When the axe falls... - page 2
I live in a town that has had two hospitals for as long as anyone can remember. One was the county hospital (now is run as a business, has share holders etc.) and the other was the Catholic... Read More
Apr 13, '12 by ebearThis is happening to experienced nurses at an alarming rate nationwide, union or not. I was laid off over a year ago with over 30 years experience, MANY certifications, blah blah blah (position eliminated). I've recently had some "amazing" interviews and sat with a nurse recruiter and 5 person peer review panel. ACED ALL the situational questions thrown my way and interviews couldn't have gone any more perfect. Was even told at the end of interview process "Oh, EBEAR! You will be PERFECT for this position with all your experience and personality!" I sent the "customary" thank you,etc. That was 2 weeks ago. Decided I would call to follow up (2nd time) today and was told that the position (s) had been filled. Thank you very much. The ONLY thing that it amounts to is that "they" want a 30 yr old nurse with 30 yrs experience at a new grad salary. Salary wasn't even discussed with me at that time; however, after asking about my yrs of experience, credentials, etc. my opinion is that it all boils down to the bottom line. kcmylorn, I fear that what you have recently experienced is going to be common practice in the very near future. Screw the patient.
Apr 13, '12 by mindlorI think it is fair to point out that a graduate nurse in CA with no experience can expect 36.00 per hour. Not to mention legally mandated ratios. Dont get me wrong. I am all for nurses making huge money. However, these wages and ratios make it very hard for the hospital to stay afloat in an era where govt thinks the best way to save money is by decreasing reimbursement for indigent care and decreasing medicare reimbursement........
Apr 13, '12 by HouTx, BSN, MSN, EdD GuideGreat thread - lots of interesting perspectives.
I just wanted to point out that health care (as an industry) is currently in an economic "squeeze play" due to Federal requirements. The phase one "meaningful use" requirements have already kicked in;which have dire economic consequences for any organization that has not implemented electronic charting systems & sophisticated informatics systems. Physicians supposed to enter their own orders in to the EHR --- yeah, riiiiiight. The 'electronization' of health care is costing kazillions of $ - three guesses as to how this impacts the bottom line of each and every organization that is affected. We all know how disruptive it is to implement each of these technology pieces - and the effect on productivity and quality. Small & independent hospitals are forced to join larger systems that can help pay for all this. Community based hospitals are going the way of the family farm - which are pretty much nonexistent these days as mega-huge agribusiness conglomerates have taken over.
In addition, reimbursement levels are now going to hinge on how 'satisfied' the patients are... tied directly to our CAHPS scores. This is a grim reality despite the fact that there is a growing body of research-based evidence that high satisfaction scores are NOT associated with better outcomes & certainly not lower costs. The only good news (for now) is that ICD-10 implementation has been pushed back to 2014 because that is going to be hugely expensive to implement also. Obviously, the inmates have taken over the congressional asylum.
With all of these factors going on upstream, it's no wonder that nurse staffing is taking a beating just about everywhere. I am a nurse educator also, and I am currently witnessing drastic downsizing of clinical education resources everywhere -- lots of very experienced colleagues are looking for work these days.
Apr 13, '12 by kcmylornAfter what I personally witnessed recently, and have read in the past year- 23 yr old inexperienced nurse during the Kaiser strike in Ca and all other similar episodes in the media, I think it's time the patients and their families, specifically their lawyers, leave the doctor and the nurses out of being the named in a law suite and their role moved to only that of a witnesse to a law suite. It's not the doctors and nurses that control these purse strings and it seems the business suites are the ones that should be held responsibility and accountability. The doctors and nurses are just trying to do their part of the patient care with the limited resources they have.
The business suites are the direct cause of patient's deaths and disfigurements- lack of staffing and educational resourses to bring inexperienced staff up to speed to where they practice competently and safely. Law suits should start focusing on the CEO's, financial dept and the the failure of the risk managment depts to intervene to these purse string holders to make changes in staffing levels and conditions more competent and safe. The budget cuts in these health care systems can certainly come from "other" areas other than those directly linked to patient care. If there were any real competent business common sense floating around these hospitals, the looking for spending cuts would focus on the administrative offices. How about copy paper, paper clips office supplies, CEO and upper managment salaries and benenfits- these things don't kill patients.
The adapation of the EHR in these hospitals is or was 60% reimbursed by the governemnt in the first year and that reimbursement rate drops each successive year after the HITEC initiative to EHR up to the year 2014(I think that's the correct year)The hospital systems just didn't want to part with their money/profits; specifically, the CEO didn't want to take a hit in their salary. Direct patient care personel staffing should be entirely off limits from cuts. These selfish, greedy, 'me' oriented CEO's need to realize,aka, they need an attitude adjustment- healthcare is not about them, their wealthy, priviledged lifestyle, nor that of their families and 'G-friend" or their pensions and retirement- it's about the patient. They keep wanting to make the governement the "bad guy"; specifically the CMS. "Oh, poor us, the governemnt cut our reimbursemnt, we have to layoff some nurses and doctors because after all we have to pay their salaries which are too high" Look at the salaries of the CEO's in the VA and other governement run health care facilities- they don't even come close to the profit mongering commercial healthcare systems- for profit and not for profit It's all a game in symatics. They are all in it for the "profit" of 1 person- the CEO- the one who is never named as the sole defendent in a lawsuite involving malpractice or negligence- in reality it IS the CEO's malpractice and negligence that caused patient harm. Patient salisfaction survey- what a farse that is- it's a indicator for greater bonus margins for the SOB CEO's. What is the golden rule of the EMS- transport the patient to the nearest ED, not the nearest one with the swankiest lobby decor. Joe Public has to start revolting against this spending waste also- 45 million uninsured and under insured. When nursing unions strike- the work get out as to why- unsafe patient care. That's why the administrations want the unions silenced and gone. 45 million against a handful of CEO's- that's quite a war.
Apr 13, '12 by kcmylornAs far as the 'sole' defendent named in a lawsuite- who has the "deepest pockets". The CEO. Certainly not the doctors or the nurses. Who is the one responsible for the decision to cut staff which creates the unsafe staffing levels- The CEO. Not the doctors or the nurses.
The lawyers need to get on this. If the lawyers were to name the CEO as the sole party responsible in patient harm. this may be the catalyst that changes the healthcare industry.They could get the big bucks for their clients.( suing someone whith a mulit million dollar salary vs. the some ones whose salaries range only from $35,000- 400,00/yr) They would have to investigate the interpersonal dynamics of the shift that the insident took place on( the bullying and the root of the bullying, stress levels, # of patient's assigned to the nurse, the doctor, the experience level of those involved), the staffing levels of that shift, the person responsible( the end user) for making thoses staffing cuts. I could see it all coming together quite nicely and with a really big pay off for the patient or family. Why waste time suiting a nurse who makes $35,000/yr when the patient could sue the CEO boss for a much larger payout award for their incompetent business decisions worth for millions.!!!!!!!!!!!!!!!!!