Long time ago, when I was a landscaper, I had a friend who owned a business. He owned a laundry-mat. He started it off right too: Put in new dryers that worked better, fixed some issues with the plumbing, made the place as a whole more energy efficient, installed some much requested jumbo washers (for comforters and such), improved the building security and had the placed manned/staffed during busy hours in case someone needed assistance. His laundry-mat was, when it started, the talk of the town. He had people driving past others to go to his. To really get things rolling, he even scored some contracts with local businesses to do their laundry (one cafe, a small assisted living place and somewhere else)............so much so he had to employ a night shift person who did it all.
There was room for improvement, but he had built a very good base/foundation for the business. One thing a lot of customers requested was that he sell detergent/fabric softener/dryer sheets right in the laundry-mat. He only had a small dispenser with stuff in it, the ones that sell little one load portions of detergent. He planned on doing that after he expanded. So, business went on as usual, no hitches.
Then he got, IDK............weird about stuff. Was sorta penny pinching everything to death. His coin/change dispenser frequently didn't deposit the right amt. of coins if someone put anything larger than a $1 in it. I saw him once get into it with someone who claimed they only got 17 quarters for their $5. He kept trying to come up with new ways to improve his business and make it more profitable, but his ideas were OFF THE WALL. Tried selling cigarettes, but then people said they'd quit using his place cause too many people were outside smoking and they didn't want their clothes smelling like it. He started selling sports cards from behind the counter, hence he had a lot of younger people coming in getting in the way of people doing laundry. He also made a bunch of displays and sold other sports collectibles.........bobble heads, mini-helmets, you name it. The last idea was a maid service that took your laundry and did it while cleaning the house. It never got off the ground. All the while, he quit doing things to improve the laundry-mat functions. Never put in the larger detergent dispenser everyone was wanting. A few dryers were out of commission and they stayed that way. He was putting so much money into sports memorabilia and equip. to get his maid service going............he couldn't be bothered with keeping what was going right........going.
I asked him one day "Are you in trouble, did you gamble yourself into some debt or something"? He hadn't (he'd done this once before), and his business was doing fine, he just wanted more. His words: "I wan't a business that does more than just fine." So he kept on with his ideas until all the laundry-mat customers were run away. Then the assisted living place he did laundry for closed and a few months later, he was in the proverbial "red". He ended up spending a lot of money fixing things so he could sell the place to an older guy who just wanted to run a simple laundry-mat. That guy he sold it to still owns it today plus three more in the surrounding areas.
I see more and more businesses making the same mistakes my friend made. Heck, there is a burger joint near me that also rents movies:confused:. Why? There is Netflix and Redbox for that. Why not just make a better burger than your competition? Another burger joint down the road is your regular boring old burger joint, but their burgers are really good. They have a line at their window at all times it seems, while the DVD/Burger symbioses is dead and closes early most days.
And hospitals are doing the same thing. Spending millions on outlandish ideas and constantly changing this/that policy in an effort to make more money. My hospital recently implemented "Valet Parking" and from all the emails and big ceremonies dedicated to it you'd have thought they cured cancer. They paid an outside consulting firm to show them how to better schedule people according to predicted peeks in census. CEO's routinely get paid thousands in bonuses for implementing staff cuts that don't save hundreds. But thats not all. They recently announced they are going to sell jewelry outside the cafe .
Wouldn't it be easier/wiser to just quit trying to avoid having to staff yourself and go ahead and do so? You'd save a lot of money in lawsuits, PG scores would skyrocket and people would choose you as a healthcare provider over the competition, regardless of whether or not the competition offers valet parking. You know, be like the burger joint that just serves better burgers.
I'm sorry, FLmomof5, but I have to diagree with you. I work for a hospital that is flush with cash. I know this because as a charge RN we attended semiannual meetings where the CFO reported this to us. The economy went south so their reimbursement make-up or payor mix changed. They took in less money over the past 2yrs but were by no means anywhere close to dire financial staits. Their response? Eliminate the education department, most msn prepared rn saw their jobs eliminated, freeze pay and cut shift differentials, cut pto time,
contract out environmental and laundry services, eliminate cafeteria for the night shift, increase insurance premiums and copays, eliminate incentive pay for float team RNs, inact lean staffing, increase the number of pts a RN is responsible for, freeze hiring and mandate overtime (this is not a complete list but you get the picture). All of this happened while building a new surgical wing and cancer center. What cuts did administration take? They gave up 8 hrs of pto time each year.
