Originally Posted by NRSKarenRN
From Healthleadersmedia.com
"Turnover is good" (and other surprises overheard in healthcare)
Insiders’ Insights
What Do Nurses Want?
Nurses are attracted to facilities with flexible scheduling, continuing education support, and a benefit package without a waiting period. Nurses who had a great clinical experience as a student nurse in the organization often will want to continue working there full time after graduation, so tuition assistance in exchange for work commitment is something to consider.
Thanks for the link to the 'healthleadersmedia' article, "Turnover is good...". I found it disturbing in a lot of respects
, although, I appreciate your comments about the conditions that attract nurses.
What about this statement: "They’ll even hire the right person who has no experience before they’ll hire the wrong person who has an impressive resume."
I take that to mean that they devalue experience, and are looking at the bottom line. The "right person" will cost them less, and, as new hires in a first job, they'll be less willing and less capable advocates at recognizing working conditions that are barriers to their ability to practice as they were taught; they're more likely to want to get along, and go along.
And this one: "How many nurses does it take to run a hospital? It sounds like the start of a bad joke, but some organizations have discovered that they don’t need as many nurses as they once thought. Forward-thinking hospitals are using nursing assistants, other staff, even family to take on roles that don’t require a nursing degree."
I found that particularly offensive, and a throwback to the beginnings of the hospital restructuring, lean and mean era of the "comodification" of healthcare. Nurses were laid off in the late 80s and again in the 90's and thus began the nursing shortage; it set in motion the movement to deskill and dumb down the profession, and replacement of RNs with unlicensed assistive personnel. Complex care is being 'delegated' to family and friends, as patients were "fast tracked" by early discharge and so-called patient focused, industry driven schemes, that are bottom-line driven, not patient need driven. Oops, there it is: non-nurses, consultants and industrial engineers began reframing and taking control of the environment of care away from direct care RNs.
If RNs don't control their practice, then they can't control the delivery of health care.
The article goes on to claim that, "Forward thinking employers are "Using nursing assistants, using other staff, using family" to do tasks formerly done by RNs; I think it's rather paternalistic, with the operative word being
"using." The RN who is directly accountable for the nursing care being provided to patients, by virtue of licensure, at least in California, is the only person who can delegate nursing tasks based on competency and scope of practice. That being said, only the task can be delegated. It is not possible to delegate the required knowledge and judgment. Hospitals may come up with various "teamwork" schemes, and give classes and have policies supporting these practices, however, many of us recognize that they have no basis in the law.
Position descriptions for health care providers must be consistent with the scope of practice identified through professional legislation.The concepts of assignment and delegation differ. RNs have distinct responsibilities and accountabilities for each. It is
important that RNs understand the difference between assignment and delegation and the circumstances within which each of these can safely take place. It is the RN who assigns and delegates nursing responsibilities, at the point of care.
Assignment and delegation are essential to the RN role and cannot be carried out by employer agencies, organizations and institutions.
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Re: "Turnover is good"
