Hospitals Firing Seasoned Nurses: Nurses FIGHT Back!

[allnurses]

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

[CHESSIE]

I agree, Banterings, this "do more with less" philosophy has been becoming worse over the years. I call this philosophy, the "Jack Welch way of doing business," and it started, in the hospital where I worked, in the mid to late 1980s. This happens in "non profit" hospitals as well as the for profit hospitals. I retired ten years ago and my former coworkers, with whom I still correspond, tell me that the situation is now dangerous, for patients and for the nurses, as they fear loss of their licenses. This situation is in a what is called a "non profit" hospital. The umbrella company, owning the hospital, owns some very profitable entities.

My husband was recently hospitalized and the few nurses who were working were fabulous, but they can only do so much. I stayed with my husband throughout his entire hospitalization, which gratefully, was not long.

[CHESSIE]

Joanna, add to that, unless you are in upper management, you walk a fine line. In the 21 years that I worked on my unit we had no less than ten directors. The clinical leader, who would have made a excellent director, saw what happened to others, as a few stellar directors, and some less than stellar directors were demoted. She always declined the directorship each time that it was offered. If the director advocated for the nurses who reported to her/him by repeatedly asking for more staff, refused to attend meetings, as help was needed on the unit and he/she stayed on the unit to help care for patients too often, thereby, missing "meetings," she/he was demoted. In that case it meant that she/he lost service. They were not in the union when in "management," and hence, had to reapply for a position, as a new hire, on that unit, or another, unit

[joanna73, BSN, RN]

Yes, we have been informed that meetings are MANDATORY. I would rather help on the unit than sit in a meeting but the managers have no choice.

[Lev, MSN, RN, NP]

Patient Satisfaction Survey Study Halted; Mortality Increased 238% with Patient Satisfaction | GomerBlog

[XNavyCorpsman]

tacomaster, it sounds like your place needs a Union.

[RK694]

So what's new? I have (or had) dealt with this abuse from administrators in almost every nursing job I've had. Nothing has changed and no matter who insists nurses are "professionals", it's a lie. They are treated like slaves. Interestingly, in my other career as a editor/writer, I was never treated badly like I was when I was doing patient care. Is there anyone who does not look down on patient care?? Nurses get it from all sides...administrators, patients, families, some doctors, the Nazi Nursing State Boards, each other, etc. Hospital/Nursing home nurses are expected to be on their feet for 12 hours, barely having time to eat or go to the restroom. This is ABUSE and most nurses don't even recognize it! They are sleep deprived, often expected to work rotating shifts, either not eat or urinate or go #2 for hours on end or shove food down in 30 minutes, AND make life and death decisions while half starved, sleep deprived, in pain from being on feet and not able to take care of bodily functions, and on and on. It has always been the case that hospitals try to get rid of the experienced nurses and hire young ones for less. This is NOT NEW.

And whoever spread the ridiculous notion that nurses get paid well...they really had low expectations of salary!! If you want to save your health, sanity, and don't want to be bullied and treated like a slave, do not be a hospital or nursing home nurse. If you want to stay in nursing, get out of bedside nursing until nurses are treated with respect or become an NP or anything else but hospital work.

[herring_RN, ASN, BSN]

Conditions for patients and nurses can and do change. We direct care nurses must be leaders rather than victims of circumstances.

Many of us have been improving our working conditions thus improving patient care by working together.

Here is one recent example of what thousands of nurses can do together:

Quote

Settlement Ends Kaiser-RN Dispute

In Largest U.S. RN Contract, 18,000 RNs Win Stronger Patient Care Voice, New Workplace Protections

With a settlement that is likely to elevate RN standards across the nation, the California Nurses Association/National Nurses United today announced a major tentative contract agreement for 18,000 California RNs who work at Kaiser Permanente hospitals and clinics that will give the RNs a stronger voice on patient care, and breakthrough improvements in workplace protections.

The agreement also provides significant economic gains and additional retirement security...

... "This is a great day for Kaiser patients and nurses," said Zenei Cortez, RN, chair of the Kaiser RN bargaining team and a co-president of CNA. "We have an agreement that will strengthen the ability of Kaiser RNs to provide the optimal level of care our patients deserve, while establishing additional security for nurses. I am so proud of the Kaiser RNs and NPs who worked so hard for so long for this day."

