"When Was the Last Time I Wow'ed a Patient?"

[Mully]

I recently went to a job interview and one of the first questions I was asked is, "When was the last time you wow'ed a patient?" Up until this point I thought the interview was going pretty well. I had worn my nicest suit, shaken my interviewers hand firmly when meeting, smiled when appropriate, and all of the rest of the textbook niceties of the dreaded interview. I'm usually quite calm in situations like these. I have a natural desire to be on stage, to act, to have the attention on myself. When this is the case, I usually perform to the best of my ability, manipulating my audience into loving what I love, hating what I hate, and most importantly, becoming smitten with me.

Then there was this question.

When was the last time I wow'ed a patient? I thought to myself. Picture the depths of the ocean floor. Picture the dark side of the moon. Imagine the inside of your eyelids. These things all resembled the thoughts that were coming to my mind. Nothing. I could think of absolutely nothing.

What does he want me to say? That I brought a box of donuts to my patient once? That I did cartwheels in the room or juggled flaming wands? Oh I know! I once put my entire fist inside my mouth! That really wow'ed Betty and her COPD exacerbation! Wow'ed her right to health!

On my way home from the interview I reflected on what that question could even mean. I thought about the fact that our hospitals are becoming more and more customer service oriented. They're no longer patients (that's an ugly word) - they're clients. It's no longer acute renal failure (that might hurt the kidney's feelings) - it's acute kidney injury. These are the types of changes many people within our health care systems spend their time making. These things are what we consider important.

What about the time I sent 200 volts pulsating through a man's body to bring him back from the dead? I think that probably wow'ed him! What about the time I stood silently in a room while a demented patient in restraints screamed about how much she hated me. What about the times that I've yelled at my patients to sit down because they were unsteady and medically unsafe to walk. Or the times when I've had to firmly remind my patients that while they are on my unit, I am the boss. Did these moments wow the patients? Maybe. Is that really our goal? To wow all the patients?

I've concluded that it's not about how customer service oriented we are with our patients. It's now about how politically correct we are. It's about being a good nurse, which stems from a desire to truly help people. When you care about people, you care about not offending them. You care about going the extra distance for them. You choose to do things like go to another unit to get chocolate pudding because you know they'll like it better than the vanilla, or take the time to grab the lotion and put it on their feet even at the end of your shift. Sometimes you do things like tell a patient what they don't want to hear. Sometimes we hurt patients, physically, emotionally, mentally, all for their own greater good. Sometimes patients aren't wow'ed. Sometimes they're healed.

I didn't get the job. They went with someone who was "more qualified". That didn't exactly wow me. Maybe though, this is a time when I'm not supposed to be wow'ed. I want to get the right job, on the right unit, in the right hospital, in the right city. Not getting this job did hurt a little, but maybe it's supposed to. Maybe we're not meant to be wow'ed all the time. Maybe we go through some hurt every now and again for our own greater good. When was the last time I wow'ed a patient? I don't know. Next question.

[LadyFree28, BSN, LPN, RN]

I think you feel as though I'm directing comments towards you or the many great nurses in the field (many that I work with). I'm not, at all. I am just disgusted by the complaining that the OP made in his/her snarky post and everyone else who followed suit and complained. I work with many great nurses, some who are much better than me. I like you was offering my two cents and opinion into this long discussion. I was merely stating that i feel it is a growing thought amongst nurses that patient satisfaction is not as important as competent care.

My suggestion would to be that you don't take what strangers say to heart and that the original poster probably has done something for a patient that wowed them and to recognize that the next time they go into an interview. It'll probably be more satisfying then smashing sour grapes and complaining on here about it afterwards.

^What impact would YOU have on my practice, or the other way around, or the OP since YOU believe the OP is being "snarky"...if could be interpreted as you being snarky, but again, depends on the tone of your posts...but then AGAIN, not my issue.

