If salaries were higher......? - page 2

After reading Frog's thread about Nurse Agents, I have a hypothetical question for all of you: if the job is the same (as far as short staffing, mandatory overtime, etc.), would you be happier... Read More

  1. by   -jt
    "And the next question is: what will guarantee that hospitals will hire more nurses? "


    They will need increased reimbursement from the govt & insurance companies in order to afford those high salaries & thats all well & good but the guarantee that they will use it for this is the plan we have propsed to state legislatures in our Safe Staffing Bills to be passed into state law:

    Let them have the increased reimbursement but tie that increased reimbursement only to nurse recruitment/retention efforts. Pay it directly to the hospitals Dept of Nursing - not the hospitals overall operating budget - with the stipulation that there are yearly reviews for evidence that it was indeed used to improve staffing. The evidence would be the data showing increased hiring or nursing staff & decreased turn-over. Recruitment/retention incentives can be higher wages, improved benefits/pensions, educational incentives, workplace improvements, etc. Hospitals that do not show improvement in an increase in hiring & a decrease in turn-over will be deemed to have not used the increased reimbursements for the purpose for which they were paid & will have to REFUND THE MONEY back to the state. Incentive enough for them to comply with the law?
    http://www.nysna.org/PROGRAMS/LEG/po...ORTAGE2001.htm
  2. by   Charles S. Smith, RN, MS
    Originally posted by -jt
    "And the next question is: what will guarantee that hospitals will hire more nurses? "


    They will need increased reimbursement from the govt & insurance companies in order to afford those high salaries & thats all well & good but the guarantee that they will use it for this is the plan we have propsed to state legislatures in our Safe Staffing Bills to be passed into state law:

    Let them have the increased reimbursement but tie that increased reimbursement only to nurse recruitment/retention efforts. Pay it directly to the hospitals Dept of Nursing - not the hospitals overall operating budget - with the stipulation that there are yearly reviews for evidence that it was indeed used to improve staffing. The evidence would be the data showing increased hiring or nursing staff & decreased turn-over. Recruitment/retention incentives can be higher wages, improved benefits/pensions, educational incentives, workplace improvements, etc. Hospitals that do not show improvement in an increase in hiring & a decrease in turn-over will be deemed to have not used the increased reimbursements for the purpose for which they were paid & will have to REFUND THE MONEY back to the state. Incentive enough for them to comply with the law?
    http://www.nysna.org/PROGRAMS/LEG/po...ORTAGE2001.htm
    JT..i understand your logic about reimbursement directly to the nursing budgets, but I have doubts that the "books" will remain clean enough for anyone to really be able to take issue if staffing and retention fall. The nursing department is subsumed in the hospital budget. Increasing the governmental cost for oversight of one department in each hospital will ultimately increase healthcare costs and red tape. Hospitals AND nursing manipulate the JCAHO every 3 years into believing that compliance has remained constant or improved over the whole 3 years (not just the 6 months prior to a survey), so I imagine that the same manipulation could and would occur with the recruitment and retention issue. Looks good on paper, but what is the real truth?

    regards
    chas
  3. by   BeeStrong
    This actually does sound do-able, and it is certainly a place to start; Unit managers have to keep within their budgets, don't we hear them moaning about that all the time? Well, then there definitely must be a way to track these funds and to audit where exactly they are going. I must admit I am not clear on exactly how these unit budgets break down but I do know that each unit is allocated a certain amount (for staff, supplies....and??) and must stay within that amount. Our unit manager also is eligible for an annual bonus if she/he stays within that budget.. So, are the managers being rewarded for cutting staff??? Interesting question. Bee
  4. by   eagleriver
    Those nurses who have dedication and integrity will do the best job they can, regardless if they are making fifteen or seventy dollars an hour.

    Higher salaries will attract some who are more interested in the money than the work. At the same time, others will finally decide they can afford to be nurses.

    As mentioned previously, the issue of low control and high responsibility is causing a lot of burnout and should be a priority concern - along with the money.

    Exhausted nurses are more likely to make mistakes. The industry should weigh the extreme toll of punitive damages against the cost of wage and working condition adjustments that enable nurses to function most effectively.

    I hope it becomes evident that the combined cost of litigation and lobbying for laws to prevent lawsuits are much higher than simply maintaining decent staffing ratios.
  5. by   essarge
    This is just an opinion, so please don't get offended.

    I think that since the government is able to "cap" so many things, why not "cap" what doctors charge the hospital and take the "saved" money and put it toward nursing salaries/retirement?

    Just a thought.
  6. by   mcl4
    Originally posted by essarge
    This is just an opinion, so please don't get offended.

