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
XNavyCorpsman said:You need to look into getting hired by UPMC in Altoona PA. I did 3 semesters of clinical there and they would be a great place to work.
You may work at a "great place to work", but that doesn't mean you stop advocating to continue to have a "great place to work" culture, regardless of setting.
Millions of nurse can't work in your facility; being proactive to protect and advance the profession sensibly is key.
LadyFree28 said:You may work at a "great place to work", but that doesn't mean you stop advocating to continue to have a "great place to work" culture, regardless of setting.![]()
Millions of nurse can't work in your facility; being proactive to protect and advance the profession sensibly is key.
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Exactly. Aren't we "WE"?
Let's act like it.
I've been out of the hospital setting for the last 6 months, but as a "lifelong" hospital nurse, I'll never shut up about what we need and deserve and have earned. Just because I've left the battle does not mean I've left the war.
I agree with this post. At my facility we have seen more people who are insured however their deductible is so high that they cannot afford that out of pocket cost and we end up writing it off as bad debt. Many rural hospitals have had to close which is sad because they provide an important service.
I agree with everything said in the original post, but I an't help but feel the "Hospital Administration" is getting all the blame. You have $X comming in, the drug companies fave already dropped thier rates as far as you can push, the equipment is so close to obsolete you wonder if you can make up the budget shortfall by selling your equipment to a museum. The good news- HHS has decided to dramaticaly cut its Medicare funding again this year- Great. What do you do? Get rid of the older, expensive nurses to hold the line on the patient load per nurse, or keep them but double the nurse to patient ratio? The equipment hass beep paid off for years, no more home decor expences, can you live with only 2 housekeepers on nights? There isn't a bottomless well of money the way health care is reimbursed these days. Sure, Insurance companies may make more than thier share, and drug and equipment companies are still doing OK, but in a global market with all economys spending less per/capita on health care- even these bastions of corporate greed are feeling the pinch. Hospital administrators are just astronauts in space with 3 holes in thier space suit and only two patches. No matter what soultion they choose- there is going to be a loud sucking sound as important stuff is lost to protect equally important stuff. I don't have a solution, but to blame it on the "Hospital Administration" is simplistic. They were told to get optimal reimbursment you have to have X patient satisfaction score That is why the push for patient sat numbers. They would love to do more with more, but the $ isn't there to pay for what we are doing now.
suanna said:I agree with everything said in the original post, but I an't help but feel the "Hospital Administration" is getting all the blame. You have $X comming in, the drug companies fave already dropped thier rates as far as you can push, the equipment is so close to obsolete you wonder if you can make up the budget shortfall by selling your equipment to a museum. The good news- HHS has decided to dramaticaly cut its Medicare funding again this year- Great. What do you do? Get rid of the older, expensive nurses to hold the line on the patient load per nurse, or keep them but double the nurse to patient ratio? The equipment hass beep paid off for years, no more home decor expences, can you live with only 2 housekeepers on nights? There isn't a bottomless well of money the way health care is reimbursed these days. Sure, Insurance companies may make more than thier share, and drug and equipment companies are still doing OK, but in a global market with all economys spending less per/capita on health care- even these bastions of corporate greed are feeling the pinch. Hospital administrators are just astronauts in space with 3 holes in thier space suit and only two patches. No matter what soultion they choose- there is going to be a loud sucking sound as important stuff is lost to protect equally important stuff. I don't have a solution, but to blame it on the "Hospital Administration" is simplistic. They were told to get optimal reimbursment you have to have X patient satisfaction score That is why the push for patient sat numbers. They would love to do more with more, but the $ isn't there to pay for what we are doing now.
In my area, health care organizations have announced record profits and have been expanding their facilities.
Yet, at an area hospital a physician actually told us, when my family member was a patient, that the hospital had had "some problems with the nurses, and had to replace them." There was a mass recruitment day at the hospital for new nurses. My family member received care from several of the new staff: Young, conscientious and caring nurses who didn't appear to be particularly experienced.
I have been an OR nurse for 43 years and over the past 18 months at the same hospital management has found any reason even changing policies, bullying , to kick me out of the department. Which they managed to do. I'm going to fight back. I'm not going down with legal help without a fight. I agree that they could hire 2 new grads for what they pay me, but they don't have the experience and no loyalty that the seasoned nurses have. I'm almost 62 and was hoping to work til I'm 65.
As an old school nurse with 17 years experience I am way to familiar with this. As a new nurse and even today I looked at every situation as a learning experience and strived to learn More and more I see younger new graduates put in positions they simply do not have the experience for and sadly many refuse to ask for help because older nurses are known for eating their young. This only jeopardizes our patients because I remember when nursing was about the patient now it seems to be about budgets. I miss those days when my patient got what they needed. Cost was not the issue
imenid37
1,804 Posts
Isn't the resistant to change excuse the most over used in healthcare? Code for don't complain or you will be canned!