Hospitals Firing Seasoned Nurses: Nurses FIGHT Back!

[allnurses]

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.

An Open Letter to Hospital Administrators

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

[mondragon]

This is called " working for Corporate " , and Corporate is soul less !

[WS Smith]

I own a commercial janitorial company and am still meeting resestance with hospital leaders to our sourcing their EVS. I've shown them how outsourcing could save the costs of several FTE RNs. I think a lot of it is about control. But hospitals need to focus on providing care not cleaning restrooms.

[Fuzzy]

I'm not a nurse but I started a new job in one of the maintenance staff positions at the local hospital. Yup I was a basement rat. My first week in this job involved a very comprehensive orientation. I was thinking wow this is an awesome place to work. We were treated very well during that orientation time. We got to meet the bigwigs who were very cordial and accommodating. Heck I even received a letter from the CEO welcoming me to the team. We all went through the PlaneTree training and did our SWANK units. I though that I was in heaven although I was at the bottom of the ladder. Fast forward two months. I loved my job in the basement. I was getting along wonderfully with my supervisors and co-workers. The compassion fatigue and burn out from my prior job was leaving my brain.

Then one week before Christmas, I was called into HR by my direct supervisor. Her direct supervisor was there as well as the HR guy. I had this uh-oh feeling. Yup I was terminated. The excuse was I was not learning the job as fast as they thought that I should have been. However I was praised for my awesome attendance and work ethic. I was blind sided by this. I asked my co-workers several times how I was doing. They thought that I was doing well. My supervisor did not have any complaints as to my progress (or lack there of) to my knowledge. In the interview I asked about the training since I had never done this type of work before. I also explained to them about my ability to get lost until I learned were things were at. They told me that they were willing to put a lot of time into training employees. New employee training costs a lot more money so they wanted to keep us working for them as long as possible.

Now I had never been fired (terminated is such a pseudo clean word for firing) before so this was a big blow to my self esteem. I was on unemployment for a time whilst working for work. Thankfully I was offered a part time job at the facility that I had left to take the hospital job. One of my friends is a supervisor at Wal-Mart. He told me that this was a common thing in this hospital. They hire, train and terminate many employees. In my current position I also work with a lot of current and past hospital employees. They also told me that my case was typical. I was told that many EMS, EVS, clerical and nursing staff were also terminated at this time.

Fuzzy

Funny, I see that my position and many others are listed on that hospital's job website. I just want to say "DON'T DO IT".

[Secretperson]

"20+ years ago nurses were HIRED on their sense of loyalty, or traditional sense of nursing, especially in small community hospitals and LTC facilities. The motivating factor was the patients. When the motivating factor became money, then a sense of a calling or tradition was made to feel silly, senseless or crazy. At one time, we were highly rewarded for these traits."

I totally agree, and most public servants (like teachers) can say the same.

But with that being said,it is the lack of progression within nursing that baffles me. We as nurses are at odds now with the so-called "MBA" problem in our healthcare system which is focused on money not patient care. Um okay? Earth to nurses if healthcare is not business then we need to explain that to 1/5th of our economy.

Fellow nurses patient safety, comfort, and ultimately their outcome is what matters and WEthe nurse who is directly involved with a patients care can hold onto tradition, pride, and love of what we are doing to keep this going (these are our best traits).

But do not get pissed when you lose your job because you never secured it through improving your worth and creating a reason or need to keep you employed.

In the end what nurses hate about business will continue to eat away their jobs, unless nurses figure out that nursing can be treated like business and be competitive. Get pumped up! Break previously set scope of practice barriers and begin to earn your worth!!

Please stop and think about this:

If computer programmers from the 1970's never stayed current on the progression of technology,regardless of how good they were, how relevant do you think they would be today with a high end laptop pc or MAC? The basics of programming remain the same, yet much more is expected for a lot less, and when almost any computer owner can now do what an older programmer used to do, how does the older programmer create worth?

[Susie2310]

Fuzzy said:

I'm not a nurse but I started a new job in one of the maintenance staff positions at the local hospital. Yup I was a basement rat. My first week in this job involved a very comprehensive orientation. I was thinking wow this is an awesome place to work. We were treated very well during that orientation time. We got to meet the bigwigs who were very cordial and accommodating. Heck I even received a letter from the CEO welcoming me to the team. We all went through the PlaneTree training and did our SWANK units. I though that I was in heaven although I was at the bottom of the ladder. Fast forward two months. I loved my job in the basement. I was getting along wonderfully with my supervisors and co-workers. The compassion fatigue and burn out from my prior job was leaving my brain.

