Monday, May 26, 2008

This "Customer Service" bullshit has got to stop.

Normally, I never post immediately on coming home from work. I'm too frazzled, too scattered, and unable to complete a spoken sentence, let alone a written one.

Today, though, it's different. Today, for the fourth or fifth time in as many years, I had a patient take a swing at me. What's different about today is that this particular patient was alert, oriented, knew where he was and what he was doing, and was trying to hurt me.

This patient was the typical Sunnydale Hospital* frequent-flier: pages and pages of old charts, all of them with extra pages attached from nurses who'd had run ins with him. The documentation was complete and careful and clear: this particular person was a nutjob. No way 'round it; he had enough baggage for the Rolling Stones on tour.

His course was also typical: noncompliance with the simplest of instructions, obscenities screamed at nurses, pharmacists, and doctors, and the final lovely touch of hiding narcotics in his room. That was just recent visits. It didn't take him long to get a file this (holds fingers apart at arms' length) thick.

So he took a swing at me. And screamed obscenities. And I reported it, as I was supposed to, to my boss, one of the Manglement Trifecta on the floor. (Winky, Blinky, and Nod, as I call them, do the work of one person, and do it.... Anyway.) Winky went on into the room, and there....

...Practiced Good Customer Service and Conflict Resolution.

The upshot? I got told the patient didn't like me--big shock, as he didn't like anybody--and was told not to do whatever it was I did to get him upset again.

Managers, read this, if you read nothing else:

Customer Service Does Not Mean Putting Your Nurses In Harm's Way.

This was a patient who'd already threatened to kill two surgeons. He had come up on out of the bed with a pharmacist and had caused three of the toughest nurses I know to refuse to take him on as a patient. Now, I am not the shrinkingest violet on the block, but one thing here ought to be perfectly clear: The only way to deal with a problem like this is to get rid of the source.

Patients like this ought not to be readmitted to the hospital. They ought not to be "counselled" about their behavior. There ought to be no quarter given: if you swing at a nurse, or scream obscenities, you should be told briefly and bluntly that that behavior is unacceptable, and if necessary, you should have a security guard posted outside your room.

The fact that this guy wasn't ditched from the hospital admit list tells me that Sunnydale doesn't give a good goddamn about their nurses' safety. The fact that my charge nurse, Winky, didn't lay down the law tells me that he cares more about our floor's customer satisfaction scores than about *my* safety.

And that tells me this: Managers, listen up: the only way you guys will ever pay attention is if we, the people on the front lines, start making a stink. 

Next time some direct descendent of Einstein swings at me, I am not going to get out of the way. I'm going to let them hit me.

And then I'm going to file battery charges.

And then I'll talk to your board of directors, Sunnydale, about the whole situation, and how much compensation I ought to get for mental anguish. Because the only way to get large groups of carpeted-area manglement types to pay attention is to talk about negative publicity and dollar amounts.

I'm not fucking kidding. There is no reason in the world that I ought to have to put up with somebody who's actively violent still being in the hospital after he's behaved like a beast. There's no reason that the charge nurse or house supervisor or whatever shouldn't march into the room and tell the person who's a nutjob that nutjobbiness is unacceptable and *will* stop, NOW, or the patient can go home. 

There is, in short, no reason for me to feel less safe working at Sunnydale than I did working at an abortion clinic. And I do. 

*w00t Buffy.


Jacob said...

Sheesh. Makes me feel real excited to start working as a nurse. Hopefully the pediatric ER isn't quite as "fun".

Anne said...

That is ridiculous and completely unacceptable. Can you write up an incident report that would go to higher-ups? Would it be worth the bother?

ERnursey said...

Hospital administration doesn't give a shit about us, to them we are just little easily replaceable cogs in a wheel.

Law enforcement needs to be involved and if you are a union they should be also.

pelican said...

Amen ... this is one area where the VA has public/private hospitals beat ... smack a VA worker (while alert and able to engage in purposeful behavior) and you no longer get care at that VA facility. It doesn't matter if it's the only VA for 500 miles, you're gone, forever, and it's on you to figure out what your next care plan's going to be.

