthcare, but exists in every other industry.

This is where you are wrong...it is EXACTLY the same model.

Contractors: Provide a service for a price...be it construction, plumbing, electrical, etc...would you hire a contractor who was rude to you or failed to accomodate your requests?

Retailers: Sell a tangible product for a price...would you continue to solicit a shop where the workers were rude to you or failed to accomodate your needs?

Food Service: Sell food and a dining experience for a price...would you continue to visit a restaurant where the service was bad and the food was worse? Where they would not meet your needs?

HEALTHCARE IS ULTIMATELY A BUSINESS, THAT IS WHY THE CEO'S OF MOST HOSPITALS ARE NOT PHYSICIANS.

What do we sell?

Healthcare!!!!! We provide a place for you to come, a team to tend to your needs. You have a choice whether to accept that care or not.

Most people with insurance cards have a CHOICE of which facility to go to and which physicians to choose...so there is competition, just like with any other service that is provided to the public. Even people on welfare benefits can typically choose their physician from a list of approved providers, so even to the free sector, there is competition.

The ones that are going to survive long term in this business, are going to "get" this connection..the ones that don't, will forever be frustrated.

So if we are going to truly follow this customer service model like stores do, then hospitals should be able to ban those patients they find objectionable for whatever reason, just like stores have the right to do. Yay, no more frequent fliers! If you are dirty, acting crazy or stink - you get kicked out of the hospital, high or drunk people should also get kicked out, retail stores won't put up with that behavior so neither should hospitals. Argumentative or highly demanding patients, those too should get kicked out, the retail world does. Retails stores also have the right to ban people for life from entering their stores, so I guess hospitals should be able to do this as well. You get banned and show up on hospital grounds then you should be arrested for trespassing - this is how the retail world handles things.

You can't pay - you don't get care, after all Wal-Mart won't give me things for free just because I may be in need. I have to pay or I get nothing. If my check bounces I can be arrested and face fraud charges, so I really have to have the money available to pay. If I don't have it, too bad, so sad. If someone says something inappropriate to me then I should get my manager and have that patient removed from the hospital, this is how retail handles that situation. Profane language, yelling, demeaning the staff, retail will kick all these people to the curb.

We are being asked to behave like retail without getting all the benefits of working retail. I'm all for going for a completely retail model if that's what the powers that be want, it will cut out a lot of the undesirables I now have to deal with.

Healthcare may be similar in some ways to retail but it is not and never will be the same.

Specializes in Acute Care Cardiac, Education, Prof Practice.

Customer service is like eating well...everything in moderation. I believe my customer service is coupled with my patient care. I educate, inform, medicate, and assess all within the parameters of my job. I do not feel my job demands that I employ over the top customer service, but I do provide customer service as an integral part of my job.

"Customer Service" for me is just a hot topic word that gets people all worked up.

What do we need to do to change nursing? Depends on your definition of what needs to be changed. Each day I put my best foot forward, support my Magnet governance, actively participate in further educating myself , advocate for my patients, keep up to date on legislature, and treat my co-workers (RN's, CNA's, MD's, housekeepers) with respect. I do my best to create the nursing environment I want all around me. Are there frustrations, yes. I hate seeing night shift get shorthanded and hear my manager say "oh they can handle it". So I remind her that I used to be there, and sometimes they can and sometimes we just couldn't.

Advocacy seems to be the common thread here. Advocate for nursing, patients, and yourself.

Specializes in ED, Informatics, Clinical Analyst.

The ER is the only place that HAS to provide care and they only need to provide stabilization. If a doctor examines you and finds there is no emergency they can put you out. Private physicians can choose not to take patients for whatever reason just like patients can choose not to use providers.

I think the business model of hospitals is comparable to places like banks or casinos. There are plenty of banks and casinos just like there are plenty of hospitals. If you visit a bank or casino and spend thousands of dollars there everyday, they will put up with whatever nonsense they have to so that you stay and keep giving them your money. The big wigs don't care if a high roller scares away a teller or card dealer or nurse because you are replaceable but the income that walks out the door (or doesn't come there in the first place) is not. That's the reality of the situation. A hospital admission costs thousands of dollars and makes the hospital money. If people choose hospital B because hospital A treated them badly hospital A doesn't make any money so customer service suddenly becomes a very big deal.

