Have Nurses become Customer Service Professionals, RN

[pyxis]

I have been a registered nurse for 20 years mostly working in large hospitals. I work mainly on Med/Surg, but have floated around, when the pay was good. I have always got along with my collegues. I never was interested in a management position. I always enjoyed patiebt care and I'm just not he manager type.

Anyway, it seems to me that gradually our jobs have changed. We are still giving patient care, but now it seems to get better evaluations, you must also be a customer service attendent. This means assisting their visitors with conversation and refreshments. Creating a friendly enviroment by moving patients to a different room if their roomate snores.

I can understand that hospitals need to keep patients happy so they return, but I feel that this takes away the real time that could be spent prioritizing patients, keeping a closer eye on patients that are safety hazards, but can't put on the light. I don't want to be graded on my friendliness and repoire with patients families, unless it is neede foir their care at home. I want to keep an eye on their blood pressure or whatever else the reason they are in the hospital in the first place is.

I enjoy spending time with patients and their families, if I have it, but with all the extra duties placed on nurses these days, customer service should be handled by the administrative staff, who seem to have the time to come up with these ideas.

Burned up and Burnt Out

[PWhite]

I hear YOU loud and clear!!
In fact this is one the subjects that can trigger a "RANT" from me as my panties get in a real twist.

Our patients have NEVER been "CUSTOMERS"........Period!

No one chooses to BUY chronic dialysis, a CABG, any number of other surgeries, treatment for MS, Diabetes, Heart Failure, rheumatoid arthritis etc. etc.

The deck is stacked against the "consumer"/ "customer" as there is no way to "Comparison Shop"
for the "Charges" for care, treatments, and surgeries whether for planned interventions or emergencies.... and one must remember that there is a great deal of difference between costs and charges.

"Comparison Shopping" for drug charges requires time, patience and persistence to obtain ones meds at the best price. This is especially true under Medicare Part D,a "benefit", whose execution was HANDED to the fox in the hen house.........Pharma! I've been playing this game for about 1 1/2 yrs and it ain't pretty.

I am NOT the "talent". I am NOT the "agent". I am NOT "the caregiver". I am NOT the "Customer Service Representative".

I am an educated RN with 45 years of experience to contribute to the well being of those who need care and their families.

[reesern1963]

I have a dim memory of someone (I think it was a nursing instructor) trying to tell us students that patients weren't "patients," they were "clients," and it wasn't during psych. Supposedly it was demeaning to refer to them otherwise. Malarkey.

There are so many days when I feel like anything but a nurse. "Get me a drink." "Get me a pillow." "Why does it take so long for this medication? Can't you run it faster?" "I waited 20 minutes for my appointment!" (Never mind that someone "crashed" and was wheeled out by paramedics in full view of the entire waiting room.)

Sigh. Nobody told me there'd be days like these. Strange days, indeed.

[PWhite]

Alas..........A LOT of Education is needed..........all around.

[copperrose]

Reese, I remember having pt's refered to as "clients" in school also. Did you graduate in the late 70's early 80's? I think that was a "buzz' word at the time. There is a way on the social securuity web sitre that you can compare hospitals on various things. I think that's a good thing. If my Dr. goes to 3 different hospitals, I want the hospital with the best % if it involves major surgery.

There are pt's who seem tp know or sense when you are busy with someone else and start demanding things. I once took care of a woman who c/o of her sink draining slow. It was in the wintewr when many of our chronic heart/lung pt's were very sick and in the hospital. Needless to say there were other things to do than fix her slow sink. I finaly had the time to call plant management and put in a request for a plumber after putting up with her c/o for three days or so. The plumber came with his snake and started working. After about only 2 or 3 minutes this coffee ground metal smelling oooze started coming out of the bath tub and the toilet. In very short order the whole room smelled like metal filings. I can still remember this lady in her lavender bed jacket, holding a lace hanky over her nose saying "I guess I shouldn't have c/o." I think she learned her lesson about complaining. I don't remember hearing a peep out of her for the rest of her stay.