"This agreement is a great achievement," added Diane McClure, a Sacramento Kaiser RN and nurse negotiator. "We are especially excited about the expanded opportunity for new RN grads and trainees in Kaiser and the protections this agreement offers for RNs and our families."

Among other major components of the agreement:

• Kaiser will hire hundreds of RNs which the nurses say should substantially improve the quality of care for hospitalized patients, as well as signaling a renewed commitment to RN training and employment opportunities for new RN graduates at a time many hospitals have frozen RN hires.
• Groundbreaking workplace protections for nurses from workplace violence to infectious diseases like Ebola to needle stick injuries.
• Substantial economic gains for RNs and NPs, many of them the sole source of income for their families or extended families. Over the three years of the agreement, all the nurses will receive 14 percent pay increases through across the board hikes and lump sum payments.
• Additional long-term retirement security for Kaiser RNs and NPs through maintenance of a secure pension plan plus a substantial increase in employer contributions to the nurses' 401k pension plans for the 87 percent of Kaiser RNs with those plans.
• Annual paid release time, the first in the nation, for 25 RNs every year to participate in NNU's disaster relief program, the Registered Nurse Response Network, which has dispatched hundreds of RNs to provide basic medical services following U.S. and global disasters from Hurricane Katrina to the Haiti earthquake to Typhoon Haiyan in the Philippines. ..

Settlement Ends Kaiser-RN Dispute | Reuters

[CHESSIE]

Several years prior to my retirement, we had a fabulous director, she had her Master's and was working to become an NP. However, she defied the "gods" and would help the staff, as this was often needed, instead of attending useless meetings. Shortly thereafter, the hospital redesigned the unit linking it with another unit. Her office was gone and someone else, not nearly as qualified, was director of both units. Sadly, she was deeply hurt, and gave up her career, and let her license lapse. She was such a loss to the profession of nursing.

[CHESSIE]

appplewhitern, I agree. unless the newly graduated BSN has been a LPN, AD, Diploma grad, or even an astute, CNA and worked as such for several years before obtaining his/her BSN, he/she will need a six month to a year of internship. Some schools, do have a five year plan and that fifth year is an internship, but those programs are rare and even more costly. With the state of staffing as it is, dangerously inadequate, a six month to one year of internship is impossible for the newly graduating BSN.

[sistrmoon, BSN, RN]

Secretperson said:

Damn that RNs have had the easy pass for years with a tradesmen education and mentality. Sacrifice has been made I get that, but stop discounting the sacrifice others are making right now. You cannot and will not get the days of old back, so stop being mean and start being supportive and embrace what will occur regardless of your complaining.

Easy pass? Ha! I have an unrelated Bachelors degree, and I graduated Summa Cum Laude. But that degree was a cake walk compared to my ADN. I was wait listed for 2 years after the very challenging pre-reqs and the program itself was extremely difficult, both in the testing methods, skills checkoffs and clinicals. Not to mention how many people failed out. I didn't lose half my class in my 4 year degree program!

Also? I'm neither lazy nor resistant to change. I love informatics and have embraced the changing technology of EHR. And I have an impeccable work ethic and work hard both at work and at home. Many many people are questioning the value of higher education, but I think it holds especially true in our profession. When I'm in the bed as a patient, I still prefer years of experience regardless of the degree of my nurse. Experience in the nursing field has taught me far more than any classroom.

[sistrmoon, BSN, RN]

It seems like California is in the forefront of positive nursing change. What have they done that hasn't been done elsewhere?

[Libby1987]

CHESSIE said:

Several years prior to my retirement, we had a fabulous director, she had her Master's and was working to become an NP. However, she defied the "gods" and would help the staff, as this was often needed, instead of attending useless meetings. Shortly thereafter, the hospital redesigned the unit linking it with another unit. Her office was gone and someone else, not nearly as qualified, was director of both units. Sadly, she was deeply hurt, and gave up her career, and let her license lapse. She was such a loss to the profession of nursing.

I understand the insult but she gave up her NP aspirations over downsizing?