Saturday, April 24, 2010

Would you like fries with that?

I recently overheard a conversation in which a patient was berating the nurse for the temperature of the food on his tray and that he could not see outside his room from where he was sitting.

Disclaimer: I am huge patient advocate and in most cases will look at a situation from the patient’s point of view as they are most vulnerable and it is our responsibility as nurses to provide competent care, ensure their safety and preserve their dignity and rights in the process…however in this particular case, the patient was treating the nurse more like a waitress than a professional. The part of the conversation I encountered upon was only a small part of the patient-nurse dynamic that had been transpiring. The tone of voice and demanding attitude towards the nurse were inappropriate and belittling. She felt that everything she did was not good enough and was spending an inordinate amount of time trying to please him, meanwhile getting behind in her medications and patient assessments. This nurse handled herself with great poise and patience, yet he continued to be demanding.

Nurses are not waitresses. Nor are they babysitters or activity directors. Yet, much of a nurse’s shift is spent making sure the patients are happy instead of cared for. I understand that the role of the nurse is multifaceted and must care for the whole patient, however there comes a point when fluffing pillows and entertaining patients interferes with real nurses work – taking care of patients. The quest for patient satisfaction has perhaps swung the pendulum too far. I am sure some would argue that is part of a nurse’s job. I would however challenge that if nursing has truly become no more than providing hospitality services, then why do we expect nurses to be educated, make critical decisions, provide complex care and so much more around the clock?

I think this situation is a symptom of a bigger problem…entitlement. Everywhere people go, the customer is always right, the service must be outstanding, the product must be perfect and if not the right to complain about it is theirs. Healthcare is different and hospitals are not hotels. There is no room for social admissions anymore; beds are tight and resources are short. If you are well enough to notice the food is cold and want to see into the hallway to people watch you are most likely too well to be in the hospital (this a perfect example of healthcare waste) and would be better off going to Burger King where you can have your way.


  1. Somebody had to say it, and to be honest it has a much larger impact coming from you, since I know you to be a staunch patient advocate.

    There's certainly a tension between "patient" and "customer". We have a duty to do what is good for our patients. Sometimes, that's not what our patients want.


  2. Absolutely - unfortunately the responsibility of the patient is sometimes lost and unduly placed on the healthcare system. There is work to be done on both sides. Thanks for your comment!