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
Ummmmm ---- as a new nurse, I ask this. If you run off the seasoned nurses,,,, who the heck am I supposed to learn from??? I am in no way "all knowing"! Those seasoned nurses have saved my butt, my license & my sanity time after time --- I wouldn't have made it through my first week let alone my first year!!! Anyone in administration who reads this, please consider the naivety, unskilled & presumptions of new nurses --- starry eyed & eager, yes,,,, but certainly not ready to fly on own!!! And even down the line, it is good to have input on seasoned nurses opinions to weigh & make good decisions.
This is why I chose home health as my career path in nursing. With the new pay per visit system in place and point of care computer systems, I get out of the home at 10:00 AM each day and back home between 15:00 - 16:00 most days. Seeing 6-7 patients / day if you map your area and route well, you can make 80 - 100 K per year... and with an associates degree, this is great. I also don't have to see my supervisors but 1 x week for case conferences and have a career that changes each day with each different home I visit... challenging and rewarding.... yes!!!!
Truer words were never written. Every thing that the author described, I have seen up close and personal. They didn't get me because I was able to escape at the age of 54 due to an inheritance. Although I hadn't been written up in years, I could read the writing on the wall as I watched 14 more experienced coworkers on my unit get purged in roughly a one year span. They were all replaced with new grads. People would refuse doing charge duty because there was no quicker way to lose your job than to find yourself on the wrong side of an event on your watch, even if you didn't have that patient yourself. I am left with a sense of bitterness and a total lack of respect for hospital administration. A pox on their house.
I have been a nurse for 20 years BUT I stayed home the last several years raising my kids. Now it is impossible to go back into the hospital as an experienced nurse. Even with nurse refresher courses the recruiters still say NO. It is frustrating because I know several very experienced nurses in this situation. They tell us no but take the new graduate nurse!
No other profession that you stayed home a few years would invalidate your coming back into the field.
As an advanced practice nurse I also experienced it but with a twist...18 years in a rural community providing healthcare and replaced with new grad PAs that I had been forced to train as students and new employees who are paid higher. I received an email to my home address with a comment that I no longer had a contract and human resources did not know how to reach me other than the home email???? Management didn't look twice when I met with them to express my unbelief that they had no clue about their providers and their serious retention issues. I declined their contract offer for my same wages (I had no raise in 5 years) and asking me to work less hrs and meet productivity. I asked them why I should work for them and the reply "I can't tell you why you should or should not work...are you going to sign this contract or not?" All I wanted to hear was this manager say I was a part of the team and I would have signed even though I was not happy, in order to continue to provide care in my community. 6 months later and I continue to receive 3-4 patient calls a week begging me to work somewhere but unfortunately there is a monopoly in rural healthcare and I am trying to think outside the box but have not had a solution yet. I am discouraged in our system and know that I am not alone in my feelings as this year 7 seasoned advanced practice providers had the same fate at the hands of these managers with a board who has not questioned any of this!
This happened to me and a few of my coworkers 10 years ago. New nurses were being hired and there were not enough seasoned nurses on nights that going to work was getting very scary. I went to days thinking this would be safer as the managers were there. No, I was blamed for everything the nurses that were assigned to me as I was charge nurse. I ended up losing my job for an accusation from a nurse that had been in the association for 4-6 months. I had been there 4 years and had14 years of experience. Then the hospital did not stop there, no they actually turned my license in to the state and I was investigated due to this accusation. 2 weeks before Christmas 2013 this illustrious hospital with all of their accolades fired half of their staff in lieu of travelers to replace the long term staff. Who needs the politics I travel and trust me it is not for the money because it does not cover the bills. I travel for the peace of mind. I don't have to deal with the politics for more than 8-13 weeks at a time. If I like the staff, hours and patients I sign another contract for 8-13weeks. I am sorry this profession has come to this. Nursing use to be about the patient but now the patients are just the means to a fat wallet for administration. As far as travel money if you can get the agency to turn loose of the tax free money one is able to make a descent wage. I can't wait to retire. I have told my son to let me die rather than take me to the hospital. Most of the travelers have only 1 year of experience so I would rather not go to the hospital to be taken care of by inexperienced incompetent new nurses.
The reason for this I have been told is because the computer charting is too complexed and seasoned nurses would have a hard time learning it. Really? I have learned 5 new computer programs in the last 4 years. This is an excuse the real reason you have experience and are worth too much money the companies can't pay you what you are worth.
BeentheredonethatRN
43 Posts
It's all about survival . Upper Amin. clearly understands the stats and probably help write your old text books ,but spit in the face of idealistic nurses. Just think about it-what a Five -Star ,Magnet Status show some healthcare facilities put on. Preaching Evidence Based Practice ,etc. but all about money and if the pt is healed that's great , but money before everything . Plus, it's not just our profession -just take a breath and look around. Thankfully, like any other movement -they usually start with young people . I'm too burned out to fight anymore -so I'm just going to continue to give them what they want. Keep up the fight !