The Customer is NEVER Right - A Nurse Practitioner's Perspective
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Another healthcare worker killed!

21 January 2015 Facebook post

Yet, again! Another healthcare worker killed. I know. It's repetitive. Yet, keeps happening and no one is paying attention. SILENT NATIONAL CRISIS!

The details are not out yet, or at least made public, but I suspect, and call me crazy, but I suspect EXAGGERATED UNREALISTIC EMOTIONAL EXPECTATIONS not catered to, again!

Making matters worse, it only makes the news when a healthcare worker is killed. Because when a healthcare worker is 
 spit on, kicked, yelled at, shoved, cursed at, scratched, pushed, punched, hit with, slapped, grabbed, thrown at, sexually assaulted,  yada, yada, yada there is no mention. Some, to include healthcare administrators and pundits, even think it is just part of our jobs. NO! Let me spit on you administrator/pundit and see how much you think it is part of your job!

And DO NOT tell me it happened to you when you were in the pit, as if being a punching bag is a right of passage, and why you are now an administrator. NO! I went into healthcare to help others and not to be a punching bag and much less to be a manager to get away from being someone's punching bag.



21 Jan 2015 Facebook post

As predicted, another dissatisfied "customer" kills a healthcare worker. Again, that is KILLS because being  spit on, kicked, yelled at, shoved, cursed at, scratched, pushed, punched, hit with, slapped, grabbed, thrown at, sexually assaulted, yada, yada, yada. are all irrelevant, some even saying it is part of the job.
Again, that is a healthcare worker who was killed and for those NOT paying attention healthcare workers are those helping others.
And, yes, as this latest article points out, not killed by a piece of CRAP but instead by another loving husband, adorable son and brother, caring father, friendly-waving neighbor, dog owner, blah, blah, blah, blah, blah…who somehow snapped. Really?
How about, DO NOT AMBUSH INNOCENCE!?! That is whether with a weapon, your hands/feet, your spit or your vile words. Leave innocent people alone!
You wanna snap? Snap your own life!
And. And. Again, just in case anyone is paying attention, the hospital’s president was “proud” of her staff’s response. What a nice thing to say “publically” about the hired help! “I am so ‘proud’ of them.” Awww, that is so nice to say.
I wonder, as I do not know, if the president feels the same about her staff when a "customer" complains about her pride and joy staff, to include that ONE staff person who says, “No,” to the "customer's" exaggerated unrealistic emotional expectations. Or does the president only side with staff when they are killed and not so much when they are “just” physically or verbally assaulted?
Not to mention, in the article, the LAST paragraph I might add, the hospital president balks at the idea of metal detectors. Awww, look, the top hospital administrator, like so many across the nation, is worried what the “customers” might think. Especially since none of the other hospitals “up the street” have metal detectors. Why would they? “Security has never been mention mentioned as a concern in any of our customer satisfaction surveys,” say healthcare administrators around the nation.
Sadly, they are right. Because incident after incident it is not the “customers” who are being mauled down or spit on but those helping others, the healthcare workers.
And, once again, the true colors show where the administrator’s interests are with regard to the staff she is so proud of.
I wrote ALL of this in the book. Yet, I cannot make it up.


