Cost Cutting/Budgeting --- the patients suffer the most

Nurses Safety

Published

So, In an effort to "control costs" the hospital has taken DRASTIC and UNSAFE steps to save money. Honest to God ( NO JOKE) a partial list of the new policies are listed below. There are three 20-bed units on my floor (all general Med/Surg) keep that in mind.

- No more morning and evening shift unit secretary. Now secretary will be 12-hour shift from 9am-9pm. No more secretary on each unit. Now the secretary will spend 1 hour on each unit on the floor ("Rotating").

- No more CNA for each unit. Now CNA will rotate between all three units 1 hour on each unit.

- If a patient need to be a sitter, No more floating extra CNAs or calling in Registry CNAs. Now the CNA will be the sitter. If more than 1 patient is needed to be sitter, the sitter patients will be moved together. If patients needing sitter are ISOLATION and other are NON-ISOLATION, the new protocol is to co-hort the non-isolation "healthy" person with the isolation patient and make sure handwashing and infection control measures are followed. If 3 or more patients need to be sitters, the family conference room will be converted as a multi-bed ward for this purpose.

- No more housekeeping on the units. CNA and RN staff will be preforming housekeeping duties in addition to patient care.

- No more individual case managers per unit --- Now 1 case manager per entire floor.

- 1 Team Leader per floor --- no more individual unit team leader per shift.

Welcome to the new world order - Healthcare Nazi-ism! Enslaved and over worked staff ensure that higer ups can recieve their $5,000 bonus this year.

Specializes in Cardiology.

I NEVER work off the clock! Not by coming in early, working through lunch, or punching out to avoid incidental OT. I work hard and am effiecient. If I can't get it done in 12 hrs, then I can't. I DO NOT work for free!

I NEVER work off the clock! Not by coming in early, working through lunch, or punching out to avoid incidental OT. I work hard and am effiecient. If I can't get it done in 12 hrs, then I can't. I DO NOT work for free!

I'm the exact same way. When I get report I'm clocked in. And if I'm not finished charting or doing whatever needs to be done at the end of my shift I'm staying on the clock until it is completed. If I don't get a lunch I clock no lunch on the time clock.

Specializes in Public Health Nurse.
Sounds like you work for the highly profitable "not for profit" Sutter System to me--or a Hospital trying to copy it's model. I am not against Hospital Groups being profitable--in fact I endorse it as it is what allows California Hospitals to replace aging and earthquake unsafe buildings and to introduce innovations like computerized charting and new surgical instruments. Yet when that profit goes to feed upper management in such grossly disproportionate ways, I draw the line.

I often care for a full load of total care patients with not one CNA. Everyone is so pushed to the max I feel unsupported. No lift teams or even time available to use the poorly supplied mechanical lifts they provide because I am constantly dealing with short staffed pharmacy in a mad scramble to get my patients their meds on time.

And now they want to gouge the RN's by trying to take our salaries and benefits to the 70's. We have been fighting back with strikes just to keep what we have fought so hard to earn. As a trusted care provider I am held to the highest ethical standards yet my upper management has behaved badly, telling boldfaced lies to the media and to their staff. I have never seen nurses so disrespected as they are at my facility. I will have no sick leave when I throw my back out. The upper management has hired bullies and lateral violence has come back with a vengeance in this facility--high quality nurses who have worked there for years and have trained me are being forced out and replaced with travelers from other states. They are enjoying the healthiest profit margins in years, yet cite "poor economy" as they have cut major services left and right.

I rarely get a pee break and chart thru lunch because the staff is so pushed to the max there is little support. This is not safe working conditions--yet Sutter is one of the most profitable "non profits" enjoying a healthy bottom line and huge upper management salaries and perks to prove it. We need to let the public know what is going on at bedside. Resources that should be at bedside are going to the boardroom. Sutter is using gouging staff and draining services in order to use my facility as a cash cow to feel it's upper levels. I am so angry at the unsafe, hostile conditions and lies--the "Nazi" approach you so perfectly voiced--that I feel compelled to take action. I haven't figured out what I'm going to do yet, but we nurses need to go to the media with our concerns.

WOW, this goes on for real? I have yet to get a job, but reading your post is scaring me. Maybe I should go back to what I was doing before and forget my pursuit of the BSN.

Where are the Board of Nursing in this? Can someone not step up and work for this NOT to happen?

Specializes in Tele Step Down, Oncology, ICU, Med/Surg.