Yes, some people really need an education about how to behave in the hospital. But then some of the nurses do to. Nursing schools in my experience have never been very good about teaching the student about "the real world" Theorys are nice in class but do hospitals really act like that? I remember learning all about "Total Patient care" in school, only to get my first job on a surgical floor and being told "Here's your nurses aide and your team of 12 pt's . Go do it."

From listening to hospital nurses talk about things, I'd say that technology may advance, Dr's may get more civilized but some things just DO NOT CHANGE. "Customer service" has a really tacky ring to it, but it is still about giving your pt's the highest quality of care. The buzz words may change, like the types of charting, or the versions of pt. care, but it's still about quality care.

[reesern1963]

I graduated in 1985.

I'm sorry, but "customer service" grates on my nerves. I am a nurse, first and foremost. I remember getting written up for not getting someone water when we were in the middle of a code in the ED. I was told by the supervisor I should have been able to "delegate." That happened several years ago and it still haunts me. I worked with that supervisor later when she was in a non-supervisory role, and she was the nicest person ever. I doubt she even remembers being so ridiculous.

I don't think customer service means the same thing anymore. It has a more selfish meaning to it. People are more impatient and demanding these days. There used to be a certain degree of mutual respect between patients and nurses. These days, not as much.

[sunnyviolet]

Depressed because just any kind of wacky compliant from any worker or client can result in being let go with or without cause in oklahoma - and there you are with your nursing structure intact but shocked that out of no where you must start looking for another job, get used to another set of people and unrealistic expectations, and embarassed to explain to the family and neighbors why you are unemployed again

[dakotaj70]

Propofol, versed drip and ativan. ET tube, tube feeds. Fecal management tube. Equals No complaints. I know, I know. Not nice but very true.

[NURSEDETROIT]

I graduated in 1985.

I'm sorry, but "customer service" grates on my nerves. I am a nurse, first and foremost. I remember getting written up for not getting someone water when we were in the middle of a code in the ED. I was told by the supervisor I should have been able to "delegate." That happened several years ago and it still haunts me. I worked with that supervisor later when she was in a non-supervisory role, and she was the nicest person ever. I doubt she even remembers being so ridiculous.

I don't think customer service means the same thing anymore. It has a more selfish meaning to it. People are more impatient and demanding these days. There used to be a certain degree of mutual respect between patients and nurses. These days, not as much.

I'll second that sister ! I've been a nurse just as long; no longer is the focus on the patient; disease and/or surgical process. . .

[houseofgar]

Everyone makes very good points, as a Nurse Manager of a busy med/surg unit I have not forgotten my days as a staff nurse and a CNA before that. Healthcare in general has evolved so dramatically since I first became a nurse in the mid 80's and not necessarily for the better. The challenge to front line staff nurses is being all things to all people, nursing has become a highly technical profession, requiring computer skills, enormous amounts of documentation and yes now nurses are expected to be customer service representatives.
I see nurses working non-stop for 12 hour + with few breaks, only to receive complaints similar to the ones described above, it took too long to get a washcloth, the nurse was rude, my water is too warm, pillow too lumpy etc. etc. as a manager I am required by the executive leadership to contact each and everyone one of these people and apologize and do my PR talk. I will agree with you that 90% of the complaints are frivolous compaired to the many other intense and complex medical issues that nurses deal with on a daily basis.
I do not and will not discipline nurses for frivolous complaints made by patients, I feel it is my job to take the hit, I am so sorry to hear of nurses being disciplined for "not getting a patient a cup of water during a code" and similar situations, if this is in fact what happened then the problem is with your manager or head nurse not you. Hang in there everybody, you are doing good things and for every petty complaint you hear, I'll bet there are 10 happy patients who just don't say anything.
What can management do for you? Advocate for more ancillary staff, nursing assistants, health technicians, patient care assistants etc. Recognize and reward the nurses who receive praise and commendations from patients. Say thank you and sincerely appreciate the stress and challenges you all endure and do whatever they can to provide you with the environment and resources you need to practice professional nursing .

