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

[caliotter3]

When I am unemployed, I do not think other nurses care about me, per se, because at least one of them got the job I just left, so someone benefitted from my misfortune, as I have, at times. It is a dog eat dog environment, no matter what.

[LeoVanLin]

I said it before and repeat again

Spread this letter. At work, to the local media

Copy it to your Facebook or other social media and ask your colleagues to do the same if they recognize the complaints (and they do...... all over the world)

Then organize a staff meeting on 12 May 2015

Every where.

Get the media to know about this.

Start making noise.

[LeoVanLin]

And being scared has not solved the problem

That is what created the problem in the first place

[FedUpinTX]

I think the hospitals around here are sneakier than that. Instead of firing you, they don't give you raises anymore. They have invented this career ladder/step program which is basically a way to get nurses to do the manager's jobs for them AND give them an excuse for not raising your pay. It is no longer good enough to show up to work on time and do a good job. Nope. Now, you are supposed to complete a whole list of tasks in order to "qualify" for an insignificant raise. You have to join a committee, attend at least 75% of meetings, maybe "chair" a committee, oh and there are unit-based and hospital-based committees, you must join both ! You will also need to do x number of volunteer hours, get an advanced certification or go back to school, not call in sick for a whole year, become a preceptor, maybe a couple more things. For ALL of this you will get, MEH 3 % raise....OH , and the BEST part...If you DON'T do it all again the next year...they will not only NOT give you a raise, they will TAKE BACK the increase they already gave you ! Yep, I kid you not !

[the nites]

Yes a sad scene that requires a full hard core invetigative journalism digging--and they call nursing a "profession" with such stress strictly due to the pporly planned staffing grids to increase mgt bonus $.

Note: Press Ganey the patient experience co. that sends pt's their surveys for md/and/hosp visits, they have a large section of their webpage devoted to Magnet Nursing--and they also own the company--formerly Moorhead and assoc--. who send you your employee satisfaction surveys---does this mean a small band of highly paid mgt/ceo's corrupting a system to increase their $ compensations--while--letting the rn and the patient think the care is being directed by themselves but alas the pt and rn are puppets.

[All4NursingRN]

I totally agree with everything said. As a young nurse (late 20's) but with almost 10 years experience , I grew up around older seasoned nurses and I definitely see the changes and feel the crunch. Hospitals were much more about an environment of care and people first even going back 10 years when I started out.

Corporate America has probably been looking to get their greedy hands on Healthcare for decades and I'm assuming the deregulation of the late 90s, early 2000's is what has lead to a culture of profits before people because it wasn't this bad 10 years ago.

Now it's almost somewhat frowned upon to be a nurse at the bedside for more than 10 years without a master's or aprn role. Now nurses graduate and re enroll into grad school in less than 3 years.

The only real problem with the nursing profession is that we have allowed ourselves to be divided and conquered. Not to mention we are a female dominated field and that has played some part in the lack of respect.

No one ever dares to push the physicians around, even though corporate hospital suits have been pushing them around too lately.

As nurses we can get this done, we just need to centralize and become more business minded as well to push back. I actually think getting physicians on board may help too.

Doctors and nurses together should be fighting for patient safety.. awesome article!

[All4NursingRN]

And yes it is so hurtful when nurses of all people who are in administration turn their backs on what they know is the right course of action or the good employee.

I once had a nurse administrator who was almost 20 years removed from the bedside. She had been in varying levels of management and administrative for almost 2 decades and it showed. She was all about numbers, I heard nothing of patient care. While she did make an effort to be on the unit, never did she roll up her sleeves to help and I mean even in crisis situations where multiple patients were intubated/cardiac arrests, etxc.. she would just grind whomever was in charge that much harder that day.

Once a nurse called for assistance, said she was inundated with patients in her area of the ed and was drowning, all the director did was go badger the already overwhelmed charge RN about why said rn was drowning???

Another time she walked by a patient who was requesting the IV be flushed, hunted down the overwhelmed, running like a chicken without a head rn to flush said patients IV. I was floored, but then I thought after 20 years removed from bedside maybe she doesn't even remember how to flush an IV...smdh.

[OCNRN63, RN]

I am a member of the NNU. IMO, the ANA is worthless for bedside nurses.

[sistrmoon, BSN, RN]

Some nurses from my facility are attempting to unionize. They had their first meeting last week and I was unable to go. My husband said, "Good, you won't get fired." I'm watching with interest, but it will definitely be an uphill battle.

[sistrmoon, BSN, RN]

JacksonNurse said:

The hospital I work at has weekly 'mandatory' lunch with CEO and HR director, this topic was recently brought up and the response was that it was 'lazy nursing' that was causing low patient sat scores, it was lazy nurses that were complaining and lazy would not be tolerated. "just because someone has been a nurse for a long time doesnt mean that we (the hospital) should do anything special to retain them" when asked about nursing retention. The majority agree where I work, union is the only way to be heard, however many are afraid of being fired

Yeah, those meetings with our facility president are always during hours night shift would never make without sacrificing sleep. He needs to come around at 1 am I think!

[MaryBethCasey]

30 some odd years ago when I started in Nursing, I was a CNA. Our Staffing for a Med-Surg 42 bed floor on day shift was 5 RN'S, 2 LPN'S, 6 CNA'S, & 1 Unit Secretary. The RN's were in charge of the patient care plans, started and hung IV medications, assessment of the patients, and pretty much helped to keep the patients alive. The LPN's passed medications, they were focussed on their task, were able to recognize of there was a problem with the patient while they were doing their job and report to the RN for further assessment. The CNA's provided the bedside care. We fed the patients, provided real bed baths (not a heated wipe from a package), obtained the vital signs and reported any deviation, gave back rubs, ambulated patients, got patients up to their chairs, or made certain they were turned q2h.

What I'm saying is patients were actually cared for. I would like to know what the patients satisfactions rate were from then...forgive me, we weren't interested in such things then, we actually cared for patients.

DRG's were put into place, and the cutting of nursing staff began, first with the CNA's, and LPN's. The idea, if there was an all RN staff, there would be better care. I hate to say it, not all RN's are capable of providing the bedside care of the CNA, not to diminish the ability of passing medications, but, that was something more relatable. And so began the rollercoaster of all RN staff vs. mixed staff.

Since I began as a CNA, I am not bothered by cleaning poop, or starting an IV. I am multi-talented and able to do any task placed in front of me.

I welcome any new task as a challenge and another item to place on my resume.

I have 1 semester before I finish my MSN, Family Nurse Practitioner. I'm elevating my position not to leave my position as an RN, but to enhance the skills I've gained over the past 25 years.

If administration wants to increase their patient satisfaction, save money on ANY lawsuits for med errors, bedsores, 30 day readmissions, BRING BACK a staff that can provide the right care for the patient acuity.

[chicagotoots]

Quit a job, with proper notice, this week due to limited help, pushing to do things faster, check all the boxes to document care (generate revenue), seeing shortcuts taken by staff to save time, they offer nurses big incentives to work more shifts (but also ways to justify not paying them), they are willing to burn their staff rather then hire more help. No time for the patients..just pass meds, computer chart, crank them thru the system. This is assembly line healthcare. It is not nursing. The young nurses will do it for the money/experience, as a senior nurse, I chose to walk instead of risk my license. Administration does not care. We older experienced RNs have seen our jobs change and not for the better.