Specializes in NICU, Post-partum.
So if we are going to truly follow this customer service model like stores do, then hospitals should be able to ban those patients they find objectionable for whatever reason, just like stores have the right to do. Yay, no more frequent fliers! If you are dirty, acting crazy or stink - you get kicked out of the hospital, high or drunk people should also get kicked out, retail stores won't put up with that behavior so neither should hospitals. Argumentative or highly demanding patients, those too should get kicked out, the retail world does. Retails stores also have the right to ban people for life from entering their stores, so I guess hospitals should be able to do this as well. You get banned and show up on hospital grounds then you should be arrested for trespassing - this is how the retail world handles things.

You can't pay - you don't get care, after all Wal-Mart won't give me things for free just because I may be in need. I have to pay or I get nothing. If my check bounces I can be arrested and face fraud charges, so I really have to have the money available to pay. If I don't have it, too bad, so sad. If someone says something inappropriate to me then I should get my manager and have that patient removed from the hospital, this is how retail handles that situation. Profane language, yelling, demeaning the staff, retail will kick all these people to the curb.

We are being asked to behave like retail without getting all the benefits of working retail. I'm all for going for a completely retail model if that's what the powers that be want, it will cut out a lot of the undesirables I now have to deal with.

Healthcare may be similar in some ways to retail but it is not and never will be the same.

We are talking about customer service aspect of the job and nothing else.

To me, the ones that "get" this connection, will make it and the ones that don't, well..won't.

Specializes in Med Surg.
I'll be honest..I came from another career before entering nursing where I have always worked with the public. Learning to work with the public is a NEEDED SKILL in nursing. For me, I had zero problems with this transition when I changed careers, but I have witnessed other career nurses that have never worked in another profession that despite years of experience, have never learned to handle difficult patients/family members. I blame the facilities for failing to teach them.

I hear it all the time....I hear nurses bite the heads off of families all the time and barking orders rather than making suggestions...it comes across as arrogant and confrontational and that is what leads to complaints. I see it every day...I'll overhear a conversation between a mother and a nurse and I can tell it's going to end up in an argument before it even gets there.

It is NOT about making the patient or family member happy all the time...you can deliver bad news, there are just ways to go about it. No, it is not going to work 100% of the time, but it will work a vast majority of the time.

Customer service will ELEVATE the profession. Just because we are healthcare professionals doesn't mean we don't have to be tactful or learn to be respectful of patients or families.

It is not going away folks...so those that think it is, will be very disappointed. Like I said, it is a learned skill and those that have never worked another job other than nursing, don't understand, that it doesn't matter what profession you work in...customer service is in place in any job you have.

So true. I spent 10 years working in a customer service oriented field before switiching to nursing. While I haven't started working as a nurse (that's next week. :)), throughout my clinical experience in school, I successfully dealt with "difficult" patients and families. Not to toot my own horn, but there were times when my instructors and other nurses were surprised that I was able to relate to and work well with these patients. That's the one part of entering the nursing profession that doesn't scare me. I fully expect my previous career to be invaluable to my new one.

I don't understand the "that's not my job attitude". Good patient care is the result of teamwork. Maybe the nurse isn't primarily responsible for taking out the trash but if it needs to get done you do it. After all, It's not housekeeping's job to tell me a patient fell out of bed or is choking on their food and can't breathe or has eloped from the unit but I'd really appreciate them letting me know those things. When the s*** hits the fan and you fall behind wouldn't you want someone to be there to help you?

I have to agree with this too. One of my clinical instructors really stressed the importance of doing all of those little things to help the patients--taking out the trash, getting more pillows, getting water, etc. She taught us to do all of these things while doing all of our nursing work. We're not going to always have time to do these things, but if you do, what does it hurt to take out the trash? Doing so doesn't make me any less a nurse or a doormat. To me it seems like not helping pass out meal trays if the CNAs are busy and I've got time.

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