HCA Profits Soar as Patient Care Suffers - page 3

Just read this article about the HCA corporation. I've never worked at an HCA hospital but have heard plenty of negative comments about them on AN. I'm also from the area in South FL discussed where HCA hospitals about, and... Read More

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    I was just in the hospital (HCA) last week for a cholecystectomy and ERCP. First room I had was a 4 patient room, second time it was a private room (weird the difference a floor makes I guess).

    The problem I have is that they fired almost all of their CNA's and replaced them with volunteers (yes some of them are desperate new grads). They have a very small inhouse group of CNA's to either work the floor or be a sitter, any time they need extra they hire from a registry. I was not really affected by the CNA situation, but I would think that if I needed to be cleaned or turned I would be SOL. All nurses had the max 5:1 so they were basically making a big circle passing meds and controlling pain.

    So my stay wasn't awful, but I also didn't need a whole lot. Those were just a couple of my observations and some of what the volunteers/nurses shared with me.
    Not_A_Hat_Person likes this.

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    WOW! A for profit using free labor. The sad part about that is those new grads can't even use that to work off scholarships (HRSA/NSP) and loans . What nerve. I'm so glad a got out of there.

    Quote from lrobinson5
    I was just in the hospital (HCA) last week for a cholecystectomy and ERCP. First room I had was a 4 patient room, second time it was a private room (weird the difference a floor makes I guess).

    The problem I have is that they fired almost all of their CNA's and replaced them with volunteers (yes some of them are desperate new grads). They have a very small inhouse group of CNA's to either work the floor or be a sitter, any time they need extra they hire from a registry. I was not really affected by the CNA situation, but I would think that if I needed to be cleaned or turned I would be SOL. All nurses had the max 5:1 so they were basically making a big circle passing meds and controlling pain.

    So my stay wasn't awful, but I also didn't need a whole lot. Those were just a couple of my observations and some of what the volunteers/nurses shared with me.
    Not_A_Hat_Person likes this.
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    This comment really isn't about HCA, but when I read lrobinson's post "desperate new grads," I had to mention that I recently was put down and flamed (not on allnurses!) because I said to someone "there is currently not a shortage of nurses, many can't find a job." One person I was speaking to said, "how ill-informed you are! There is a well-documented shortage of nurses, blah, blah, blah." (Failure to see the big picture.) Now, about HCA, I would be surprised if a volunteer was allowed to do actual, hands-on patient care. Isn't that setting them up for a potential lawsuit? I'm not saying they can or they can't, I am simply wondering.
    Not_A_Hat_Person likes this.
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    Quote from applewhitern
    Now, about HCA, I would be surprised if a volunteer was allowed to do actual, hands-on patient care. Isn't that setting them up for a potential lawsuit? I'm not saying they can or they can't, I am simply wondering.
    That's what you would think, yet there they are, helping with clean-ups. Maybe they are not "allowed" to do it, so if a potential lawsuit comes up they can claim it was the employee being reckless and operating out of their scope of practice. Don't get me wrong, the nurses generally buddy up with other nurses to do most of their work, but on such a crazy busy floor I think it would be hard to say no to an extra pair of hands.

    I think I might look into it further to see what they can and can't do. I definitely was saddened that many a new grad take volunteer positions and CNA jobs after they graduate. I am not knocking the job of a CNA (I am one), but it just feels like you could be so easily taken advantage of.
    Not_A_Hat_Person likes this.
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    I used to be a traveler. Worked at a few HCA facilities....there were issues that I did not like, for example, we had to ask permission to draw blood, or start an IV. Now, as an experienced ED nurse, I usually knew who needed an IV. I felt very frustrated when someone who was having a clear problem came in and I had to sit on my rear waiting for "permission"

    THere are really some issues with HCA. Then again, there are really issues at each hospital...
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    This may not be a very popular thing to say, or there are those who may think this is way out there: but, one that needs to be explored with reference tp " the issue of new grads working for free or any other nurse for that matter" This phenonmenon would be considered a form of Human Trafficking aka Debt Bonding.

    Look up the definition of Debt Bonding on Wikipedia go all the way to the bottom and look at the other links and you will find "Student Loans" listed. Corporate Healthcare is using the vulnerablities and desperation of nurses- new grads with student loan debt to intice them into taking positions for free- work for free and offering them the sacred acute care experience to gain their first job, or nurses who have been out of the acute care area for more than 2-3 years to entered into a free labor force position.