We are Unionized for now, but Sutter is trying to break our Union. I was apathetic at the start of this fight over a year ago now, as I'm not a fan of the Union. However, after watching a middle manager with the support of HR bully people who were good nurses (and this is why so many of us clock out on time as the pressure to not incur OT is very high), and after hearing and seeing the lies management was telling to staff and the media about what we earn and about how my bargaining team didn't show to meetings (when they had time stamped video indicating correct room and time), and after laying down huge takeaways and yet refusing to negotiate about them for a full year and claiming they had to lay people off when they are hiring travelers left and right and enjoying record profits, and after seeing my working conditions degrade at the bedside to the point I have to hunt for N95 masks for a TB room and run around looking for bleach wipes for my c-diff rooms, I've just had it and am fighting, stinking mad and have joined the strike line with a vengeance. Jobs are scarce in the Bay Area at the moment but the economy shows signs of improving and as soon as another job opens up within a Hospital Group that treats their RN's as the professionals they are, somewhere with lift teams and decent non-hostile management, somewhere that can still make a healthy profit without gouging the RN's, I am jumping. Until then, I will continue to be a hard working, highly educated and prepared RN who practices in an ethical manner (unlike my management) and support my Union in putting on the pressure on this hugely profitable corporation as much as we all can.

You have a union, I would be writing everything down managment does. Bullying, intimidation tactics to not claim OT for no lunch, staying late for charting, poor staffing( you know what your staffing numbers should be- write these people up!!) the staffing ratio issuses go to the Deptartment of Health- believe me they will investigate- that is their job and they are obligated by law to investigate every complaint they get. The clocking issues and no lunch breaks- that complaint goes to your Department of Labor Wage and Hour commission. You can make these complaints anomonously- they will look into them. Most importantly- stick together as a union. I was a union nurse for 18 years and the hospital succeeded in breaking our union- they refused to go to the negotion table in a strike. They just left the nurses out their on the picket line. The nurses who crossed that picket line thinking the hospital was going to make good on their promises to keep things as they were, these nurses are regreting it now- the nurses are treated like and talked to like trash. There have been reports of one mananger even putting her fithy hands on a nurse and shoving a nurse infront of a patient and turning around and denying she did it. The manager screams at her every chance she get and does this on a daily basis. The nurse is in her 60's and close to retirement, the manager is trying to make her quite so she will loose her pension. If that were me and that manager put her hands on me- they would have to pull me off of that peice of trash. This is nursing managment without a union!!! The manager goes behind drawn patient curtains and screams at the RN's infront of the patient. This manager will tell a nurse to do something and then when the nurse is doing it, she walks over to the nurse and screams at her,"what are you doing? I want you to do that". The new nurses are leaving left and right- they can't keep staff. One of the new hire slightly more experienced nurses 5-6 years was sreamed at and humiliated by this witch infront of a group over a hair band, the nurse resigned after 3-4 weeks. This is nursing managment without a union!! Without that union, there is NO ONE to protect your rights!!! If that union wants support and solidarity- they had better be in managment's face every time there is the first sign of trouble and with pen in hand filling out greivances!! and taking their sorry butts to the NRLB and what ever legal entity they can think of. Many of the older nurses will be lucky to have their jobs if the hospital breaks the union- they will be the first to go because of their higher salaries and pensions. The younger ones will stay until they can't stand it anymore and move on. It is no sweat off managment's back. With this much attrition they are free to do as they please. They like the revolving door- no witnesses, no money lost. It becomes a managment playground- they don't like the way you look, not smiling enough( so help me god, one nurse was screamed at because they were not "smiling enough"), out the door you go. They want nursing beatten down and LIKING it. This is nursing management without a union!! There are very little places where non union managment treats their nurses well, there may not be any in your state. I would also notify the CNA/NNU. Managment is not rational now a days. It's going to take some drastic measures to turn nursings working conditions around. Managment today all over the country is like some one who was stung in the backside by a wasp- because of the CMS decrease in hospital reimburments and the healthcare reform and the crack down on hospital readmissions. That is what they are taking out on the nurses and the doctors to and it does trickel down to the patients. The CEO and their big money making CZARS in administration are not willing to cut their very lucrative salaries- which wouldn't even put a dent in their multimillion dollar paycheck or their lifestyle, they are taking it out of the nurses backs and therefore the patients so they don't have to take a cut.

Why should the CMS pay forfor poor managment aka inadequate staffingwhich cause the patient complications due to poor staffing? So the Medicare system can be bled dry so some CEO can continue to make a million dollar payday. That CEO doesn't need medicare in their old age, they will still live like a king with out it. If that CEO lost their job tomorrow, do you think they will need unemployment?? I know one who had the gonads to collect it- it was published in one of the major newspapers. And unfortunately, will they never be on the receiving end of poor staffing. They have the money to pay private duty RTC. They will never be in a nursing home being one of 60 waiting for their meds or the toilet either. They will have RTC nursing care in their lovely home. I think the CMS is well aware of how much money these top adminstration jerks make and are saying enough is enough buddy. It's a showdown and the nurses, doctors and patients have been put in the middle.

Specializes in Critical Care.
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Welcome to the new world order - Healthcare Nazi-ism! Enslaved and over worked staff ensure that higer ups can recieve their $5,000 bonus this year.

