It's a nurse's market - page 2

Here's what I don't understand...Every hospital in this country is short staffed and BEGGING for nurses to come and work at their facility. Yet, we are working in the worst possible conditions nurses... Read More

  1. by   Mijourney
    Hi colleagues. I agree that it should be a nurses' market. I also agree with those who feel that nurses should be proactive in negotiating employment contracts prior to agreeing to a position. Perhaps all of nursing should go to 3rd party payment as most physicians do. It has been noted several times in this forum that nurses are paid from room and board charges. I am curious if nursing agencies or registries are also paid from room and board charges of a medical facility? I think that irregardless of whether a nurse seeks employment through an independent agency or with a medical facility, there should be a contract in writing detailing negotiations prior to accepting a position. I don't know if this can be done in a right to work state or nonunionized facility or not. Maybe a state board or nursing association representative can answer that. For those nurses who serve as consultants, entrepreneurs, or in some other independent fashion, I wonder if the liability insurance is higher; I wonder if you are expected to perform at a higher level then those employed by the medical facilities to sell your services; I wonder if there are more problems in obtaining affordable medical and disability insurance when working as an independent-I believe most nurses who work FT are working for benefits; I wonder if there are problems with employers compensating independent nurses enough for health and medical needs and other extras to be comfortably addressed; I wonder what bucket the independent contractor is paid from when providing services in a facility; I wonder the impact on nurse practice acts if EVERY nurse became an independent contractor. The idea of being an independent contractor is thrilling, but it sounds as if a lot of planning has to be done for it to be successful. Nurses must be in unity when a colleague is applying for a job and demands to negotiate for servics.

    [This message has been edited by Mijourney (edited December 29, 2000).]
  2. by   Charles S. Smith, RN, MS
    MJ...you are certainly correct in many of your statements/questions. Independent practice is NOT for the faint of heart. Independent practice is premised on business skills and expert practice. Most nurses are good at their jobs and many practice at expert levels as employees. Many, however, will have difficulty using their skills, talents and expertise without a manager, supervisor or organizational officer dictating the boundaries of work. Most nurses are used to having the business end of work spelled out for them, done by others, or do not deal with it at all. It takes a great deal of preparation to start a business, maintain it and move it to new levels. It is also challenging to move RNs dependent upon employment into modes of independent thinking and self-employment, but it can be done, it is done and will be done in greater numbers in the future. It is only since the industrial revolution that this country converted to mass employment. Before the industrial revolution, we had around 80% independent practice and that includes RNs (trained nurses). Other groups of individuals/vocations are moving into self-employment again and so can nurses. As long as we are employees, we will always have someone else exerting control over our lives and the lives of our families by extension. In my view, the failure of nurses to progress professionally is the barrier of employment. When we realize that we can do for ourselves what others have purported to do for us, we will be in a far better position to control our professional and personal destinies.

    I look forward to a very prosperous 2001 as an independent professional and wish the same for all of my nursing colleagues.

    regards
    Chas
  3. by   OC_An Khe
    Goldilocks, just because the answer to a problem is easy to arrive at, doesn't necessarily mean the implementation of the solution will be easy.
    Jim, your last post truer words were never spoken.
    Whether nurses work as employees or independently, it requires that the economic worth of nurses be recognized. That has yet to happen. Until finance types recognize that RN's create income for institutions and lower costs; they will never receive a fair share of that revenue.
    To paraphrase an old historical quote"millions for recruitment not one penny for retention". Retention of existing staff is by far the better way to insure adequate staffing. Retention of RN's within hospital nursing will lead to better working conditions and attract more qualified individuals to nursing. It just requires a change in allocation of capital. That won't happen unless nurses demand it to happen. If we don't demand it then Nursedudes answer will predominate. Including quitting not only your employer but the profession as a whole.
  4. by   Iwant2banurse
    I definitely agree with Chas Smith. We need to work as a collective force and take back control. When you think about we are no less educated than MDs, especially when it comes to patient care. I mean that not only do many nurses continue their education, going to school 7, 8, 9 years to be a practitioner, specialist or earning a PhD, they are constantly learning about their patients.

