Facing Financial Cut-Backs

[greg in mass]

Are you facing major financial cut-backs in your work place do to the current recession we are in?

1. Yes

2. No

3. Don't know

[NRSKarenRN, BSN, RN]

I work for an independent home care agency that is part of a large Mid Atlantic health system. Two years ago the agency downsized to the bones, nine months after I arrived. Luckily, 2 nurses retired or I would have been out the door.

This week, the health system announced the closing in 2 months of inpatient services & the ER at a 100 bed hospital they purchased 11 years ago. Occupency had been only 30 beds. It had never made a profit in all this time; will keep doctors office space and same day surgical/short procedure services. The staff are offered positions elsewere in the system. Administrations building built less than 5 years ago has been sold and they are moving to the empty hospital space.

The Flagship hospital has been having 15-20% vacancy rate in nursing positions, newspapers reported. They are closing their pediatric unit as 4 childrens hospitals are located within a 30 min drive; 5-10 min medevac ride. Because of the nursing shortage, 2 units are closed and we hear 10-15 patients wait several hours in the ER for beds. A consolidation seems appropriate as the hospitals are less than 10 miles apart, a 20 minute drive.

A new CEO brought in a year ago immediately ousted the previous nurse and physican insensative administration.

A nursing union entered the picture about 5 years ago because of work conditions. Much effort has been spent over the past year to improve nursing relations.

Kudos are given to the staff at the flagship hospital for their beefs with administration have not been taken out on the patients as my families experencies there have been possitive and patient oriented the past year. Parents now prefer this facility over another local one they went to for 50 years BECAUSE it's retained its focus on the PATIENT as a customer in these trying times.

[kewlnurse]

we are having cut backs but it hs nothing to do with the current "recession". It's because of piss poor management.

[willie2001]

Cutbacks started long before the start of the so called recession. The advent of "managed care" started that ball rolling. The recession will probably only make things worse.

[wildtime88]

willie2001,

I would like to point out to you that even with managed care, health care prices have continued to rise as well as salaries and bonuses of the CEOs. Salaries in other health care professions even rose. Nursing seems to be the only profession in health care that has been significantly affected in the long run.

[willie2001]

I was speaking from a nursing viewpoint. You are absolutely right, nursing has taken the brunt of the cutbacks. There is no equity.

[NOAH'SDAD]

Our hospital has just closed the maternity ward and are talking about cutting many more maternal/child care programs. Our cuts are related to local tax cuts and bad management.

[prison_goddess]

This last year I lost two jobs due to financial cut backs. The first of the two was in a clinic. In nevada they do not recognize medical assistance as a certification. They laid off both of the nurses working in the clinic and replaced them with untrained help. Nevada allows for a "medical assistant" to work under the Doctors licence. My second place of employment closed down due to financial problems. I never thought that I, as a nurse would be collecting unemployment. Needless to say, I was able to get gainful employment within six weeks. The down fall is I have to drive 125 miles to work, stay in a hotel for three days, then come home. It beats unemployment!

[Uptoherern, RN]

In the last few months of a new CEO, we have had pharmacy hours reduced from 24/7 to 0600-2100, housekeeping has had a 10 person layoff (they pay so little it took 10 housekeepers to make it worthwhile), our cafeteria has cut operation hours, numerous staff have been "let go" including people who have been employed for more than 20 years in admitting, volumteer services, etc. We all, (of course) suspect that the CEO is making six figures, and will go on to greener pastures once he has cut us to the bare bones. He came from a Vanguard hospital, and did the exact same thing there, before coming to our hospital. So, rumors abound that we are cutting costs to get us ready for sale (4th time since I've been an employee since 1992). Of course, no one will admit that that is what they are doing. Our director of ED just resigned....told us it has become too unsafe, and she will no longer be the bottom line responsible for patient safety... If only the public knew what we know!!!!!

I am writing a letter to our local newspaper, hoping that they will follow up on what is going on. How would you like your mother to stay on our telemetry unit, knowing that the charge nurse is the monitor tech, unit secretary and has total patiient care for five patients????

My unit coordinator in the ER just asked me if I am planning to quit...everyone else is. I told her I have no plans...yet. I will not put myself in a position to endanger my license or someone's life! I am also writing to my State board of nursing: re: nursing supervisors dispensing meds from the pharmacy after the phaarmacy is closed. This is total BS., and nurses have put up with doing more and more with less and less for too long!!

[DethOkay]

In 1997, arround july, the hospital i worked for in Kentucky decided to downsize at about the same time as several hospitals were in hiring freezes. Our glorious nurse adminstrator cut the RN nursing staff by 20% at the time. lab, resp, and pahrmacy were all cut and reduced and we had minimal support staff on days and none on night. On night we had to draw all our blood including the moring 6am labs ( I started at 3am ), give prn resp treatments and compleate our standard nusring care. It was hard on us as we were working on a 36 bed med surg floor with 2 RN's, 2 Lpn's, and 1 tech with a census of 22 to 30 every night. and it got worse, by Sept we had a bad cold and flu season and were running 99% census 28 day out of 30, and most other hospitals were in the same circunstances. We recieved no more support and were told we we not working hard enough. I had a MD tell me the hospital adminstration had CUT the FAT and it would get better.... What happened was the patients complained to L & R and the state, the hospital was fined for inaduquate staff and clerical paperwork errors. But it was swept under the rug by the admin people, and it went on as buisness as usual for 1 week until they reinspected and threatened to close them down.

The end result of 6 months of reinspections and fines was the placement of new nurse adminstator, ALL of the floor department heads were REPLACED, and agency staff, which at that time had NEVER worked at the hospital replaced some of the staff and 80% of the lay off's (yea that what the they called them) were rehired most with a raise.

After that the hospital has adiquate staffing levels, and has added staff in excess of the 1997 levels and supplements staff with agency personell. BUT to ask a admin if there ever was a problem well you never get answer. If as if the problem never existed.

[leesonlpn]

In our little hospital in British Columbia we are way over budget. Rumor says a million buckaroos. We are going from 25 health regions to 5 big ones. Do you see that tornado coming? We have a new provincial government. The new premier has never been hungry or had to do without/His socks probably cost more than my whole wardrobe. They are threatening to roll back our wages granted from the previous government.They are evil enough to do it. Our hospital needs new beds, new equipment new staff, new everything. Miss daisy, I'm afeerd.

[debbyed]

Actually our hospital is doing well, and although "Customer Service" seems to be a bad word here, we attribute our increasing customer satisfaction with our increasing visits which translate to increased admissions. Because of this the nurses have all gotten cash bonuses, wages have increased and non-nursing staff also got somethin extra at christmas. There have been staff appreciation dinners and parties.

Our nursing department in currently in a 5 year plan to obtain "Magnet" status. Over all an awareness of customer service has brought us financial and professional rewards.