    Look at the nursing wages in this country and what has happened to them- flat, no raises to keep up with the economy or gone down, look at the messages sent out there about nursing unionization which had significantly fought for and protected those wages, look at the staffing conditions and the unsafe practice enviornemnts in our hospitals- its not just one hospital but many and unsafe is more the norm than not. Look at the federal healthcare trend in the change of focus from acute care to primary care and what does all think that is doing to the profits of the acutecare healthcare corporations in this country- cutting down on their profits( more patients being treated in the community and less in the hospital) and acute care healthcare corporate leaders are not supporting this shift of focus to the primary care model. Why is there not an abandonment of the old business practices( on the part of the CEO and the MBA in the financial depts of the healthcare corporations) that are not working for these healthcare institutions now a days- cut the direct care givers positions to "save money due to the economy and high cost of healthcare" . Why is it that doctors and Public health prepared professionals can come up with inovative, and on target plans to give cost effective and more common sense approaches by utilizing data mining, case management a and disease managment( essentiall RN positions) to the war on chronic diseases while cutting healthcare costs to treat diabetes, morbidly obese, cardiac disease medically complex patients in under served and uninsured areas of this country- the very patients they accuse of bleeding the healthcare dollars out of these institutions?

    Corporate Healthcare America is without ethics and scrupples. I most definately think this is corporate healthcare's take on the "round about way" around the human trafficking laws in the US. First we have importing of foriegn nurses to take less paying jobs and they don't speak up like an american born nurse would, thus are willing to take any line of crap the CEO and the hospital adminsitration can fling at them and out of fear of loosing that workers permit and being sent back "home" to a country will worse working conditons and poorer wages. Now they have squeezd and shut down the new grad entry level into the hopsital envirorments, forced out the older nurses and locked out thoses who would re enter afew years of absence. Hense the only way to gain access is through taking the offering of "free labor workforce" Are these free labor job positions counting as current RN experience or the reuirement: atleast 1-2 yrs acute care experience qualifiying them to gain a first position??? on their resumes???? Who knows???

    This issue will not be fought in federal courts but will have to be fought against by the nursing profession. Why because the lawyers for these CEO's have found ways around these laws. and the nursing profession is not up to/equipped/prepared to take on this kind of an undertaking to stop it. Leaving the nursing workforce vulnerable to exploitation!!
    JMHO
    Last edit by kcmylorn on Aug 18, '12
    emdrn74, wooh, and Not_A_Hat_Person like this.
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    Quote from lossforimagination
    Consider the source...NY Times. Uber liberal paper which will always demonize big business. That said, I've worked in several hospitals, and they were ALL understaffed.
    Why don't you try considering the content? Do you think the people quoted in the article were misquoted? Has your own research shown that their facts and figures were wrong?

    The bottom line, as was obvious when HCA bought the hospital in which my father worked, was that profit was the front-and-center concern. That makes sense, since as a public company, their fiduciary responsibility was to their shareholders, and not to patients, the community, or any other entity. Now that HCA is owned by a private equity firm, it's business as usual, but more so.

    I'm still trying to find a privately-owned, world-class hospital. One that's of the caliber of the Mayo Clinic, Mass General, B&W, Sloan Kettering, MD Anderson, Stanford, UCLA, Cedars Sinai, etc. Where are the shining examples of how the tangled ball of perverse incentives can be made to work?

    Do a handful of random nurse's anecdotal experiences negate all that?
    wooh and Not_A_Hat_Person like this.
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    Quote from emdrn74
    WOW! A for profit using free labor. The sad part about that is those new grads can't even use that to work off scholarships (HRSA/NSP) and loans . What nerve. I'm so glad a got out of there.
    Unless the worker is getting either pay or academic credit (or both, which would be quite rare), how is that legal? How is it not a violation of labor laws?
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    I wonder how much of that profit came from unnecessary cardiac procedures?
    wooh likes this.
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    Quote from tamadrummer
    Don't believe everything you read in the paper. I did my mental health clinical in an HCA facility that is of the highest quality available and half my class did critical care and leadership in another HCA hospital. Both hospitals are fantastic places for patients and nurses. Just because a company makes money doesn't make them horrible, and because they make money doesn't mean another place has to suffer. I did not notice anything lacking and never heard staff whining and complaining that the evil shareholders and 401k retirement plan holders that are invested in healthcare are stealing supply money for themselves. The newspaper is going to slam anyone making a profit as evil. I don't work for them only because they are almost 2 hours from me, I hated driving there for clinical but the experience was fantastic!
    For the record the NYT has been rather ecumenical in it's *attacks* on hospitals/healthcare systems.

    Wyckoff Medical Center, NYU-Langone, NYP, and other systems in both New York and beyond have been called out for one thing or another by the paper. You can find links to some of the stories posted by Moi elsewhere in the "News" forum.

    IMHO had the NYT left out the bit about Mr. Romney the piece would have seemed a bit more impartial, or if they mentioned it as a matter of disclosure rather than within the first few paragraphs.

    It is no secret to those of us in NYC and one assumes elsewhere that the "Old Grey Lady" has taken a rather liberal, some might even say extreme liberal tack over the past decade of so. While the NYT editorial staff and others have often taken pot shots at Mr. Rupert Murdoch and his Wall Street Journal (amoung other holdings) as not being able to be impartial, the NYT often speaks out of both sides of it's mouth on that matter.

    People probably wouldn't really mind if the NYT stopped playing the noble and better than thou act, but time and time again they are caught with their trousers down and have to publish a correction or apology. For the record IIRC the WSJ is doing well if not alright financially, however the NYT is not.


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