21st Century Customer Service: A Nursing Guide for the Enterprise

This is a cross post from my article published in LinkedIn Today. Apparently Phil Baumann is a top 150 “Thought Leader” on LinkedIn (write-up here in Wired) – up there with Richard Branson, Barak Obama, Mitt Romney, David Cameron, Reid Hoffman, T. Boone Pickens, and other people who are actually famous. Don’t ask me how I got picked for it. Maybe I do know what I’m doing after all.

Anyhoo, here’s a SoundCloud with some insights into mashing-up different disciplines to make things better  – like customer service.

The original post is here. I’ll be on LinkedIn more often – it’s a far more valuable network than Twitter. I’m on LinkedIn here. And you can follow the other 149 “Though Leaders” here. Oh, the irony. 😉

@PhilBaumann – @HealthIsSocial

Pedagogical Osmosis Between Nurses and Physicians

There is going to have to be more pedagogical osmosis between nurses and physicians.

What is “pedagogical osmosis”?

Just a fancy phrase for redesigning medical and nursing education.

Nurses need to have more education about the sciences and ways of thinking undermining medical knowledge and practice.

Physicians need to have a more profound understanding of healthcare communications, people-skills and a patient-centric appreciation for how needles, tests and bad news feel.

The Crimean War ended a longtime ago.

Sadly, the military-industrial frame-of-mind it engendered in healthcare persists in today’s academic and practicing institutions.

It’s not easy to unthink entrenched patterns that cause the wrong behaviors.

But it needs to be done.

Phil Baumann

Why I Became A Nurse

Regular readers may know me as the guy who looks at the intersection of social software and Healthcare. I’m on the Advisory Board for Mayo Clinic Center for Social Media. I created the first Twitter chats for clinicians. I wrote about Twitter in Healthcare when most people never knew what “a” Twitter was. Yada yada yada. (This post is all about ME by the way – so much so that it’s about YOU.)

What you probably don’t know about me is that there was once a time I never really cared much about Healthcare.

As a matter of fact, I long felt that the industry was totally weird: bad customer service; an industry full of smart people doing stupid things and following arcane rules; a paradox of care and of selfish personalities; an industry (mis)-led by less-than-average-intelligence busineses funding dopey marketing campaigns. (I still feel that way, but please keep that confession on the down-low.)


Long before I became a nurse, I bought into a lot of the sad stereotypes about nursing: it was a “chick” profession; dudes who got into nursing were probably gay (not that there’s anything wrong with that!); and that nursing was a pretty straight-forward profession of good-hearted people doing work that wasn’t very sophisticated.

Now, these weren’t strong beliefs – it wasn’t something I gave much thought: mostly the product of an ignorant culture spreading ignorant memes.

I never ever thought I’d become a nurse. If you told me years ago that I’d become one, I’d be in total disbelief. Being a nurse was the last thing I’d even consider.

Before becoming a nurse I held a financially successful career in corporate enterprise. I graduated with a degree in accounting and did stuff like financial reporting and management and SAP implementation. I even helped to organize the effort to raise $2 Billion in capital for a public utility that needed to come out of Chapter 11 bankruptcy. And emerge from bankruptcy it did.

Reflecting on that time now, I was so young, so emboldened by curiosity, so eager to learn from the ‘elder’ business leaders. I was lucky to be thrown into the fire by gray-haired executives who took a chance on the next generation. I was the golden boy. I had a promising corporate future.

But one day I decided to just walk away from the corporate world. Oh it wasn’t just a spontaneous thing. Many things were brewing in my head about where the future would offer us.

One thing I knew, though, was that the fruits of the 21st Century weren’t going to go to the corporate professionals. The job mentality was a soul-trap.

I thought the fruits would go to those fearless envelope-pushers who kept on changing careers – those who thirsted tirelessly for knowledge and experience and freedom.

So when I walked away from it all and boarded a flight to Florida with my wife and friends, I had NO idea what I was going to do. None. Zilch.


Then the Towers fell.

The nation was in shock. A collective PTSD and Depression descended on America (it still hasn’t recovered).

