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
shellyma
3 Posts
When I worked in a Hospital in MI the early 90's the patients saw that there wasn't enough staffing. They would make comments like: I feel so sorry for you girls, you are always on the go. Can't they get you some more help? Why do they always make you work short of help? I was instructed that I was never to comment on working short, as we were NOT working short. We had proper staffing according to guidelines. I often requested we have staffing based on acuity instead of by just receiving 13 patients per team. I was labeled a trouble maker. I would say and ask things of the supervisors to no avail. I even asked every Patient I had for one month to be sure to fill out the Patient Survey and return it. They sure did! We were called into a meeting, the Nurse Manager reported that for some reason they had gotten quiet a few Surveys back pertaining to our Unit and most comments were they were satisfied with the actual Nursing care they had received but they felt they had to wait at times and they felt it was because of poor staffing. We were told that since we received so many surveys about this would have to work harder and smarter. I stood up and said "boy did that backfire !" She asked what I meant. I told her I had suggested to all Patients I came into contact with to complete the Survey and I see nothing is going to change. I then didn't care what I said to whom. I then was told I was topic at their bed meetings quite a few days a week. I was told I was an excellent Nurse, Co-Worker and I went over and beyond what my jobs duties were. I just had one main problem. I was a trouble maker. So I was a problem on the Unit. The next time I worked 15 min over, I was told I wasn't going to be paid for it. I can't type what I said to her but I marched right down to Human Resources and told the Rep ( the Unit Mang best friend) they better get me off her Unit and do it now or else, and again I can't type what I told her and I was transferred to the Hospitals Home Health Care. Nothing has changed since the 90"s for me. I just quit Nursing for all the same reasons and I am happy!