Do high customer service score equal great care from nurses?

The profession of nursing is currently under assault. The profession has remained in the shadows of health care, despite nurses constituting the largest amount of health care providers in the health care system in the United States. Nursing developed historically in a patriarchal society in which few women held jobs outside of the home.  Nurses were educated to provide a supportive role to the physician because; this was in the historical context in which they lived. The profession of nursing has evolved into a complex role where the nurse provides complex medical care, crisis intervention, critical thinking, advanced education and the ability to orchestrate a complex medical team (Buresh & Gordon, 2006).

      The nurse is often the one who provides lifesaving intervention in the time of crisis and chaos. Nurses have failed to demand role recognition, professional identity and respect for the role they hold in healthcare. The reason nurses remain in the shadows is complex. Educators, senior nurses continue to promote ways of thinking about the profession that is antiquated. Nurses give many reasons as why they remain in the shadows but, by doing so they are hurting the very people they have vowed to protect the patient. The failure to adequately portray the significance of the profession makes the backbone of the health care system replaceable and endangers the public (Buresh & Gordon, 2006).

      One example of this is very evident in the laws were hospitals are going to be reimbursed by Medicare, biased customer service scores. Nurses are the driving force behind these scores. This law communicates to me that Washington law makers are unaware of the role of a nurse. High customer scores do not always indicate quality of care because; healing is not always a comfortable endeavor. Patients demand procedures, medication, surgeries or care that is that is unnecessary and can be detrimental but, they are indulged to increase customer service scores. If Washington was aware of the complex nature of nursing they would pass a law that would demand lower nurse to patient ratios, longer patient stays, promotion of nurses as preventive health educators and demand advanced education for entry level position into nursing, instead of demeaning nurse to educated hospitality hostesses. Nurses have a duty to portray an accurate portrait to the public and other health care professional of their role as a collaborative member of a highly complex health care team member and remove antique view of nurses being an angle of mercy, helper to the physician (Gordon, 2005).

     A sad reality is the misconception held by the public regarding the role of the nurse, is a failure of the profession to adequately communicate and portray the profession in light that is context with complexities and responsibility awarded to it. In essence the nurse holds the life of the patient in a balance every day. Each individual nurse is responsible to communicate the professionalism the profession deserves. Ways to communicate this is through dress that is professional. Heart, flower and Disney scrubs may send the wrong message in an adult acute environment. Even little things may change an individual’s perception that the nurse does not take the job seriously such as a pin with hearts and guardian angles. The nurse must be careful in the speech they use when introducing themselves. An example would be to introduce themselves as a collaborator of care instead of Dr. Smith nurse. Nurses also have to be aware of non- verbal actions that may portray them as handmaids to the physician such as cleaning up after a procedure or getting up to let the physician use the front desk computer. Nurses need to participate in responses to the editor, reporters and how they communicate what they do to the public on a daily basis. Most importantly nurses should take pride in their title and introduce themselves as a Registered nurse and their full name (Buresh & Gordon, 2006).

      If nurses choose define their careers by clichés they will remain in the eighteenth century depiction of a nurse and fail to gain the recognition of the advanced technical skills require to perform nursing duties. Let’s face it your mother, husband neighbor can care about you but would you want them mixing your chemotherapy? Nurses must articulate the technical mastery that is used to help the patient survive their hospital stay. Jean Chaisson in the article asking the right questions gives a very well-articulated example of how a nurse should communicate the knowledge and technical skills require performing her job as a nurse (Buresh & Gordon, 2006).Ms. Chaisson is taking responsibility for the work she performed as a nurse. To say she is placing herself in the spot light is being falsely humble and failing to accept accountability for actions. This not only allows the nurse to loose credibility but, it is dangerous for the patient. Does not Paul warn against false humility in Colossians and the twisting of this virtue into a sin?  The French moralist La Rochefoucald stated “false humility is often only feigned submission which people use to render others submissive” and by the nurse failing to take responsibility for their professional actions, they are practicing in dishonesty and lack professionalism (Felber, 2002). Chaisson is successful in communicating the advanced technical skills required in developing a nursing assessment this, is evident when the patient states “nobody has ever asked her about these things before” (Buresh & Gordon, 2006, p.41).

     The chapter on the voice of agency has made me review how I communicate my profession in non-verbal as well as verbal manner. I must communicate that my profession demands respect or how can I expect it? How I communicate the profession of nursing takes thought and deliberation. “The greatest problem with communication is the illusion that it has been accomplished” (Felber, 2002, p.11).  The chapter on voice of agency has made me question many practices that have been ingrained in me since the beginning of my nursing career twenty years ago. Is how I view my profession antiquated? It had not occurred to until reading this chapter on voice of agency that I may be passing on to the next generation passive, non-professional behavior that is giving the power of my profession away. Am I really caring for someone when I fail to be authentic and honest in my communication with them. I have come to understand my resentment of the customer service satisfaction scores. The question press Ganey ask the patient to evaluate my skill and level of expertise in my profession is; how well did my nurse care for you? This definition of care is impossible to live up to and is defined differently by each individual patient, unless nurses as professionals help the patient define it. This fails to recognize the skill and expertise required of my profession. I am angry at myself for allowing someone to define me in this manner. It is difficult to accept that the resentment that I feel for not being appreciated for what the work I do on a daily biases, is my own fault because of my passive communication. “In communication it is important to say what you mean and mean what you say” (Felber, 2002). If we communicate are ideas well, are world will dramatically changed. From this day forward I will state my position and my role as a patient’s health care collaborator with technical expertise and skills, to help move a patient towards health, I will not allow others to define that role for me.

    

     To define my work as anything but a ministry would be a failure for me to authentically communicate who I am as an individual. The work that I do in this world is in service to my Heavenly father. God expect honesty from his children and for them to live out the life he has given them with integrity. Failure to accept accountability for my profession by accurately portraying my role is nothing less than a lie and playing a victim. God does not except lies or victimhood. If God keep a record of all my good deeds, does this not say I am to take responsibly as well as celebrate them? “So do not throw away your confidence because it will be richly rewarded” (Hebrews 6:10). By showing others my confidence I am demonstrating my trust I have in the Lord of the Universe. By staying in the shadows as a nurse I fail to show the light of Christ (Ortlund, 2000).

References

Buresh, B., Gordon, S. (2006). From silence to voice. Cornell
   
     university: Ithaca, London; Cornell university press.

Felber,T., (2002). Am I making myself clear? Nashville; Thomas
  
     Nelson publishers.
 

 Gordon, S., (2005). Nursing against the odds. Cornell
  
     university: Ithaca, London: Cornell University Press.
  

Ortlund, J. (2000). Fearlessly feminine. Sister, OR; Multnomah
  
     publishers.