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

kbrn2002 said:
LTC is the most regulated industry in the US and you are right, it's still not enough. I've worked LTC for 20 years, and I don't know rather to laugh or get angry at the games. We have a pretty good idea when state is going to show up, and of course then we are fully staffed. Management magically comes out of their offices and gasp! answers call lights and helps with meals! The state surveyors can't possibly be so naive as to think that happens all the time.

I don't think so but then one never knows but at one LTC I worked at-the scheduled visit was in October. Well one year they showed up in July unexpected. Caught everyone off guard especially the administrator. Mind you, all went well even in an unexpected visit. Someone might have tipped off the health department of staffing and other ongoing issues.

Specializes in Geriatrics, Dialysis.
EwaAnn said:
I don't think so but then one never knows but at one LTC I worked at-the scheduled visit was in October. Well one year they showed up in July unexpected. Caught everyone off guard especially the administrator. Mind you, all went well even in an unexpected visit. Someone might have tipped off the health department of staffing and other ongoing issues.

There's been many times I've said "I wish State would show up to see how this place is really staffed." There are no lie days when the entire night shift, yes both CNA's and nurses, are mandated because it's so short staffed. Of course that really wouldn't help as not even the almighty state surveyors can make applicants magically appear.

SatkinsRN said:
I've worked in hospitals for over 20 years now. I've noticed (in my limited experience) that hospitals that are owned by Fortune 500 companies, whose primary reason for existence is to make money for their shareholders, simply SUCK! The equipment is shoddy, they do not value having an educated nursing workforce, nurses have little voice in the governance of the facility, and nurses are literally worked like dogs-except that most compassionate people will actually let a dog drink some water, eat some food, and have time to "do their business." I'm curious to know...what are other nurses' experience with for-profit versus not-for-profit facilities? I've recently started working at a catholic hospital. Although I'm only in my third week there, I've been exceedingly impressed with their thorough orientation process, and exceptional hospital education department.

I agree with you about the dog thing- and I just took a huge pay-cut to go to work for a non-profit. The job hasn't started yet, though. The turnover is very low. They only had an opening because one nurse is moving back to his home state.

I am curious to see how this job will differ from working at a for-profit facility.

DCBW said:
We seriously need to do something about this guys. What can we do? Should we contact legislators? These kinds of practices need to be made ILLEGAL!

Any ideas?? Let's ORGANIZE!

Even if it's made illegal it would have to be enforced. There are many shady, disgusting tactics being used by companies to save a buck that are absolutely ILLEGAL in my state but they do it everyday, especially on the weekend, because in their eyes the state will only show up unannounced on the weekend if someone dies! I quit a long term care facility that was chronically understaffed almost a year ago. Management didn't care. Wouldn't fire employees that did not show up on the weekend. Refused to use agency staff and wouldn't get off their lazy butts to come in and help. I was the nurse/med tech/aide/person in charge for the day for 110 residents😰One person showed up 10 minutes late. I believe theirs a minimal staffing requirement for long term care facilities in FL! They found my notice on their desk Monday morning.

I graduated with my BSN, with honors, paid for by my employer. Due to having, literally, 50+ nursing schools in a 100 mile radius, I couldnt find a job to save my life, other than volunteering. I took a job in IT for a few dollars less an hour. Then we were 'acquired' by the largest health system in the state. I lucked out... I had guaranteed hours. Nursing went from nagnet nurse satisfaction focused to money focused. Nurses constantly complain about being sent home without pay.

The focus of the profession is now forcibly changed for us. Contact your representatives. It will change, but I fear only after tragedy.

LTC are notorious for this type of games. The staffing is challenged. Nurses have a patient ratio of 30 residents to one nurse. The nurse is attending one resident while another resident is has gotten out of his or her chair ambulating without assistance and either falls or doing something strange. She/he gets in trouble for something out of her control. They get written up and terminated. LTC love to set their nurses and/or staff up. To get rid of their staff but yet they hang on to staff that son-t do their work. Does that seem fair?

In reply to inshallamiami #45 - So true...nurses are needed to run the place, but yet, what we think and feel is practically

contemptible to management.:no:

Quote
I think nurses need to form a strong and serious union to get our points across.

I don't think unions help because they charge a lot and then when you really need them, they don't

help much...sorry, but that's been my experience...:no:

Anna S, RN said:
I agree with you about the dog thing- and I just took a huge pay-cut to go to work for a non-profit. The job hasn't started yet, though. The turnover is very low. They only had an opening because one nurse is moving back to his home state.

I am curious to see how this job will differ from working at a for-profit facility.

I think you have a good point about the for profits but they also seem to pay more and that's what most people want - more money - but actually, you do work harder for it too.

malamud69 said:
Unions unions unions!

Unions like to take your money and then when you need their help on an

individual basis, they don't help.

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

Unions do try to do their best, but the "big guns," of administration are far more powerful.

Just look around your area, and if it is anything like my area, any doctor who "dares" to open his/her own facility makes the hospital administrators very displeased. You will see that they are "punished" by the hospital administration for being "competitive." It should be patently obvious that competition breeds excellence, whereas lack there of, breeds mediocrity.

One fine gastroenterologist opened his own facility due to the fact that the hospital would not purchase state of the art endoscopy equipment. He invested in more modern, safer equipment, for his facility, and shortly there after, he was deposed of his position as head of the gastroenterology department. Four months later the hospital did invest in the same equipment that he had in at his facility. These fine physicians may have state of the art equipment and many are able to to some procedures in their facility without the patient having to be in the hospital, which saves money for the patient, and without the hassle of a hospital admission. Considering the dangerously low staffing in hospitals this is a plus for any patient.

When hospital administration learns to invest in staffing, and up to date equipment, instead of the plethora of directors, managers, and needless cosmetic "improvements" perhaps these fine physicians will be more willing to utilize hospitals because they know their patients will be receiving optimum care. Apparently, the administration cares more about their own high salaries than patient care. Sadly, it will take a tragedy, perhaps involving "someone important," to wake them up.

Secretperson said:
For the last decade I have heard many nurses voice their concern about the nursing licensure not being regarded or respected as a profession. So nursing leaders began to compare educational requirements to other so-called professions and found that the minimum educational requirements for nursing were equivalent to a trade not a profession. So the tide began to shift in a direction to change not just the educational requirement but also the culture of nursing.

Now as I read through this thread and view responses to other posts (including my posts) two major preconceived opinions of nursing are unfortunately validated. Most nurses are jerks to other nurses, and most nurses are resistant to change.

The RN license knows no boundary, yet many people assume the minute you use the terms education or "bedside" the conversation applies only to acute care or educational areas. Education and expertise combined is key for a profession, For example healthcare consultants, pharma sales, HHS, and DHS all employ RN credentials for clinical expertise, and you can bet your *** experience alone did not qualify these RN's for their roles.

Look get mad at me and others who want nursing to be a respected profession. Go ahead and continue to use the victim mentality of how life is too difficult or how you don't have the money to go back to school. 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.

You sound like a male and an arrogant, profane one at that. You sound like you're probably in administration because you have a very cold tone. Anyway, you will really be enlightened whenever you become a patient to find out that it really is experience that matters. You sound like you're a little jealous over those nurses who have that experience, maybe because you know that the experienced nurse can always get a good paying job. Nursing models may change, but the industry can never do without the nurse who genuinely cares about his/her patients and wants to help them. Patients are consumers and any hospital, doctor's office, outpatient facility, etc., wouldn't last without those who genuinely care. Consumers can go somewhere else, and word of mouth is very effective. You complain about nurses being mean to other nurses but you don't sound like a nice guy either.