Like I stated before....let people have their fun...didn't think OP's comment was snarky either...again, they are entitled to it...as to your opinion. In the meantime, reread your post and make sure to take that same advice...I'm all good over here

I'm done participating in hijacking the fun...I'm enjoying the thread...it has "wowed" me, lol!

[Mully]

...I am just disgusted by the complaining that the OP made in his/her snarky post and everyone else who followed suit and complained...

...I was merely stating that i feel it is a growing thought amongst nurses that patient satisfaction is not as important as competent care.

...It'll probably be more satisfying then smashing sour grapes and complaining on here about it afterwards.

There is a difference between complaining and reflecting. This was not a rant or vent post. This was a reflection on a topic that many nurses have noticed with healthcare, and you hit on it exactly with your statement regarding competent care.

Patient satisfaction isn't as important as competent care. This is where the problem lies.

The very fact that I was asked about wowing patients for a job at a large ICU, and yet I wasn't asked about my competence in treating DKA or my ability to recognize flash pulmonary edema is what annoyed me enough to write my article. It's like we've turned Maslow's hierarchy on it's head. Make sure the patient feels nice, then worry about their pathophysiology.

You failed to recognize the ending of my article describing that it's not about the fake smile we paint on when in customer service mode, it's about actually caring for the people we treat. Great nurses are the ones that care about the people they take care of, not necessarily the ones that smile the most or wow everybody.

prep, I think you kind of missed it, that's all. Oh well.

p.s. I can't believe you didn't like my snarkiness! I consider it one of my best qualities:sarcastic:.

Anyways I gotta go to work. Time to get my WOW on!

[prep8611]

There is a difference between complaining and reflecting. This was not a rant or vent post. This was a reflection on a topic that many nurses have noticed with healthcare, and you hit on it exactly with your statement regarding competent care.

Patient satisfaction isn't as important as competent care. This is where the problem lies.

The very fact that I was asked about wowing patients for a job at a large ICU, and yet I wasn't asked about my competence in treating DKA or my ability to recognize flash pulmonary edema is what annoyed me enough to write my article. It's like we've turned Maslow's hierarchy on it's head. Make sure the patient feels nice, then worry about their pathophysiology.

You failed to recognize the ending of my article describing that it's not about the fake smile we paint on when in customer service mode, it's about actually caring for the people we treat. Great nurses are the ones that care about the people they take care of, not necessarily the ones that smile the most or wow everybody.

prep, I think you kind of missed it, that's all. Oh well.

p.s. I can't believe you didn't like my snarkiness! I consider it one of my best qualities:sarcastic:.

Anyways I gotta go to work. Time to get my WOW on!

Ok I guess i took it the wrong way so I apologize but I'm going to argue with you again haha. Nursing skills in an ICU or any floor can be taught but you can't teach work ethic and personality. When they are hiring you they are hiring a personality and not your knowledge base and I see why that upsets people. However, I think nurses can be trained to be competent over time but someone's work ethic or personality can not be changed. When they ask these questions they are only trying to figure who you are... I dont think they truly cared about the answer you gave in reference to the WOW question just that you could acknowledge a time when you went out of the way for a patient which I'm sure was often. As we start our careers we know nothing and as we move onto different positions we are constantly learning something different so we are always hired by how we come off during an interview.

And just to put this wayyyyy out there..... Would you want the smartest nurse in the entire world taking care of you if she doesn't answer your call light when you have to go to the bathroom?

This is why hospitals ask these questions and dont hire off testing or any other measurable attribute.

[Mully]

Ok I guess i took it the wrong way so I apologize but I'm going to argue with you again haha. Nursing skills in an ICU or any floor can be taught but you can't teach work ethic and personality. When they are hiring you they are hiring a personality and not your knowledge base and I see why that upsets people. However, I think nurses can be trained to be competent over time but someone's work ethic or personality can not be changed. When they ask these questions they are only trying to figure who you are... I dont think they truly cared about the answer you gave in reference to the WOW question just that you could acknowledge a time when you went out of the way for a patient which I'm sure was often. As we start our careers we know nothing and as we move onto different positions we are constantly learning something different so we are always hired by how we come off during an interview.

