Patients Get the Chance to Voice Opinions

It appears that our government cares about our perceptions and opinions regarding hospitals and the care we get when confined to one.

The results of the first ever (what took so long?) federal survey of almost all hospitals in the U.S. (some chose not to participate) are in and many patients are not happy health care consumers.

National Hospital Association members helped develop standards for the this survey that provided patients with a constructive method to complain about grumpy nurses, inattentive doctors and less than aesthetic hospital rooms (translation: dirty and noisy).

On average, 25 percent of patients reported that nurses did not communicate well with them. Many reported they were not treated with courtesy and respect by nurses and doctors, did not receive adequate pain medication following surgery and either did not receive or clearly understand discharge instructions.

Granted, we are performing well 75 percent of the time but this reported communication gap is nothing to ignore. Poor communications are a major source of medical errors and inadequate discharge instructions greatly increase the likelihood of an emergency room visit or readmission to the hospital. And, of course, all of that then becomes a money issue.

The release of the survey data received praise from employers, labor unions and consumer groups, declaring that the information will make hospitals more accountable.

FYI, the state with the highest average satisfaction score (79 percent) is Alabama; the lowest (56 percent) is Hawaii. And, the hospitals that chose not to cooperate with the survey process? Medicare reports there will be a monetary penalty—perhaps as much as $100 per patient.

The data from this survey is posted online at http://www.hospitalcompare.hhs.gov/.

Nurses Can Issue Doctors' Report Cards on CareSeek.com

I’ll bet there’s not a nurse out there who hasn’t chosen a doctor for him or herself, or for a family member, based on witnessing a doctor’s performance. Observing a doctor’s technique, bedside manner, attention to detail, overall knowledge—it’s the very best way to select a doctor, in my opinion. I’ve had nursing jobs in which I worked shoulder to shoulder with doctors in a variety of specialties and subspecialties. The up close and personal nature of those work situations made it a snap to decide to whom I would entrust my life and the lives of my family.

When I later moved to a new city, I was at a loss as to how to wisely choose new doctors. I asked around, of course, but I didn’t know many people at that point and, although I was given suggestions, it was hard for me to trust opinions of those not in the biz. It seemed as though I might as well open the phone book to the yellow pages listings of physicians and throw a dart. There were a couple trial-and-error situations but, for the most part, things worked out.

I wish I’d had access to CareSeek.com back then. CareSeek is the brainchild of Gale Wilson-Steele who founded the site in 2006, utilizing her experience in health care information and communication to create a forum for sharing personal experiences. Nurses, patients and doctors can evaluate doctors online. Evaluating doctors is something we’ve done informally for a long time. Let’s now formally share what we know and contribute our two cents worth to CareSeek. We’d be doing health care consumers a big favor.

No Surprise--More Money Needed to Increase Nursing Ranks

Two years ago I interviewed a highly esteemed professor of nursing, considered to be an expert regarding the critical nursing shortage that we are experiencing now and which is expected to mushroom in the next 12 years. He remarked that to fix the problem congress must step up to the plate and appropriate money. He suggested a billion dollars would be needed to do the trick; an amount, he claimed, "that is nothing."

A shocking statement, I know, but his remarks should be put into the context of ‘everything being relative.’ Considering the astronomical amounts of money being spent by our country on other endeavors, a billion is sounding smaller all the time.

In January 2007 Senator Richard Durbin (D-IL) sponsored and introduced S446 Nurse Education, Expansion and Development Act 2007. A simple explanation of the proposed bill is that monies, in the form of grants, will be awarded to schools of nursing that meet certain requirements, for the purpose of increasing nursing faculty and students. As you might expect, the bill in its entirety is somewhat more complicated. I am not privy to the amount of funding being sought, or even wished for (a billion?).

I’ve always heard that the wheels of government turn slowly and this bill must be an example of that grind. The bill was proposed over a year ago and, short of phoning some very busy in-the-know people, I have been unable to find evidence that any action has been taken.

Congress, show us the money!

Let's Use Good Sense and Use No Scents

When I was in nursing school, students were often reminded (adamantly!) not to wear perfume in the hospital. At that time the concern was for the patient. Anyone whose condition warranted hospitalization was likely to have a delicate constitution that could be further complicated by odors and fragrances. In other words, we were to leave the Shalimar and English Leather (yes, even in the 60s there were guys in my class) in their bottles or risk nauseating our patients (and some kind of punishment that I don’t recall).

These days it seems that an increasing number of people have allergic or other bad reactions to scents. Headaches, including migraines, are frequently reported in the bad reaction category. Some people, like my sister, just don’t like scents and find them annoying.

Now, there is concern for nurses and other hospital workers who need to be protected from others (sometimes patients) who are fond of the eau de cologne.

I recently heard about a nurse, who is highly sensitive to strong odors in general, who politely asked another nurse to refrain from wearing perfume at work and explained the uncomfortable effects brought on by the scent. The offending nurse flatly refused to forgo her atomizer. The scent-sensitive nurse appealed to supervisors on ever-increasing levels of authority. Some spoke to the offending nurse about the issue but she continued to wear perfume. The last I heard, nothing had been resolved.

Many hospitals have no-scent policies. Just as hospitals are smoke free, some are now scent free. I think that is a good way to go and it is simple to do—or not do, in the case of spritzing clouds of perfumed mist on oneself.

I happen to be quite fond of a couple of perfumes but I would never wear them in the hospital—or near my sister.

Does anyone have asphyxiation-by-perfume stories?

Bringing Nursing Back

Has anyone seen the 5-minute video, “We’re Bringing Nursing Back,” on YouTube? Made by nursing students at Binghamton (NY) University, it is intended as a recruiting video and has been viewed in excess of 180,000 times since it first appeared online in late 2006.

