Agency Nursing vs Staff Nursing - page 3

Hi All! I am preparing to do a debate in my Nursing 510 course about agency vs staff nursing. It is a formal debate complete with PowerPoint presentation, etc. My team and I will be arguing... Read More

  1. by   Teshiee
    Susy K

    You are absolutely right! There has to be a better way. Now that situation with a nurse who couldn't do a crash C-section and left you holding the bag that is bad. I really can't speak for other units. I know in NICU they do not give us very critical kids. But if we were to do a contract where we would be used on a consistent basis then it is likely we would get the sick kids if there isn't enough staff.

    Everywhere I work we are short staffed. Nurses arent trying to return to work because of one reason or another. Even if they spent money on retention and these sucker bonuses nurses still don't stay.

    When I worked in L&D as a unit ward clerk. I couldn't believe 3 separate times they would hire a bunch on nurses by the end of the year you may have one or two left. It is a very sad situation. I feel the powers that be know this and simply don't give a damn. Registry is expensive but I understand full time employees are more. I don't dispute that in the long run if you hire a full time employee and he/she stays for the long haul I say it was a very good investment for all. But that is not happening. When I started my new employement I was pulled off of orientation because we didn't have enough staff! Luckily I am an experience NICU nurse. The powers that be are only looking out for themselves just as long as they can get away paying a registry nurse big dollars and screw over the nursing staff they will continue to do it. This is going on and the regular staff complains about it but doesn't do anything to make it known to the obvious individuals that can change it.
  2. by   CindyCCRN
    Susy K - Hi! I definitely need to reply to this one.
    I have been a hospital ICU RN for a long time... have lived through the collapse of health care and nursing... many approaches and well-functioning programs for analyzing staffing needs and supplying adequate ratios have intentionally been destroyed, in lieu of the almighty $$$ (greed)... There is BIG profit in healthcare and in most hospitals (the HIGH Execs) make big bucks... Why else are the Big Guys like Tenet and CHS buying up hospitals like crazy and running them like sweat shops? Just watch their stock on the NYSE...

    They simply just don't value nursing and choose instead to try and fool the public by cosmetically "improving care" with BS - new wall paper,carpets, etc... Most don't care at all how chronically unsafe the care is, how many patients are neglected (even in ICU, or whose license they're jeporadizing... "just do the best you can" and believe me if you get sued, the hospital will be looking at all the things you didn't do or couldn't do... Higher numbers bring more $$$...Quantity, not Quality!

    They are not really interested in the nursing dilemna or care crisis, other than how it effects their PROFIT. They might appease you and pretend to sympathize or understand, all the while counting their change. As in California and hopefully soon Massachussetts (?sp) and other states, the only thing that will help protect patients, the quality of care, this profession, and our nursing licenses are LAWS that mandate these pigs to meet safe standards and compensate nurses...
    For alot of years, We RN's looked mainly for respect or some form of appreciation from administration... They took full advantage of "the nurses' kind heart". I doubt if they will ever value nursing until they have to do without them...
    I do work with plenty of agency staff and personally feel that all of us deserve to be paid at that rate. The more agency the better! Let the hospitals, etc.. finally pay nurses what they deserve... Agency nurses are our best hope and we should all be independent practicioners, rather than at the mercy of cold-hearted, non-caring institutions that really do not care about patient care and have NO respect for nurses...

    ...Be advised that everytime you avoid doing right, you increase your disposition to do wrong...
  3. by   Brownms46
    BRAVO BRAVO BRAVO


    I could not have said it better!
  4. by   Teshiee
    I second that Bravo! It is us versus them. Why make it us vs. us when we pretty much want the same thing we are just finding other avenues to do it!
  5. by   SKM-NURSIEPOOH
    Originally posted by Susy K
    Hi All!

    I am preparing to do a debate in my Nursing 510 course about agency vs staff nursing. It is a formal debate complete with PowerPoint presentation, etc. My team and I will be arguing against the usage of Agency nurses as a bandaid to the "real problem " (yet to be identified)

    As a good debater should do, I am researching both sides so I can anticipate the other team's argument and refute it. I have several articles both from nursing journals as well as pop culture mags, however, I was looking for input from nurses who are either for or against as well to help me build my argument.

    If there is anything you can offer, it would be greatly appreciated. Thanks!
    Hi Susy K,
    First of all, good luck on your debate for your class...I hope you'll be successful.

    I would like to know is how will you be able to defend your point of view without having the cause of the situation established? Wouldn't you have to have at least one in order to support your point of view? To have pros or cons in a debate, I would think one would have to establish the core of the problem in order to be able to set-up your debate?

