Thanks to Medicare changes...My Job Was Just Eliminated - Page 4

Wow! When I submitted this article, I had no idea it would be such a hot topic! However, I am delighted to see others who are interested and the various levels of understanding of this topic.

I appreciate all the well-wishing for a speedy result to my job search.

For those who have replied, I would like to clarify a few things:

1. There is no union at this hospital.
2. This hospital is a not-for-profit, Catholic health ministry. Charity care has always been a sizable portion of the care provided. However, that percentage has more than doubled in the last few years with local unemployment running in the double digits most of the time...including now.
3. I am eligible to apply for any open positions at that hospital. However, as someone mentioned, it would be at 87% of my previous pay.
4. As someone else surmised, I do have health issues that limit my ability to return to bedside nursing.
5. The day my position was eliminated, there were 25 other positions eliminated as well...not all were in the nursing department, though the majority were.
6. While my position was not responsible for the final retrospective review and submission of data, it was my job to make sure that the sample would meet criteria once the medical records were selected for retrospective review. By that time, any window of opportunity to accurately reflect the care that had been given was closed. The redundancy that you mentioned could be perceived as such by those who have never actually been involved in concurrent auditing and prevention of "fallouts."
7. The changes that brought about the loss of my job are the ones that will be taking effect in the coming months. The Value-Based Purchasing may have been piloted years ago...but was not implemented until 2012 (August or October? I have heard both. I would think October with the new fiscal year for the fed goverment.) There is a formula that is used to calculate the reimbursement. The patient satisfaction (HSCPS) score is approximately 30% of that formula and certain ones of the clinical core measures make up the remaining 70% of those measures. The "qualifying period" was from July, 2011 through March, 2012.
8. I do have concerns that there were still loose ends that I found almost daily...down to those few people who 'just didn't think it applied to them" or whatever. I could count on one hand the surgeons that still refused to use the pre-printed SCIP-compliant ordersets...and I knew which CRNAs were most likely to "forget" to document the pre-op prophylactic antibiotic...etc. The retrospective reviewers do not even look at the medical record until long after the patient has been discharged and the medical record has been coded. Way too late to catch any of the omissions. I can only hope for the best for them. Our community needs all of our hospitals to stay open. We really can't afford for any of them to close.
9. As for my job hunt, I went today to the service that the hospital hired to help those of us who were laid off. And I have a brand new, hot-off-the-press resume -- written by professionals! They managed to fit 35 years of nursing experience onto less than two pages! Imagine that!!!?!!!
10. I also have just launched a writing career...with my first fiction short story on Kindle published two weeks ago. So, for the moment, I have two jobs: 1. looking for a job; 2. writing my next story to publish ASAP!
11. As for Obamacare disappearing from the title, hmmmm...guess it was magic!!!! ;-)

Allyna Berry

I had not planned to go there...but, since you brought it up...

1. I already stated in my original article that the irony that my job was created for healthcare reform and then was eliminated due to the same healthcare reform was not lost on me (I guess it was lost on you, eh?) And if you had read it closely enough instead of jumping to unfounded conclusions...perhaps "doing your homework first" as you suggested that I should have done....you would have caught that I already was aware of that.

2. As for "cushy desk job",...I eventually reached the conclusion that with my recently eliminated job, I had not done my job correctly that day unless someone was ticked off at me by the end of the day.
It is not part of my character to thrive by "stirring the pot"...arguing with surgeons almost daily, taking on the medical docs and the ICU docs...not my idea of a good time....but I did it. Having to deal with the Anesthesia folks...talk about a group that thinks they are exempt from everything that everyone else is required to do. If that is your definition of "cushy"...more power to you! May your "cushy job" be waiting for you when you are 58 yrs young!

3. If my body would allow it, I would go back to labor and delivery in a heartbeat. I always wanted to be a midwife....but fibromyalgia got in the way. Now I play by fibromyalgia's "rules." If you don't know what those are, lucky you!