Customer Service in health care

I have talked about this often but not using the words customer service. I talk about understanding and listening to the person and their needs and responding appropriately to what the person wants, not what you want to give them. You will also often have heard me talking about "who is paying your wages". It is the same thing.

This came up again when i was out of Auckland recently. It is particularly apparent in nurses from overseas although not exclusively. It includes both registered nurses and caregivers.

So what can we do to address this?

Well my next topic I am going to put on line is "Introduction to Caregiving". This is Customer Service. It will outline what is expected of a caregiver and will come with worksheets. It is not a required topic for District Health Boards but it is an essential topic for care - at all levels.

If you want to give your residents the best care available then your staff need to understand customer servicer, customer relations and social interaction. All of these come together to provide a place where people want to come and live, not fear; where people tell others it is a great place to live so so it sells itself; where staff retention is high and people are clambering to come and work for you; where you can pick and choose your caregivers.

All in all this is a good model of care and should be the industry standard. Who knows, it could do auditors out of a job!!!

And while were talking about the bowels!

When is the appropriate time to give aperients?

In my experience, mostly it is given at meal times in conjunction with other medications often mixed up with food ( and yes I have been guilty of this too).

Did you know that this could affect the efficacy of other medications? Why?

Because aperients are designed to stimulate the bowel thus could influence the efficacy of other medications and speed up the absorption of them.

So when should aperients be given? At least 30 mins either side of medications being given.

Are aperients designed to be given every day?

Well of course not! So why do we give them every day to some people. Do they actually need them every day or do we, as nurses and caregivers, think they do?

Food for thought isn't it?

What is normal bowel habits?

I know this is not something we sit and talk about over a cuppa but how different are your bowel habits to some one else? Do you know? Have you thought about it?

Therefore what is normal bowel habits for people in your care? Are you trying to regulate someone to what you consider normal bowel habits for you which may be abnormal for the person.

Maybe this should be a question that is asked in more depth when a person enters your facility so that you don't give them laxatives when they don't need them.

Next I will talk about when laxatives should be given.

Educating Caregivers on who is paying them

I am working towards helping caregivers have a wider perspective on the care they are giving and how where the money comes from. I am doing this by frequently mentioning through my inservice workshops that the client/resident is actually the person who is employing them because they are paying for their care.

Payment can be directly through their own bank account or indirectly through the taxes they have paid over the years. I explain that the company they work for are only the filter or the bank if you like that collects the money and pays caregivers wages.

I also try to get them to understand that wastage of products like continence pads, are actually paid for by them through their taxes as the overnment subsidises the products.

I do this in the hopes that they will look carefully at the way they not only look after people but also in the way they use products and equipment. If caregivers have a wider understanding of how the money comes in to pay their wages and that they are paying for wastage may help them think a little about the care they give.

I hope to get them away from the government being a bottomless pit and that business have access to unlimited finance. This is not true. The money has to come from somewhere.

Repetition is the mother of skill

I always become really heartened when something positive happens in my day. Last week I got an email from Fiji from people interested in my online training. As this training for caregivers is relevant in all countries, it has inspired me and excited me at the future of online training.

Being able to repeat the training over and over again is a benefit as I know that when ever I attend any training session I only pick up on a small amount of content, I then have to put it into practice and go back for another session to gradually build on my knowledge.

When I learnt to speak in front of a group of people I attended 6 full weekends training. I paid for the first one then I went along and helped in my own time, for another 5 weekends. This is what has given me confidence to speak in front of a group.

I have sat through countless sessions that Gigi Lim has presented on Medications for Clinical Update in the last 5 years and I am still learning things and I know they have been in presentations before.

So the beauty of the online training is that your staff can listen to the same training session several times till they understand the topic. That wouldn't that save you time in not having to repeat yourself.

Did you know the colour you wear influences the impact you have on others?

Yes this is for real. I know that the colours I wear reflect how I'm feeling. I first became aware of this when my marriage broke up. I would not see or visualise myself in anything but black, white or grey. Every other colour, I thought, looked terrible on me.

I also know that the more colourful my clothes are the more joyful I am and my personality and behaviour reflects this.

Well apparently this is true. You can see more on this website http://www.colourcomfort.com/

Here are some examples of colour and impact.
If you want show determination, activity and motivation then wear red.
If you want to show authority, wisdom or intelligence, then wear navy blue
If you want to show calmness, inspriation or fantasising, then wear purple
If you are an innovative thinker, ready for change then magenta or fuschsia is your colout. (this is a colour I wear a lot and feel really good wearing)
Now if you want create harmony, decision making and team work then wear green. Give it a try at a staff meeting and see the results.
Interesting if you are reserved, mysterious or want to blend in, wear black. How many people wear black!!! Lighten it up with a colour and see the results.

Now you don't have to be decked out totally in the colour to create impact. It can be as simple as an accessory like a cardigan, tie or scarf.

There are many more colours that influence people so go and have a look at the website and see what you come up with and use colour to your advantage.

More people paying for private home care

We are more and more becoming a user pay society.

While I am not altogether against this as I think people have more control over who they employ. If they are not happy with the care or service, they can terminate the contract and shop around for someone more suitable. It is not as easy if you have been referred to a service provider.

What my concern is the level of training the caregivers receive and the supervision. There is no one checking on the care being given on a day to day basis and is right for the person. Nor do we have a "watch dog" to see if the person is being treated fairly and respectfully.

Vulnerable people, whether they are elderly or not, are not known to speak out if they are receiving respectful or indeed the correct care. They take what is being dished out to them by the caregiver and don't want to risk being victimised or being left to fend for themselves if they do speak out.

So how do you address these issues? It is a difficult one but training is one way. It is not a panacea to fix all but it does deliver some understanding for those who are willing to learn. It does work for those who generally care and want to deliver what is right for the person or what the person wants.

What does need to happen is the caregiver has to understand they are employed by the person they are delivering care to regardless to who is paying the account. When this happens there should be a change in attitude towards their work and the important job they do. Training is part of this process.