    I think that since the government is able to "cap" so many things, why not "cap" what doctors charge the hospital and take the "saved" money and put it toward nursing salaries/retirement?

    Just a thought.


    Because the physicians, who have influential lobbyist in Washington, and can afford to send the politicians a significant amount of money. I see this as never happening under our present political system.
  7. by   tonchitoRN
    This is a topic that I love to debate. No matter how much money you get you will still have to deal with the workplace problems i.e. working hard, being tired, doing everyone else's job etc. Money will not solve these problems. It will only quiet you down a little ... for a while. Then you will start complaining again. I used to work in a non union hospital where the pay was considered low compared to other hospitals. Many of my younger friends would ask me why I do not go to one of the higher paying hospitals. For me the answer was simple. I had piece of mind. I did nursing duties, I NEVER had to do the work of housekeeping, nursing assistants, I NEVER had to clean poop, vomit, give baths, do respiratory treatments, do physical therapy or phlebotomy, change beds give food etc. My nursing duties included monitoring patients, giving meds, doing treatments, education, the stuff I went to RN school to begin with. On a Telemetry floor we had 6 patients. What more could I ask for. I had piece of mind. I enjoyed my work. I had a life with my family and kids. And I had respect.
    You want respect? Stop doing the dirty work. How much respect to floor sweepers get. When was the last time you asked your garbage man their opinion on the current conditions of his job. You probably did not even look him/her in the eye. As long as you are willing to empty a bedpan you are not going to be respected by the public or anyone else.
    So don't complain about money. You get paid a whole lot more than the majority of the population. As far as the nursing schools putting out better nurses because of the lure of money. Think again. You will get an influx of people who are in the profession for $$ and not to help people.
    Say what you want but money will not solve your problems.
  8. by   PhantomRN
    For the woman who is nottanurse. Right now the money that we make is lumped into the room charge and other various charges: dressings, tylenol etc. So If they gave us more money and charged for nursing services that would come up as part of the bill and your charge for the other stuff would go down.

    granted there may be some increases in billing to cover us...but who takes care of the patients......the lab person who draws blood once a day?...the PT/OT who might see the patient once a day for 30 minutes? Dietary, who wheels the food cart on the floor and leaves (then nursing passes out the trays)

    NO it is nursing who takes care of the patinets with out us...............Patients WOULD NOT make it out of the hospital ALIVE..........BECAUSE WHILE OUR PATIENTS ARE THERE WE ARE THEIR EYES AND EARS. WE MAKE SURE THAT LAB COMES UP AND DRAWS THEM, WE MAKE SURE THEY RECIEVE THEIR FOOD TRAYS, WE MAKE SURE THAT IF PT/OT IS SCHEDULED THAT THEY SHOW UP.......AND THE LIST GOES ON AND ON.
  9. by   BeeStrong
    Tonchito, I find it interesting that you regard emptying a bedpan as being "beneath" a nurse and not worthy of any respect? Excuse me, but bowel care and bathing are still part and parcel of nursing as far as I know. When a patient asks for a bedpan, do you tell them to wait until you find a nursing assistant?? Yoo hoo, this IS nursing, like it or not!!! Never had to bathe a patient? Come on, what are you going to do when your one nursing assistant on a 30 pt ward is busy, let all of your patients sit in their poop and vomit??? Get off your high horse, my dear, this is what nursing is all about not simply passing your medications and doing your assessments, this is about CARING FOR and about people...If you think you will lose respect because of handling a bedpan then you really are in the wrong profession. And more money makes a BIG difference to every nurse that I know. It is called appreciation for a hard and difficult job which fewer and fewer are willing to do.
  10. by   radnurse2001
    Originally posted by tonchitoRN
    This is a topic that I love to debate. No matter how much money you get you will still have to deal with the workplace problems i.e. working hard, being tired, doing everyone else's job etc. Money will not solve these problems. It will only quiet you down a little ... for a while. Then you will start complaining again. I used to work in a non union hospital where the pay was considered low compared to other hospitals. Many of my younger friends would ask me why I do not go to one of the higher paying hospitals. For me the answer was simple. I had piece of mind. I did nursing duties, I NEVER had to do the work of housekeeping, nursing assistants, I NEVER had to clean poop, vomit, give baths, do respiratory treatments, do physical therapy or phlebotomy, change beds give food etc. My nursing duties included monitoring patients, giving meds, doing treatments, education, the stuff I went to RN school to begin with. On a Telemetry floor we had 6 patients. What more could I ask for. I had piece of mind. I enjoyed my work. I had a life with my family and kids. And I had respect.
    You want respect? Stop doing the dirty work. How much respect to floor sweepers get. When was the last time you asked your garbage man their opinion on the current conditions of his job. You probably did not even look him/her in the eye. As long as you are willing to empty a bedpan you are not going to be respected by the public or anyone else.
    So don't complain about money. You get paid a whole lot more than the majority of the population. As far as the nursing schools putting out better nurses because of the lure of money. Think again. You will get an influx of people who are in the profession for $$ and not to help people.
    Say what you want but money will not solve your problems.