    We need to unite and work as a group, stop the pettiness that separates one type of nurse from the other.

    Chas, do you have any suggestions at how we can best be in charge of our own careers?
    What do you think about the Million Nurse March?

    Kris
  5. by   Charles S. Smith, RN, MS
    Originally posted by Iwant2banurse:
    I definitely agree with Chas Smith. We need to work as a collective force and take back control. When you think about we are no less educated than MDs, especially when it comes to patient care. I mean that not only do many nurses continue their education, going to school 7, 8, 9 years to be a practitioner, specialist or earning a PhD, they are constantly learning about their patients.

    We need to unite and work as a group, stop the pettiness that separates one type of nurse from the other.

    Chas, do you have any suggestions at how we can best be in charge of our own careers?
    What do you think about the Million Nurse March?

    Kris
    Hi Kris..sorry about the delay in response, but I had to find this post on page 2 of the general discussions.

    There is much to be done toward moving ourselves individually and collectively into more powerful, accountable and responsible positions within healthcare. The first issue to tackle is individual preparation. Each RN must be not only willing to change directions/foci, but also must have the ability to change. Ability comes with preparation, not necessarily formal degreed preparation (it doesn't hurt, however), but rather carefully crafted self education about issues of heatlhcare, business, finance, marketing, etc. As a group, nurses are woefully inadequate in these areas. Collectively nurses comprise the largest portion of healthcare providers, yet as we all know, do not reap the benefits of our numbers. Somewhere along our developmental process we were told that we must do as we are told, not think independently, accept the meager gifts from hospital hierarchies, be thankful for our jobs, and leave the business of healhcare to those who were priviledged enough to be invited into the boardroom. Nurses bought it hook, line and sinker. Just as medical knowledge is available to each of us, business knowledge is also available to each of us if we avail ourselves of the opportunity to learn. No one person or one group has exclusive rights to knowledge or exclusive rights to use knowledge in purposeful and meaningful ways.

    As for the Million Nurse March...I believe that any effort to mobilize nurses is worthwhile. I have watched with great interest some of the posts about the MNM and have difficulty understanding how some nurses can discount the effort without knowing about it. It is my belief that action is better than inaction any day of the week, even if the results are less than anticipated. We can always redirect our efforts toward better successes as we go, even if it is one nurse at a time. Be patient and begin to prepare yourself. Share your preparation with others as you learn. New vistas will open up to you as you are open to others.

    regards
    chas
  6. by   Mijourney
    Hi Chas. Your last post was very constructive, and it offered great advice and encouragement. Somehow, I would not be surprised if you post that you have written or collaborated on a book about business for nurses, right? Anyway, I think more and more of us are going to find that the energy we expend being frustrated about jobs we don't have any control over are going to find that it will take no more energy to strike it out on our own. Is that a good guesitimate? For the record, I'm not as yet ready to get off the bottle of traditional employment. I'm satisfied right now just reading and responding to topics on bb.
  7. by   Charles S. Smith, RN, MS
    Originally posted by Mijourney:
    Hi Chas. Your last post was very constructive, and it offered great advice and encouragement. Somehow, I would not be surprised if you post that you have written or collaborated on a book about business for nurses, right? Anyway, I think more and more of us are going to find that the energy we expend being frustrated about jobs we don't have any control over are going to find that it will take no more energy to strike it out on our own. Is that a good guesitimate? For the record, I'm not as yet ready to get off the bottle of traditional employment. I'm satisfied right now just reading and responding to topics on bb.
    Hi MJ...and thanx for the positive feedback. You are almost correct in your suggestion about the book for nurses. I am in process as we speak of putting together just such a manual. I have been teaching the content for some time (even taught it formally in BS and MS classes...). It is no longer just educational content, however. You are welcome to visit our company website www.preferredrns.com and critique. Sign our guestbook please and i will respond to you personally.

