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Confessions of a Hospital Administrator: The Good, the Bad and the Ugly

Nurses Article   (14,046 Views 41 Replies 911 Words)
by ServantLeader ServantLeader (Member)

ServantLeader has 25 years experience and specializes in Administrator inspired by nurses.

6 Articles; 7,636 Visitors; 42 Posts

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A look at recent data that explains the impact of uninspiring workplace culture. You are reading page 2 of Confessions of a Hospital Administrator: The Good, the Bad and the Ugly. If you want to start from the beginning Go to First Page.

ServantLeader has 25 years experience and specializes in Administrator inspired by nurses.

6 Articles; 7,636 Visitors; 42 Posts

All of your feedback: lack of nursing input; poor work processes (including info overload); inadequate pay, etc all come down to poor workplace culture. As many of you know, I've talked about this topic in other posts. If hospital administrators want to have a market advantage for which there is little competition, they must address nursing concerns. Nurses will set high metrics they can support given the opportunity. Achieving this end requires servant leadership; this is easy to say and difficult to do. Most hospital administrators are taught to be command and control leaders. Herein lies the root cause of nursing unhappiness and dissatisfaction. Thank you for reading my post.

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NursesRmofun is a ASN, RN and specializes in Registered Nurse.

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I ditto the thought that better staffing would solve a lot of problems. Not all, but a lot. As someone else said in a different way, you can't focus on your most important work while handing out the third cup of ice in an hour to return to explaining, "What's going on with Mom?" while trying to keep the man in the next room from doing a head dive out of the bed while your CNA is busy doing vitals somewhere far down the hall.

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I was just thinking, all these administrators/DONs/other hospital administrative types come here asking what the problem is, and we KEEP TELLING THEM and nothing ever changes. We TELL them we need better staffing, and it NEVER improves. Why keep asking if you don't plan to DO anything about the problem? Because they want an answer that won't affect their bonus for bringing the hospital in under budget, that's why!

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BeenThere2012 is a ASN, RN and specializes in PICU, Pediatrics, Trauma.

1 Article; 6,861 Visitors; 775 Posts

If they REALLY want to know why mistakes happen, I worked 23 years on an oncology unit. I 95% of the time was doing primary care on 6 - 7 patients, and 99% of the time (I can count on the fingers of one hand I when wasn't) I was giving 2 units of blood to at least 2 patients in addition to giving chemotherapy to at least 2 patients, plus the others were usually immunocompromised, and we had one STNA for the 14 to 17 patients. THAT is how mistakes happen!

I can't even imagine. Did you have the second nurse available for checking chemo? How on earth did you manage? Who was taking the frequent VS for the transfusion patients?

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There were two nurses on the floor, one other one plus me. The poor STNA and the nurse on that team (either me or the other nurse) had to do it. So (obviously) breaks and lunch were out of the question, but we still had to clock out for lunches (mandatory) even though we never got them. In all the time I worked there, I got lunch approximately 10 times (as best I can remember.) But it was a pretty good place to work in that we all worked together and "had each others' backs." We had a good crew. And our afternoon supervisor was good, she felt for us even though she couldn't do much. But if we were having a totally disastrous night, she would "turf" admissions to another floor for us (because we didn't complain unless it was a total disaster.)

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BeenThere2012 is a ASN, RN and specializes in PICU, Pediatrics, Trauma.

1 Article; 6,861 Visitors; 775 Posts

There were two nurses on the floor, one other one plus me. The poor STNA and the nurse on that team (either me or the other nurse) had to do it. So (obviously) breaks and lunch were out of the question, but we still had to clock out for lunches (mandatory) even though we never got them. In all the time I worked there, I got lunch approximately 10 times (as best I can remember.) But it was a pretty good place to work in that we all worked together and "had each others' backs." We had a good crew. And our afternoon supervisor was good, she felt for us even though she couldn't do much. But if we were having a totally disastrous night, she would "turf" admissions to another floor for us (because we didn't complain unless it was a total disaster.)

Wow! Everyone....Does sthis situation seem even remotely okay? I'm sure everyone has their own stories, but knowing what I know about caring for Onc patient's (not much), even I can't get a grip on how all this was done safely. Not to mention no breaks. Mandatory clock out for a break you don't even take. Where is the oversight for this? KUDOS to you and your coworkers for handling it as a team.....but then, for those of us who manage to skirt by without conseguences/disasters...we perpetuate the problem. Why change anything as long as remarkable nurses like LadysSolo make it work?

I have to say, LadysSolo, you must be one heck of a nurse to be able to run like this and still catch the potential problems that may come up. You must REALLY know your stuff! What happens when a less knowledgeable nurse comes along with the same expectations from management? Does she get fired for incompetence or loose her career when she makes a mistake? Not to mention have to live with those consequences.

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You make it work because it's all about the patients. I got out on time about the same # of times I got lunch - you could NO WAY keep up your charting under the circumstances, you make notes on the paper on your clipboard so you can chart later. I also am extremely anal about things, and very organized. I also used to joke that my patients were "well-trained," I would check into everyone's room about hourly, and they could ask me for what they wanted then (cut down on call lights), and their families got used to it too (I worked 5days/40 hours/week) so it made things better. I also knew from friends that it was no better anywhere else, so I stayed where I at least had good co-workers.

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ServantLeader has 25 years experience and specializes in Administrator inspired by nurses.

6 Articles; 7,636 Visitors; 42 Posts

When I started as a hospital administrator in 2000, an older guy explained to me about how hospitals were becoming more complex to management: "You know, it used to be in the old days you counted the money in the morning, played golf with the doctors in the afternoon and underpaid all the nurses all the time." He was serious. While I know some good administrators who really care about their staffs, not allowing nurses time to take lunch or bathroom breaks or staffing so charting can be done properly makes me think we're not so far removed from those days in some hospitals.

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SmilingBluEyes has 20 years experience.

2 Followers; 64,796 Visitors; 19,541 Posts

Not to mention, violating labor laws by charging people for breaks they don't get. That would not work with me.

When I started as a hospital administrator in 2000, an older guy explained to me about how hospitals were becoming more complex to management: "You know, it used to be in the old days you counted the money in the morning, played golf with the doctors in the afternoon and underpaid all the nurses all the time." He was serious. While I know some good administrators who really care about their staffs, not allowing nurses time to take lunch or bathroom breaks or staffing so charting can be done properly makes me think we're not so far removed from those days in some hospitals.

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ServantLeader has 25 years experience and specializes in Administrator inspired by nurses.

6 Articles; 7,636 Visitors; 42 Posts

Oh yes, it is illegal. But I have seen cases were doing something illegal was not enough to motivate executives to make changes - they had to get caught, first (this is not widespread, but I have seen it first hand). I had such circumstances brought to my attention once and it brought to light a serious understaffing issue, which I corrected.

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SmilingBluEyes has 20 years experience.

2 Followers; 64,796 Visitors; 19,541 Posts

Oh yes, it is illegal. But I have seen cases were doing something illegal was not enough to motivate executives to make changes - they had to get caught, first (this is not widespread, but I have seen it first hand). I had such circumstances brought to my attention once and it brought to light a serious understaffing issue, which I corrected.

A class action lawsuit (if proven and people banded together)--- would fix the situation and sink their reputation quickly.

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