Budget-Cuts my Butt!

[HeroOfNone]

I work for a large multi-specialty clinic w/ 12 doctors, 9 PA's/NP's and 30+ nurses. All of the nurses are CMA's w/ the exception of the two nurse managers who are RNs. At the beginning of the year we received a company-wide email stating that due to the new health care reform we may not be getting raises this year and that we would be notified of the decision in the coming months. A few weeks ago another email came out stating basically the same dribble, that raises are uncertain and will be determined at a later date. I am well aware how the new reform could potentially hurt the clinics profits, but this is what really bites my butt...

Over the past year and a half the clinic has undergone reconstruction/remodeling. Mostly just redecorating in my opinion since we only gained and extra 6 exam rooms per floor. Butt gosh the place sure looks purty. We were given a beautiful break room w/ windows and a computer w/ printer for leisure purposes. I guess we should consider this our bonus? I got friendly w/ the foreman's assistant and discovered to my horror that all of this "necessary" remodeling has racked up to a hefty 2+ million dollars. This would include hiring the attractive decorator who walked around w/ the maintenance man who watched him hang obscenely expensive art on the walls for three days, and a gorgeous but also obscenely expensive couch that sits uselessly outside the elevator lobby.

During lunch the break room conversations is almost always focused on how the nursing staff is disgusted that we will, in all likelihood, not be getting raises. In the mean time the doctors and other providers have already received their quarterly bonuses and there is rumor that we will be hiring two new specialists (cardiologist and GI). It's obvious that the clinic is NOT strapped for cash. When the nurses try to wrangle me in to one of theses conversations I state what I have stated from the beginning. Strike. This word brings fear to thier hearts and understandably so. We do not have a union, though I have encouraged time and time again that we need to form one (for reasons beyond the threat of not getting a raise). Our biggest problem is that we are totally replaceable. For every insulted nurse who tries to rage against the system, there are 8 unemployed nurses jockeying for position to take our job, and the company knows this. I do want to fight. I want to stand up and defend my fellow co-workers (receptionists and coders included) but unfortunately, NO ONE will stand beside me. Seems like everyone would rather take the abuse than take a stand. And if I were to lead the charge then I would be instantly fired (they'd find a reason) and made an example for others who might find a speck of courage or pride.

I dunno...I guess I'll just do what the other girls are doing and start looking for a private practice who will pay me a respectful wage. In the mean time though, my colleagues are showing the powers-that-be that they will be the lemmings they want them to be. Is there ANY way I can encourage the nursing staff to be bold or is it a useless cause? I'd love advice from a seasoned veteran who's been in this type of situation.

Thanks for listening.

[wooh, BSN, RN]

and 30+ nurses. All of the nurses are CMA's w/ the exception of the two nurse managers who are RNs.

So not 30+ nurses. 2 nurses and a bunch of medical assistants?

Here's the sad fact of life. Doctors, PAs, NPs= More money in. Nurses, medical assistants= More money out.

As long as you're replacable, you have no power. You have to do something that makes you worth keeping. Generally that means skill/talents that are well above average, or the willingness to take less money and shut up and be quiet about it.

[caliotter3]

Even if those MAs and coders were RNs, they probably are very cognizant of the fact that their job could be given to someone else at the employer's whim. You won't be able to get any action out of any of them.

[roser13, ASN, RN]

" company-wide email stating that due to the new health care reform we may not be getting raises this year company-wide email stating that due to the new health care reform we may not be getting raises this year "

That's interesting - I'd love to hear how that reasoning works. Reminds me of how my clinic employer used the recession as a reason to withhold raises for a year, even though our business had not decreased in the slightest.

"All of the nurses are CMA's"

Do you mean Certified Medical Assistants? If so, your sentence doesn't make sense to me. MA's are not nurses. I'm guessing your practice is one that enourages my pet peeve: unlicensed personnel (cheaper than nurses) calling themselves nurses. Obviously you feel that you are functioniong in the nursing role.

"Seems like everyone would rather take the abuse than take a stand"

What abuse? The lack of a raise? Hardly abuse. Other than that, it sounds like a pretty nice place to work. If lack of raise is your only issue, I'm not sure I would consider leaving. As you yourself stated, there are 8 others to take your place. Those 8 might consider your position pretty cushy, especially if they get to call themselves nurses.

Has it ever occurred to you that spending money in the short run in order to stay competitive in a patient-serving market will benefit the practice (and you) in the long run?