Our laundry and environmental services are horrible. We often receive dirty linens in our linen closet, run out of linens and other supplies on a daily basis and our rooms are often dirty after they were supposedly cleaned. I guess you get what you pay for. When ever we voice our concerns about how these cutbacks are effecting patient care, we are labeled and reprimanded for being negative.
I'm sorry but patients come to the hospital for nursing care, not jewelry, book sales or even to visit the CEOs. The problem with some administrators is that they fail to recognize and appreciate that. We are who makes a hospital great. The docs in our town practice at both hospitals but they and their patients choose ours because of the care we provide. They look at us an expenditure. Can an administrator operate a hospital without nurses? Absolutely not but that does not stop them from treating us like they can.
The gift shops, valet parking, concierge service, flat screen tvs, wooden floors and all the other seemingly foo-foo, unecessary, wasteful add-ons are investments with a specific goal in mind. Elective procedures. That's where the money is and those are the folks who can afford it. That's the market the hospitals are trying to attract. I guess we'll see if the roi plays out as expected.
Oh, yes. My hospital is adding OR rooms right now as we speak. Problem I have with this is:
This is not a movie, we are not living with a "Field of Dreams" script here.
"If you build it, they will come"...............if your hospital has the reputation to draw them in. If, instead, you drive away all your clients with poor staffing, bad word of mouth reviews and penny pinching relations..........well, you can build all the elective surgery rooms you want but people will take their business elsewhere. You must be "Five Star" to attract this group of people, and most hospitals are anything but that right now.
I'm sorry, FLmomof5, but I have to diagree with you. I work for a hospital that is flush with cash. I know this because as a charge RN we attended semiannual meetings where the CFO reported this to us. The economy went south so their reimbursement make-up or payor mix changed. They took in less money over the past 2yrs but were by no means anywhere close to dire financial staits. Their response? Eliminate the education department, most msn prepared rn saw their jobs eliminated, freeze pay and cut shift differentials, cut pto time,
contract out environmental and laundry services, eliminate cafeteria for the night shift, increase insurance premiums and copays, eliminate incentive pay for float team RNs, inact lean staffing, increase the number of pts a RN is responsible for, freeze hiring and mandate overtime (this is not a complete list but you get the picture). All of this happened while building a new surgical wing and cancer center. What cuts did administration take? They gave up 8 hrs of pto time each year.
Our laundry and environmental services are horrible. We often receive dirty linens in our linen closet, run out of linens and other supplies on a daily basis and our rooms are often dirty after they were supposedly cleaned. I guess you get what you pay for. When ever we voice our concerns about how these cutbacks are effecting patient care, we are labeled and reprimanded for being negative.
I'm sorry but patients come to the hospital for nursing care, not jewelry, book sales or even to visit the CEOs. The problem with some administrators is that they fail to recognize and appreciate that. We are who makes a hospital great. The docs in our town practice at both hospitals but they and their patients choose ours because of the care we provide. They look at us an expenditure. Can an administrator operate a hospital without nurses? Absolutely not but that does not stop them from treating us like they can.
I've often heard management say "People come to hospitals for the doctors, not the nurses. You can't attract patients, but you can lose them."
I can't say I completely disagree with it, but they left a part out:
"People don't come to hospitals for CEO or VPs either" So how about a pay scale that better reflects their standing in the whole picture?
Whenever family or friends ask me about a physician, I always tell them to be aware of the nursing care they will receive because when the poop hits the fan you'd better hope you have a good nurse at you bedside who knows what to do and when to do it since the odds of you physician being there are slim to none! People watch Grey's Anatomy and think that's the reality of hospitals. I've had to tell my daughter that a lot of the things they show Meredith doing is the responsibilty of the nurse.
If we are not the soul of the hospitals why are patient satisfaction surveys primarily focused on the nursing care and the hospital environment? Our patient survey has one maybe two questions related to the physicians.