I think your plan's a good one, and I'd certainly be sure to file a Worker's Comp claim for the injuries associated with getting walloped, as well as pressing criminal charges, filing a complaint with your union, getting your legislative representatives involved (if Sunnydale receives public funding), dropping a line to OSHA, and going to the BOD meeting with your union's atty.

The loco days of locolorenzo said...

It's funny when healthcare becomes all about customer service, to heck with the safety of people actually providing care.
And people wonder why we try to dissuade others we know from going into the field.
Sister, I hope that the next time, you get hit(lightly) and sue that heckhole for millions....and then turn around and start a agency for safe nursing...I'd know I'd come work for ya.

Anonymous said...

I wish we could have a "no-admit" list, like the TSA's "no-fly" list, just to keep folks like this out of our work environment. As for management, you got it right, the only thing that will get their attention is $$$ and bad publicity. Sucks they don't seem to care about the people (us nurses) that enable them to take home their 6-figure salaries. Glad to see it turned out OK and you didn't get clocked.
I'm no lawyer, but isn't assault the intention and attempt to cause bodily harm and battery the actual causing of bodily harm? Just thinking...

John S said...

Just curious - what would happen if you slugged him back?

I'm sure there would be 'Failure to Give Good Customer Service' and 'Lack of Conflict Resolution Skills' references.

But what else?

David said...

It's funny that the manager mentions that the patient didn't "like" you.
Because as we all know it's nothing but a big old garden party at work.
well..I guess if you're a manager it really IS a big old garden party.
when are they gonna come down out of their ivory tower?? never.
what makes me really sick is that after years and years of it you start to act like an abused person.
you start to feel guilty about having been it's your you somehow deserved it.
what management did in your case was not only to empower the abuser..but they made it seem like it was your fault..(they didn't *like* you)..thus reinforcing the fucked up cycle that the abuser initiated.
and who says we don't eat our young?

nurse advocate said...

I agree with you and support your decision to press criminal charges next time it happens, and it will happen again. I have been making the arguement for years that if the same thing happened at any other place in our society the offender wouldbe arrested and probably sued. The hospital makes it legal for sane persons to assult another person with no excuse other than the didn't feel well. If their not found to be clinicaly disoriented or psychotic then they should be charged and our administrations should be the one pressing charges on our behalf. Please feel free to visit my blog site and email me if you think you would like to vent their as well. The blog is

Deenie said...

I'd document the fuck out of it, and go to the higher ups letting them know just how much their management *care*.

You can be sure that if you start mentioning the "dollars" word and staff walk outs, they will all of a sudden grow things called ears, and actually use them for what they are supposed to do - listen

Then again, we are talking about bean counters. Maybe I am being too optimistic.

Anonymous said...

Been there, done that. We are glorified waitressess. SMILE chart early chart often SMILE customer satisfaction SMILE positive attitude SMILE time management Smile come come yell at kids, drink some beer go to sleep WAKE UP & DO IT ALL AGAIN & hope I get hit by a truck on the freeway.
im going on my seventh year of this bullshit can you tell?

Outsource Call Center said...

Customer service isn't about being perfect. Customer service is about making things right, not just the immediate problem, but the root cause. And it is totally about listening to the customer. Thanks for the post.


Lance said...

Don't call security, call the police. The "patient" is a criminal guilty of assault. Your "manager" is complicit in the crime and a detriment to the safety of his or her employees.

Lance said...

Just noticed this is from FIVE years ago. Wondering if you're still alive.

I'm in Las Vegas and we have the rudest damned patients in the world with an "I'm on VACATION" attitude and "Gimme EVERYTHING right NOW!" ego trip. Las Vegas has the worst nursing ratios in the country and they are at the tail end of respect for their nurses in favour of "the customer" and their abusive families.

Anonymous said...

We need unionization of all nurses nationwide in the U.S., to help protect us from situations like this, and the corporate mentality as well.