Public and Private Hospitals - whats best?

  1. I want to share a story first. Tonight, I worked an agency shift and we had 2 RN's on an acute medical ward for 15 patients. There was two new admissions, a post op, and a gastro prep in all that.
    When I got there I told the manager I was extremely unhappy at the lack of staff and the situation was dangerous. She said she was unable to obtain any more nurses, she sent us a patient care aid.
    It was a private hospital. The ward had 35 patients in total. We ended up with 4 RN's, 1 EN and 1 PCA.

    The nurses in the area I was working with did not want to divide the patients up. She said they normally team work. I said I wasn't happy to do that and wanted a patient load that I could ensure medications and Obs, ect were done for. So, in the end she said okey but I know she was not happy.

    I work in acute medical part time in a public hospital, we don't have nice carpet, pretty curtains, instant telephone and TV access, equiptment that works fully, pretty quilt covers, nice fancy cakes for afternoon teas (our patients don't even get afternon tea!) like the private hospital BUT we have nurses!!! We always have the amount of nurses we require, eventhough half our ward is staffed by agency and at times co-ordinated by agency. You may get a gab of 2 hours where they don't staff the area fully between 1 and 3pm. But, we always get nurses. We average about 5 patients each.

    I have private health insurance because if I was ever to need medical care, I wouldn't want to be on a wait list. But, I would rather a nurse than a home made chochlate chip cookie, a room with fancy curtains ect.

    Well, I prefer to work in a safe environment before a pretty one. I was thinking of ringing the nurses agency and finding out if they had staff that didn't get a shift tonight, then I would tell them why I am asking and then I would write to the hospital concerned. I am SERIOUSLY considering taking my name off that hospital with my agency.

    I'm now left wondering why I have private hospital cover. This is not the first time I have been at a private hospital who use the nursing budget (IMO) to paint the walls and put new carpet down. oh, and leys not forget the home made choc chip cookies either
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  2. 13 Comments

  3. by   RN from OZ
    Well !
    I have worked in both the public and private systems in NSW.
    I left the public system after 10years due to the decline in the standard of Pt care...basically in a level 3 NICU with vented Pts we were dismally lacking in senior staff sometimes more new grads than exp staff.
    Inflexable rostering.
    Also the patients and relatives were becomming so abusive interferring in care, not respecting a single regulation upon entering the unit...eg washing hands quite time not looking at other peoples babies notes..and then there was DOCS.
    I have worked in 2 private systems one owned by a profit organisation one owned by a non profit organisation ..like a religious affiliation.
    The ones run for profit are pathetic..you recieve no better care...perhaps worse care than the public sector..staffing was a scandal 2 to 30 pts in a maternity unit post op C sections and these women come with a baby so really 60pts to 2.
    But the clientel are a breath of fresh air and very compliant.
    In the non profit one where I work now I cannot speak highly enough of it. They train their staff and pay for it. we are always well staffed no more than 8 pts per RN and an AIN on the Am shift to do beds and linen. A Lactation consultant on every second day to do the ward round assisting with feeding issues flexable self rostering and nice environment all the equipment we need.
  4. by   gwenith
    Have to agree with RN from Oz above and this is not a unique situation - the not-for-profit private hosptials are actually very good with excellent patient/nurse ratios if not top notch equipment then at least it didn't come in on the ark. The for profit organisations are a disgrace. One major group is notorious for bad staffing, poor equipment and no back-up.

    The bottom line has to go back to the ACHS the so -called quality improvement watchdog.
  5. by   bulletproofbarb
    Ah, it was a for profit private hospital. I haven't worked in a non-profit one although we have them in WA. So, I know to stear clear of those profit peny pinchers.

    I rang up the agency, they had an EN who didn't get work last night, according to manager of the hospital, none where available. The agency was very "interested" when I told then this. I also said if it happened again, I would not go back there. Apparently, alot of the agency nurses won't go there unless it's a last choice. I think I know why.
  6. by   OzNurse69
    RN From OZ - Their initials weren't MH were they??!!
  7. by   Jacfitz
    I have worked in both private and public I have also been a patient in two big private hospitals. I totally agree with the oppinions. While the hospital may look like a hotel it is the care that is key. I left a public hospital who had great nursing admin and staff but left me with a new grad in a special care come recovery unit on pm and night shift. In all facilities I have found the standard of nurses exceptional. But budget constraints and staffing levels are killing the "goose that lay the golden egg".
    Admins and HMO's didn't realise the value of THE NURSE until they lost them in droves. Now they are in a mess that won't be easily fixed. I have been an RN for 28yrs and have seen the deterioraton. I currently work in a Day surgery which is outstanding in staffing levels, quality of care and respect of the nursing staff.
  8. by   bulletproofbarb
    Oh, I forgot to say, it puts my mind at ease somewhat about private health because my local private hospital is a not for profit one. So, hopefully, if I ever needed it, it would be fine.
  9. by   RN from OZ
    MH it was...I heard a rumor that they are selling off all their hospitals...too much trouble not enough gain.
    They actually wanted us to have a higher turn around of Pts to justify more staff...these poeple are funded for 6 days for a delivery and that is why they come so they are not kicked out in 4 to 24 hours like in the public system with no support.....thats what happens when truck drivers run hospitals !
  10. by   rebelwaclause
    Private hospitals tend to have more $loot$, more "new" stuff and more snobbery. Public hospitals are overlooked and under-funded, but have spunk and intellect because of the deficit AND dedicated people who are there.