[wooh, BSN, RN]

What abuse? The lack of a raise? Hardly abuse.

Yeah, last year, "because of the uncertain economic times," our yearly raise was postponed, then it was 2% for everyone. (This year, with raises back in full force, I got a whole 3%!!)

Of course, there was money for remodeling and other cosmetic things. Supposedly it costs $40k per room to deep clean and paint them. That doesn't include any kind of remodeling. Which I find ridiculous. I'll happily paint and deep clean for half that. They've also instituted some new policies that make us unhappy, because they know with this economy, we aren't going anywhere.

So I understand the annoyance with a lack of raises when obviously there's some money available for other things that seem wasteful. (Like our hospital system's full time decorator.) But it's not abuse. And when people depend on their job, no raise is better than no paycheck at all.

[meandragonbrett]

First off, CMAs are NOT nurses.

Secondly, be glad you have a job.

Thirdly, the MD, PA, and NP bring money into the practice. What money do you bring into the practice to keep it running?

I see no abuse here.

[GaMBA]

" Is there ANY way I can encourage the nursing staff to be bold or is it a useless cause? "

I hate to say it, but I think it would be a useless cause on your part. As I understand, this is a privately-owned business, meaning the people who own it can spend their money as they please. If they want upgrades and remodeling rather than raises for their employees then unfortunately for you guys that's how it is. It may not seem fair to you but that's the reality of working for other people.

Also, given the current state of the job market in general, I doubt you will find too many people ******** and moaning to their employers about anything, much less not getting a raise. Like others have said, most employed people at this point are just thankful to have a job to go to. If these people you work with like their job, like the employer and are content, you will be hard-pressed to get them on your side. And you can forget trying to persuade those who are their family's breadwinner.

Like another poster suggested, maybe refocus your efforts on making yourself a more marketable candidate who can command higher wages on the job market. in general, jobs pay what the market says your skills and experience are worth, which may or may not be what YOU think they are worth. Continue to build yourself in terms of what you have to offer and opportunities will open themselves up.

[Chisca, RN]

I think you may have seen Norma Rae one too many times. Even if you were to go on strike you would quickly be replaced as the market is saturated with nurses. The market determines your wage and unfortunately it isn't what you think it should be. The three things I look at in a job are wages, convenience, and professional satisfaction. If I can get two of the three I consider it a job worth keeping.

[Nurse SMS, MSN, RN]

Hiring more MDs makes sense. They bring in more money. That has nothing to do with you other than providing you with greater job security and making you more competitive away from there if you choose to go elsewhere. Them spending money on decorating has nothing to do with your salary or lack thereof. They are two totally different parts of a business budget driven by two totally different sets of goals and resulting in completely different liabilities on the bottom line of the business. You can't just take money from one column and plug it into another and have it make sense from an accounting standpoint. They budgeted for decorating this year and got the financing to make it happen. They can't finance you and your colleague's salaries and then amortorize it over the next five years like they can office improvements and business loans. Chances are the decorating decisions were made based on a forecasted FUTURE profit level that the next doctors will help to bring in and based on a higher end clientele that they hope having a modern looking office will attract. None of that changes the likely fact that in this economic climate right this moment, things may not at all look rosey. And often bonuses are written into employment contracts in certain ways and must be paid whether it is economically wise at that moment or not. Witness the CEOs that have come under scrutiny after our recent catastrophic collapse of the economy, who got bonuses in spite of losing money hand over fist.

A few business classes help make all of this make more sense. You just see them spending money. Likely the money they are spending is via carefully calculated loans based on a five year financial forecast. It has nothing to do with you or your salary unfortunately. I mean this kindly, but yes, you need to be grateful to have a job and recognize how replacable you are. If you are unhappy, start looking elsewhere. Everyone else at that level of employment is replacable too and you will likely find another position in time. Best of luck and I am sorry you are unhappy.

[roser13, ASN, RN]

"Even if you were to go on strike you would quickly be replaced as the market is saturated with nurses"

This post would be applicable if you actually were a nurse. As it stands (to my understanding), you are currently operating outside your area of expertise and actually should be glad to have the job that you have.

[JennRN65]

CMA's are NOT nurses.

Your employer is not required to check with you when they complete projects that may or may not increase the value of their practice.

Please stop calling yourself a nurse. According to your post you are a Certified Medical Assistant and it is illegal to pretend to be a licensed professional nurse.

[RNYC]

RNs = complete and total overhead?

Yeah ok. Take them out of every hospital in America and then see how many people use those hospitals for care lol