And just to put this wayyyyy out there..... Would you want the smartest nurse in the entire world taking care of you if she doesn't answer your call light when you have to go to the bathroom?

This is why hospitals ask these questions and dont hire off testing or any other measurable attribute.

I definitely understand what you're saying. No one wants the smart nurse that doesn't answer the bathroom light. I understand what the interviewer was trying to find out about me. He was trying to find out, does this person truly care about their patients? Do they work hard to help the patient not only have a safe experience but also a satisfying one? I get that. It's a legitimate topic. Interviewers need to find this out before they hire you.

I guess the disdain toward the question comes from a deeper feeling that there is a lot of management out there running many of our hospitals that think patient satisfaction scores and "very good care" check-boxes are the only things that matter. As a poster alluded to earlier in the thread, these are the people who haven't taken care of a patient at bedside in 20 years or maybe ever. They don't understand that we are very different than the hotel or food industry. Not everyone that comes through our doors is going to have a good experience, no matter how nice we are or how much pudding we give them.

I agree that nursing skills (such as foley insertion) can be taught, but I don't agree that ICU nursing competence can be taught. You have to be a certain caliber in order to survive in the ICU. Some nurses just don't have it, and that's okay. Although I understand what you are saying, certainly you can see the flip side to it as well. Would you want the nurse who will give you the longest back rub in the middle of his/her shift or go the extra mile to make you smile, yet forgets the difference between atropine and adenosine when you're coding? Probably not.

Thanks for contending my thread. It caused me not to just write the question off as dumb, but to think about what was the underlying information he was trying to figure out is. The question is dumb, I think. Really dumb. But next time I get asked it, I should be more prepared.

When was the last time I wow'ed a patient? OH! I thought of a good one!!!

[RNperdiem, RN]

If only there was a way to flip the question back to the interviewer: "How does XYZ hospital encourage and help the nurse WOW the patients?"

The personality and work ethic of the nurse is only one factor in creating a caring atmosphere. External factors, of which many are under control of the hospital and management.

[LadyFree28, BSN, LPN, RN]

If only there was a way to flip the question back to the interviewer: "How does XYZ hospital encourage and help the nurse WOW the patients?"

The personality and work ethic of the nurse is only one factor in creating a caring atmosphere. External factors, of which many are under control of the hospital and management.

^I will DEFINITELY flip this back to the interviewer if they give a "wow" type question.

[royhanosn]

agreed! if your so called wow...dont know why you need a wow! just do your job! Those comments are needed during your so called yearly assessment, if you been a good nurse.

[RNNPICU, BSN, RN]

When I read the OP first post, I thought to myself, what a great question, it really get's to the heart of nursing because it can really show how you care about your patients. It was an interesting take on the question of when was the last time you went the extra mile for your patient. Nursing is not just about competent care it is about how we care for the whole patient and even the family. Think about the time when we are providing patient education and adjust to meet the needs of the patient because we know it is the right thing to do. Think about the time when we have talked to a family member who is now grieving that their life has now changed because of their child, loved ones, new diagnosis. All of those are wowing a patient family. And that is just a few. Wowing a patient might be the new buzz word of the year but it still come down to basic patient care and the care we provide everyday to our patients.

[prep8611]

Would you want the nurse who will give you the longest back rub in the middle of his/her shift or go the extra mile to make you smile, yet forgets the difference between atropine and adenosine when you're coding? Probably not.

I'd hope theyd give me neither unless i had SVT or symptomatic bradycardia. Ill take a couple rounds of epi and some shocks please with some high quality CPR :)

[R!XTER]

Just read through this entire thread and I absolutely LOVED it!

To the OP: Your article WOWed me!! You hit the nail smack-dab on the head by getting to the root of everything that is wrong/challenging with nursing today, and healthcare in general.