    That's about it in a nutshell.
  11. by   OzNurse69
    Originally posted by RN from OZ
    MH it was...I heard a rumor that they are selling off all their hospitals...too much trouble not enough gain.
    .....thats what happens when truck drivers run hospitals !
    Funny thing is, they're actually quite a good transport co, or were, from what I hear. They just suck when it comes to health care!!

    Ruth
  12. by   gwenith
    The trouble is that that particular group has run down the hospitals they intially took over, took the best profit out of them and now will sell them on.

    What annoys me is that the ACHS which is supposed to maintain standards at our hospitals does not do a thing about staffing but spends most of it's time examining the documentation.
  13. by   Grace Oz
    I worked in a non profit private hospital some years ago & they installed a $4,000 etched glass (HUGE) window in the staffroom! This window faced the backyard!?! You know, the bins, the linen trolley's etc?!?...Next thing, us NURSES, you know those important people which NO hospital can operate without??!!...Well, us nurses had our hours cut back, less staff each shift, NO MORE bikkies for AM or PM tea breaks,( gawd, we felt like our throat's had been cut!) LOL
    Restrictions on amt of linen used, had to search high & low for equipment such as adequate dressings etc. Then.... they said they couldn't give us the pay increase we'd been plugging for, but... they COULD give us salary sacrifice! Many on the staff were NOT going to benefit from this 'offer', for many reasons.And so, it was a USELESS option for them! Management and the board,reckoned they didn't have the cash for the pay increase?! But they found $4,000 for a bloody "feature" window that NO-ONE saw, other than from the staffroom on the INSIDE??!! Then they built a new staffroom in the new addition UPSTAIRS ( adding on costs $$, right?!)& guess what????.... The OLD staffroom became the BOARDROOM!!!! HELL-LO??!!!...

    Then there's the experience of working in a public hospital which is PRIVATELY managed!... After orientation, I attended my first shift. Looking around for a thermometer, couldn't find one, asked other nurse;"where do I locate a thermometer in order to do my obs?" Know what I was told?...."We bring our OWN"!!!... "Aw" sez I, "stop the BS, I'm too old to be messing with, where's the bloody thermometers?" Nope, she was DEADLY serious! Same with stethoscopes! Managed to get through the shift by beg, borrowing & stealing. Saw the unit manager first thing next day & queried the whole thing. sure enough... her unit BUDGET had dried up, and no more $$$ in the budget for EXTRA thermometers!!??!! Advised to buy my own, keep it on my person, and use on each & every patient I was assinged!! "You can claim it back at tax time", is what she told me!!!
    As GOD is my witness.... ALL the above is TRUE!!

    I NO longer work in EITHER hospital!!....

    Cheers,
    Grace
  14. by   gwenith
    HMMM Grace I think we worked at the same hospital

    Good news is that they have now decided to supply thermometers mainly because the agency staff used to turn up for work unprepared and have to beg steal or borrow. I think the union might have stepped in.


    I suppose I am angry at the ACHS because I ran into a major problem at a major hospital and TRIED to take my concerns re care standards to the nursing administration and got told "A policy does not have to be written down to be a policy". This problem was not short staffing it was poor care and a culture of "Don't rock the boat" along with some of the worst documentation I have ever had the displeasure to encounter anywhere. NO care plans.

    That hospital was accredited. After I failed to get any action or satisfaction from the administration of the hospital I tried approaching the ACHS myself only to find there is no mechanism for complaint.

    Frustrating!!! One of the major problems with heatlh care is that the current "feedback" about poor standards of care is the law courts when someone sues the facility. This sort of feedback does not improve standards and can have anegative effect as payouts reduce budgets.

    We need a method of feedback to the overseers of quality assurance if a facility is running below par.

    Imagine this scenario. The ACHS instead of being a "Paper Tiger" became more like the health rights commission BUT it primary dealt with complaints from health care workers. You are concerned about the infection rate at a hospital - you contact them and they investigate. There would have to be checks and balances in place to ensure it did not get abused.

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