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
Dangerous said:I rejoiced in the fact that I knew the younger nurses were raised and educated in an environment where they will not be subservient and will speak to authority. Good for you. And hit them in the public eye and also in the purse-strings if you can — that's the ONLY language they understand.
^THIS.
It will have to be a layer effort; lawsuit, mandatory ratios, and NNU style enforcement of proper safety and staffing mandates; along with collaboration of CMS oversight to properly utilize the acuity model that is a part of HCAPS where staffing is based on acuity ensuring proper reimbursement and taking most of it out of the hands of people who are looking at the bottom line instead of the reality.
LadyFree28 said:It will have to be a layer effort; lawsuit, mandatory ratios, and NNU style enforcement of proper safety and staffing mandates; along with collaboration of CMS oversight to properly utilize the acuity model that is a part of HCAPS where staffing is based on acuity ensuring proper reimbursement and taking most of it out of the hands of people who are looking at the bottom line instead of the reality.
THIS^^^
BGBDMOM said:I do not know where to begin to respond to this drivel. Let's begin with this: A BSN, an MSN, let alone a PhD in "Nursing" has one main accomplishment. It means you are no longer a Nurse. That RN behind your name, followed by all those UN-neccesary alphabets, simply means you have been "educated" beyond the bedside. Guess who comes up with all of these "Policies" and "Studies" that do more damage to working nurses than any bean counter CFO? You guessed it. The overeducated "Nurse" desperate to make themselves relevant and justify their 5 digit student loans. "Older establishment Nurses "chose to complain"; No my dear youngling. We were too busy raising our family, living a life to partake in a losing battle. The day medicine became for profit, was the day that all the fou fou degrees and pedigrees in existence, and since made up, would not withstand the hurricane of greed. I cannot help but smile at the irony of your last line, "My only hope is that the new breed of uber educated nurse will use their smarts to undo the mess that is being left." Sadly, in most cases, the "uber educated" are dumb as rocks.
The only profession where investing in one's education is seen as a negative because, you know, the only place for a nurse is at the bedside.
I hope no one tells Nightingale that she wasn't a nurse.
My Husband had always told me men wouldn't put up with the crap that Nurses do. He said he understands women who are single parents, Divorced, caring for a grandchild etc would be fearful of losing their jobs. But it really made him angry when I would come home from work and tell him everything going on. He had been a committee man in the union and said that's what Nurses needed. Though he said the union reps would have to not be afraid of standing up for the employee or it would not succeed.
shellyma said:My Husband had always told me men wouldn't put up with the crap that Nurses do. He said he understands women who are single parents, Divorced, caring for a grandchild etc would be fearful of losing their jobs. But it really made him angry when I would come home from work and tell him everything going on. He had been a committee man in the union and said that's what Nurses needed. Though he said the union reps would have to not be afraid of standing up for the employee or it would not succeed.
I was just in a discussion a couple of weeks ago with a fairly well known physician about the future of nursing. I had brought up the point that the fact that men are increasingly entering the profession will forever change nursing for the better.
I am one of those nurses that had been let go for unfounded reasons after 23yrs in hospital nursing, and I have been in nursing homes and home care also. I am furious with how nurses are being treated and how our patients are unfairly impacted to the point of utterly unsafe and undignified treatment. I would like to see a documentary on this for all to see. If I had the talent I would be all in it :).
Asystole RN said:The only profession where investing in one's education is seen as a negative because, you know, the only place for a nurse is at the bedside.I hope no one tells Nightingale that she wasn't a nurse.
The guiltier one feels the more defensive they become. A little too close to home for you?
shellyma said:My Husband had always told me men wouldn't put up with the crap that Nurses do. He said he understands women who are single parents, Divorced, caring for a grandchild etc would be fearful of losing their jobs. But it really made him angry when I would come home from work and tell him everything going on. He had been a committee man in the union and said that's what Nurses needed. Though he said the union reps would have to not be afraid of standing up for the employee or it would not succeed.
I agree with your husband. Single moms do not make for a good brick wall unfortunately.
JayHanig said:The guiltier one feels the more defensive they become. A little too close to home for you?
LOL, not in the least. I personally do not see my BSN as being anything special, or am I supposed to? LOL, th guy who sprays bugs at my house has a bachelor's degree LOL.
I find it funny when people think the only nurse is the bedside nurse. Nursing is a broad profession with many specialties that serve our patients with each specialty being an important link. A case manager is just as important as a nurse in a long term care facility as a nurse in an ICU. All nurses, all important.
Especially when one looks at the founders of modern nursing and realizes that nurses like Nightingale and Seacole spent much of their careers as educators and administrators.
This a subject I have been dealing with as of recent years. I have 21 years of nursing experience, CVICU, ICU, OR, PACU, ER Med/SURG Tele, Pediatrics and neonates. I have worn many hats and strive to excel in my profession. The hospitals in my area are all Magnate status and now you need a BSN to be hired, of which I am in the process of attaining. In my area most of the hospitals are hiring new graduates only, whose experience is classroom and limited hospital experience, and I cannot find permanent placement due to these ridiculous and incredulous practices. I am now working as a traveler in my area, because they cannot find the nurses who meet their criteria they set forth, creating a severe nursing shortage and a dangerous health care environment. The stress level of the facilities where I have worked is critical, and the exits are blocked by people leaving in droves. The administration and management at most of these facilities feel they are gaining ground by using fear of retaliation and a crack the whip mentality, to drive nurses to take on more than they can handle, which endangers the patients and the nursing staff. Most not for profit hospitals I have worked at are not like this. At these facilities money is not the object of their function, only quality patient care. I feel it is imperative to form a national nurses union, so that we can have a strong voice to advocate fair and safe labor practices, and regulate administrative tactics used to intimidate nurses and ancillary staff. United we stand, divided we fall. Another point that needs to be made is that countries who have socialized medicine are not facing what we here in America are having to deal with. Being patient focused and not dollar focused should and can be what makes all the difference in our country.
Dangerous
19 Posts
Am now retired, amen. However, several years ago, I rejoiced in the fact that I knew the younger nurses were raised and educated in an environment where they will not be subservient and will speak to authority. Good for you. And hit them in the public eye and also in the purse-strings if you can — that's the ONLY language they understand. P.S. After the sudden death of a younger colleague and being subjected to mandatory doubling from nights to days (one time did the trick), I retired early because I realized life was too short to put up with administration's BS.