Should nursing services be itemized on patient's bill?

babs_rn · Aug 6, 2003

I just have to wonder how you can put a monetary value on all that we do....if you did, the already sky-high bills would be astronomical....

But then maybe we'd get paid what we're worth? Would we work on commission, then?

It'll never happen, at least not the way it SHOULD...but it's an interesting theory.

Jeepnurse · Aug 6, 2003

Don't really think it would work but wouldn't it be great if there were a PIA surcharge or a surcharge for ALL the family bothering us at change of shift

redshiloh · Aug 6, 2003

If only we had a PIA surcharge....or code brown bonuses

AndyLyn · Aug 6, 2003

We recently had a house built, with my husband being the general contractor. Every single profession that worked on that house gave us a bill for everything they'd done, itemized. If plumbers, electricians, heating and cooling guys can do it (down to the pipe fitting and screws!) why don't nurses? Doctors and lawyers certainly don't do their work for free, they put a fee on each service, and customers/clients/patients pay accordingly. Yup, it's expensive. But it's what makes those professions independent, right? Is nursing independent? Do we want to be?

Great question, I'm anxious to see what everyone else thinks.

Scis · Aug 6, 2003

Just think about it everyone....currently nursing services are billed along with the room and board of staying in the hospital; sort of like grouped in with the housekeeping, dietary, etc. staff that care for the patient. Now I ask all, with all the years of schooling, all the independent study, all the work and liablility and accountability that goes into practicing the role of a professional registered nurse, do we not deserve a separate billing code at the very least?! I fear it is like this because, " it always has been like this, " not because it SHOULD BE! If we don't insist on a value placed on nursing and our care, will anyone? Sure, what we do is important, healthcare facilities, especially acute care, cannot function without professional registered nurses. Independent RN's are the wave of the future, will you ride on it or sit quietly on the beach?!!!

flowerchild · Aug 6, 2003

I have always felt nurses should be paid on a fee for service basis. After reading the posts on this and similar threads, I started to think....uhoh, lol, about how it would affect the nurses who are working in the hospitals.

When I did HHC it was like being paid per service. I was paid per visit, being paid more for some visits than others ie: IV, supervisory, admit, etc. all paid according to the complexity of the visit. I made $15 for a supervisory or I could do an IV for $40-$50 per visit.

There was occasional competition for certain visits during normal census but, when our census went down, it would get very competitive. Ever seen a nurse out to get what she wants?? Nuff said there.

OK, so I'm picturing nurses in a hospitals, never leaving anything for the next shift to do, day shift does all the procedures that can possibly be done, nurses wanting orders to be written, Asking others if they can help, etc. Could be a good thing. Or could really be bad if we got competitive about doing billable activities. Granted, we'd get a set rate for the patient being in our assigned bed but what if you get all your patients with minimal and someone else gets all the "good" paying patients?

Doesn't matter b/c I doubt it will ever happen. Even Docs can't bill that way anymore. The insurance companies and gov't have taken away the Doc's ability to charge fee for service.

fergus51 · Aug 6, 2003

I don't think nurses should be paid on a fee for service basis. If you happen to have a lighter assignment than your colleague one shift, do you want to be paid less? And this doesn't help create teamwork (are we going to have nurses only help eachother if they are paid for the service?). A decent hourly wage is fine with me, and if they want that broken down separately on their bill, I have no problem with that.

Tweety, BSN, RN · Aug 6, 2003

Question, do they pay when the dietician is consulted? Does social service charge a separate bill?

I'm still learning about this issue and don't have an opinion.

purplemania, BSN, RN · Aug 6, 2003

Actually, I asked the question not because I think nurses should be "fee for service" but because none of the paperwork going out to the public reflects nursing care was involved, although the reason people are admitted to a hospital is because they REQUIRE 24 hr. nursing care. How will be ever convince the public of our "worth" (please, I KNOW that some patient appreciate us but it is not the same)? Even the discharge papers reflect the attending physician's orders, but not the nurses' involvement. Would like to have process, other than acutity (which does not accurately reflect the work involved) to demonstrate our effect on pt. outcomes.

Chaya, ASN, RN · Aug 6, 2003

I would like to see this happen as a means to increase our visibility if not our pay scale. Maybe it would result in a redistribution of accounting, maybe not. But as a first step it might increase awareness of the actual "quantity" of care contributed by nursing and keep "nursing" from being lumped in with heat and electricity.

debralynn · Aug 6, 2003

Maybe our nursing organizations should run an ad for Nursing, and in that ad put something like:

Did you know what a Nurse Actually Does when on duty:

then list everything, and I mean everything a nurse does.

put it in a fully page newspaper national ad to recruit for Nursing. Of course they would have to sweeten it up a bit to really recruit, like tell all about the rewards a nurse gets from appreciative patients, but maybe this is a way to let the public know, and other hospital personnel truly know what nursing involves.