Should nursing charges be separate from the room charges? - page 3
I have been wondering about this for a long time. Nursing services are routinely included in the room charge for patients. Now we all know that some patients require A LOT more nursing care than... Read More
Mar 9, '03How about the tough IV sticks, NG tubes or Foley catheters. At my hospital, if the doc inserts them we can charge extra, but if you get the skills of a 20 year RN we can't charge. Doesn't make any sense.
Mar 9, '03Originally posted by canoehead
How about the tough IV sticks, NG tubes or Foley catheters. At my hospital, if the doc inserts them we can charge extra, but if you get the skills of a 20 year RN we can't charge. Doesn't make any sense.
Mar 9, '03some food for thought articles:
1998: nursing nomenclature and classification system development
classification is a rather new idea in nursing. it began as a movement to develop a language that would describe the clinical judgments made by nurses. there was great support by clinicians for describing problems that nurses are educated and licensed to treat which are not in medical language systems. currently there are major efforts nationally and internationally to develop a nursing language system that includes nursing diagnoses, interventions and outcomes. these are the basic elements in a nursing classification for practice, minimum data set for health statistics, in costing out patient care, developing computerized patient records, and for education and research.
gordon, m. (sept. 30, 1998): nursing nomenclature and classification system development online journal of issues in nursing. http://www.nursingworld.org/ojin/tpc7/tpc7_1.htm
1998: the international classification
for nursing practice project
the rationale for standardised languages and classifications for nursing applies all over the world. development in the usa was earlier than in other countries because of the imperatives of reimbursement systems, accreditation; and litigation. however, translation of languages developed in and for the usa may not be appropriate for other countries' practice; cultures, or health care systems. many countries are already developing their own systems in their own languages, but others have no system. the international council of nurses' project to develop an international classification for nursing practice will provide a unifying framework for existing systems and a system which can be used in countries which have none. only when we have such a tool will we be able to describe and compare nursing practice across nations, and test the commonalties and differences of its concepts, values and practices.
clark, june dbe, phd, rn, rhv, frcn (sept. 30, 1998): the international classification for nursing practice project online journal of issues in nursing. http://www.nursingworld.org/ojin/tpc7/tpc7_3.htm
2001: classifying nursing work
...the erasure of nursing
nursing work has traditionally been invisible, and its traces have been expunged at the earliest opportunity from the medical record. this has been accomplished both externally, by hospital administrations, and internally, by nurses themselves....
bowker, g. c., star, s. and spasser, m. (march, 2001) "classifying nursing work" online journal of issues in nursing. available http://www.nursingworld.org/ojin/tpc7/tpc7_6.htm
other articles can be found here:
what's in a name?
this current posting of ojin brings to light issues on standardized nursing language, vocabularies, and taxonomies. the need for a common language to communicate with consumers, health care providers and policy makers on both national and international levels is long overdue and is essential as we approach the 21st century. authors in this issue concur that a common language will improve the delivery and documentation of patient care and enhance research efforts.
Mar 9, '03Thank you, Karen. Correct answer!
The articles mentioned above and the authors are the real authorities on this.
Anyone interested in this VERY important topic should visit the NANDA web site (and links to NIC, NOC and NDEC. Consider becoming a member of NANDA (I think it's still < US$ 100.00/year and includes a subscription to their journal This is also a fascinating area to find research topics if you are considering returning to school for that next degree.
Mar 9, '03I totally agree, even though I am not a hospital nurse anymore. But I can remember that some patients took up a lot more of my time than others and some just needed you to pop in now again and check them. I also know that it would be better as a patient if you go in for just a small thing that you wouldn't get charged as much as someone that was really sick.
The last time that I was in the hospital was with a wound infection after my hyst. The nurses only came in when I needed IV antibiotics and when they changed my wound dressing. I would also tell them to bring in my sleeping pill and pain pills when I was going to get my antibiotics, so I didn't cause them any extra steps. But then I got charged the same amount as the patient that was much sicker and on thier call light every twenty minutes......that doesn't seem fair either.
Mar 10, '03Don't you think that different pay for equal tasks smells of discrimination? I wonder if ANA has identified this as an issue they want to work on.
Mar 10, '03I remember discussing this in nursing school 27 years ago. See how far we've gone with this? LOL!
Mar 18, '03Exellent idea. I remember, during the downsizing craze, after a "nurse shortage" then there was not a nursing shortage, now there is one again. I think it has more to do with whether they are hiring or not. A lot of money is made and saved by having nurses work short. Anyway back to the downsizing. Doctors, Physical, Respiratory Therapy, Lab, Pharmacy etc were viewed as "revenue producers" Nurses were, because their services were not billed directly, were and still are viewed as "revenue consumers" This is part of the image problem we have to overcome in order to be acknowledged as essential professionals in the medical field. Not just hand maids to the Drs., or butt wipers, I've had to do everything from empty the trash, mop and buff floors, because janitorial services were reduced during downsizing. We provide 24/7 care, when the docs gone, janitors, dietary, and all other services are enjoying their time with their families, we have to be there to provide much needed care to an ever increasing sicker population with insurance mandated shorter stays. We do produce revenue and it's about time this is recognized!!!!! Now I'll step down from my soap box.
Mar 30, '03deespoohbear:
IMHO,The nursing shortage stems from the phenomenon that nurses are, on the whole, invisible in society unless you or someone you love is in immediate need of one. We must insert the awareness of our existance as well as a realistic perception of what we do into the fabric of our society. Nurses must be shown in realistic numbers and prominence in TV shows portraying the medical field as well as in magazine and newspaper articles. They should be used as spokespeople side by side with the MD's when there is any public affairs-type release of information by hospitals, news stations or universities. AND- hospital charges should be re-apportioned without raising rates to more accurately reflect the overall contribution of nursing care during the hospital stay. I feel that Oh, say, 60% of the room charge would be about right.