Then one week before Christmas, I was called into HR by my direct supervisor. Her direct supervisor was there as well as the HR guy. I had this uh-oh feeling. Yup I was terminated. The excuse was I was not learning the job as fast as they thought that I should have been. However I was praised for my awesome attendance and work ethic. I was blind sided by this. I asked my co-workers several times how I was doing. They thought that I was doing well. My supervisor did not have any complaints as to my progress (or lack there of) to my knowledge. In the interview I asked about the training since I had never done this type of work before. I also explained to them about my ability to get lost until I learned were things were at. They told me that they were willing to put a lot of time into training employees. New employee training costs a lot more money so they wanted to keep us working for them as long as possible.

Now I had never been fired (terminated is such a pseudo clean word for firing) before so this was a big blow to my self esteem. I was on unemployment for a time whilst working for work. Thankfully I was offered a part time job at the facility that I had left to take the hospital job. One of my friends is a supervisor at Wal-Mart. He told me that this was a common thing in this hospital. They hire, train and terminate many employees. In my current position I also work with a lot of current and past hospital employees. They also told me that my case was typical. I was told that many EMS, EVS, clerical and nursing staff were also terminated at this time.

Fuzzy

Funny, I see that my position and many others are listed on that hospital's job website. I just want to say "DON'T DO IT".

I'm sorry this happened to you.

This is a business model. Nurses and other staff are viewed by many facilities as flexible labor. Why pay a temp agency when staff can easily and inexpensively be hired and fired to suit the balance sheet? Workers are often fired at the time they are about to become more expensive to the company, I.e. before they qualify for certain benefits, I.e. pension plans, even if they are a good worker.

My suggestion is to try to seek out employers that are known to treat their employees fairly. Some people have advised working for facilities with unions: I believe this is a wise idea.

[joanna73, BSN, RN]

There are few jobs in comparison to the number of applicants in every sector, not just nursing. Since the recession of 2008 it's an employers market. Although the concerns are valid and should be acted upon, corporate does not care what nurses or their patients think.

Many facilities have been going through "workforce transformation" despite union protests, petitions and rallies in Canada and they're getting away with it. The unions continue to file various grievances with few results.

At the end of the day, someone will accept the working conditions because they need to eat and the CEOS are well aware of it. The general sentiment is this: "If you don't like it, find another line of work."

Once more people start dying from substandard care, maybe then they will take notice. It's pathetic.

[ericbelew]

I am at a loss to understand how there can be a huge desire to let go of experienced nurses at the same time that new grads can't find jobs (I do get it, my naiveity has to ask). What is happening out there? So experienced nurses are actually losing their jobs......but are new nurses actually getting hired? While this doesn't have a clear answer, my amazement is in the fact that i hear it is almost impossible for a new grad nurse to get a job. As a nurse with over 15 years experience, I am getting my MBA. Not because I want to be the ass in the meetings trying to cut corners and blame floor staff for loss in profits, but because I can see how all the legislation is leaning towards finding ways to cut reimbursements to hospitals, mostly around patient falls, nosocomial infections and other errors....which administrators will happily blame on nurses. F**K that, I am a nurse, I get our environment, if I can be an administrator and stand up to the bullying in this finance driven world and defend the true hard work that happens in a hospital, then i have done my job. I know many laugh, it is ok to be a cynic, i am one myself, but until more of us at least try and get into these positions and help the nursing profession be recognized for the strengths, skills, and professionalism that it is......we are all lost........

[Secretperson]

Ericbelew gets it!!!!!!!! You Rock

[Ryn RN]

Agree totally! Just myself left a bedside nursing position. I have been in Nursing 30+ years and cannot believe how bad things have gotten. They are replacing seassoned Nurses with new grads in my old ICU then they can lead them how admin wants to. They feel fortunate to find a job!

[DonnaBrownDubs]

I actually felt like this article was written about me. I can attest to the validity of every point brought up here.And as a seasoned nurse, who has no job , thanks to these points brought forth , I would be happy to confirm my experiences or add to any research being done. Thank you for posting these utter truths.

[Ryn RN]

So true they really don't care what we think! And nurses in my old ICU were actually told if you dont like it, find another job!

[Wellseasoned101]

WOW, sounds like you work at my hospital! I have over 3 decades of experience. I love caring for sick people and mentoring new nurses. But over the past 3 years I have been appalled at the decrease in quality patient care mostly due to unprecedented stress. Management and administrators seem to be ignorant to what makes a successful business thrive. You can't have miserable employees who are driven by fear and intimidation and expect positive outcomes of ANY kind. Someone needs to wake up before the bulk of baby boomers leave the profession one way or the other. We refuse to be task oriented nurses who only practice our profession via the physician orders. We are the nurses who still use critical thinking, much to the belittlement of management. God help us when we age and need nursing care. Who do the administrators and their family members think will be available to offer them all their survey demands???