Agency Nursing vs Staff Nursing

babs_rn · Mar 26, 2002

As an agency nurse who has sworn off hospital staff nursing:

Agency nursing is the next best thing to working with a union that there is in states that don't have unions. We have much more flexibility in our hours and develop a large and very diverse background in nursing without being essentially "owned" by that hospital. Certainly under a contract you do give up some liberties regarding scheduling, but for a nurse who chooses to work per diem, there are lots of shifts available (yes, you're limited by what shifts are available and how far you want to travel, but they ARE out there) and you don't have to give up your family time to do it. I, for one, never ever accept an assignment where I'm not appropriately credentialled and comfortable and the places I've worked have been very good to me for the most part, even giving me lesser assignments because they don't want me to not want to come back! Of course I help out everybody else when possible and when wanted.

I just could never be subject to the degradation and dehumanization of being a hospital employee again. No thanks.

Babs

EXOTIC NURSE, RN · Mar 26, 2002

I work in house registry right now and I feel that was the best move for me for many reasons.......number one....when I was on staff I did not make as much money as I do now.....(2) I do not have to deal with all the political crap that goes on (3) I work when I want to and after I have filled my obligation I am not required to work any more the rest of the month so I can pick and choose how I want to work ( 4) I can go on vacation when I want to and go to my children's games and other functions. I was a staff nurse so I know my unit very well and I know the policy and procedures of the hospital and I look forward to eventually going to agency nursing as well and to contract to come back to the same hospital I am working registry now because I feel comfortable with knowing the hospital and the policy and procedures and I plan to stay in my area of nursing. The shortage allows for nurses to have that type of autonomy right now and until something is done about the nursing crisis it will remain that way for a while.

Teshiee · Mar 26, 2002

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.

CindyCCRN · Mar 27, 2002

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...

Brownms46 · Mar 27, 2002

BRAVO BRAVO BRAVO

I could not have said it better! :cool:

Teshiee · Mar 27, 2002

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!

**SKM-NURSIEPOOH, BSN, RN** · Mar 27, 2002

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? :confused:

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

IMHO:mad: ...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

Q. · Mar 27, 2002

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. :confused: Please clarify as I really love the input.

:)

Teshiee · Mar 27, 2002

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.

BadBird, BSN, RN · Mar 27, 2002

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.

**SKM-NURSIEPOOH, BSN, RN** · Mar 27, 2002

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

Brownms46 · Mar 28, 2002

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... :cool:

:cool: