It's all about the budget

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July marked the beginning of the new fiscal year at the hospital I work & as always they are trying even harder to cut costs. For over a year now a "SHARE" program has been in effect where employees find ways to cut cost & are rewarded monitarily (i.e. standardizing after-hours snacks, using cheaper contrast media, eliminating sign-on bonuses, blah blah, blah). They have also changed the staffing grid AGAIN. We were using a 4:1 ratio on our unit & our customer service scores were improved, but now they want budget cuts (even if that mean sacfrificing customer service???) & they have made us go 6:1. The hospital I work at is in a poor community mostly populated by senior citizens or people receiving government aid. We see very few private insurance, but we see a ton of self-pay. This has to effect the bottom line & don't they know that? Anyone out there going through similar situations at their hospital & what steps are being taking to improve the budget?

Specializes in OR, CVOR, Clinical Education, Informatic.

We the unwilling, led by the unknowing, are doing the impossible for the ungrateful. We have done so much with so little for so long, we are now qualified to do anything with nothing.

And management wants to keep it that way.

Remember, the better you do the more they expect.

Specializes in neuro/ortho med surge 4.

My facility is taking away a nursing assistant per shift, giving us another patient, and cutting the unit secretary's hours on the weekends. So we are now expected to do more with less. My unit already has a high fall rate due to the nature of our patients. We get the change in mental status which means all of the detoxers, strokes, and little old peeps from nursing homes or from families who cannot take care of them any longer. We also have ortho on our unit which is also a high fall risk area. We spend so much time dealing with the "needs" of the detoxers and the poor confused patients that our alert and oriented patients receive less attention. Guess who the "customer service" surveys are sent too? All of our alert and oriented patients who feel short changed because we are so busy dealing witht he confused and neediness of the detoxers. The customer service forms are not sent to the confused and detoxers so our HCAP scores are low. Maybe they could send these forms to the families of these patients so that our scores would be higher. I also learned that only the responses of always and never are counted. Why bother putting sometimes and almost always on the forms if they are not counted. I mean the world is not black or white.

With the cuts in staff I can see worsening customer service scores, increased patient falls and more overtime. I cannot get out on time as it is. Time to start looking for another job.

Specializes in Ante-Intra-Postpartum, Post Gyne.

I am in California so they can not change our ratios. But they are taking all our unit clerks, techs, and aids away. They keep hiring Per-Diem people to "fill in" so they do not have to pay benefits. They took away charge nurse pay for day shift. They look away "re-call" pay for when you get called in when you are on-call.

Specializes in neuro/ortho med surge 4.
I am in California so they can not change our ratios. But they are taking all our unit clerks, techs, and aids away. They keep hiring Per-Diem people to "fill in" so they do not have to pay benefits. They took away charge nurse pay for day shift. They look away "re-call" pay for when you get called in when you are on-call.

So, in a nutshell, you guys and gals are going to be no better off than before the ratios. I have been working since I was 11 years old. I have worked as an RN for 15 months. I am now 44 and in all of my years I have never been so mistreated and worked to death on a job. Now I am not a lazy person as I worked 2 and 3 jobs at the same time for 8 years. I always had time to eat on any other job I had and left on time. This tells me something is wrong with the nursing system. You would think that where we deal with patients lives on a daily basis that we would somehow be ensured of a break so we could take a breather. Can hospitals not find some other way to cut costs? This burns my rearend!

Specializes in Tele, ICU, ED, Nurse Instructor,.
On my floor, charge nurse no longer gets a 1$ incentive, and now they are taking anywhere from 1-3pts...so basically, we DONT have a charge nurse to help facilitate and assist sometimes cuz they are busy with their OWN patients!

Its because of this whole budget crisis that I am still a CNA with my BSN and RN since last may....they cant afford to hire new grads, they arn't replacing those who go on maternity leave and they are cutting corners everywhere!!! not safe....

Not able to replace the nurses who goes on maternity leave because they are still a full time employee. The facility is paying them their paid time off and/or sick time.

Maternity leave i think is a federal law. Be grateful you have any job. Health care is cutting back just like everyone else out there is. There are so many others, so much worse off.

We the unwilling, led by the unknowing, are doing the impossible for the ungrateful. We have done so much with so little for so long, we are now qualified to do anything with nothing.

And management wants to keep it that way.

Remember, the better you do the more they expect.

LOVE THIS!! So true.:yeah:

Specializes in Tele, ICU, ED, Nurse Instructor,.

Keymaster you have a good point. Now, what are they going to do when the errors starting to increase due to burnout. We get tired also. Some of the best nurses making simple mistakes that we all know are preventive. At the facility I work we do every shift chart check and bedside report. The shift chart check is like a waste of time sometimes because some orders are still being missed and not being noted by unit secretaries. Orders not done in 12 hours which involves an incident report. I dont think it intentionally it just nurses trying to get their shift over and go home and we know nursing is 24 hours a day. This is the way we have to think sometimes. I work night shift. As you probably know nurses call night shift the clean up shift. I know for myself I have cleaned up and found orders that needed to be done. I inform the nurse if they are coming back the next day about it not to be mean just for they can be more cautious. We have certain doctors that like to go to admin. I understand the reason most of the time because we are taking care of patients who counts on us at all times. Sometimes we are placed between a rock and a hard place. I know at the end there is a light.

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