The Customer is NEVER Right - A Nurse Practitioner's Perspective
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A ten-year strike, a tick in an ear and a sack lunch

After a ten-year union strike and the union telling the world, The hotel treats their workers and customers equally poor and the community knows it,” a hotel remains in business. How is that possible? That is ten-years of daily union demonstrations in front of the hotel and despite that the hotel continues to conduct its daily business. I have never been to this hotel, or ever heard of it, and when I viewed the street view of the hotel on Google maps, on 1 Jun 2013, picketers were present in front the hotel, not good for anyone’s marketing. I am not a business expert and after everything I been told that customers will bad mouth your organization and take their business elsewhere I am curious to how a hotel survives after the union’s malicious guerrilla tactics to derail the organization yet the hotel survives with so many around to choose from?

Could it be possible the hotel had a good product? I know so-called experts will try to label it an isolated anecdotal event, however, ten-years of bad mouthing an organization and it not going out of business must have some significance.

Whether the hotel was or is wrong or not is a moot point to my argument that customers will bad mouth the organization and tell others to not do business with your organization without it being catastrophic to an organization. In this case, the epitome of the customer service and satisfaction driven business, a hotel. Could it be that the hotel was valuable to at least 75% of the population and it choose not to chase or cater to exaggerated unrealistic emotional expectations, entitlements and so-called VIP? Likely money well SAVED rather than money poorly SPENT!

Interesting enough, I would be writing this blog on a morning when my first patient in the emergency department would be a patient who told me was homeless and lived outside near a tree. The patient’s medical complaint was a foreign body in the left ear, which the patient though was a tick. When I looked in the ear I found the backside of a tick. No problem. Seems pretty simple. With the patient’s consent, I numbed up the ear with a viscous anesthetic which would also kill the tick by sufficating it in the canal and then just pull it out with a hemostat. Done!

During the procedure I cannot tell you the number of times the patient thanked the nurse and I for trying to get the tick out of the ear and once the tick was out the patient was even more thankful, despite that a piece of tissue, the tick was latched on to, was ripped from the ear canal and the tick was still grasping it when I pulled it out. After removing foreign bodies from cavities it is common practice to look again to make sure no harm was caused and to ensure the foreign body was removed in its entirety, so I looked again.

To my surprise, there was a second tick at the distal end of the ear canal latched on to the ear drum. Now that was going to be a bit more difficult to remove. Once again, with the patient’s consent, I tried to grab it with the hemostat but was unsuccessful after two attempts. Regardless, however, of the failed attempts the patient continued to thank the nurse and I for trying to get it out. However, after two unsuccessful attepts and with the patient’s agreement I filled the ear canal with more of the same viscous anesthetic and asked the patient to remain laying on her side and I would return after thirty minutes or so to try again. So I left to write the chart and take some time to plan on how to approach removing the second tick latched on to the ear drum without causing harm.

Thirty minutes had gone by, well maybe thirty-seven minutes, when I returned to hear the patient telling the nurse, “I am leaving. You guys do not care about my ear so I am leaving.” Not one to argue with adults who are awake, alert and oriented to person, place and time with appropriate decision making capabilities, I said to the patient, “That’s fine. Can I give you some antibiotics for you to take to try to prevent from you developing Rocky Mountain Spotted Fever?” The patient said, “Sure.” And I asked the nurse to get the patient those antibiotics. Unknown to me, the nurse had collected from the hospital's cafeteria a sack lunch for the patient and gave it to her, along with the antibiotics, before the patient walked out the emergency department.

Then the patient left, telling anyone who would listen in the emergency department, and in the waiting area, that she was leaving because we did not care about her ear. Its possible, given the opportunity, this patient would have picketed in front of the emergency department for ten-years, as well, telling the world that we did not care about her ear and that the community was aware of it too. That is customer satisfaction. It has nothing to do with what actually happened and healthcare administrators are not willing to watch the redundant video tape because they are more concerned that patients will bad mouth their organization.

Maybe healthcare organizations would be better off spending their money elsewhere, like sack lunches, and instead allow the satisfied 75% to spread the word that the organization has a good product in terms of medical care and the healthcare workers who provide it. And that those with exaggerated unrealistic emotional expectations, entitlements and so-called VIP are sent away with a snack lunch.

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