911 made it clear to me that our problems as a tenuous Republic were mostly health-related. And that in the dead-center of the terror-fire were the true heros: the nurses, the doctors, the counselors, the social workers, the firefighters, the loved ones of those murdered into char and powder that blue blue blue day.

It occurred to me that our main National Security Concern was health. An unhealthy culture is a dangerous and weak culture. It will die, wallowing in its own addiction to self-destruction, breaking the hearts of those who once loved it.

Long-story-to-short: Nursing appeared on the radar and I decided to go to nursing school. I wanted hard work. I wanted work that required a re-wiring of my brain. Work that required the endurance to sacrifice self.

And I knew then, intuitively, that nursing wasn’t about just being a “caring” person. I knew it meant both cleaning up excrement while understanding the complexity of multiple systems of the human body.


Right now, I have absolutely no idea what my life would be if I never became a nurse.

But I’m glad I took the plunge, the journey to a difficult place.

I’m glad I was there when that young mother of three died and her youngest lost her mind jumping on top of her mother’s body in grief. “MOMMY MOMMY MOMMY MOMMY, WAKE UP!!!!”

Glad?? Why glad? Because I was there to witness this child’s pain and to give silent comfort. The young residents and busy nurses there just didn’t know what to do – or just froze – so I tapped into my fresh nursing intuition and fearlessness. It was like stepping out of my body in order to calmly hold the kid’s spirit within to keep it from leaving to a dark place. A moment like that can make or break a life.

I wasn’t glad at the time – later that day I shut myself in the linen closet, broke down and wept myself into momentary insanity like never before nor since. But that’s life – it sucks, but together we can do small things that make big differences.

My heart breaks anytime I’m reminded that I too once held the stereotypes held against nurses.

Nurses are still treated poorly – oh, yes, they have respect and people will praise them – but deep down, there’s a systemic prejudice against nurses that may just be America’s Achilles Heel.

I left bedside nursing for several reasons.

But I never left nursing. What I do now is to keep a vow to help this marvelous but misunderstood profession.


For decades I’ve known that social networks would take over the world.

For decades I’ve known that technology would eventually infiltrate our lives – for good and ill.

I’ve always been an outsider.  Always will be. And so should you. You see things others miss.

This blog is ultimately a way for me to expand nursing’s role. Not into the turf of physicians. Nursing and medicine are different but utterly complementary disciplines.

Rather, nursing needs to expand from the bedside to the Web. What I do is my attempt to do something not quite done before. And I just hope every day I’m doing it right. A new kind of nurse in the making perhaps.

The Web has opened the doors of perception and collaboration and communication and new kinds of creativity.

It’s why I created RNchat, and then later MDchat – because I could. Because I saw that it was needed. Something never done before. I didn’t need anybody’s permission. You can do that with the Web.

It’s why I’ve connected with Healthcare marketers and HIT peeps anybody with a good brain to learn as much as I can from digital marketing agencies. Marketing is everything – especially in Healthcare.

This social media stuff – most of it is rubbish frankly. I mean that. Still, there’s a portion of it that’s very very important.

And it’s the important stuff – like understanding how these media are influencing our lives and their proper roles – which absolutely fascinates me. This is where the nursing perspective is sorely needed.

There aren’t many people right now who bring a nursing perspective to it all. Not enough artists either. There’s too many marketers parroting and misleading each other who should reconsider their own professional trajectory. It’s a weird world some of them might be making.

Not all this social media is good – the next big wars will be fought via social media. Small packs of well-armed terrorists deployed in half a dozen cities can conduct their evil for days via Twitter (or proprietary analogues).

Technology is assaulting privacy. If you think that’s OK – that the end of privacy is *all* good – then I sincerely hope that you never have to hide yourself in a linen closet because you need to break down and weep all alone.

Dignity is next. No dignity, no civilization.

Ultimately, nursing is about protecting, preserving and promoting human dignity.


A nurse is someone who understands the human condition like nobody else.

A nurse is someone who cares for you when the administration’s insolent, half-baked and black-and-white rules threaten your care.

A nurse is someone who will probably be the last human being who touches you before you dislocate from this world.

A nurse is someone who knows the value of communication.

A nurse is someone who has the guts to tell a patient they’re wrong without hurting feelings.

A nurse is someone who knows the difference between being nice and  being good. Nice disappoints. Good disturbs.

