Service Training in Action

Now that our patient satisfaction scores will actually affect reimbursement rates, Hood Hospital is trying to teach all of us ragamuffins down in the ER how to act right so our patients will be happier. Who better to teach us than a bunch of people from finance and upper management who have never taken care of a patient in their entire lives? I can't think of anyone with a better perspective. Anyway. They've been doing mandatory training the last month, and despite the fact I will never get those hours of my life back, at least the things these people think will work to improve our scores are hilarious.

The vast majority of the stuff they are trying to teach is are things that decent nurses already do. Hi, don't start a Foley with the door open, don't talk to the patient about your child support case, explain what the hell you're doing before you do it, maybe talk about the discharge papers a little while instead of just throwing them in the patient's general direction. Yeah, okay. No, the true comedy gold happens when these jackwagons present to us the things they actually think will make our patients happy. It's kind of sad, really, as they've clearly had many a meeting about synergy in healthcare and buzzwords or some other bullshit and come up with some stuff that they probably think is really fantastic and practical, only to be met by icy, dead silence or riotous laughter when they present it to those of us who actually take care of the patients.

So, with that in mind, ER BFF and I thoughtfully considered their suggestions and pondered how they might apply to the situations we encountered that weekend. Here's a couple I'd like to share with you.

"Mr. Homeless McCrackhead, you seem upset. Please allow me to listen without interruption about what the problem is. Yes, I can see you're very upset that we can't bring you a third sandwich and that the staff won't allow you to go into other patients' rooms to ask for their phone numbers. I'm so sorry this is happening to you. Let me see what I can find out for you about a bus ticket to that nudie theater downtown. Thanks for choosing Hood Hospital!"

"Hi Mrs. Abdominal Pain of Mysterious Origin with Multiple Non-Narcotic Allergies! My name is Hood Nurse, and I've been an RN for nearly 3 years and I have a lot of experience starting 24 gauge IVs and pushing Dilaudid through them. I see that Dr. Unnecessary Workup is going to be your doctor today, and let me just say that he comes highly recommended by other patients with problems similar to yours. Today we will use state of the art technology the perform several fruitless tests on you, and when they all come back negative, we will continue to take your pain seriously by giving you criminal amounts of IV Dilaudid. After a couple of hours, Dr. Unnecessay Workup will probably admit you for pain control to Dr. Spazz Hospitalist. I've heard many good sources that he has a pulse, and I've noticed he's been urinating on himself a lot less lately. Please let me know if there is anything I can do to make your stay more like a combination between a spa and a trip to Disneyland. I have the time. And for the 40th time this year, thank you for making Hood Hospital your first choice. We are delighted to take care of you again and hope we have this opportunity to collaborate in your care again soon."

"Mr. Drunken Head Laceration, I'm sorry you're not feeling well today. I realize that hitting and groping the staff might make you feel better. However, we're concerned about some possible issues to your health and safety, so we may have to use some state of the art leather restraints in your care today. We may call in the hospital police to help make your stay more enjoyable. They and their tasers have several years of experience dealing with patients a lot like you, and they are excellent at what they do. Now the doctor is going to use his excellent technique to staple your head closed. We will allow you to voice you concerns in the form of multiple obscenities screamed at the top of your lungs in an uninterrupted fashion, because we respect your point of view. Let me, as an agent of hood hospital, express how sorry I am that the doctor will not prescribe narcotics for your head laceration pain. It seems he is concerned about the possibility of mixing them with alcohol. I recognize that this is unacceptable to you, so I'd love it if you'd stay to talk to our house supervisor, who would be happy to provide you with a gift card to our on campus Starbucks. We'd be happy for you to enjoy a gingerbread latte on us for your trouble. Or, if you really do feel that you would prefer we, as you say, 'shove that up our asses', we would be happy to do that as well, if it would make you more likely to recommend us to your friends and family. As always, thanks for choosing us today!"

I don't see how communication like this couldn't fix all of our problems. I mean, obviously any problems we're having with feedback are certainly solely related to our shortcomings in communicating, as opposed to lack of staff, budget, resources, training, or reasonable expectations.