There has been some criticism (by those long out of nursing school) about the students’ minimizing, in the opening scene of the video, the importance of Florence Nightingale and the ideals of nursing she espoused. It is obvious that the young woman portraying a professor was trying very hard to make her Nurse Nightingale lecture as dry as dust. I can live with a little tongue in cheek humor but, in my opinion, the entire opening should’ve been left on the cutting room floor. Jumping right into the message of the nursing shortage, steady employment, good salary and working three days per week (gotta love those 12-hour shifts) would’ve been more effective. Besides, I have a theatre background and there was a serious lack of enunciation and projection in the intro that I found annoying.

The students’ decision to dance and rap “We’re Bringing Nursing Back” as a take-off on Justin Timberlake’s “SexyBack” also didn’t go over very well in some quarters. Something about linking a video that promotes nursing to a song about dirty sex raised some eyebrows. Not that I’d have a clue. Sure, I know who Justin Timberlake is but I don’t know anything about his music. When I watched the video, nothing salacious came to mind. I saw energetic young people as enthusiastic cheerleaders for a profession they appear to value and enjoy. Whether their performance will win converts to nursing, I don’t know. Their message is aimed at a demographic decades younger than I am, and I can see there would be some appeal for that set.

The Binghamton students get an A for effort and cleverness.

Watch the "We're Bringing Nursing Back" video on YouTube

Happy Nurses are a Shot of Adrenaline

In a fluke of scheduling, I recently interviewed four RNs—three by telephone, one in person—back to back for articles I’ll be writing. The enthusiasm exuded by each of them was something to behold. If we all could be as excited about our jobs as those four women are about theirs, the world would be a happy place—and jazzed! The adrenaline, or something like it, began to build and by the time the fourth interview ended I felt as though I’d had 10 large espressos chased with a gallon of Jolt. I was really wound up!

But, how refreshing that they are not only deriving a great deal of satisfaction from their work, but that the creative wheels are turning in their heads, always thinking about the next best thing to accomplish their missions. The four of them are in widely divergent fields and they all are leaving big footprints in their fields (pun intended, sorry).

We get stretched so thin sometimes that the only thing job related that we can be enthusiastic about is going home at the end of our shifts. But, there’s an old Dale Carnegie chant that goes, “Act enthusiastic and you’ll be enthusiastic!” Run that through your head a few times a day, chanting to a bit of beat, three or four times to a set, and you might get jazzed, too. I know it sounds corny but it can work.

Small Acts of Kindness Reap Rewards

On December 26, 2004, Nate Berkus, the host of Oprah’s new TV show The Big Give, was vacationing at a beach resort on Sri Lanka when earthquake activity at the bottom of the Indian Ocean triggered a gargantuan tsunami. More than 225,000 people in 11 countries died as a result of that disaster, including Nate’s partner, Fernando Bengoechea.

In the ensuing three years I have seen Nate interviewed a few times and, when he speaks of his experience, he always mentions how grateful he was for the small things that were done for him in the days immediately following the tragic event. He spoke of it again today in a TV blurb that promoted The Big Give.

He said that after the tsunami hit, he had nothing. He was in a foreign country without a passport, without money, without clothing and grieving because his friend had been swept out to sea. He said the smallest gesture of kindness was appreciated in ways he’d never dreamed. The offer to share a hotel room with several others, the clothes he was given, something as simple as a smile—he was grateful for all of it. This is a guy who pretty much had it all--a lucrative design business, a measure of fame, a cushy lifestyle--but, there he was, grasping onto a stranger's smile for comfort.

I don’t want to come off as a Pollyanna, although I must say I don’t see anything wrong with being one, but little acts of kindness can make such a big difference for our patients and their families, for our colleagues, for someone you might meet on the street—anyone at all.

Speaking of customers at her business, a friend once told me that she considered unhappy people a challenge in a positive way. She felt it was her mission in life to make them happy and she worked on developing skills and creativity that would allow her to be successful at it.

Technically, nurses aren’t in the hospitality business, but we really are. Hospitality? Hospital? I think there just might be an undeniable connection. Perhaps if we treat our patients a little more like guests, our work days could be described using words like serene, calm, smooth, pleasant. It's not out of the question. Smiles and kind words are easy to dispense and they’re free.

Insurance Companies Get Failing Grades from Hospitals

The country’s largest health insurers have taken it upon themselves to rate hospitals on quality and cost and, then, make their findings known to the public. The insurers say that, based on the ratings, health care consumers can make better choices when choosing a hospital.

In a back-at-you move, hospital executives, in a recent survey, have rated insurance companies based on how promptly and fairly they respond to claims. Three of the five biggest insurers had larger negative approval ratings than positive ones. One company received negative ratings from 91% of the survey respondents.

OK, mainly I’m surprised that anyone is surprised. Run of the mill citizens, such as myself, have known pretty much forever that insurance companies are famous, not only for disallowing too many claims, but for sending the most confusing statements known to man. My big gripe is that often the charges are posted months after the actual date of service, which makes it a challenge to figure out what the charges are for. Would it be so hard to post the date of service? I’m sorry, but I need simple.

Back to the survey. The information is supposed to be a wake-up call for employers who provide group health plans for their work force to investigate and choose insurers that take care of claims without hassle and that have good working relationships with their primary providers.

I happen to be self-insured, so it is imperative that I be a good and educated consumer when it comes to buying health insurance. It’s no walk in the park, I’ll tell you that. I dread my birthdays because, not only do they signal growing older, that’s when I usually get the notice that my premium has made a big jump. Happy birthday to me.