Facilities are firing seasoned, higher paid nurses and utilizing younger less experienced nurses. This cost-cutting measure is putting patients at risk, working nursing and support staff to the point of exhaustion, and causing staff to leave the profession.
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This article was written by a member on allnurses. Due to the controversial and emotionally charged nature of the article, the member wanted the topic out in the open so nurses could discuss it. Because she is afraid of retribution if any of her hospital administrative staff should read this article and link it back to her, we offered to publish it for her anonymously. Please add your comments regarding this issue negatively impacting nurses and the healthcare system.
I am an experienced nurse that has watched many of my very talented colleagues leave the bedside due to the changes that have taken place in healthcare as of late. I have seen staff cut to the minimum, while patient acuity and nurse to patient ratios increase. I have seen support staff break down in tears because they have not been able to do their jobs properly. I have seen staff pushed to their breaking point, all the while administration stays in their offices, or in the meetings, determining yet more ways they can cut our resources. I see your salaries raised to ridiculous amounts, while we are denied cost of living increases, housekeeping is cut at night, and our benefits cost more, while the services are decreased.
I see our retirement cut while at the same time, the amount matched continues to be diminished or non-existent.
I see ways in which we are constantly blamed for declining patient satisfaction, increased patient falls, late medication administration, all the while we are asked to do more with less. I have seen you fire experienced staff and hire less experienced, cheaper, staff. I have seen that new staff break down because they have no resources, no experience to draw from and I have seen patients suffer from that inexperience. I have seen codes increase, inappropriate admissions to floors, transfers to higher levels of care, all because no one was there initially to advocate for a higher level of care for the patient, to begin with.
I still see you in your office. I do not see you on the floor. I see you with your graphs, your pie charts, your questions about readmission rates when I had already advocated for that patient to stay longer but was simply laughed off by doctors and not supported by you. Yet, somehow, I need to be on a committee to fix the problem.
I am now required to work extra shifts, because staff are getting sick due to stress, or leaving completely because they are tired of dealing with things. I see you develop a culture of fear, where our jobs are at stake and threatened at every turn. Yet, you still look to me for solutions.
"How can we do more with what we have?" I am asked.
My answer: There is no way to do more. We are at our limit. You are losing nurses as fast as you are gaining them, at a time when we need to be building up our profession when the baby boomers are just starting to become a factor in our healthcare environment.
My answer to this is simple. It is time to get real and start valuing your employees. If you want to be reimbursed for patient satisfaction, increase your services. Staff departments with what they need - enough nurses, enough aids, monitor techs, secretaries, ED techs, whatever. Then you will see positive results. Falls will decrease. Medication errors will decrease and medications will be given on time. Patients will get the treatment they deserve and patient satisfaction scores will improve. Your reimbursement will improve and you will stop losing money. Everyone wins: most importantly, the patients.
We need to stop the assembly-line mentality of medicine and return to the service mentality.
Yes, we are a business. But any business that has ever done well has not done well by decreasing the services to people or by mistreating its staff. Otherwise, healthcare facilities are going to see more of the same and suffer more financial penalties, less high-quality staff, and patients will suffer.
I was talking with several of my colleagues just the other day. All of us had many years of experience. Many had been at the bedside for over 20+ years. Many are leaving the bedside due to the unsafe conditions they are seeing. They just don't want to be a part of it. Perhaps this does not scare you, but it should. You must not be a patient yet.
For a follow-up article, please go to Nurses Fight Back! Why Some Hospitals are Despicable
Hospitals Firing Seasoned Nurses_ Nurses FIGHT Back! _ allnurses.pdf
Secretperson said:Thanks for the welcome, I did not intend for this to be a debate:)I am a realist my motivator is my family, please understand at this point in time in society if someone says "I do this because of a calling" or "I'm in it for the traditional sense of nursing" they are either well supplemented by their spouse, still living with their parents, or delusional. Tradition does not pay the bills its a cop out used over and over to justify a disappointing career choice. Own your worth for crying out loud.
You say I'm lazy for stating that a generation of nurses. neglected to validate their career for future generations .... Please... I consider myself atypical from a nursing standpoint. I am not a victim of circumstance, and I actively support change.
if you honestly believe that it's simply about a calling, tradition, or its what you're meant to do, give me your paycheck for two weeks and see who's more satisfied:)
and finally, some of my best preceptors were LPNs so by no means am discounting experience or degree level.
Yea, you totally misconstrued what I said.
I don't understand your point about bedside nursing. So this doesn't go deeper, maybe you can clarify for me. Are you saying the only reason a nurse would work bedside is because she or he has no other choice? And that going in to nursing and wanting to stay in patient care is BS?