I think you're missing a zero or two. I work for a non-profit where the CEO made a $550,000 bonus last year. The bonus is based in part on how much they cut costs which he did very well; non-contract employees received no raise or cost of living adjustment, and he managed to shift about half of the employer's healthcare contribution to employees, effectively giving everyone a $4,000 a year pay cut, so essentially he gets more for giving everyone else less.

I think you're missing a zero or two. I work for a non-profit where the CEO made a $550,000 bonus last year. The bonus is based in part on how much they cut costs which he did very well; non-contract employees received no raise or cost of living adjustment, and he managed to shift about half of the employer's healthcare contribution to employees, effectively giving everyone a $4,000 a year pay cut, so essentially he gets more for giving everyone else less.

How in the god's name does anyone justify this? A CEO recieves a $550,000 bonus in one year while cutting staff and staff's paultry benefits and salary( paulty, compared to a $550,000 bonus not salary or benefits, including a stock portfolio).

When are these clowns going to be indicted for this? And they have the gaul to complain and criticize CMS for cutting hospital reimbursement.

Have we as a country become that numb to this kind of dealings, that we turn our heads and keep moving? This would not have gone over with the American culture of the 60's. These CEO's would have been exposed loud and clear, a riot would have broke out and it would be on the nightly news what they are doing. They would not be able to carry on 'business as usual' as quietly and as long as they have today. There is something wrong with our contemporary culture. it's a culture of dishonestly- sneaky and mentally ill.

With this order of business, what is the point of nursing research and evidenced based practice. What is the point of nursing education or medical education either? We can't practice the way we are supposed to- there's no staff and no money. I guess the less than perfect should just go in the hospital to be diagnosed and counted"Oh, yes, your sick" Put then in room 123 and don't forget to smile while you draw the cutain and fluff the pillow and left to die. Can't die without the fluffed pillow and the patient satisfaction scores.

I heard a news report a while back where some CEO from texas died in an MVA- you what I thought: Who cares, good the country is one less CEO.

Specializes in Public Health Nurse.

Why is the media not awared of this? They can make the public know this, and there will be an outcry where the CEOs and Hospitals will have to reply to all this non-sense. Lovely, so they cut cost by barebacking the nurses and what they save they put in their pockets to enjoy the luxury the nurses cannot afford. WOW.

It says no more housekeeping on units...

That doesn't necessarily mean that they expect nursing staff to do the housekeeping. Where I used to work and where I'm about to start working there isn't housekeeping on the units...

But you page them if they're needed and they come. In the meantime, they are doing rounds where they're gathering the trash, mopping, etc.

You can't be saying that they expect nurses to fill up mop buckets and clean the floors, scrub the toilets, etc. Nobody likes change, but surely it's not THAT drastic?

Hate to say this but that is exactly what some of my duties are. I work in a private urgent care and they don't hire cleaning people because they expect us to literally fill that bucket, mop the floor and scrub the toilet. Also do patient registration that includes insurance verification and patient call backs the next day.

Granted, we don't get that many patients, average of 20 in 11-hour shift (2 nurses and one doc all day). And our electronic charting system is easy and fast. Oh we also do xrays and lab tests ourselves.

Specializes in Emergency.
How in the god's name does anyone justify this? A CEO recieves a $550,000 bonus in one year while cutting staff and staff's paultry benefits and salary( paulty, compared to a $550,000 bonus not salary or benefits, including a stock portfolio).

When are these clowns going to be indicted for this? And they have the gaul to complain and criticize CMS for cutting hospital reimbursement.

Have we as a country become that numb to this kind of dealings, that we turn our heads and keep moving? This would not have gone over with the American culture of the 60's. These CEO's would have been exposed loud and clear, a riot would have broke out and it would be on the nightly news what they are doing. They would not be able to carry on 'business as usual' as quietly and as long as they have today. There is something wrong with our contemporary culture. it's a culture of dishonestly- sneaky and mentally ill.

With this order of business, what is the point of nursing research and evidenced based practice. What is the point of nursing education or medical education either? We can't practice the way we are supposed to- there's no staff and no money. I guess the less than perfect should just go in the hospital to be diagnosed and counted"Oh, yes, your sick" Put then in room 123 and don't forget to smile while you draw the cutain and fluff the pillow and left to die. Can't die without the fluffed pillow and the patient satisfaction scores.

I heard a news report a while back where some CEO from texas died in an MVA- you what I thought: Who cares, good the country is one less CEO.

About 9 months ago someone in our ICU found the tax records from my hospital online. Since we're a NFP organization, I guess with the freedom of information of act, they have to be available? Anyway.

It listed the top 10 salaries in the company. Our CEO got a bonus that was equal to 50% of his salary. He took home almost two million that year as a result. Meanwhile, we don't have enough money to buy 10 refurbished feeding pumps.

Our CEO got a bonus that was equal to 50% of his salary. He took home almost two million that year as a result. Meanwhile, we don't have enough money to buy 10 refurbished feeding pumps.

That's why he is entitled to that big bonus.

He saved all that money by not buying feeding pumps.

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