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
Yes they railroaded me out of my job nurse 42 years at an HCA hospital 18 years charge nurse last 6 nursing supervisor them all of a sudden it was decided I couldn’t do my job
yes some young punk from the ER wanted to be a day supervisor so they were changed my hours 2 years before retiring
i told them to stick the job and went to home health
I was fired after 18 years with a certain medical monopoly on the east coast after 18 years of exemplary and spotless service (total RN of 30 years). “Coincidentally” my troubles began after I spoke up about activity that violated my state’s nursing practice act, and after my salary was capped. Afterwards, bogus allegations were made and I was fired with zero peer review of the alleged incident. In fact, I appealed the termination and had it reversed but admin wouldn’t do anything to change the culture that perpetuated the chaos in the first place. Therefore , I felt it was in my best interest to resign rather than tolerate the bullying and abuse.
I am landlocked in my little area of the country and nursing jobs are limited. This stunt cost me a $30k cut in pay. So, here is yet another tactic in which seasoned nurses get fired! It’s shameful.
On 1/22/2015 at 4:30 PM, kbrn2002 said:That is sad that they won't at least grandfather in their own grads. Depressing thought to give your entire career to one facility for them to basically say screw you at the end.
It’s not state board driven- it’s hospital driven. They are still licensed registered nurses. Utterly ridiculous.
The order of priorities of a majority of healthcare facilities:
1. Increase revenue
2. Cut costs
3. Patient care
What's really disturbing is that all those nurses who have posted here with stories of being forced out with 20+ years of experience are the nurses you really want to have working at bedside. Their experience is desperately needed in patient care and to mentor the new nurses. These administrators and nurse managers who are complicit in getting rid of the most experienced nurses; I just wish you become victims of your own doing and one day find yourselves getting substandard care because of what you've sown. You deserve it. And judging by the shape of many of these administrators and nurse managers; they're probably going to need care sooner than they think. Just proves they don't give a damn about patients and care even less for what should be their most valued nurses.
I feel like I am beating my head against a wall sometimes.
I hope most of you realize that this is not driven by the "greedy evil administrators" but by the federal government right? Doubt it because evil admins are easier to demonize.
CMS through the DRG base rate controls staffing by providing incentives and punishments to staff lean, and cut labor costs. Hospitals are PUNISHED if they staff appropriately and pay nurses "too much."
The DRG is split into various sections, the base rate or "bed fee" which is an averaged number regardless of diagnosis is split into two sections with one section covering labor costs. CMS artificially keeps this rate low to control labor costs. If a hospital staffs appropriately or has too expensive or too seasoned of nurses they are financially penalized by CMS.
If you do not like staffing, if you do not like how the hospital is moving towards the customer service model, if you don't like them firing seasoned nurses then look into why they are doing it... Things were not always like this, there is a reason why it changed when the DRGs went into effect.
53 minutes ago, Asystole RN said:I feel like I am beating my head against a wall sometimes.
I hope most of you realize that this is not driven by the "greedy evil administrators" but by the federal government right? Doubt it because evil admins are easier to demonize.
CMS through the DRG base rate controls staffing by providing incentives and punishments to staff lean, and cut labor costs. Hospitals are PUNISHED if they staff appropriately and pay nurses "too much."
The DRG is split into various sections, the base rate or "bed fee" which is an averaged number regardless of diagnosis is split into two sections with one section covering labor costs. CMS artificially keeps this rate low to control labor costs. If a hospital staffs appropriately or has too expensive or too seasoned of nurses they are financially penalized by CMS.
If you do not like staffing, if you do not like how the hospital is moving towards the customer service model, if you don't like them firing seasoned nurses then look into why they are doing it... Things were not always like this, there is a reason why it changed when the DRGs went into effect.
Keep banging your head against that wall then....maybe you will begin to realize RNs generally aren't motivated initially by $$...they generally want to provide CARE for people and to heal patients, I know I do. Your reasoning is nothing but an excuse, there's nothing in it that speaks to exploring creative solutions for the hospitals and the RNs it employs. That's the poorest of reasoning arriving at the simplest solution. No thought given to the the human cost to the patients or nurses. Cold, hard, dollars...I pity the patient in your hospital.
You (or whomever you speak for) apparently see patient care in dollars and figures, while it's really about people...patients and workers. How about bringing that into the calculation?
There's a reason that health care sucks in the US...this is a big part of it AFAIC. People are not figures on a computer screen. They're flesh and blood and heart and soul. This is a sad situation made worse every day by the lazy bean counters and execs.
"If a hospital can treat a patient while spending less money than the DRG payment for that illness, the hospital makes a profit. If, while treating the hospitalized patient, the hospital spends more money than the DRG payment, the hospital will lose money on that patient’s hospitalization."
And therein lies the problem. Don't tell me hospitals aren't shooting for the profit.
How Your DRG is Determined-July 7, 2019, Elizabeth Davis, RN
That is the way is. With all these technologies around, in the future, human nurses will be replaced by robotics. Do you know artificial intelligence can now think on its own? Also, some robot can even walk like a human. You can check that out or google it "Boston Dynamics."
Those CEO's running the hospitals are not nurses. They only have cost cutting in their minds.
My prediction: Nurses will be replaced by robot in the future.
bedwards6
8 Posts
I left the hospital after 33 years, going to work in an aircraft plant in occupational health. When that position was contracted out, I became a production line supervisor as I wanted to stay with the company. In 1 year, I am making $5 more per hour than at the hospital. No holidays, most weekends off. I kept my license active but doubt I will ever go back to bedside nursing. It breaks my heart but I refuse to give substandard care because of poor nurse/patient ratios. Priorities in this country are so messed up! Fire, EMS, police, teachers, social workers, and nurses........all professions that everyone needs. Professional athletes and celebrities......professions no one needs. $ vs. $$$$$$$$. SMH