    I look forward to hearing from you.

    regards
    Chas
  8. by   goldilocksrn
    It is so refreshing to see that other RNs realize that we are a valuable necessity. Before we can educate others on the importance and amount of what we do, we have inform those among us that they are in control of their practice, not administrators. How can we empower our patients when we can't empower ourselves? This is the positive attitude we need to make the MNM march successful.
  9. by   Charles S. Smith, RN, MS
    Think about this question folks....
    Why are patients admitted to the hospital? They are admitted to hospitals for NURSING care. If patients did not need continual monitoring by nurses, all procedures, care, etc would be performed as outpatients by MDs and techs only. General medical care can be rendered outside of hospitals. Surgery can be done in outpatient settings, but can not be done without the assistance of nurses. Surgical recovery and followup monitoring can not be done without nurses. I hope this helps you understand your worth and value. RNs are very valuable and in great demand now. Take stock of your personal worth and share with a co-worker how valuable she/he is to the system.

    best regards
    chas
  10. by   goldilocksrn
    I think that before we improve our working conditions, the mentality of a lot of the nurses we work with must change. I had an incident yesterday where a nurse went and told on me to management because she thought I was unfairly influencing staff in a vote we were having. ( we are a severely short staffed hospital where we were being paid 8hrs of reg pay and 4hrs of time 1/2 for 12 hr shift. pay is $6 hr less than other hospitals in the area.) We were voting to prevent the hospital from taking away 2 hrs of our overtime on our 12hr shift = to a $300 a month pay cut. If we didn't agree, we would be forced to go back to 8hr shifts again. We voted for 8 hrs shifts (which the hospital can't staff, which meant we could keep our money)Since the hospital can't even staff us now, they would have to keep us on 12 hr shifts with all of our pay. This particular RN blamed me for "getting" staff to vote this way and told on me, she said I was being very "negative". This nurse was supposed to be my friend, and she did this. I mean, all we were doing was trying to stand up for ourselves and keep the money we were working so hard for. She was mad because SHE didn't want to work 8 hr shifts(neither do I) She didn't get that we were making a stand to management that losing this money was unacceptable. I see her behavior as selfish and undermining something that would benefit everyone. Why do we as nurses do this to one another?
  11. by   sa48sh
    Originally posted by PPL:
    Hey everyone, have you been receiving phone calls, emails and mailings from recruiters? This has been happening to me, and I wonder how much of this is going on. I'm afraid to answer my door, they might try to DRAG me to a job! By golly; I won't go without a fight!
    LMAO but when will nurses realize how much power is in their own hands? It's a case of the emperor's clothes. Administration knows we have the upper hand but if they pretend we don't maybe we will just go along with the facade. I for one make a very good wage. More than most of the rest of the staff. Wh? because I'm willing to go elsewhere if I don't get what I want.Sure it's risky, but,risky is better than misserable,broke,and disheartened with the profession that I love so much. By the way I love my job. Wonder if it has anything to do with standing up for myself? The others?"Leave them alone, and they'll come home, waggin their tails behind em" There are enoough of us if we just stay true,that we CAN force a change. We don't have to be organized. They'll soon figure out the mystery of supply and demand.They sure took advantage of it when we were flush with nurses.

  12. by   Jenny P
    It is a nurses market right now; all we have to do is take a stand for ourselves and for our patients. As long as nurses are willing to come in early, not take breaks, and stay late without charging the hospital for overtime, the hospital does not have to pay for our services-- or look for extra staff. We need to get out of jobs that make us feel incompetent and into jobs that take full advantage of our skills. I love the job I have, but I do feel I am not being paid enough for what I have to know and do in the workplace. Our contract comes up this June, and there are rumors of "strike" every day. I do see some changes in nursing, we just all need to stand up for our selves and our rights. We may disagree amonst ourselves, but it is important to remember why we are doing what we do. Nurses are patient advocates; well, the patients' name is NURSING and we'd better start advocating NOW while the patient is critical, and not wait til the patient is dead. It's much easier to treat a live patient rather than doing CPR on one who is found down, pulseless, blue and has rigors setting in. Nursing is not there yet.
  13. by   OC_An Khe
    Chas.
    You are correct as usual. Patients are admitted to the hospital for nursing care. This fact is (should be) obvious to all RN's as well as to everyone else in health care. To get non RN's to accept and publically agree to such a position is another challange that our profession needs to take.

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