Customer service training often includes instructions for staff when patients or families have complaints or concerns about care.
- “My husband needs his pain medication. We put the call bell on a half hour ago.”
- “I’ve been waiting an hour to talk with the nurse about the swelling around my IV.”
- “HELP! My mother just fell off the toilet. She was waiting and waiting and decided to try it herself.”
Carefully worded training instructs staff to apologize to patients and families and go get help, but never tell them that “we are short of staff”. This approach puts patients, families, and staff in a difficult and unsafe predicament. Staffing influences care in many ways such portrayed in this blogpost about overmedication on a dementia unit.
I have a friend and colleague who is an oncology nurses, (an excellent one) and she and I have differing opinions about this. She believes telling patients and families about shortages is inappropriate because it would increase stress and worry for patients. I can see her point, and yet think, if it is true, patients and families have a right to know. They would have realistic expectations and be empowered to increase family support, seek treatment elsewhere, or hire an advocate.
In many healthcare settings there is a big gap between what we say we can do, what we should do, want to do for patients and what we humanly can do. I don’t want to add stress to patients and in general don’t approve of caregivers complaining to patients about organizational problems. However, uncovering, discussing, and addressing truths about staffing and workload expectations will help to get us on the same side in terms of seeking solutions. Shouldn’t consumers and providers be on the same team? And shouldn’t consumers be informed?
A recent study at Johns Hopkins suggests that Patient Satisfaction Surveys may misleading as reported by Kaiser Blogger Jordan Rau in, Patient Satisfaction May Not Be A Good Indicator Of Surgical Quality”. I think this is because there is an imbalance of focus on hospitality and perception rather than engaging consumers and frontline staff to build better systems.
What would happen if staffing patterns became transparent to patients and families? This could be by verbal report on a given day and/or by posting information about ratios of caregivers to patients, turnover, sick-calls, and back-up staff coverage policies (protocols for and effectiveness of) replacing sick workers etc). Progressive organizations such as Magnet Hospitals might use this information to promote exemplary patient safety and staff recruitment records. Organizations that are chronically understaffed may have to address staffing and related issues such as morale and turnover. Both seem like positive outcomes.
What do you think about making staffing patterns transparent?
Beth is an organizational development consultant, medical improv trainer, and author of Confident Voices: The Nurses’ Guide to Improving Communication & Creating Positive Workplaces. For bulk orders contact email@example.com