    Your professor is going to accept your position without the established reasons for the problem?

    IMHO ...no matter whatever the cause...you should decide & establish what the root(s) of the problem is (are). That would lend credit to your point of view.:zzzzz
  6. by   Q.
    Hi. I see what you are saying...BUT, the real problem is the shortage of nurses and why they are not willing to work. Alot of agency nurses have identified WHY they went agency to begin with (flexible hours, no MOT, higher pay) so..if those factors existed in the hospitals, agency would be obsolete.

    The topic of agency vs staff can branch out to many different subtopics, but I think if we started mentioning shortages, managed care, etc we would get OFF topic.

    Unless I am missing your point. Please clarify as I really love the input.

  7. by   Teshiee
    Susy K

    You have answered your own question. I am wondering of the 2.2million nurses that arent working for hospitals how many are doing agency work? The topic you chose is a great topic because what you have mentioned in your previous post about managed care and shortages plays an integral part why nurses may have chosen agency work as an alternative. And what are the advangtages for being full time vs agency?

    I can say this when the census gets low in hospitals staffing agencies start cancelling you like crazy and you start working on floors you simply don't like just to keep your financial flow going. It is not a perfect solution but for some they feel they have no choice. Please keep us posted on your debate in class. I am sure you will bring some valid points in your arguement.
  8. by   BadBird
    Well, here is my opinion, I have worked both and at the same time. I currently work only agency and I would never go back to being a staff nurse for many reasons. 1. the pay is much better, 2. I plan my own days and hours worked around my family. 3. the regular staff comes in and starts complaining immediately, the agency comes in and goes to the patient. 4. After you work in different places you become familiar with many different pieces of equipment, ask a lot of questions and never handle anything you don't understand. 5. I have been asked to go staff everywhere I worked but I am not interested.

    The regular staff complains if they are mandated over, and they still complain if the hospital staffs with agency, there is no pleasing them. After many years experience in both I have to tell you that some of the best nurses I have worked with are other agencies. It is a pleasure to go to work, take care of the patient and leave the BS behind.
  9. by   SKM-NURSIEPOOH
    Originally posted by Susy K
    Hi. I see what you are saying...BUT, the real problem is the shortage of nurses and why they are not willing to work. Alot of agency nurses have identified WHY they went agency to begin with (flexible hours, no MOT, higher pay) so..if those factors existed in the hospitals, agency would be obsolete.

    The topic of agency vs staff can branch out to many different subtopics, but I think if we started mentioning shortages, managed care, etc we would get OFF topic.

    Unless I am missing your point. Please clarify as I really love the input.

    In your first post, you mentioned:
    My team and I will be arguing against the usage of Agency nurses as a bandaid to the "real problem " (yet to be identified)
    ...I just thought it would be difficult to present your view point regarding the cons of Agency Nurses...as a system problem - not the nurses' abilities of course...without stating or identifying the cause. Let's just say that the nursing shortage is the "real problem" in your opinion, then I believe that you'll have to give some literature with sample numbers as evidence of being the "real problem". If nursing shortage is the main or "real problem"...then you can present your side of the topic Agency vs Staff Nurses; but it seems to me that you'll have a difficult time debating the topic without identifying the cause of the "real Problem".

    I don't want anyone else to go off the topic here at hand either. Because you asked for our input though...perhaps we should include our thoughts of what the "real problem" is in our posts.

    I'm not asking for the posters here to come-up with the cure to the "real problem"...just think about what it is for them. You'll have more material to select & identify the "real problem" from.

    Good luck - Moe :kiss
  10. by   Brownms46
    Excellent agruement Moe!

    But I personally don't think the shortage is really the biggest problem. I have been agency since 1981...and they were crying about a shortage even then. But I think one of the real problems is...that nurses want to have control over their lives. D/t the shift work and families no longer having mom at home. There is a guilt trip most every mom or dad goes through. They want to have a career...but they want to give quality time to their families also. I think one the bgigest reason is because shift work and having to work weekends...is inherent in this profession.

    I remember when they tried going to a baylor program....where you work M-F...and the people who liked working weekends would work 32hrs on the weekend or 24 and be considered fulltime. Well this worked for a while...but people go tired of never being unable to go away for the weekend...or be with family and friends who did have the weekends off. Then they tried having a schedule where you have 7 days on and 7days off...some have even gone back to that again. But you're so tired from doing the 7 straight 10 or 12 hr shifts...that by the time you got to your 7 days off....it took you most of those days...to get over the 7 you worked!

