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
avengingspirit1
242 Posts
The education of PAs and doctors who are board certified to perform surgery is as different as night and day. They are both educated and licensed to perform completely different functions. You can Blah, Blah Blah all you want but people high up in four year institutions have already admitted degree elevation is all about the money.
I went to a three year straight-through-the-Summer hospital based nursing program; and yes Leadership and Research Methodology was a part of the program. The only difference is that my program was not inside four walls named John Smith University so it could not be accredited as a bachelor's program. I matched the content with BSN programs and found them to be the same.
I have also spoken to PTs and OTs who told the only thing degree elevation did for them was make it more expensive to attend and put them more in debt after graduation. The treatment a patient would get from an experienced PT with an entry-level master's is no different than what they would get from a DPT. It also was done so PTs and OTs could try to vie for a higher pay scale. But that hasn't panned out. Not once did a patient or doctor ever ask me if I had a AS, BSN or Diploma.
Now that baby-boomers are aging and enrollments at four year schools have suffered, academic elitists tried to think of a way to suck more money out of nurses and keep revenue flowing into the institutions. And to remind you that an RN, MSN does not have an earned BSN. I checked with Universities about this. So by the academic elitist logic and RN, MSN should have to go back and get a BSN. To see all these overweight, middle-aged and post middle-aged academic elitist nurses who haven't touched a patient since Bill Clinton left office get up from their desks, and pie charts (as well as the pie and doughnuts they are eating) and have to take BSN classes would be a sight for sore eyes.