I'm sorry, FLmomof5, but I have to diagree with you. I work for a hospital that is flush with cash. I know this because as a charge RN we attended semiannual meetings where the CFO reported this to us. The economy went south so their reimbursement make-up or payor mix changed. They took in less money over the past 2yrs but were by no means anywhere close to dire financial staits. Their response? Eliminate the education department, most msn prepared rn saw their jobs eliminated, freeze pay and cut shift differentials, cut pto time,
contract out environmental and laundry services, eliminate cafeteria for the night shift, increase insurance premiums and copays, eliminate incentive pay for float team RNs, inact lean staffing, increase the number of pts a RN is responsible for, freeze hiring and mandate overtime (this is not a complete list but you get the picture). All of this happened while building a new surgical wing and cancer center. What cuts did administration take? They gave up 8 hrs of pto time each year.
Our laundry and environmental services are horrible. We often receive dirty linens in our linen closet, run out of linens and other supplies on a daily basis and our rooms are often dirty after they were supposedly cleaned. I guess you get what you pay for. When ever we voice our concerns about how these cutbacks are effecting patient care, we are labeled and reprimanded for being negative.
I'm sorry but patients come to the hospital for nursing care, not jewelry, book sales or even to visit the CEOs. The problem with some administrators is that they fail to recognize and appreciate that. We are who makes a hospital great. The docs in our town practice at both hospitals but they and their patients choose ours because of the care we provide. They look at us an expenditure. Can an administrator operate a hospital without nurses? Absolutely not but that does not stop them from treating us like they can.
I have no problem with you disagreeing with me....that is what discussion is all about!
A discussion is when BOTH sides are discussed. I am weary of listening to the MSM or many posters here scream about the greed of the CEOs, etc...."demand" that we cut their exhorbitant salaries....and "treat nurses better". OK, but WHAT does that get you? Does cutting the CEOs salary get the nurses what they want? Does 'reinstituting' that which the nurses "lost" (remember, you had to pay more in premium because the company was charged more....they didn't put that in their bottom line at the hospital) get you what you want....and then cause the closing of the hospital later because (1) they went bankrupt and/or (2) no CEO would be willing to take the position?
My hospital is starting to offer automotive detail service in the ambulance bays. ER staff will be washing\waxing the pt\customer vehicles while they are being seen. Should be a nice way to fill in staff down times......
OK, maybe not. Thats just as reasonable as the jewelry sales, book sales and every other wild hair sale that comes up.
Hospitals doing only healthcare would be a novelty.
I have no problem with you disagreeing with me....that is what discussion is all about!
A discussion is when BOTH sides are discussed. I am weary of listening to the MSM or many posters here scream about the greed of the CEOs, etc...."demand" that we cut their exhorbitant salaries....and "treat nurses better". OK, but WHAT does that get you? Does cutting the CEOs salary get the nurses what they want? Does 'reinstituting' that which the nurses "lost" (remember, you had to pay more in premium because the company was charged more....they didn't put that in their bottom line at the hospital) get you what you want....and then cause the closing of the hospital later because (1) they went bankrupt and/or (2) no CEO would be willing to take the position?
I don't think that is what most posters are referring to. I'm all for remaining viable in this economy. What I am against is the cuts that infringe upon me be able to effectively and safely do my job. Administrators do not have lives on the line when they report to work but we do. Yet we are expected to work in unsafe conditions while they enjoy the perks of working for a financially sound organization. Nursing staff are constantly told what little money the organization has money is spent on unnecessary things. Their wages are raised while ours stagnate. Our resources and staffing are cut while their's is not. I'm sorry those things affect the quality of patient care and the ability to retain and recruit quality nursing staff.
I completely agree... and in all forms of business. If a business provides a quality product/service at a reasonable rate - people will patronize this business. If the quality is consistent and customer service is first, people will be loyal.
I believe that the reason so many clothing companies, restaurants, electronics manufacturers, etc... crash and burn after imploding from the unsustainable growth they take on (opening Xmillion chains while declining product quality by 500%), is that they lost sight of the bottom line by magnifying their bottom line. In other words, they got a little too greedy. This is rampant right now. What do we make in the USA anymore? We have outsourced so much of our manufacturing that we cannot employ people (with any stability) who would work in manufacturing or support small businesses like we used to. That is a slippery slope so I digress.
I think healthcare is absolutely too concerned with growing profit in an ineffective manner. It's too bad. The staff and pts suffer, meanwhile the business is also harming itself by growing a negative reputation. I don't care how great your gift shop is if you are so understaffed that my nursing staff cannot safely/effectively do their job.
