Linda--thanks for your dialogue with me here. If I sound argumentative, sarcastic, or anything else negative, please accept my apology. I have been pretty upset lately over what I see, hear, and read about the situation in nursing.
Yes I am an administrator, I have been a COO and a CEO. Yes I am a registered nurse and have been for 18 years. My degree is an MSN. I worked as a staff nurse in direct patient care for many years. Then became a nurse manager, nursing supervisor, department director, and so on.
Yes the staff nurses know my face and name. Yes I advocate daily for nurses and good patient care. But yes, I have to answer to my bosses who are expecting increasing profits and decreasing operating cost every year. It is really sickening to me to see the financial report and know how much profit my hospital is making every month and to hear and see what administrators and corporate bosses are doing around the country to cut costs and create the impression that things are "fiscally tight" as one nurse put it. The only thing fiscally tight is the increase in revenue that is expected from CEOs every year by their bosses and/or stockholders in their companies.
I pursued and obtained an administrative position so that I could be in position to advance the profession and improve care for the patients. So my comments and ranting and raving is not just all talk, I have taken action, spent many days, nights, hours working on issues, and worked my way into a position to be a decision maker.
I have watched the attempts of nurses to make proposals to improve things, reduce costs, for improvements in their compensation package, new ideas for enhancing services and so on. As I sit in the meetings with my associate administrators, chief financial officer, and other assistants, it is very apparent that the nurses lack the knowledge and skill to "sell" administrator-types on ideas they have. I know that is a broad statement, but, nurses in general don't have the financial knowledge to do all of their homework and present quantitative data that links nursing interventions to patient outcomes to improved operating margins. Administrators will listen to that kind of presentation and take action.
I go about, on a daily basis, the business of encouraging nurses to continue their education, to enhance their knowledge of the healthcare system, to know more about the environment we are working in, to learn about the people that are actually running the healthcare system, to arm themselves with information that will make them more effective in promoting their ideas. Reality is that most are so busy at work that when they get off from work they are exhausted, burned out, and the last thing they want to do is read about healthcare finance and corporate structure etc.
I interface daily with corporate executives and other hospital executives and I am extremely concerned and alarmed with what I hear, what I see, and the decisions that are made concerning the nursing workforce. I don't think that most staff nurses out there working for a living from shift-to-shift realize the forces that are at work and how that could impact their job as a nurse. No other discipline in healthcare is going to advocate for us. As a matter of fact, other disciplines (collectively speaking) have been chipping away at nursing for a while and continue to do so by absorbing things nurses used to do. Many other departments find nurses very difficult to deal with and are not really supportive of nursing. Administrators are not going to advocate, doctors aren't, pharmacists, physical therapist, etc. Nurses are going to have to do it for themselves and are going to need to learn how to do it effectively. We need some help with good, credible studies that can be put together with reliable financial data that can demonstrate that nurses help hospitals generate revenue, not simply consume resources.
Thanks for your comments and forgive my lengthy and sometimes heated/emotional posts. I am just very passionate about this.