Bonus Checks for Marketing...More Pain for Nurses!!

[Emma123]

I work in a LTC/Subacute Rehab Unit. Typically I'd have 19 patients or so. Now I have 28. One nurse. Manager is in meetings all day for the most part, so she can't help too often.

I have to say: I am getting really stressed. I'm feeling frustrated. There's so much charting, PRN's, etc. I send out a patient to the hospital on almost a weekly basis, so it's not like these patients are stable, long term care people with naturally occurring ailments.

So I approach my unit mgr and tell her about the stress I'm feeling. She says it happens all the time when the census is high; the nurse on the floor gets stressed, and then there's a lot of call-ins. Yes, I can see that. Burnout City. If they know this happens, why don't they do something about it? I told her I get nearly nauseated when the marketing girl comes strolling down the hall with her pleasant radio-d.j. sounding voice, heels click-click-clicking down the hall with flower in a vase in hand, ready to hand over a new admission (during med pass with roughly 10 diabetics who are unstable). I nearly want to each time I see her coming.

They have a BUDGET (for profit organization) they have to adhere to.

SOOOOOOOOOOOOOOO....When I learned that the Marketing girl.....gets a BONUS CHECK....thus the smile on her lovely face.......for increasing the census....thereby bringing more money into the facility.....

Can you imagine my disgust?

Is this typical? Is this the norm? Throw your front line troops (nurses and Cena's) under the bus, burn 'em out, fire 'em, re-hire (this is the norm where I work; the turnover is HIGH).......and....

GIVE BONUS CHECKS to the non-clinical staff who have no clue how hard we work?????

I've been written up for overtime. How do I manage to cover my butt (chart), get all of my work done (believe me, my pace is beyond fast; I race down the halls), and not have overtime? I get told, "We are a 24 hour facility...pass it to the next nurse." (Yah, and have the next nurse pass on to the next....then when there is a care conference they pick up on the fact that some of the admission paperwork is incomplete, and "Why wasn't this done? Why wasn't that done?"

Sorry. I just had to get this off my chest. The only thing that keeps me going there is the learning experience, I like most of the girls I work with, the commute is not bad at all, and it's a job in this hard economy. So, I probably should just bite my tongue and be thankful. I know.

But seriously...bonus checks?

Where's OURS?

Thank you for listening,

Emma

[classicdame, MSN, EdD]

Your administration is out of touch with reality. If there are no nurses then there is no nursing care and no need for any marketing. Maybe you need to talk to someone above your supervisor's pay grade, with the supervisor in attendance, so you can get some straight answers. Don't bring up the marketing person or you will sound jealous and petty. Just give the facts about staffing, acuities, nursing standards, etc.

[diane227, LPN, RN]

I worked for a for profit hospital for about a year as the ED director. We had certain standards that we had to meet such as getting an EKG on patients with chest pain within 5 minutes of arrival. Occasionally we would all have these big regional meeting to see how we were all doing. We were a little over the standard, by about 2 minutes. So this cardiologist, hired by the for profit hospital system was telling us that we had to do better. So I asked him to give me some data regarding outcomes. Was there a difference between the outcome of a patient who has received an EKG in 5 minutes vs. 7 minutes. He did not know. So I asked him what this was all about them. He sort of looked down at the floor and some of the upper management folks from the corporate level were just standing there and I was standing up waiting for an answer. Finally he admitted that it did not matter to patient care but if we did not meet the standard the CEO of our particular hospital would not get his bonus. I almost walked up to the stage and strangled him.

[Rascal1]

I'm incredulous ...,that patient care and safety appears to be of no concern to the powers that be. Meet with the higher authority. They would have to be brain damaged to not understand your concerns. And marketing needs to be in communication with you or the manager regarding the appropriate timing of a new admission. Good luck ....

[StNeotser, ASN, RN]

This facility is just interested in the money, and not in patient care at all, obviously.

Our charge nurse refused to accept report from the hospital on a new admit who was TPN, needing q1hr accuchecks. The reason? Patient was meant to go to a floor where there was one nurse to 25 patients. After arguing with the admissions office who saw no problem with this scenario, she just refused to accept the report.

Perhaps the admissions manager was just looking out for her bonus too?

[RN1982]

And the more we give in to this kind of crap, the more oppressed our profession will be. Neo, you did the right thing by refusing. I would have too.

[firstyearstudent]

I think it's time for you to .... go into MARKETING!!!!!!!

(Do you know how to lie real good?)

[Emma123]

I couldn't refuse to accept report. As for the timing of new admissions (I've already tried to inquire about timing), they tell me that we have to take them when the hospital discharges them to us. We have no choice.

I guess my biggest problem with this scenario is what was described by the earlier poster, in the bonus check for the powers that be.

I cannot tell you how many UTI's our patients have developed...duh...when they have to urinate and they put their call light on and it's on for 15 minutes if not more (then a family member comes to hunt me down as I am getting an I.V. flushed), I am embarrassed.

I care about patients. You'd think that as many patient surveys that have been done and the overwhelming response is that they need quicker response to call lights....they would see.

But...unfortunately here in Michigan (maybe all states; I'm not sure), there is not a mandated nurse:patient ratio in long term/subacute rehab care. Seriously, 28 patients???? All who have legitimate needs that should be met in a timely fashion. One nurse, struggling to meet their expectations. It's sad.

All they say (TPTB) is that they "have a budget to adhere to". Again, so why the bonus checks for the marketing deparment????????

To add insult to injury, this same marketing individual says to me, "Make sure the bed in room 350 is made." The new admit's room. Why do they delegate that to nursing staff? We're busy trying to do patient care. She walks slowly away and chit chats....someone should teach her how to make a bed.

Thanks for listening.

I appreciate the advice on meeting with the higher ups....but trust me when I say they are patronizing, stubborn, refuse to listen, are always right, and it's all about the dollar.

Emma

[Emma123]

Isn't THAT the truth!!!! Regarding the (Go into marketing....lie real good) post.

[BradleyRN]

Management at facilities nationwide deserve Oscars for their performances, pretending like they dont understand why we are complaining about having too many patients. There is no point in meeting with them, unless your cable tv is out, and you need some entertainment.:)

[StNeotser, ASN, RN]

Emma, we have no staff to patient ratio mandate either in Colorado.

Our LTC is accepting all kinds of inappropriate patients right now, people who really need to be in gero psych instead or people who really still need to be in acute care. We also have many new admits to the sub acute and rehab floor who spend less than 24 hours with us and then turn right round back to the hospital.

I really don't think adequate health care and profits and bonuses mix very well. I mean, most nurses never went in to it for the money.

Also had the DON call up on a Sunday to ask if the nursing staff could give an empty room a quick clean for a new admit. The previous occupant had died less than 24 hours before and had respiratory MRSA as well as MRSA in the urine. Hmmm.

[RN1982]

The longer nurses are passive about the abuse that they receive from administration, the longer the oppression continues on our profession. It's time that we stand up for ourselves. If I worked in the LTC where Emma works, I'd march right into the DON's office and demand to know why marketing personnel get a bonus yet there is 1 nurse for 28 patients. It's sad to say that many nurses put up with this instead of telling the DON "look if you don't do something like get more staff or supplies then I'm leaving". Because no matter what, you can always get a job somewhere else.