Healthcare Admins and Experience??

greenfiremajick · Jul 1, 2010

I have a question. I see so many on here, complaining about the admins of their hospital/facility, etc....Don't these admins have experience, or a license? I ask because it seems that after being in the trenches, they would have a better idea of what it was like to be there...Or do a lot of them have no real experience and that explains it??

noone has any thoughts on this, at all??

pielęgniarka, RN · Jul 1, 2010

The administrator/CEO where I work has a bachelors degree in business administration & community planning, also had to take some state board exam to be a licensed administrator. Before this job she was some sort of government representative.

brownbook · Jul 1, 2010

I love how you re-post your question. I really don't think it matters a lot, yes it does matter a little, if administrators have worked in the trenches. Some administrators, with little bedside experience, just get it, do a good job, help out when needed, support their staff. Some have worked the trenches, feel they paid their dues, kind of a "you think you have it tough, when I was a bedside nurse we had to sew the patients sheets and pounded out bedpans at the forge... so quit your complaining and get back to work!" attitude.

jstanrs · Jul 1, 2010

oh, where to begin...?

the cold, hard truth is that healthcare is a business - a heavily regulated business. as a result, the focus of most admins is the bottom line and compliance with regulations so their facilities don't lose medicare / medicaid funding, get fined, bad pr, etc ... regrettably, nurses are a drain on the bottom line - we are an expense. as for regulatory compliance, that is largely about paperwork. therefore, as you would imagine, nurses, or more specifically, the care they give to patients, is not truly a priority, although most admins are skilled spinmasters and will claim otherwise. sadly, at least in my experience, there is no accountability. even when confronted with irrefutable evidence contrary to their claims, i have known admins to band together and lie through their teeth in order to cover themselves.

and if you speak up about it, you have a bad attitude, or time management problems, or problems with setting priorities, or are not a good match with their facility...

as for your question re: their experience and licensure: yeah, most have some form of both and it boggles my mind that they can do what they do. i have decided that many of them are either alarmingly out-of-touch or appallingly dishonest.

TDCHIM · Jul 1, 2010

even when confronted with irrefutable evidence contrary to their claims, i have known admins to band together and lie through their teeth in order to cover themselves.

i certainly won't take issue with most of what you posted. a lot of what you said is why i hang around here night and day, trying to soak up information on the problems primary caregivers deal with every day.

however, on the admins banding together and lying issue...they've hardly cornered the market on such behavior. people in all types of jobs, from manual labor to the highest levels of government and business engage in this sort of behavior. in some places it works; in others, it isn't tolerated or the cabal falls apart due to infighting or power struggles. as has been noted in other threads on this board, staff nurses themselves aren't immune from this type of behavior. so i guess i have a bit of an issue with bringing it up to the detriment of administrators when one could say the exact same thing of any field.

that's just the two cents of a future paper-pusher....

CNL2B · Jul 1, 2010

Most hospital admins at the highest levels are physicians/nurses in this geographical area. We are full of "non-profit" hospitals though, and I think in heavy for-profit areas there are subjectively less clinicians and more businesspeople. There are others at the top as well that are businesspeople here as well though. Most are at a minimum Masters degreed (if they don't have an MD), but not all. I don't think there is an "exam" persay that hospital administrators have to take to get their job, but many of them have healthcare administration focused degrees, and many have relevant clinical experience and have climbed the career ladder from staff nurses and doctors, or from support staff to management and beyond, to the role they are currently at.

In LTC at least in the State of MN there is a licensing exam for a nursing home administrator. I don't think that here it is very easy to get a job (you may not be able to at all -- not sure, I don't work LTC) if you haven't taken the boards. I am not sure what the requirements to sit for the boards are. The State on their website presents this as a means to ensure that those that are running LTCs have some standardized training and know what they are doing.

jstanrs · Jul 1, 2010

is it ever okay, regardless of how common it might be? i find it particularly egregious in this situation due to its ultimate effect - the perpetuation of a system in dire need of overhaul - one that literally costs lives. if you doubt that, please read the following:

http://www.jointcommission.org/nr/rdonlyres/5c138711-ed76-4d6f-909f-b06e0309f36d/0/health_care_at_the_crossroads.pdf

[color=#231f20]excerpted from the above:

[color=#231f20]higher acuity patients plus fewer nurses to care for them is a prescription for danger. according to joint commission data, staffing levels have been a factor in 24 percent of the 1609 sentinel events - unanticipated events that result in death, injury or permanent loss of function - that have been reported to the joint commission as of march 2002. [color=#231f20](that's' 386 lives ended or forever changed for the worse). other identified contributing factors, such as patient assessment, caregiver orientation and training, communication, and staff competency, implicate nursing problems as well. conversely, several studies have shown the positive impacts on quality, costs and health outcomes when nurse staffing levels are optimized - fewer complications, fewer adverse events, shorter lengths of stay, lower mortality.

[color=#231f20]this report is more than an analysis, and even more than the recommendations that it contains. it is about accountabilities. the joint commission has recently developed and introduced cutting-edge staffing standards that create a new framework for measuring and improving nursing care. the joint commission is also taking major steps to reduce the documentation burden that so often falls on the shoulders of overworked nurses. [color=#231f20](has this changed in your facility?) this latter effort will undoubtedly require continuing attention and adjustment. but there are others with accountabilities as well - hospital ceos, public policy makers, nurse executives, schools of nursing, physicians, private industry, insurors, and still others. we as a country must understand not simply what needs to be done, but who specifically, alone or with others, is responsible for getting each task done.

[color=#231f20](sadly, this report was issued 8 years ago and to my knowledge, not a lot has changed).