I would have loved to respond to that question with "If my patients KNEW everything I did for them every single one of them would be wowed every single day!" So much of what we do is unknown to them, or unnoticed by them even when we do go above and beyond our job descriptions (side note: What is our job description anyway?? How can anyone even begin to describe or define what we do and are expected to do?). I can't count the number of times I've gone to another unit in the middle of the night because the emergency department literally had no food for a patient who was hungry at 2am. But I didn't necessarily tell that to them. I just handed them the food with a smile. When my patient is in pain, and the doc is taking his sweet time getting in to see them, and I give him repeated verbal shoves in the derriere so I can finally medicate and alleviate their pain, I don't go in and say "here's the morphine I just begged the doctor for five times on your behalf" I just administer it with a smile. When I'm running around like a crazed chicken without a head taking care of multiple sick people and the least sick of the pack asks for a sandwich, yes I may do an inner eye-roll, but I don't tell them everything I'm dealing with at the moment, I just go and get the sandwich, and I try to do it with a smile. And if I catch an error that a doc made on an order that could potentially harm them, I don't say "hey check this out! You could've died today if I hadn't been between you and your doctor" If I did, maybe they'd be wowed occasionally.

The fact is, our patients are rarely "wowed" by us, because they don't know half of what we are doing on their behalf. They expect us to be kind, compassionate, and take their pain away. Sometimes they thank us for it, sometimes they don't. If we shave off 15 minutes of our break time to clean them up because the kayexalate finally kicked in, we don't tell them "Hey, by the way this is my break time and I'm sacrificing it to wipe your behind." Even if we did say that, I doubt they'd be wowed.

It makes me sad that hospitals are so focused on customer service, when we are constantly involved in it, but the "clients" just don't always see everything that goes into caring for them. They see us come in and administer meds, but they don't see that we just double and triple checked all the doses to make sure they're safe. And yes we may seem rushed sometimes, but it's because we're doing the same for 7 other patients.

My hospital's new mantra is "hospitality". They made every single employee go to special "hospitality training" classes, from administration all the way to the guys who sterilize equipment and never even come in contact with patients. Then they made us all sign contracts that we would be hospitable to our "clients". I get it, reimbursement is now related to "hospitality" and without reimbursement we wouldn't have jobs etc etc. But its so sad that for 12 hours I am focused only on my patients and keeping them safe, warm, happy, clean, pain-free, etc. and this is still not good enough because they were not "wowed"

[anotherone, BSN, RN]

One time...... I noticed some changes in a pt's condition and paged a dr who determined it was actually a huge deal and pt needed stat surgery.... ( i don't want to get too detailed).. the pt was very suprised and taken back by this, it could have been easily missed...pt didn't appear "that sick" said pt before being wheeled off to icu before OR, thanked me so many times so sincerely I was very shocked by it .... doing my job really wowed her..... Yes, I have gotten pt's puddings and ice creams and back rubs that they seemed "wowed" by but that pt really sticks in my mind.... now that I am thinking of it similar events have happened. those are the wows I really remember... yes that is our job and excpected of us so does that mean the wows for getting ice cream aren't our job? has anyone done anything that wowed a pt that any other nurse couldn't do as well?

[monkeybug]

I was merely stating that i feel it is a growing thought amongst nurses that patient satisfaction is not as important as competent care.

.

But see, that is a real issue for many of us. I've had a manager tell me that I could kill a patient, and as long as I did it with a smile, the family would probably not mind. I have a real problem with this attitude. I would rather have a very intelligent, very competent, brusque nurse over Suzy Sunshine who pushes potassium IV and doesn't use appropriate sterile technique. Doctors are usually judged by their competence, not their personalities (how many times have you heard "he's not got the greatest bedside manner, but I'd want him to do my surgery"), and I judge my nurses the same way. I try to be kind and personable with all patients, but I really think my ability to spot issues, my proficiency with procedures, and my knowledge should be more important than pillow fluffing and scripted patter. What nurses do is important, and it should not be reduced down to, as one other poster put it, "do you want fries with that?" and "service with a smile."