These are some great replies. I wonder if the bottom line isn't the incentive behind the VP's comments? Return on investment. I had an incident that is related.
When I began my nursing career if I did what was the best for the patient, and I didn’t step on the doctor’s toes too much, then everyone thought I was doing a fine job. Now, when my supervisor, a member of the ruling class in one of these healthcare conglomerates decides I no longer am doing what is best for the company or as is currently explained ‘not a good fit for our organization’. Then they can fire me ‘for negligence or incompetence’ as they were the ones deciding the definitions. The healthcare organizations can also ‘weed out’ the nurses who become too smart or compassionate or the personnel that require too much pay that would threaten the profit margin of the institution. Which explains why there continues to be a nursing shortage if nursing schools are churning out graduates at a breakneck pace? I continue to see ads for nurses and pleas from nurses who can’t find a job. There seems to be a disconnect.
I have recently found out that my state Board of Nursing has the same investment in these healthcare conglomerates. I recently had a hearing to determine if I was negligent and incompetent. The accusations were: 1) I neglected to write down one value in a list of vital sign values present on the evidence. The evidence did not include the nurse’s notes, which could explain why the value wasn’t entered (the wave form could have been abnormal or the value could have been faulty). The evidence also didn’t include the physician’s assessment of the patient at that time. The accusation also implied my inaction caused the patient to die 7 days later. 2) That I had knowingly disabled monitoring alarms. Alarms are going off all the time in an ICU. When I respond I turn the alarm off since it has served its purpose in alerting me. There was no death mentioned with this accusation. 3) That I had responded to an alarm only when the daughter of a patient alerted me. I was documenting the care delivered to this point and was finishing a sentence. The daughter was very aware of her father’s condition and I considered her interest in his condition as more than mine. And, since I was sitting in front of the patient I was quite aware and expected this alarm to happen as the patient’s heart condition indicated it was more than probable. The treatment was the same regardless. No one died.
What the accusations didn’t mention was my supervisor threatening me with Board of Nursing notification when I told her I would quit because I wasn’t able to deliver quality care in this ICU. My patients and their families always come first and if I can’t perform by own principles and morals; it is time for me to leave.
I was more than a little surprised at the hearing when the Board of Nursing objected to my statement that other nurses declined to be my witness as they feared retribution by the healthcare organization. I wasn’t something I would make up. I was under oath.
To complicate employment matters even more for me was my self-reporting alcohol addiction treatment to the Board of Nursing, as required, and placed on 5 years’ probation. I didn’t complain. I just wanted to do the right thing. I was dismayed to discover no healthcare organization in this metropolitan area would hire anyone on probation. I have been without a job for over 2 years. I am working on another degree in another profession, but can’t get a job anywhere (one business hired me, I was in orientation, then told I couldn’t be hired without an explanation when I asked.) even McDonald’s. I will soon be living on whatever social aid I can get and become a burden on society. This doesn’t have any logic. If I am such an incompetent nurse: why didn’t it come up before 30 years? Why didn’t it come up previously at mentioned healthcare institution before being employed there 4 years? If, indeed, I was incompetent and negligent why didn’t they contest my unemployment compensation?
These are the questions that keep me awake at night and fear for the quality of healthcare in this state and country. The current rankings by various healthcare monitoring organizations make perfect sense to me. I have been present and seen the changes.