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

[abbaking]

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.

[Testa Rosa, RN]

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.

[Forever Sunshine, ASN, RN]

The housekeeping duties that have to be done by the nurses just baffles me.. "aint nobody got time for that."

.. sadly but this is the theme song for nurses these days.

[Silverlight2010]

Isolation and non-isolation patients rooming together to save on sitter costs? Wonder how long that will last after the first lawsuit by an outraged family/ SDM if the non-isolation patient becomes infected. Housekeeping duties? When do they think the nurses will have time for that with all the other cuts? Sheesh.

[wooh, BSN, RN]

Sounds like you work for the highly profitable "not for profit" Sutter System to me--...

Or HCA...

[JZ_RN]

I am a nurse, not a housekeeper. I would flat our REFUSE to do any housekeeping. Everything else is asinine too but that is just degrading.

[SHGR, MSN, RN, CNS]

How silly. Case managers save money, no? And housekeeping makes less money per hour than nursing staff, no? Awesome how the place will shoot itself in the foot trying to save money...while harm patients,and alienating nurses and the community in the process.

[That Guy, BSN, RN, EMT-B]

Hmmm, this might be useful to you

Writing a Resignation Letter

[Ntheboat2]

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?

[kcmylorn]

If you guys live in California- write all this down, with name date and time and send your letters of complaints to the CNA/NNU AND your Department of Health, your congress people, your senators and the media. The manamgnet gets away with this becasue no one comlains or exposes them.

[Anna Flaxis, BSN, RN]

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 part of the problem. When nurses work off the clock like this, it looks on paper like you are capable of handling the workload that is being asked of you.

If just one or a few nurses refuse to do this, then it is easy for them to be singled out as poor time managers.

However, if you create a culture on your unit where your federally mandated rest and meal breaks are taken and nobody stays late to finish charting (or overtime is requested either due to missing breaks or having to stay late to chart), then it will be apparent that it's not just a few "troublemakers" and that the nurses are overworked, and the idea that the nurses can handle an unrealistic workload becomes indefensible.

[DSkelton711]

I have been a nurse for 26 years. No way would I think of becoming one these days. Bless all you newbies out there.