Nursing care affects a patient’s experience more than any other factor during a hospital stay and negative patient satisfaction surveys are affecting hospitals financially (see my previous post regarding HCAHPS). Because government financial incentives are being linked to survey scores, hospitals are asking nurses to bulk up their customer service skills and deliver care with a smile.
However, it is not written in the official job description that nurses have to be friendly toward patients and disciplinary action cannot be taken against nurses who don’t smile. A nurse’s job is to keep patients safe—not necessarily happy.
Furthermore, starting pay rates in most New York City hospitals are not based on an applicant’s potential for giving smiles and there are no raises awarded for friendly care. Nursing union (1199SEIU) and association (NYSNA) delegates pre-determine the starting pay for all new-hires based on years in the union/association and/or years as a registered nurse. Friendly, happy, patient-oriented nurses do not get paid more than burned out, angry, task-oriented nurses.
Yet smiling, friendly nurses are correlated with high patient satisfaction scores which ultimately result in financial gain for hospitals. Unfortunately, the nurses who are responsible for those high scores don’t reap the rewards. Nurses do not have any vested interest in the institutions that they work and don’t get shares in the business or financial bonuses when the company does well.
Nurses in New York City don’t have a whole lot to smile about when they are overwhelmed by increasingly high patient loads and dangerous staffing levels. The hospital environment is often negative and chaotic with sick, confused and angry patients, scared family members, frustrated doctors, and unsupportive administration all counting on nurses to fix their problems.
The hospital’s expectation for staff to smile and be extra helpful will cause a backlash among nurses in the City. Union and association members will file grievances and demand increased pay for increased responsibilities. I support the hard working nurses of New York City in this endeavor as I would like very much to be paid for something that I have been doing all along for free.
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