23 January 2015 Facebook post

Again, I cannot make this up but this tragedy continues to unfold as if written somewhere, like in The Customer is NEVER Right.
This latest article talks about security, after the fact of course, and the claim is made that securing a hospital this size (60,000 daily visitors) would be a nightmare. Really? Why?
Phoenix Sky Harbor International Airport is one of the ten busiest airports in our nation with more than 100,000 passengers arriving and departing on a daily basis, yet, it is secured. Not to mention it is very welcoming with all its restaurants and shops in and out of the secured area.
The first excuse in the article is that “there are too many entrances and exits”. Really? I am not a security expert but I would limit those avenues of approach, as we called them in the Army, just like they are limited at the airports. Yet, at the airports 100s of thousands of people move through those limited entries and exits on a daily basis, and without a hitch I will add, so not as difficult as they want to make it.
Just last week, while sitting at Hartsfield-Jackson Atlanta International Airport, the world’s, not the USA’s but the world’s, busiest passenger airport, which moves more than 250,000 passengers per day, I saw something that caught my attention. It was early in the morning and employees were moving to their places of work and I noticed that despite all of them had gone through a TSA inspection, like the rest of us, the employees who worked the flight line could only get there from the respective gates they worked at. In other words, those employees all had to key themselves passed a secured door in order to access the flight line. Adding to that security, employees had to access their own entry to or exit from the flight line. In other words, despite the line of employees to get down to the flight line each one had to wait until the door locked and the door was ready before the next employee could enter or exit the same door. So despite the line and whether late for work or not the polite gesture of holding the door for the next person, like when one holds the door for another customer at a so-called “secured” hotel, that behavior was not displayed. It is very likely the security system not only grants access but also keeps tabs on who was on or off the flight line.
On that note, I do not believe ANY hospital has more entrances and exits than an airport, especially the world’s largest airport. Not to mention, not a greater volume of daily “customers” either. So please, spare me the CRAP! And although some will argue the security measures at airports are post-9/11 that is not the case either. I recall going through security and metal detectors at airports as a child in the 70’s.
Having said that and as a lead into the next point, I recall my younger brother going through a metal detector at the airport once, in the 70’s when he was 7 or 8 years old, and unknown to him he had some firecrackers in his pocket. It just happens that as he walked through the metal detector he set off the alarm. Making a long story short, security stopped the adult behind my brother, as the gentleman must have been in a hurry and walked through the metal detector just as my brother stepped off, and my brother kept walking as nothing had happened. It was not until we reached our destination when my brother emptied his pockets that he found the fireworks in his pockets.
Yes, fireworks have always been illegal in New York, regardless if carried by an adult or a school-aged child, but that is another story.
Anyhow, for the sake of argument let’s agree with the director of Mass. General’s police, security, and outside services and just say that it is true, that metal detectors “aren’t foolproof”. That discount despite every courthouse I ever been to uses metal detectors, not to mention, so does the TSA at the airport, but I am willing to let that argument go because that is not really the issue.
The issue, as mentioned in the book, is that those security measures would give the appearance of “a locked-down fortress [which] is not the welcoming image a hospital wants to project to visitors.” Now that is the issue. Why? Because healthcare workers are caring and compassionate people who help others and in doing so they have been nurtured to accept, and happy to do so, with putting themselves at risk so a hospital can project that “welcoming image”. How sweet? That paradigm has to change!
If I recall correctly, and those in Hawaii correct me if I am wrong, but when I did my BSN clinicals at Queen’s Medical Center in Honolulu Hawaii in 1999, I recall a single entrance into the emergency department that was manned by security and was bulletproof. Yes, bulletproof, and that was in Hawaii where the annual murder rate (16 incidents in 2012) was 4.75 less than the national rate (76 incidents projected for 2015 for the same population). Yet, somehow, Queen’s maintained its “welcoming image” and that is aside of it being in Hawaii.
The article continues with, “Of course, now we’re thinking about this and trying to figure out how to advise on security, but it has to be in the context of what’s best for the patient,” said Dr. Michael Cantor, chief medical officer of the doctors network.
Dr. Cantor, obviously an administrator, saying, “…[let’s do] what’s best for the patient.” Again, hiding behind patients. Why? Because healthcare workers are ALWAYS happy to allow themselves to be vulnerable, it is part of the culture in healthcare and everything they do is for the patient. More CRAP!
Now, can some tell me why would security “be in the context of what’s best for the patient”? It is not patients who are being spit on, kicked, yelled at, shoved, cursed at, scratched, pushed, punched, hit with, slapped, grabbed, thrown at, sexually assaulted, yada, yada, yada. So why would security revolve around patients? WHY!?!
Do not get me wrong, I know that on occasion a patient or two may be collateral damage, however, healthcare worker directed violence is DIRECTED at healthcare workers NOT patient. So Dr. Cantor, and to all your administrator colleagues, WAKE THE F&#K UP! As much as you and others want to sugar coat it healthcare has enemies. Because of that, YOU, and your administrator colleagues, need to be FIRST concerned of the safety of those who work by your side, your loyal employees. Remember, those you vetted and chose over all the ones who applied. On top of that, you, and those like you, need to quit hiding behind petulant, unreasonable, angry and demanding customers. What is it going to take to get that in your skull and the skull of those like you!?!
Granted, Dr. Cantor is right, this is an extreme example. However, does that mean being spit on, kicked, yelled at, shoved, cursed at, scratched, pushed, punched, hit with, slapped, grabbed, thrown at, sexually assaulted, yada, yada, yada is okay when “patients do not get what they feel they need”, Dr. Cantor? NO! NO! It is NOT okay!
As if not enough, another administrator shares his lack of awareness that he is not on this planet alone, “Patients or their families sometimes make threats but stop short of carrying them out. Dr. Richard Pieters, president of the Massachusetts Medical Society and a cancer specialist in Worcester, said a patient’s father once threatened to ‘take out my kneecaps.’ But that was 25 years ago, and it hasn’t happened since.”
Are you FREAKING kidding me!?! I am going to have an aneurysm. Dr. Pieters, sir, you got lucky, very lucky, and when you win the Powerball we will celebrate your luck again. I will tell you this too, there are very few professions where the providers are wary of those they provide services too. Granted, Kramer, of the TV show Seinfeld, stalked his cable guy from across the hall but that was satire. Healthcare directed violence is not satire but real, very real, and it alone is our nation’s most silent crisis. Yet Drs. Pieters and Cantor, and others find it easy to stand with the crowd and look away.
As for your suggestion, Dr. Pieters, that communication and a human connection is the best protection we have, I will tell you, Dr. Cantor and the colleagues who believe as you, those impotent theories of telling someone to “unclench their fist” or “verbal judo”, as some have called it, do not work. Instead, the best protection from being ambushed is to fight back and with overwhelming force.
Because, if “verbal judo” were so effective, why then, despite all the training suggested by a number of professional and government agencies regarding conflict resolution, aggression management and all the customer service mumbo-jumbo dollars that healthcare has thrown at the problem, has nothing improved—if anything, the situation has gotten worse?
That is not JUST me who is stating that as the article too points out the same, “While hospital shootings are rare, other violent crimes and assaults at US hospitals are rising.” That not so shocking news is something I have cited over and over and here is yet another source with the same unfortunate assertions. My question is, what is it going to take for us to take back our profession from those who have hijacked it for their hidden agendas?
After all that, I will also tell Drs. Pieters and Cantor and colleagues who believe as them, studies show that gullible people will believe anything, as long as you add the words “studies show” to whatever kool-aide you are selling them.
I will also tell them, and those who believe as them, “We can’t solve problems by using the same kind of thinking we used when we created them.” –Albert Einstein
I will also tell them, and those like them, “The more changes you give someone the less respect they’ll start to have for you. They’ll begin to ignore the standards that you’ve set because they’ll know another chance will always be given. They’re not afraid to lose you because they know no matter what you won’t walk away. They get comfortable with depending on your forgiveness. NEVER let a person get comfortable disrespecting you. NEVER! –Anonymous
I will also like to share with those who disagree, that accommodating EXAGGERATED UNREALISTIC EMOTIONAL EXPECTATIONS is not only the cause for the collateral damage in healthcare but will be healthcare’s demise as well, the courageous and powerful words of Stephane Charbonnier, “I prefer to die standing up than live on my knees.”
Lastly, I will tell all that I wrote the book, “The Customer is NEVER Right”, with the intent of finding companions who are willing to go against the grain in the direction of much needed change as the time for conversation has long passed.
Having said all that I will add, “Be careful when you blindly follow the masses because sometimes the M is silent. –Anonymous
Some will say, “We cannot prevent these types of incidents,” and I agree. But “verbal judo” is not the solution. I say, if a patient or family member spits on, kicks, yells at, shoves, curses at, scratches, pushes, punches, hits, slaps, grabs, throws at, sexually assaults or whatever else towards a healthcare worker that person is no longer a patient or family member but a detainee of the law. And that detainee can get their healthcare at a detention center while they wait their trial. Why not? That is what a passenger would transition from if they got stupid with an employee at an airport. Oh, and no questions asked.
Administrators kick and scream that the cost of security is too much. Yet, somehow, customer satisfaction/experience mumbo-jumbo and scoring isn’t. I say, take care of yours first and everything else will fall in place, to include profits and prestige, as well-taken-care-of employee will put customers before themselves.
Not to mention, the mentioned paradigm shift alone, that we are here to help you and not to be your punching bag and if you ambush innocence you will be arrested and charged, will curtail a lot of the disrespect and violence directed at healthcare workers. That paradigm shift does not mean an administrator gets to make the call as to what is inappropriate or not but the healthcare worker caring for the patient at the time, just like a flight attendant or any airport employee for that matter, whatever they say is it, PERIOD! And. And. Most important, although likely the most challenging for healthcare workers, especially those who believe they can make a difference, maintain solidarity with your colleague as to the incident, again, as flight attendants and airport employees do.
Healthcare has followed the airline industry in so many other aspects and here is another, security. If this incident is ignored it will be nothing more than just another tragedy at the hands of EXAGGERATED UNREALISTIC EMOTIONAL EXPECTATIONS.
My two sense [sic]!


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