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

[rachel100639]

I wish you would have gotten an MBA. They need people like you to change things.

[danielle2000, MSN, RN]

Without nurses you cannot run a hospital so with that being said why are we still dealing with the insensitive nature of administrators. They simply care about keeping their salaries high and decimating good nurses by forcing more degrees with no incentives in staying at the bedside, yet expecting experienced nurses to train their new grad BSN nurses.

[Ryn RN]

Well said and my opinion exactly Farawyn!

[Ryn RN]

Do we really care what admin says about us?!!!!!

[CHESSIE]

Hi Kalle,

Since I have been retired for ten years and am nearly 80. I do not give a rat's patootie about what they might say about "me," now. I really did not care when I worked, as they did not have a clue what it meant to be a nurse. However, sadly administration did and does have the power to enact RIFs, which happened all too many times in my many years working clinically, and later in patient education.

Staffing was inadequate ten years ago, and more recently, in January, when my husband was hospitalized, it was dangerously inadequate. Interestingly enough, the numbers of administration has increased dramatically in the ten years since I have been retired, while the numbers of RNs has decreased.

[EwaAnn]

CHESSIE said:

Hi Kalle,

Since I have been retired for ten years and am nearly 80. I do not give a rat's patootie about what they might say about "me," now. I really did not care when I worked, as they did not have a clue what it meant to be a nurse. However, sadly administration did and does have the power to enact RIFs, which happened all too many times in my many years working clinically, and later in patient education.

Staffing was inadequate ten years ago, and more recently, in January, when my husband was hospitalized, it was dangerously inadequate. Interestingly enough, the numbers of administration has increased dramatically in the ten years since I have been retired, while the numbers of RNs has decreased.

Well since they are decreasing nursing staff and increasing administration staff, they should put administration staff on the nursing unit and make them deal with the same things nurses have to put up with like no breaks (coffee, lunch, cigarette, etc) and make them wait to go to the bathroom, put up with demanding families and visitors, work on their day off, you name it. Oh yeah, make sure you tell them they are not working fast enough and they have to clock out on time. Most of all answer call lights. Let them walk a mile in your shoes and see what they have to say. They might sing a different tune

[CHESSIE]

:-) Cute answer, but we all know that the administrators would not know the first thing to do, even if you gave them the simplest task. They would be overwhelmed.

[EwaAnn]

CHESSIE said:

? Cute answer, but we all know that the administrators would not know the first thing to do, even if you gave them the simplest task. They would be overwhelmed.

That is exactly it. Then they will know what we go through

[babydolltoo, BSN, RN]

Unfortunately I agree that the hospital administration does not care. The bottom line boils down to MONEY!! I agree with this article 100%, being a casualty myself. I was fired after 28 years at the same hospital! Not for my experience & nursing, but for other reasons. Thanks for publishing this article. I just hope changes will come, but I don't think it will be soon enough, or in my lifetime.

[Ryn RN]

Then again, some of the newer nurses are arrogant enough to think they already know everything and are thrilled to have the responsibility!

[Ryn RN]

But are admin and assoc hearing?

[Sunshine#2]

I totally agree and experience the same problem you have discussed in this letter. There got to be a way nurses can voice this problem, even if its to a higher authority.

brian said:

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.