    Hey tonchito RN where did you go to nursing school? How do you do a complete patient assesment without doing the dirty work? In the days before this nursing shortage (early 1990's in this area of the country) I used to have 6 patients on days, on a medical cardiac/stepdown/eps floor, and had the time to do the teaching, meds, assesments, and the other "RN" work, but I'd also had time to do baths, bed changes cleaning vomit, weaning 02 and some of the other things you describe as "NON RN" work. I loved those days!!!! Are you unawarwe that a lot of assesment can be done while bathing a patient? True story---I was bathing an elderly patient one morning and found odd bruises on her body---asked her about it and she broke into tears--Son was abusing her. Most PCA's or nurse aides are not trained to pick up subtle patient clues such as this one. Does you nursing assistant know the difference between diahrrea and c-diff? Does your nursing assistant know how to do accurate calorie counts? Do you know if your patients are getting good nutrition? Don't your physicians ask about the amount, color and quality of the vomitis when you call about it ? Do you feel confident enough to put you license on the line? These are questions I used to ask myself before I left floor nursing. I felt very unsafe---I left. So before you go delegating who's job is who's (sorry about the spelling), tonchito RN,I think there is some assesment questions you should ask yourself and question why it is you became a RN.
    In addition this doesn't help the nursing shortage at all, RN's thinking their not doing RN work when it comes to patient care. Anything to do with our patients is concidered RN work as far as I'm concerned.


    Now I feel better---have a nice day everyone!!!!!
  11. by   Jenny P
    Tonchita, I became a nurse to help and care for people who are sick. My unit doesn't have aides or techs all of the time. The RN's are the PRIMARY caregivers-- we don't have LPN's in my CV-ICU. I have no problems with bathing or bedpans; I place myself or a loved one in that patients's place; and try to make the patient as comfortable as I can.
    I do object to doing housekeeping duties- I do not feel it is necessary to clean the undercarriage of the guerneys and beds (I've been told that is in some RN job descriptions!); and I don't understand why some nurses place emptying linens and garbage as high priority items when the patient is supposed to be our primary concern (I am not talking about overflowing trash containers here; if the garbage is contaminated and overflowing; it does become a health issue and should be emptied). Even though I feel this way; I do not feel that I am any better than the housekeeper; we are both humans and equal in God's eyes. The housekeepers in my unit are vital parts of the health care team and everyone- even the doctors- know them by name and converse with them.
    As far as garbage men, in many parts of this country they DO make more than RN's! They can look us straight in the eye, because they make living wages that are better than many people imagine. You talk as though you think you are better than those in "lesser" occupations; remember, your education is possibly the only thing that separates you from their circumstances. Remember, most Americans are only something like 4 paychecks away from homelessness; so are we better than anyone else?
    Last edit by Jenny P on Aug 21, '01
  12. by   eagleriver
    When the Lord made man, all parts of the body
    began to fight to see who would be boss.

    The brain said that since it controlled all
    the parts of the body, it should be boss.

    The legs argued that since they took the man
    wherever he wanted to go, they should be boss.

    The stomach countered with the explanation that
    since it digested all the food, it should be boss.

    The eyes explained that since, without them,
    the man would be blind and unable to see,
    they should be the boss.

    Then the rectum applied for the job.

    The other parts of the body laughed so hard
    that the rectum got mad and closed up.

    After a few days the brain got foggy,
    the legs got wobbly, the stomach got upset,
    and the eyes were crossed and unable to see.

    They all conceded and made the rectum boss.

    The point is, if we attach levels of importance or superiority to our jobs, we are overlooking the reality that ALL parts of the body, organization, health care profession, or whatever institution need to be regarded as important enough to take measures to assure the well being of those parts. Additionally, all those parts deserve respect.

    President Bush would soon find himself unable to function if his housekeepers abandoned him. What about his plumber or electrician. Somehow, I can't see the Secret Service doing a decent job of cleaning toilets or fixing pipes.

    On the other hand, I think it would do Bush a lot of good to find himself cleaning his own toilet once in a while.

    If a DON is willing to empty a bedpan once in a while, it honors both the badpanner and bedpanee. Crosstraining is a good thing also - within reason. For the most part however, the majority of an individuals work should be within the scope of their training and in a way that most effectively utilizes their talents.

close
If salaries were higher......?