Hospitals Firing Seasoned Nurses: Nurses FIGHT Back!

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.

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

Nothing new in the reports of firing experienced nurses in order to hire cheap inexperienced nurses. Happened at the major hospital where I lived twenty years ago. A massive layoff of nursing staff. Four months later, running ads in large metropolitan newspaper looking for new grads. They didn't even waste any time waiting for the ink to dry on the layoff notices.

In response to the article regarding "Hospitals Firing Seasoned Nurses" I wrote this article around 2007 when they started to implement the brilliant NOT idea of taking patient care assistants off the floors. I guess not much has changed? I currently work as a home health nurse. Not sure if I could ever go back into the "battlefield." I worked many years as a floor nurse.

"I have worked in the field of nursing for over twenty years. I have been an R.N. (a real nurse). I never heard that phrase until I began working in the hospital setting. Actually, it was an L.P.N. (Licensed Practical Nurse) who referred to R.N.'s as the "real nurses." Well, if my memory serves me correctly, when I was a graduate nurse working at Shore Memorial Hospital in Somers Point, New Jersey back in 1984, it was the L.P.N.'s who showed me the ropes of how to be a "real nurse." But that was years ago, over twenty to be exact. I am certainly no longer a graduate nurse, but I have graduated to the growing number of nurses suffering from burnout. Too many days of not enough nurses. Too many demands

for turkey sandwiches and ice water . . . when you haven't even medicated a post-op patient. I have learned that the turkey sandwich and ice water mean ever bit as much to an incapacitated patient than the pain medication that needs to be administered. So, you take a good look around to find "someone" to help you. There is no one. YOU are it.

YOU are it day after day, shift after shift. Your eight hour shift turns into a nine or ten hour shift. Your twelve hour shift . . . well we won't even go there. On second thought, I will go there. A twelve hour turns into a fourteen hour shift. I must ask, "Who works like this?" I mean steady working. Sometimes no breaks that is, unless you are a smoker (no offense smokers). Somehow smokers find the time

that non smokers can't seem to find to leave a floor for fifteen minutes or so every hour and a half. I used to get upset but I don't even get upset any more. It is how they cope. I seriously thought about taking up the nasty habit just so I could escape like the smokers, but I value my lungs far too much. So, I don't pay it any more attention when nurses leave, dragging on their Winston's (if they still make

them . . . I wouldn't know as a non-smoker).

A great friend of mine, who I met when I was a home health nurse, got to the point where

she didn't want to go to work any longer. She dreaded work. I used to think, "Poor thing." Well, at the time, I didn't know I was next in line to becoming the "poor thing."

Burnout happens slowly but when the final stage of it appears, it smacks you in the face and knocks you down flat. You become like a child who screams, "I don't want to go to school!" (but in your case it is work) Unlike the child, you have responsibilities and many of them. You can't just shut down.

But, there is something greater than responsibility that hollers out, "If you don't stop, you are going to really lose it, and I mean lose it." Before the end of burnout comes around, you begin to get the dreads. You literally dread going to work. Look it up in Websters: "a profound and deep-seated spiritual condition of insecurity and despair in the free human being.".

Let one or ten more things compound this feeling of dreading your job and you are like a sinking ship. That is, unless you throw up your hands and say, "I need help." "I really can't do this any longer." So, you call your work. You take a deep breath. "I can't come in." The "caregiver" needs care--desperately. They write your name as a no show for the next shift. The guilt sets in. At 5:15 the hospital staffing secretary calls to see if you are coming in that day. I learn about the 5:15 call when the 7:15 a.m. call comes. "Are you coming in?" "The floor (the unit where I would have been assigned for that day) is looking for you." There has definitely been a lapse in communication. The pit in my stomach has intensified.

I was awakened by their call for help. It was obvious that my plea was totally disregarded. I call again later in the morning. This time, I speak to a nurse who I think may understand. I explain to her that today is my anniversary, my husband is 1000 miles away asking for a divorce, I have a fourteen year old who every word out of her mouth is, "Can you?", I have a home in Florida that I left to the tenant who has also placed many demands on me, I have daughter who is working on her Master's Degree and who works full time in Child Protective Services who recently had called to tell me she is pregnant, and THEN, there is the hospital calling me at the but crack of dawn after I had already explained to them that the candle is no longer burning. Nobody knows the effort it has been taking for me to do simple things like go grocery shopping, take my daughter to school after she has missed the bus, or just sitting down to pay the bills.