I'm not getting your point, and I get most points.
nursel56 said:Thank you to the person who wrote the article! It saddens and angers me that this is so familiar to so many of us from many different areas. It seems like all over the corporate world there is a draining away of a concept I can't quite verbalize other than to say "a heart". It seems to have started in the early to mid-80s with merger-mania.I marvel to think that a union was able to to garner enough signatures at the first hospital I worked at (in the mid-'70s)to vote the union in or out and the union actually lost. Why? Management was able to make a convincing case that their wages, benefits etc. equaled or exceeded what the union could offer. Those days are long gone.
The NNU was born out of a disagreement within the most influential organization, the ANA (or nursing lobby which I define as powerful compared to other factions of nurses, not anything else). The ANA is against ratios. It would certainly help if members of those two organizations could get on the same page (house divided cannot stand). Here's a recent article if anyone is interested.
Just a thought....include LPN's the ANA or any national organization. Better yet, have one organization incorporate all levels of nurses. There are 800,000+ of us, and yes, we really are nurses. Imagine what we could do if all nurses were together in the fight?
mc3:yes:
Unions have their advantages and offer protection to the employee HOWEVER.... the employer knows all the loopholes within the collective agreement and the employer will take whatever measures they see fit.
In Canada, we enjoy better working conditions overall than most countries because nurses are unionized. Nursing continues to face the same issues as everywhere else, even with the collective agreements in place. Facilities are downsizing, beds are closing, nurses work short. In some areas, nurses have picketed and held rallies. Yes, we have a voice but few positive results happen these days because the government dictates the unions.
Not saying nurses shouldn't organize but I am well aware that even the strongest unions are no match for the powers that be.
That's what it felt like for me at a former job...even wile telling myself I must be paranoid I felt Like they had me in their crosshairs and I was only delaying the inevitable (think nature shows on TV where the pack of wolves single out, surround, and bring down the deer). No recognition was given in numerous situations in which I had gone above and beyond to rectify safety issues, ensure my patients and their caregivers fully understood their discharge instructions and how to follow up and when to get more urgent help get, reach out to new staff-but you can bet every instance of critical judgement on my part was second-guessed by TPTB, even If I handled these situations the same way as those in higher favor. The thing is I was so traumatized and felt so worthless I was unable to imagine obtaining a position anywhere else with the kind of referral they would give me that and I became paralysed when it came to finding any other situation that would get me out of there. I know-no one else can make you feel anything. I'm sure that sounds bitter; that's something I'm still working on. And I realize I'm mourning the loss; every so often I'll be in a situation where the "inner nurse" kicks in and I say "Damn, I was good!" I miss it.
Guttercat said:An RN I worked with told me something I think we all "know" but it was still shocking to hear it affirmed: tactics they use to get experienced (expensive) RN's out the door. One included a former nurse manager that confirmed she was told to "give substandard employee reviews" to RN's--even if they were performing at or exceeding expectations. The goal being to get them so discouraged they'd leave of their own accord.
START TODAY. Copy the letter and sent it to your local news paper. Post it on Facebook. Point it out to your colleagues and start making noise. TIME FOR ACTION.
Let's make 12 May 2015 a world wide day of concern from nurses. Let's show the world a day "without our care". !! 12 May 2015 Nurses CARE !!
I could have written this letter !!!! All areas are true. Intimidation about job security, staff reduction, liability for the entire unit if one patient falls...................jobs are restructured and re-aligned (it's cost-effective). After 30 years, my job doesn't exist. I have no choice but to move on.
I agree!!! I LEFT bedside nursing 6 years ago because of the lack of care provided to patients due to the lack of staff and increasing workload. I became an RN because I care. Unfortunately, working as an RN in a hospital setting does not permit nurses to provide the care that is considered safe and needed. It's easy to see that the "CARING" factor is missing. Who is suffering in the end? The patients!!!
CodeBlueRN911
1 Post
I decided to leave the bedside for good after a maning a 10 year post in the ED, never going back due to the fact that Nursing will never be what it was. We can thank our administrators, and regulations like accountable care that have placed primary emphasis on satisfaction scores.
The day before I left I actually had a patient threaten me stating "you better get me my dilaudid and a ****** sandwich or I'll be given all you a bad press gainey"
So I told her she could get her own sandwich from the lobby vending machine on her way out the door. Of course when she called administration the next day I was drug into the office for reprimand.
I didn't become a ****** ER nurse to kiss ass, shoot dilaudid, and serve sandwich trays. I did it to save lives. Which is exactly what I said to my Spineless pencil pusher administrator on my way out the door for good. single finger in the air. Now working for an EMR vendor and I couldn't be happier. Sorry to all of those still getting burned by the downfall of our new healthcare world, but don't expect any changes any time soon as the mega-health corporations continue to buy up and ruin any good organization that can't compete standing alone.