A nurse is someone who needs to be active on the Web.

A nurse is someone who can learn marketing, public relations and how to holistically repurpose digital media in common sense ways.

A nurse is someone who will tell you things about social media you might miss or not want to face.

A nurse is someone who rescues the human being from the technology.

Curiously, now that I’ve written this post, I don’t fully know why I became a nurse.

I’m just glad I did.

To paraphrase Rainer Maria Rilke:

You must quit your job.



This Gets My Attention

By way of a tweet from @JaeSelle, I found this post from Sarah Cowherd (@SarahBethRN), where Beth relates the story of using an iPhone application during one of her shifts. She’s writes that she is then approached by her supervisor who tells her:

Sarah, you need to put your phone away while working. It really looks bad, and not to mention you are not focused on patient care.

Sarah was using Medical Lab Tests, an iPhone application, in the care of her patient.

Now this is very interesting.

Sarah’s view of patient care as a “new young nurse” is that technologies like iPhone tools can be used in the ordinary course of care provided to patients. Sarah has a perfectly caring view of technology – that mindful use of technology can enhance the recruitment of knowledge and the delivery of care.

Sarah’s supervisor’s view of patient care is that the caregiver’s eyes and other natural faculties of attention are what define care, and that technological devices are likely distractions – and thereby weaken patient care.

Niether of these nurses are wrong. They each beam their perspective based on their own backgrounds. The technological and cultural conditions in which Sarah grew up were different from her supervisor’s.

And yet we know the “right” answer. We know that technologies won’t go away. We know that technologies – ventilators, stethoscopes, palpation techniques, medications – are vital to health care.

Sarah’s supervisor is right, in a sense, to claim that a nurse or a doctor using an iPhone “really looks bad”. Patients do want to know that their caregivers care and pay attention to them. My sense is that Sarah’s supervisor cares deeply about patient care, but that she just hasn’t had the nudging needed to know that an iPhone isn’t a toy to everybody.

She hasn’t been shown – vividly – how re-purposeful these technologies can be.

What…we’ve…got…here…is: Failure to communicate!

Or rather: connect.

We have a disturbing disconnection between the past and the future (which is now). It’s disturbing on these levels:

  • Technological literacy and competence is core to nursing and medicine. Core.
  • Willfully disregarding the cultural ramifications of technological disruption within Healthcare is tantamount to inattention to patient care
  • 21st Century nursing and medical educators have a duty to instill and encourage the proper use of technologies clinically
  • Hospitals have an obligation to create environments that foster innovation, problem-solving and patient communication and education for this century

Sarah’s story may seem like a small one on the surface.

But this problem goes deep. Deep. Deep Deep DEEP.

This partially explains why we still have paper medical records and can’t have ubiquitous, invokable and secure medical data in the year of our dear lord Two…..Thousand…….and……..Ten.

This mentality has cost all of us dearly.

Now Josh raises a good point about form: the iPad may alleviate clinical concerns about how providers look to patients as they access information through a plate of glass. That the iPad’s size and design creates a mutual ambiance between patient and provider. (Something to think about in healthcare technology innovation.)

Nevertheless, we need a way to solve this problem. This failure to connect the “old” world with the “new”. (They’re really the same worlds – just different experiences and lenses.)

We need education here.

We need more nursing and medical students to express their views without fear of retribution from those ignorant of their world.

We need more hospitals and schools to get more involved with today’s technology – and not just setting up a Twitter account and a Facebook Page. I mean, really ripping it up and taking the time to understand – at a fundamental level – just what’s happening in the world today.

I often hear “Oh, well, Healthcare always has a lag”.

Screw the lag. That’s no excuse.

Baby steps aren’t going to do it. Not anymore. Not today.

This gets my attention.

I hope it gets yours.

I hope it gets the attention of those nurses who’ve been abused and disrespected and shit upon for thirty years while undyingly giving dignity to the dying, who – after feeling abandoned – walled themselves off from the world around them.

I hope it gets Sarah’s. I hope you wish her the best in her career. I hope you Like her.

Because Sarah represents the bright future of caring nurses who just want to bring Healthcare into the 21st Century.

Is that too much to ask for?