I decide to take control of this situation before it does any further damage. I have to be make myself more important that my job at this point because if I don't take care of myself, I can see that no one else will. I tell the nurse that I won't be coming in today, or tonight (I had scheduled myself 7 a.m.- 3:30 p.m., take an 8 hour break then come back 11 p.m. - 7-3:30 a.m. (all so I can get the hours in so I have more time off)). I tell them I probably won't be coming in for a twelve hour shift on Thursday either. I schedule an appointment with an Employee Assistance Counselor . . . but I can't go in until Tuesday, which is seven days away. I asked the nurse/receptionist, "What am I supposed to do until then?" Her suggestion was this, "Get up in the morning and put your uniform on and just do it." I stuffed the scream and calmly said to her, "I have been doing that for a few months now. Getting up and doing it all over again and again. I am beyond that. I can no longer get up and put my uniform on. I want to keep my pajamas on and do nothing. I want to sit and watch a comedy on television, maybe eat a bon bon or two. ANYTHING, but put a uniform on and go in to take care of five, six or seven needy patients with no nurses aide or patient care tech to help me.

I will go back. But, I will get well first. There is an old adage, physician heal thyself. Well, this is nurse heal thyself. I will get the help I need. A Chaplain at the hospital suggested that I check into a local Holiday Inn (by myself, of course), take a bubble bath and meditate on the Lord's words that He would comfort me and protect me from all harm. He told me that I could rest on the assurance that the Lord knows what I am going through and that He would help me through it.

I will be o.k. I have always been o.k. But burnout sure is scary when it happens. The initial phase is worthy of your attention. When you dread ANYTHING, pay attention. Dread isn't normal. Dread will kill your spirit and take your physical body along with it. If any of this sounds familiar, whatever your profession or job, don't be afraid to ask for help. No amount of money is worth your mind. Your mind is your most valuable asset God has given you. Make arrangements with work. ASK for others to help you. People care about you more than you might think. If you don't have the time off, ask creditors to work with you. Tell them exactly what is going on. You will be surprised at the response. Everyone needs a nurse at some point in their lives . . so it is to their benefit to help you so YOU can help them."

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It's a conundrum isn't it? All these new grads essentially wanting and needing positions opened up for them.

Is there any data re new grad hires and if they're replacing a retired nurse, filling a newly created position or back filling for a terminated seasoned nurse?

Specializes in ICU, APHERESIS, IV THERAPY, ONCOLOGY, BC.

This article truly highlights exactly the depths of indifference, incompetence, greed and immoral practice which has been imposed upon nursing practitioners. Management has accepted all acts of power mongering and bullying tactics as key to nursing control- a form of corruption.

How this impacts health care, both in quality care and cost amounts to almost criminal intent. The sub-human treatment of seasoned nursing colleagues by inexperienced nursing management with advanced degrees demands legal advice. The reality is that all nurses and patients are being placed under attack through misguided, poor managers with non existent decision skills.

Health care, education and social stability are key aspects of democracy, good government and accountability. A break down in any of these areas negatively affects everyone with serious secondary run off effects. . It is time this was collectively exposed by nurses in practice to the public. Nurses are not disposable commodities and their role in healthcare cannot be underestimated.

All nurses applying for Executive Management jobs in nursing need to be tested and thoroughly examined re. their ability to manage, to think and to assess problem solving and interpersonal skills. levels of reactivity, subjectivity and objectivity in practice need to be measured. This is the routine applied to other executive managers in any industry. Business managers have to be put through such testing due to the need for the right fit for the job.

Nursing does not apply these rules and the consequences, having been ignored as management competency is not thoroughly examined. Rather when faced with management dilemmas, the preferred practice has been to hire externally, a non health care professional with multiple MBA or management degrees. This has proven over and over again, how incompatible this is in a healthcare setting. Nurses are educated, competent professionals and unfortunately, this often proves incompatible to new, highly qualified, non healthcare professionals who desire to see nurses as little more than bedpan givers without the ability to think, as this further feeds the new managers sense of power. The consequence as we know, is always disastrous. Nurses can make good managers. Not every nurse wants this and not every nurse can do this particular job.

Two mandatory words stand out in healthcare and nursing, Experience and competence with education. If applying for management roles, nurses need to undergo similar testing for the appropriate fit. This is not to say that nurses do not make good managers, it is rather to assess where in management they actually belong, thereby ensuring continuity in best practice at all levels of the profession. WE, as nurses, know what is needed, what works and what does not. Being able to assess the right fit and have further training is crucial to eradicate the level of incompetence and quasi-corruption right now.