    Also...there is always going to be BS...whenever you people thrown together in stressful situations....or just in a group period!
    This is the other attraction has been agreed to by several here. So there is no getting around that point.

    What I'm saying...is shortage or no shortage...that will always be those who will want to work agency. Hospitals are a 24hr business...no two ways about it. And I feel as long as it is....you will have those who don't want to work as staff on a fulltime basis.

    Also I agree totally with CCRN...that nurses wil never be paid what they should...because admin will try to hold the line as long as they feel it's beneficial for them to do so. Agency work has been around a long time...and no matter what...I believe it will continue to be around in some form or other for a long time to come. Many of those 2.2 million aren't going to want to come back to the hospital...no matter what changes. Some of them have totally changed fields..but keep their nursing licenses current ...just in case they have to come back...but are hoping they never have to! Not becaue they aren't still caring people or good nurses....but because they have found freedom...and could never go back to giving someone else total control over when and where they work...

    Last edit by Brownms46 on Mar 27, '02
  11. by   Q.
    Well Moe-
    What led to our debate topic WAS a discussion of the nursing "shortage," which, is predicted to get worse. Hospital conditions aren't improving all that much (some pay has increased and some benefits - like full tuition reimbursement for new grads) but says nothing of retention. Adding fuel to the fire is agency. And that's what spawned our debate topic.

    Agency allows increased pay, flexible scheduling, no call and no MOT. So....it's not the hospital environment per se that is so horrible, it's the pay, the INflexible scheduling or rotating shifts, the call and MOT. When agency is used inappropriately, it can be argued that that contributes to staff nurses leaving, either for agency themselves or a different setting altogether, contributing to the shortage, which in turn contributes to the use of agency.

    It's a vicious cycle. That's why we need to show that using agency, on top of being unsafe at times due to poor skills, is also not HELPING the nursing profession at all.

    Though I was really convinced with someone's argument (I think Teshiee) who said "let the hospital be the fool and pay exorbant amounts for agency" This is convincing, but wouldn't it be better to pay the regular staff that salary?
    Or perhaps nurses ALL need to be independent contractors, and be allowed to bill out based on education, experience, etc.
  12. by   Brownms46
    Originally posted by Susy K
    all.

    This is convincing, but wouldn't it be better to pay the regular staff that salary? - Susy K


    Brownie- Yes it would...but I believe they will never do it...as it would kick into profits too much. I mean when you pay a staff nurse...you pay more than just her/his salary for the hrs they do...the hospitals pays more in benefits also...and overtime...as you know there are still not going to be enough nurses who want to go full time!

    The other thing is that no matter what...the agencies are there because those in power don't want to pay all those bennies out...they don't have to carry agencies nurses on their payroll...they don't have make sure they who needs to renew their licenses...who needs to renew their cpr...who needs to do the annual recert...or whatever. They are relieved of having to worry about that agency nurse once they leave at the end of the shift....because she/his is the agencies problem. They don't have to worry about work comp either...and dealing that nurses medical bennies...retirement....lord I could go on....but I won't....

    Agencies came about because someone in the higher ups saw a way to make money. Are you aware that there are agencies out there fronted by nurses...with money put up by doctors??? I mean they're are making money hand over fist. And now the there are hospitals who have sought to even control what they agencies may charge for a nurse.....further keeping down nurses ability to get a decent wage......

    Or perhaps nurses ALL need to be independent contractors, and be allowed to bill out based on education, experience, etc.
    - Susy K


    Brownie...- BUT...aaaaaaahhh...NOW you have hit the nail squarely on the head. This is the only way ...that a nurse will be able to really have autonomy....is by controlling her own purse strings...Bravo...Susy K...Well done...!
  13. by   grouchy
    SusyK,
    I liked your last comment, about independent practitioners. Great minds think alike!;} Do nurses really need to be direct hospital employees? I know this sounds really pie-in-the-sky, but,hey, it works for the docs!

    Maybe the hospital is an outdated institution that needs to be reinvented for the new millenium.

    Personally, I think the #1 reason to be a hospital employee is to gain training as a new grad, or when switching to a new area of practice. Once you're experienced, you might as well go agency, if you can swing the insurance. Maybe we need to do things more like doctors do.Since many of us ( especially us BSN nurses ) come out of school in need of alot of practical training, maybe we need an arrangement similar to internship and residency. We'd go to school for the theory, then do a residency after graduation for the hands-on. We'd get training, they'd get staff for a certain guaranteed period of time. After we completed our residencies we could be independent businesspeople OR employees, like the doctors are.

    Just something to think about!

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Agency Nursing vs Staff Nursing