What's going on???


Hey everyone,

I'm a new LPN currently on orientation at a fairly busy ER outside of Wash. DC. I work in Express Care "aka the Fast Track" which is where the lower acuity patients are seen (lacs, sutures, ankle sprains, etc).

I am tired of hearing how low our Press-Ganey scores are (we are averaging about 20% each week, while the Main ER is averaging in the 80's and higher). I don't understand, whats going on, why is the Main ER at such a higher level of patient satisfaction?

In Express Care, patients are usually in and out within the hour, sometimes within 15 minutes depending on the case. Orders are inputted into the computer, and carried out within 5-10 minutes of being written by the PA or MD, whereas on the Main ER, orders can sit there for quite some time since the nurse has 4 patients being admitted, one on a vent, another receiving blood (you get the idea).

Anyone have any ideas as to what I personally can do to increase the scores, or at least score some great feedback from patients? I always hear patients telling me how great the service is, how friendly everyone has been to us, and yet our scores are so low! The administration has gone as far as getting rid of 3 of the Express Care RN's and sending them out to other Departments in the hospital.

Please help!

Here is a horrible paint drawing I made of our department, do you seen any design flows of the department itself?

Privacy is a HUGE issue, because even whispering at the nurses station can be heard by any room, unless they are lucky enough to have a door and its closed. Some of our rooms are just curtains only, 7 feet in front of the nurses station!!

See attached.

Please give me some advice, I really am tired of trying to be a good nurse, and getting GREAT feedback from my patients, then being told by Administration that we are not doing something right because our survey scores are low.


CrufflerJJ, RN

1 Article; 1,023 Posts

Specializes in ICU. Has 5 years experience.

Admin should be able to tell you what comments are made on the patient response cards, or exactly which score is low on your Press-Ganey.

If admin is just saying "you're doing a lousy job - you need to do better", they are not giving you the info you need to make things better, and they themselves are doing a LOUSY job of managing customer expectations.

morte, LPN, LVN

7,015 Posts

as much as i hate to say it.....tell the happy clients to tell the boss......because, right now, it is only the unhappy ones that are doing so......

locolorenzo22, BSN, RN

1 Article; 2,396 Posts

Specializes in Ortho, Neuro, Detox, Tele.

I would agree...the happy ones need to talk to management and admin...and the admin also need to tell you what areas are low...and where can you work on....

and then the department needs to make a plan and stick to it!

Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr. Has 15 years experience.

the others are correct. the unhappy clients (people who think they have an ailment that deserves an admission) are loudly complaining, while happy people are saying nothing. i currently work a medical surgical floor that is the worse in my hospital (moving to an er at another hospital soon). i hear from my patients that they love me and many make sure i am the nurse they get the next night i am working (i try to work straight nights in a row to provide consistent effective care). in any case, the loud-mouth-drug-seeking-frequent-flyers speak to management more then my happy patients when i first started on this floor. thus, i had nothing but complaints. when i realized what was going on i began telling my happy patients to tell my charge nurses on days and nights that they want me back if that is what they wish. that has helped my patient satisfaction scores improve significantly and it has helped to drown out the complainers because they are now out numbered by the patients who like me.

btw, i also noticed that patients who are happy tend not to fill out paper work! so, there needs to be some way in your er setting for happy voices to be heard outside of a written survey. maybe a follow up phone call? or maybe have someone in admin perform a verbal survey of those who are being discharged before he/she leaves the floor? just some thoughts.

-new grad joining you in the ed soon... :up:


106 Posts

Try telling the happy people that they will be receiving a survey, and you would really appreciate it if they would fill it out. While personal comments to management are important, they don't take the place of those "most meaningful" Press-Ganey scores.

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