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

It has been nearly one year since I left a staff nurse position that I had held for 25 years.As an RN with over 30 years experience ,I was at the top of my pay scale.If management wants to replace senior staff they have multiple tactics to strongly encourage "retirement".Schedule changes,shift changes,improvement plans,poor evaluations and removal of incentive pay were only a few examples.The predictability of their plan was almost comical.Management thinks we have no idea what they are up to?The blatant disregard for patient safety and staff development will eventually bite them in their dollar driven behind.Healthcare is about individuals,that is why it can never succeed as a business-to many variables.Nursing is quickly losing the very essence of the profession.....young nurses need mentors and the "gut feeling" of an experienced nurse will alarm long before any electronic monitor.As the mother of a nurse I can only hope for improvement as she deals with the ever changing enviroment of healthcare.

Administration cares nothing about the patients or the nurses, especially the seasoned nurses. The bottom line with administration is $$$$$$. They are not interested in hearing from the people on the front lines and they don't want seasoned nurses not only because of the pay, but because they will bring attention to these problems. Rather they would prefer nurses who would rather sit and play on their phones that ones who are concerned about patient care and safety. It is scary to be a patient or have a loved one in the hospital.

What a well thought out letter,,, everyone is experiencing these changes

I agree and believe we need to do something before things get worse.

This article is painfully true. After 25 years working in an acute care setting I was forced to retire. I foolishly made an appointment to voice my concerns with our Vice President of Nursing. I naively believed she would care about my concerns about safe patient care. After all she had 18 years of prior experience of working the ER both as staff and as the manager,surely she would understand my concerns about unsafe staffing levels. NOT! her answer to me was, " perhaps Benefis Hospital is not for you." I walked out, went to HR and started the paperwork to retire. They lost a damn good RN and now 5 years later its only gotten worse. Meanwhile management continues to get their bonuses!

So so very true, after 36 years of trauma, OR, and Clinical Nursing I have quit , due to all that was said in the article. Now I use my experience in making sure my family is taken care of when admitted to hospitals!!!

We just had this discussion last night...it was chilling when I came across this article too actually read the realization of this by so many. I am a float CNA and feel the pressures of my co-workers on a daily basis. Moral is down and people are just going through the motions till the end of their shift. The newer nurses have a different outlook on patient care and seem to be there just for the money. Im scared to see where healthcare is going. My position will be done away with soon just because of the pay factor. No one actually considers job performance anymore.

Well said! Sadly healthcare is no longer just that . It is all about the MONEY! Ambulatory care is no different. My clinic operates at such a bare bones level that if someone gets ill or is out for any length of time it throws the clinic into a dangerous spiral. Administrators look the other way and refuse to help. Never thought it would have turned out this way when I graduated 38 + years ago!

I agree. This is happening everywhere. You can thank the new insurance law, I will not mention it's name everyone knows. However, simply writing about it will not make a difference. Maybe it's time hospital staff unite, not as a union but rally. Do a petition to hospital administrators. I would like to see this type of letter printed in major newspapers calling out the institutions by name. I would like to see complaints filled withe the state boards, acha, osha jacho. Your right hospital administrators sit in their cushy offices lining their pockets. I'm tired of hearing complaints that the hospital is in the red, while the ceo drives a moserati. Meanwhile, the floors are filthy, the nursing assistants are being cut back, and fired if they sit for five minutes to relieve their aching feet. Yet they have 1 assistant for a busy icu unit of 32 patients. Yes patient care is suffering. Let's remind these administrators, government heads, as well as the departments I mentioned before, acha osha and jacho that they will someday be a patient and woe to them if things continue to go the way they're going.

So I agree, but....simply writing a letter and posting it here is not enough. Maybe it's time to let the entire country know what's happening. Lets write letters to the presses, and file complaints with the departments that can do something about it.

Just a thought.

Another comnent. When will we be afraid of retribution and really a speak out. Everyone is afraid of being fired but, they can't fire all of us. We need to take further measures.

We as nurses have all of the power but no balls to use it. The newest change at our hospital is making all nurses have their BSN degree. Most of the seasoned nurses have their diploma or associate degrees and are some if the best nurses we have.

That's why it has to be all or none. They can't replace 100 nurses. Everyone needs to stick together. All as one!!