Great posting, great example. I've been trying for years to make the same point! The best way I could put it was that when your money runs out, so does your doctor.
I became disabled January of last year. The hospitals insurance was so bad that even the Blue Cross Blue Shield employees were commenting it was a shame my employer had designed such a bad policy for it's employees. Took a year to get properly diagnosed, my insurance wouldn't help, so I spent my life and retirement savings on getting diagnosed, still ended up bankrupt. Finally DX'd a rare auto immune dealy, may be able to work again by the end of this year. A single payor health care system would have been more efficient, faster, and cheaper, IMHO. It just wouldn't make a profit for all these fools.
You can't buy life with money so why should you forfeit life for lack of it?
To the OP: THANK YOU! You posted in words what I have been thinking about for awhile, but had the writing skills to put it in an eloquent post :)
A hospital near where I live has implemented a lot of the same sorts of 'fluff' things. There is valet parking, a large beautiful lobby that I'm sure a Hilton or Mariott hotel would love to copy, and beautiful sky lights throughout the hospital.
I also have a family friend that is a nurse at that hospital, who has privately mentioned to me that the nursing staff is generally overworked and understaffed.
What saddens me more though, is that people, meaning customers/patients buy into this. My own mother saw the lobby of the hospital and immediately thought that "this must be a good hospital."
In reality, it's common sense. I mean, truly, what would YOU want from your healthcare providers/hospitals/facilities? I'd want:
- Caring and competent nursing staff
- Competent, respectful physicians
- Efficiency
- Getting me out of the hospital as soon as possible, with me in the best possible health my situation realistically provides.
Guess what? Valet parking doesn't help me with any of that!!!!!
selling jewelry in the lobby? they've had us selling sodas to staff in the nsg station one time,fifty cents each, the night charge RN was responsible in collecting and keeping the sales and turning it in to the dietary every morning...
Let's see, the hospital where I work has 2 gifts shops, 2 coffee shops, and monthly sales of something or another. Sometimes its jewelry, sometimes its electronics, sometimes its movies/books, oh and recently they added a Chick-fil-a (which I might add charges more for their food than a regular Chick-fil-a) Plus the two other places we have to eat now charge for those little packets of jelly, butter, creamer, plastic cups and plates.
Sometimes when I walk down the main hall I feel like I am at the mall not the hospital...
And you know what I love the most, today in our hospital newsletter it had a list of benefits of working here and my favorite one: free parking (who cares that our parking is 4 or 8 blocks away and we have to take a shuttle to get here.) So I am sure once they stop being nice to us they will start charging us parking too. -__________-
Older post, but the hospitals in the mega east coast city I lived in ALL charged their employees for parking.
. 
CCRNDiva, BSN, RN
365 Posts
I'm sorry, FLmomof5, but I have to diagree with you. I work for a hospital that is flush with cash. I know this because as a charge RN we attended semiannual meetings where the CFO reported this to us. The economy went south so their reimbursement make-up or payor mix changed. They took in less money over the past 2yrs but were by no means anywhere close to dire financial staits. Their response? Eliminate the education department, most msn prepared rn saw their jobs eliminated, freeze pay and cut shift differentials, cut pto time,
contract out environmental and laundry services, eliminate cafeteria for the night shift, increase insurance premiums and copays, eliminate incentive pay for float team RNs, inact lean staffing, increase the number of pts a RN is responsible for, freeze hiring and mandate overtime (this is not a complete list but you get the picture). All of this happened while building a new surgical wing and cancer center. What cuts did administration take? They gave up 8 hrs of pto time each year.
Our laundry and environmental services are horrible. We often receive dirty linens in our linen closet, run out of linens and other supplies on a daily basis and our rooms are often dirty after they were supposedly cleaned. I guess you get what you pay for. When ever we voice our concerns about how these cutbacks are effecting patient care, we are labeled and reprimanded for being negative.
I'm sorry but patients come to the hospital for nursing care, not jewelry, book sales or even to visit the CEOs. The problem with some administrators is that they fail to recognize and appreciate that. We are who makes a hospital great. The docs in our town practice at both hospitals but they and their patients choose ours because of the care we provide. They look at us an expenditure. Can an administrator operate a hospital without nurses? Absolutely not but that does not stop them from treating us like they can.