[NURSEDETROIT]

I do not and will not discipline nurses for frivolous complaints made by patients, I feel it is my job to take the hit, I am so sorry to hear of nurses being disciplined for "not getting a patient a cup of water during a code" and similar situations, if this is in fact what happened then the problem is with your manager or head nurse not you. Hang in there everybody, you are doing good things and for every petty complaint you hear, I'll bet there are 10 happy patients who just don't say anything.
What can management do for you? Advocate for more ancillary staff, nursing assistants, health technicians, patient care assistants etc. Recognize and reward the nurses who receive praise and commendations from patients. Say thank you and sincerely appreciate the stress and challenges you all endure and do whatever they can to provide you with the environment and resources you need to practice professional nursing .[/QUOTE]

Your statement of being an "advocate for your staff" is commendable. In my experience, I can only, truly say that I've ever had perhaps 4-5 managers who would ever consider doing so; those who actually "walk the walk." Typically if one is not "one of the favored few," you loose. The cronyism and nepotism experienced at some institutions is enough to make anyone choke. As a staff nurse for 28 years, because I have chosen to do so, no desire to manage anyone other than myself, have experienced so much negative, it makes me wonder and leads me to question, "Is Nursing a true profession?" Had just about enough of all the games and BS as subjected to; behavior rather that I've deemed as unprofessional. Those who would/do throw that term at you, i.e., "professionalism," usually don't have a clue what this actually entails, let alone regard their fellow staff with any sense of decency. I've always said, some I would kiss the ground they walk on; others, well, I just assume walk away. . .

The problem lies with all the assorted suits that would call themselves leadership, yeah right. . .They dictate and implement the conditions and circumstances we are now all faced with. They have no clue. . . the only thing they care for is the PR, their bonuses, and Press Ganey scores. . .it's not just a business.

[houseofgar]

The problem lies with all the assorted suits that would call themselves leadership, yeah right. . .They dictate and implement the conditions and circumstances we are now all faced with. They have no clue. . . the only thing they care for is the PR, their bonuses, and Press Ganey scores. . .it's not just a business.

I could not agree with you more on this one, nurse managers,head nurses,nurse supervisors whatever title they are given are really the "pawns" in the corporate world of healthcare (so has been my experience). Most of the "suits" or talking heads as I refer to them, have no clue about healthcare or what is really happening on the front line, they are business people and sadly their focus is on the $$$ and performance measure scores etc. not patient care.
I believe our healthcare system will continue to decline until the "talking heads' stop talking and start listening! Listening to direct patient care staff, managers and the people who are actually keeping the hospitals running by providing care to the patients who pay the bills and their salaries.

[scotttyna]

I could not agree with you more on this one, nurse managers,head nurses,nurse supervisors whatever title they are given are really the "pawns" in the corporate world of healthcare (so has been my experience). Most of the "suits" or talking heads as I refer to them, have no clue about healthcare or what is really happening on the front line, they are business people and sadly their focus is on the $$$ and performance measure scores etc. not patient care.
I believe our healthcare system will continue to decline until the "talking heads' stop talking and start listening! Listening to direct patient care staff, managers and the people who are actually keeping the hospitals running by providing care to the patients who pay the bills and their salaries.

I agree with you houseofgaou you are right!!!

[NURSEDETROIT]

I could not agree with you more on this one, nurse managers,head nurses,nurse supervisors whatever title they are given are really the "pawns" in the corporate world of healthcare (so has been my experience). Most of the "suits" or talking heads as I refer to them, have no clue about healthcare or what is really happening on the front line, they are business people and sadly their focus is on the $$$ and performance measure scores etc. not patient care.
I believe our healthcare system will continue to decline until the "talking heads' stop talking and start listening! Listening to direct patient care staff, managers and the people who are actually keeping the hospitals running by providing care to the patients who pay the bills and their salaries.

Exactly the problem. My question to all of this is and given that all nurses are disregarded by the "talking heads" (as you put it so appropriately), and if the nurse is indeed the last line of defense for the patient, where does that leave any patient in terms of patient advocacy?