Specializes in Nurse educator,correctional,LTAC,Med/surg Tele.

This was to be my next topic to submit to the nursing journals when i am done with graduate school, this is a severe problem and i have been trying to get others involved in taking control of our profession, things such as letting our local politicians know whats going on so mandatory staffing laws are implemented country wide. Nurses are the largest group of professionals yet we cannot get together to show force and strength that enough is enough...While I know we all fear retaliation for speaking up (been there done that), the reality is we have to take a stand and yes isn't it a blessing that we have careers that are in high demand? We have to take a stand and stop being held captive, awareness of this issue must come to light and not swept under the rug anymore. As long as it is done with the professional standards that we should have then my hope is that our voices will be heard...Can this letter be forwarded to local newspapers? or television?

Specializes in Inpatient Oncology/Public Health.
Ruby Vee said:
"Tow" the party line?

There's another thread here that's referring to nurses with 18-36 months of experience as "seasoned nurses." Now THAT's scary!

(And I think it's "toe the line.")

I'll never forget at my current job being called a "Senior Nurse" when I had like 3 years experience. Sad thing was, it was true, especially on night shift. We had nights when it was all green nurses and I just prayed to whatever god would listen that we would get through okay. I'm 8 years in now, and I still don't feel seasoned but a bit less green. We not only have nurses with 6 months-1 year being charge but also precepting the brand new nurses.

Shameful, and it's not like they are overpaying experienced nurses. There are plenty of other places to cut expenses other than where the rubber meets the road.

I am one of those nurses who am 60 years old have been at the same hosp for more than 30 years and do not wish to take on the debt so near retirement to get my BSN, because of this my hospital will no longer let me stay in my current position which I helped to start more than 7 years ago and are going to place me back to a Clin 2 ont he clinical ladder (I was a 5 before this position) and cut my pay by about 7.00/hr. We are a magnet hospital and we are also told that there are no outstanding evaluations. Does this not make you want to discourage anyone from going into nursing ???

Specializes in Geriatrics, Dialysis.

The nurse that replaced me when I left my night shift position [my choice btw] was one I had trained in. She is a new nurse, this is her first nursing job. She was sincerely terrified when she realized that me leaving that shift made her the senior nurse and by default the supervisor.

My point is, it's not just the "seasoned" nurses that are aware of the problems facing facilities that push out experienced nurses in favor of new, inexperienced ones. Some of the new nurses are scared, suddenly the realization hits that they are now the the ones "in charge."

Specializes in High Risk Labor and Deliver.

I left the floor 17 years ago to purse Nursing Informatics when they raised our patient ratios in High Risk Labor and Delivery. Managed care took the spark out of bedside nursing for me. Now I see RNs passing out Meds and documenting while aides do everything else. My husband was lucky I am a nurse when he had a stroke in 2013. I can tell you first hand I am very worried about our lack of healthcare system.

Specializes in Med/Surg, OR, Peds, Patient Education.

This is tragic for patients as well as the experienced, competent nurses. Hospitals are poorly staffed, so poorly staffed that they are unsafely staffed. I saw this first hand when my husband was hospitalized. The nurses, what few were there, were exceptional, but they can only do so much. They get no breaks and don't even have time to use the bathroom as needed. However, the hospitals seem to have plenty of administrative personnel who walk around in expensive suits.

When my husband needed to be hospitalized, I stayed with him to help him to the bathroom, after having a colonoscopy prep. There was no way that there were enough nurses or ancillary care givers to do that. He was given an inappropriate medication that should have been only used for someone with an upper GI bleed, as it was a PPI. My husband had a lower GI bleed of bright red blood. Admin knew that we were unhappy with the situation and they sent a "patient care excellence" administrator to speak with us. When we spoke up about inadequate staffing and other issues, regarding hospitalists not speaking with our PCP and ordering an inappropriate medication, he suddenly had to leave to "attend a meeting," and we never saw him again.

Hospital care is not optimum, or anywhere near even adequate, and the two of the issues are insufficient staffing, and hospitalists who do not communicate with patients' PCPs.

My daughter in law's dad was in the Hospital recently. His IV pump started beeping, he rang the call bell. The CNA came in the room and said she would have to get the Nurse. She then stated that the Hospital planned to send all the CNA's to class to learn how to set and restart the IV pumps. She was a older CNA and said she did not want to be responsible for anything to do with the IV pump, but was told that will be one of her new job responsibilities once she is trained. So yes Nurses are being replace rather quickly. People need to be aggressive with their loved ones regarding medical care and know who is preforming the care.