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.
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
At least a decade ago we had good nursing research that demonstrated beyond doubt that better nurse/patient ratios decreased errors and adverse events. The cost to prevent sentinal events is far less than the cost of treating the outcomes of such events.
The research is still coming in. I remember when I was a new nurse and it bothered me that we were told (by higher ups) staffing doesn't affect outcomes. I felt so justified and validated when NURSE researchers a few years ago finally starting empirically proving what we floor nurses have known for years: good care improves outcomes. Work like this is part of what inspired me to become a nurse scientist.
This just out today, and I'm sorry if it requires registration, but a new study finding fewer ICU patients die when there are more nurses. Who knew?
Same reason why I left my last job and accepted a job for a little less money but with a company that actually values its RNs and employees. Always seems like a no-brainer when a company has high turn-over rates due to poor job satisfaction yet senior management does NOTHING to solve the problem -they just keep cashing those huge paychecks and making poor decisions in their management bubble.
I worked in a union hospital for 10 years and saw the good, bad, and downright ugly side of unions. With that said, THIS is why you need unions. Im not even a nurse but Ive seen in all allied health careers and nursing. They LOVE the fact that there is no shortage anymore, no matter what articles or reports you read. There is NO shortage. No nursing shortage, no xray tech shortage, no respiratory therapist shortage.....PERIOD.
Upper management....usually ones that wear suits and haven't touched a patient since the Nixon administration (if ever) want to get rid of all the $40+/hour making people and dangle a job over 30 applicants heads to see which sucker will take the less money and benefits.
Its happening folks and there aint a damn thing you can do about it except join together.
I once greatly enjoyed being a nurse, but after a few years of working for a very controlling manager followed by a total narcissist who would agree to anything to further herself, my love of nursing has waned. Things like HCAHPS and value added purchasing have done little to improve nursing. They have just polluted healthcare with more toxic smog. We are here to heal and treat people primarily, not to make them "happy." If you are smoking and have a growth restricted baby, I am supposed to encourage you to stop smoking....but then will you "ding" me when the "survey" comes????? HMMMMM? As healthcare providers, we deliver a lot of messages people may not want to hear. I want patients to like me, but more than that I want to the right thing. Unfortunately, it all boils down to the mighty$. The top box scores, the desire for "cheap" labour, the clamouring for government moneys. It isn't about people so much anymore... Not our patients or valuable experienced staff. With all of the technology and despite these "surveys" measuring satisfaction, it has become very unsatisfying in many ways. I know after almost 28 years, I feel really frustrated and spent.
Yup!! It's a killer. Healthcare is so big that a small business person with a dream could not start a hospital. The greed of the established healthcare run systems and political legis causes this possibility to be something like a miracle out of the Bible. But that is what it would take to move that billion dollar mountain to start benefitting our families again. One common sense and out of the box hospital who would seperate the infectious and non infectious patients/visitors and staff. Charge rates based on what the cost is to the persons. Facilitate education to patients and staff. These are a list of items that are easily changed for being cost effective with better patient outcomes. Most are not rocket science. In fact it may be elementary school science for much!!!
First time I have posted here so not sure if I am doing this right. This is a comment for the "Hospitals Firing Seasoned Nurses: Nurses FIGHT Back!" article.
First the formalities I am a nurse, now that that's out of the way here you go:
There are two side to every story, for some the reasoning behind the elimination of seasoned nurses is act of malice, yet for other it is a Necessary Evil of human resources. Let me explain, based on recommendations from organizations like Baldrige, Magnet, and the Institute of medicine, nursing has been steered to toward a mandatory higher expectation of education with no expectation of higher compensation. This has little to do with individual hospitals, clinics, or ltc facilities, for the true culprit is the established 20 year nurse. For years nurses have chased the illusive respect they felt they needed to be coined a "profession" nurses have allowed their compensation, practice, educational, and certification requirements to be dictated by people who have either never worked in the shoes of a nurse or are many years disconnected from the actual human to human interaction the majority of our nursing staff work.
So many of our established aging nurse population chose to complain and take it on the chin as the workload increased and the healthcare delivery model changed, they neglected to demand higher rates of compensation as nurses became much more than an expense to their facilities. "Progression was just for the master's prepared nurse not the workers" they said....Boom All of a sudden people act like they are blindsided by the recent 22 year-old nurse with an MSN being precepted by 30 year ADN who is bitter and underpaid. Get real nurses the rumors of increased educational requirements started in the 70's. Changes always occur in nursing in a liberal manner where those who make the recommendations and rules benefit the most. I challenge every nurse to research the "real" reason you work 12's and every other weekend, now look at the niche areas of nursing with consistent hours and see which area flows better and has nurses that love showing up. Education is important and increased education expectation is superb, but not when nurses are so top heavy that there are 20 different MSN's. There will be no more good nurses if we disincentivize nursing education. The old 20+ year ideologues who are behind the scenes pulling the strings in nursing leadership are establishment nurses who did well and are self-serving career motived people, they do not understand business and cannot find a better way for nurses to give efficient, cost effective care that is still focused on patient safety.
My only hope is that the new breed of uber educated nurse will use their smarts to undo the mess that is being left.
DCBW said:Here's something interesting, ED Shultz, MSNBC host and super pro-union guy, is married to a PSYCHIATRIC NURSE named Wendy! I wonder if he'd give our issue the hook up on his show?http:// http://www.biography.com/people/ED-schultz-21044911#political-commentator
Should we go to the media first or get things set and then go?
DCBW---Good for you! an actual idea instead of this general moaning and groaning! (of which I am guilty, also)
I feel we can do both! Heartfelt letters sent to ED Schultz might be effective! At the same time the NNU could be contacted (aren't they roaming around allnurses somewhere?)..what are their ideas? do they have a plan? what have they done.
But remember, unfortunately we are a deeply divided country, and that will be evident amongst nurses and how they perceive the CAUSE of the problem.
ive been a nurse for 27 years and feel i was " let go" 2 years ago from my job of 10 years just to prove a point to younger nurses what happens to u if u question authority as i refused to work in unsafe condition for my patient and accept any more patients as he should have been in icu and they had no more staff or beds to care for him. They are indeed hiring younger nurses as is more economical and IS NOT best for pt care!! time to wake up here!
Sassy911
1 Post
Serious problem. So sick and tired of ALL the managers pushing lead to figure how to save more money.....while staff is over worked, pushed into salaried positions they never asked for, expected to work "till it's done" while they bring home TONS more $$$. Won't do it much longer....while the youngins on the floor don't know "yes they are suppose to walk their patients so they don't get DVTs". Patients leaving much less mobile than when they came in, at least thats what happens in Bloomington....pathetic