Ethical? Nursing + commission

[PetiteOpRN]

Just wanted to get some perspective.

I work PRN at a plastics practice. We have always done cosmetic procedures, but now there is a "bonus" attached to every new patient that a nurse sees who books surgery. Essentially, there is a $50-$100 commission when the patient 'converts.'

In addition, we are now starting to carry skin products and makeup. And every sale we make (to patients) earns commission.

So far I have not seen a patient approved for surgery who was not a good candidate, but I'm worried that there is too much emphasis on making the sale and not on providing the best care to every patient, regardless of their financial situation ability to buy lots of expensive makeup.

Am I making a big deal over nothing? If a similar program was started at your facility (ie, going from room to room and selling refreshments for bonuses and commission) what would you do?

[OCNRN63, RN]

I, for one, make plenty at this facility (no idea what the other RNs make, none of my business). I have worked in sales before and I'm not questioning the legality.

I'm just concerned that patient care is being replaced by sales. When I worked in jewelry, if a customer who was knkown to be a big spender came in the door, we were at her service. If a customer with below-normal IQ came by for the 3rd time that week to ask the same 5 questions about the two cheapest things in the store, um, time for my 15 minute break x the entire department.

If there are 6 consults and the nurses really want to convert them, then what is the incentive to take their time with the 2 week s/p TRAM flap? I'm afraid we will compromise care for other patients, in addition to pressuring patients to book surgery.

But totally legal. No question about it.

You want to "convert" them? What are we talking about, surgery or religious indoctrination?

It sounds unethical to me. It's probably not illegal, but it doesn't sound like a place where I'd want to work. It sure doesn't sound like an office where I would want to be a patient either, for that matter.

[linearthinker, DNP, RN]

I don't really have a problem with it. I have been a cosmetic surgery patient, I don't care if the staff get commissions. They never talked me into anything, I went there in the first place because i wanted it. Cosmetic surgery is the same as the Chanel counter IMO. I expect to pay alot of money for a luxury I decided i wanted before I even got into the car.

[PetiteOpRN]

You want to "convert" them? What are we talking about, surgery or religious indoctrination?

It sounds unethical to me. It's probably not illegal, but it doesn't sound like a place where I'd want to work. It sure doesn't sound like an office where I would want to be a patient either, for that matter.

Conversion in the sales sense. As in convert from a consult or potential customer to a surgery or actual customer.

RNs are now evaluated based on conversion rates.

[OCNRN63, RN]

Conversion in the sales sense. As in convert from a consult or potential customer to a surgery or actual customer.

RNs are now evaluated based on conversion rates.

I work where my skills as an RN are valued, not my salesmanship. A woman who needs breast reconstruction d/t CA needs time and attention just as much as a woman who wants to turn the clock back; moreso if you ask me. Again, it wouldn't be my cup of tea; I doubt I could look in the mirror in the am and know I was short-changing some patients just because their cases weren't as lucrative.

If I as a patient know of this practice, you can bet the ranch I'd find a different provider ASAP.

[Batman25]

Are the nurses doing the initial consult not the doctors? Why? Is this typical in the plastic surgery business? I've never heard of that before but it isn't my specialty.