The Customer is NEVER Right - A Nurse Practitioner's Perspective
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A letter to a champion for healthcare

I sent the following letter to a champion for healthcare. His reply, "I LOVE IT." (Yes, ALL CAPS!)


Good morning, 0046hrs. I just watched your video about the savage crime against a healthcare worker. In 2012, I published “The Customer is NEVER Right: A Nurse Practitioner’s Perspective”. Since, I have been on a single man crusade to ABOLISH rating healthcare and putting healthcare and healthcare workers FIRST! Rating healthcare, HCAHPS or Press Ganey-likes, have done NOTHING for healthcare but leave behind an overwhelming amount of collateral damage, to include healthcare directed violence. In Oct 2016, I presented at the 5th International Conference on Violence in the Health Sector, in Dublin, Ireland, where scientist and researchers from 42 countries presented some 180+ studies on this very well-known topic that is healthcare directed violence NO one wants to talk about. Most recently I presented at the NursesTakeDC Rally, May 2017, and in July 2017 I will be presenting at a nursing conference in Vancouver, BC, Canada. With this recent savage attack of a healthcare worker I was contacted to join “another” FB group intended to champion a cause. I would love to have this conversation with you, and others, as rating healthcare and healthcare directed violence have been my demise for well over 15+ years now. Because of that, I have thoughts on this topic that are way out the box and off everyone’s radar, not because of interest but by default.

Please take a moment to read a reply I submitted to “another” FB group. Also, I included a PDF version of “The Customer is NEVER Right” if interested. You can find more on my story and my credentials at Again, I hope we find the time to chat about this as this has NOT only gone too far BUT these dismissals of healthcare workers are why so many have left healthcare and NOT fatigue, as NO one fatigues from helping others. Thank you for your time. Jose Angel Torres (@TheKnittedBrow).


Second, the outcry for laws to protect healthcare workers is NOT a position of mine. I get it, I too want this savage low-life pile of shit fried on the electric chair but not executed. Instead, I want him taken to the edge of death only to be resuscitated back to life and cared for by the profession he, and so many, take for granted, healthcare workers. Only for him to be later executed, using only propofol, after his lengthy recovery. An emotional response of mine? Sure. But also a well thought out execution that I know will not keep others from the same crime but at least for this pile of shit it will cause him to die remorseful for committing such vile crime against those helping others. But I digress—not to mention, this pile of shit was shot dead by police during the mentioned incident thus the above well thought out execution no longer possible.

That said, there isn’t a need for new laws that are specific to any profession or occupation. Case in point, kidnapping is a crime already. As is assault and battery. And rape as well. Of those crimes, what is different when the casualty is a healthcare worker or a common human being the casualty? What additional punishment would be included when the casualty is a healthcare worker?

Not to mention, these “feel good” policies and laws serve for ONLY two purposes, as they are purposefully IMPOTENT as to NOT offended patients or families. First, they are intended to quench our immediate anxieties that are short-lived if allowed to play out. And second, they are purposeful with intent to distract our attention from the root causes of the problem.

What needs to change instead is healthcare’s submissive, altruistic and accommodating culture. Not for this vile crime against humanity as this crime is repugnant by any definition or argument and for that alone this savage pile of shit would have easily been convicted and the keys thrown away. What healthcare needs to change is its culture about are the trillion a day subtle infractions that are dismissed as petty.

Here are a few examples of the trillions that occur EVERY day across our GREAT nation:

Patients calling us ANYTHING but our names. Telling us to get them this or that. Rolling their eyes. Pushing our hands away during their care or our assessment. Talking to someone else, on the phone or present, when we are speaking with them. Winking or blowing kisses at us. Raising their hand at us or grabbing an object and either pointing at us with it or threating to throw it at us. Ignoring us when we speak to them. Touching or feeling us. Throwing things at us or elsewhere. Raising their voice at us. Doing other than what we asked. Telling us how to our jobs. Reminding us how expendable we are. Snatching things from our hands. Telling us to get out of their rooms or to get someone else but us. The list goes on and on as I purposely mentioned some of the most common and those most ignored.

ALL petty! Of course, if you are okay with those things happening at home from loved ones I guess you will find them petty. But you are NOT at home. You are at work where everyone must set a consistent tone. Keep this thought in mind, “The culture of ANY organization is the worse behavior tolerated.”

Of course, NONE of those mentioned so-called petty infractions compare to the savage crime that occurred against a healthcare worker. Some might even say they are apples and oranges. To which I reply, “All food! More important, food for thought.”
Why should those mentioned so-called petty infractions against healthcare workers and the cited savage crime be different at all? Inappropriate behavior should NOT be a continuum between inappropriate behavior that is acceptable and inappropriate behavior that is NOT acceptable. INAPPROPRIATE IS INAPPROPRIATE, EXCLAMATION POINT!

Here is an example, of MANY, if nurse Bruno allows “X” behavior from patients than nurse Megan should allow “X” as well. However, if nurse Megan DOES NOT allow “X” than it is nurse Megan who has the problem according to healthcare’s junior-high school culture. Some, in healthcare, will even say it is nurse Megan who is the common denominator as these incidents ONLY occur with her, thus she clearly is the problem and NOT the person who is inappropriate. Those same persons accepting the inappropriate behavior as benign will then label nurse Megan as being either too thin-skinned, too serious, or the latest social GARGABE—lacks emotional intelligence, just to name a few of the name-calling.

It is healthcare’s responsibility, NOT anyone else’s (to include the law), to cultivate our profession and steer it in the right direction without compromising healthcare workers or patients.

This tolerated and largely ignored silent national crisis, that is healthcare directed violence of any scale, is ONLY because healthcare administrators and pundits DO NOT want to offend patients or families, as it jeopardizes the administration’s goal of customer retention for profits. Customer retention for profits being the driving force in healthcare and the reason why healthcare administrators side with customers over their very own and extensively vetted loyal employees and the safety of those employees.

What if Megan is NOT the common denominator but instead the uncommon numerator. The difference, the common denominator is the inappropriate behavior everyone tolerates and ignores as it is the path of least resistance and how we get to keep our jobs. On the other hand, the uncommon numerator is the one who dismisses those who annoy US. And NOT just those who annoy nurse Megan but those who annoy ALL of US! Except the rest of us BOW because we DO NOT have nurse Megan’s testicular fortitude to dismiss those who annoy US ALL!

By nurse Megan dismissing those who annoy us, those being the rude, the entitled, the abusive, the demanding, and those who have taken us down the wrong tracks, it immediately deescalates any situation. The dismissal instantaneously taking away the thunder and attention from those being inappropriate so desperately seeking. More important, dismissing those who annoy us frees us to focus on those who value, trust and appreciate us for the care we give.

The myth that businesses lose money or close because of those being dismissed told friends and families is hogwash. Businesses close for many reasons but NOT because of those who were inappropriate were dismissed. Sure, businesses might lose the ones who were inappropriate and that is fine as we should focus on those who appreciate us and those, by far, are in the majority. If anything, dismissing those who annoy us will cause them to change their inappropriate behavior after realizing they gained nothing from being inappropriate and were dismissed.

Again, “feel good” policies, like conflict resolution, aggression management and customer recovery, and laws our professional and government organizations have offered are purposely IMPOTENT as to not offend patients or families. Not to mention, inappropriate behavior resolution is NOT in the job description of ANY healthcare worker. That is for administrators to manage. No healthcare worker should EVER have to confront ANY hostile person, EVER!

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