Manager Bonuses

KeepItRealRN, BSN, RN · Jun 13, 2014

It is made clear you WILL lose your position if you continue to not increase productivity and run over budget. If you can't do it they WILL find someone who will.

^^^^^^THIS!^^^^^^^

Gypsy Moon · Jun 13, 2014

So, on another site, I found average cost per day of hospitalizations for various surgeries of $10,000 - $14,000. And the bedside nurse has 4 to 6 patients. At 4, that is $40,000 / day and at 6, that is $60,000 / day. And if the nurse earns $75 / hour (this fake nurse is earning differentials or overtime at a big city hospital or double time as a new grad) this is $1,800 /day plus some insurance package, IDK, lets say $2,000 / day. So RN wages are 3 1/3 to 5 % of the cost. Even giving a nurse 2 extra patients would save the hospital 1 1/3 % and increase the nurses' work loads by 50%. So the hospital can have more profit, is that the goal?

applewhitern, BSN, RN · Jun 13, 2014

I have heard that our upper and middle management gets a bonus each year, but I don't know if that is true or just a rumor. We don't staff short, unless we simply can't get anyone to come in when nurses call out sick. We just cut down on OT instead of cutting down staff.

Esme12, ASN, BSN, RN · Jun 13, 2014

So, on another site, I found average cost per day of hospitalizations for various surgeries of $10,000 - $14,000. And the bedside nurse has 4 to 6 patients. At 4, that is $40,000 / day and at 6, that is $60,000 / day. And if the nurse earns $75 / hour (this fake nurse is earning differentials or overtime at a big city hospital or double time as a new grad) this is $1,800 /day plus some insurance package, IDK, lets say $2,000 / day.

I do not know what you are looking at...but I real nurse in Boston at a Union facility WITH staffing ratio protection makes around that $75.00/hr for a seasoned nurse plus shift diff and perks. Remember not all hourly wages are equal when you figure in cost of living.

So RN wages are 3 1/3 to 5 % of the cost. Even giving a nurse 2 extra patients would save the hospital 1 1/3 % and increase the nurses' work loads by 50%. So the hospital can have more profit, is that the goal?

I am not sure what you are asking? What other goal would there be? Happy patients? Get closed by operation in the red? Of course the goal is to gain more profit. Most hospitals even "not for profit" ones are run by corporations now. The big guys at the top get all the steak and the little guys eat hot dogs. That is the way things are run these days.

ALL CEO's I have been around consider nursing a necessary evil. They HATE that nurses do not bring in billable resources and consider nurses just red ink...sucking money from the bank account. All debit and no measurable credit back.

iluvivt, BSN, RN · Jun 13, 2014

Nursing comes with the room charge

Gypsy Moon · Jun 13, 2014

Yes, I don't want to make the company run in the red. But happy, cared for patients would seem like a better goal than a few more percentage points in the black. What kind of patient ratios in Boston? Maybe I should move there :sarcastic:

Esme12, ASN, BSN, RN · Jun 13, 2014

Yes, I don't want to make the company run in the red. But happy, cared for patients would seem like a better goal than a few more percentage points in the black. What kind of patient ratios in Boston? Maybe I should move there

It depends on the facility like every where else. The Facilities that are collective bargained by the MNA have better staffing for the most part. We have a surplus here for nurses and many facilities are now only hiring BSN nurses.

While the $75.00 seems great. The average apartment in Boston is around $2,000.00/month for a studio. Not cheap. The average 3 bedroom home...around $400,000.00.

A hospital on the north shore has for their heavy med surg dumping floor (chemo to ETOH) for 35 patients has 7-8 nurses and at least 4 CNA's who do lab draws and all EKG's for days. 6-7RN's for evenings and same CMA's and nights has 5- 6 RN's and 3 CNA's. Now a non Union facility has 6 RN's plus a charge for 35 patients and 2 or 3 CNA's for days and 4 RN"s for nights with 1 or 2 CNA's for nights....for 30-35 patients.

Esme12, ASN, BSN, RN · Jun 13, 2014

Yes, I don't want to make the company run in the red. But happy, cared for patients would seem like a better goal than a few more percentage points in the black. What kind of patient ratios in Boston? Maybe I should move there

They don't really run in the red. It's all smoke and mirrors. It is well established that a lower nurse patient ratio leads to shorter stays and increased satisfaction. The problem is the bottom line is profit that the bedside nurse NEVER sees.

toomuchbaloney · Jun 13, 2014

They don't really run in the red. It's all smoke and mirrors. It is well established that a lower nurse patient ratio leads to shorter stays and increased satisfaction. The problem is the bottom line is profit that the bedside nurse NEVER sees.

So very true.

I read an older thread somewhere here on AN where a post reminded us why people come and stay at a hospital.

Some people think they come because they need medical care. No. Most medical care is available in the office setting.

Some people think that they come because they need surgery. No. Most surgery can be provided in an outpatient setting.

Some people think that they come because they need medications or IVs. No. Medications, IVs, and most treatments can be provided in the home or in an outpatient setting.

People come to and STAY in the hospital because they require NURSING care. In the absence of that acute need, they can go home.

Gypsy Moon · Jun 14, 2014

Esme, that sounds terrible. My CNA has 15 and I have 8? I don't know about chemo except when I float, they mostly are ambulatory and oriented but tired. I have had a supervisor tell me it would benefit me to be able to give chemo. Maybe I am off course to want to be on a 1 to 5 or 1 to 6 between 11 to 7?

Gypsy Moon · Jun 14, 2014

Oh dear toomuchbaloney, So crazy but one sweet, young supervisor laughed that patients come to the hospital to see the nurses. Rather they come to see the doctors. It is difficult to explain I guess l

MrChicagoRN, RN · Jun 14, 2014

So, on another site, I found average cost per day of hospitalizations for various surgeries of $10,000 - $14,000. And the bedside nurse has 4 to 6 patients. At 4, that is $40,000 / day and at 6, that is $60,000 / day. And if the nurse earns $75 / hour (this fake nurse is earning differentials or overtime at a big city hospital or double time as a new grad) this is $1,800 /day plus some insurance package, IDK, lets say $2,000 / day. So RN wages are 3 1/3 to 5 % of the cost. Even giving a nurse 2 extra patients would save the hospital 1 1/3 % and increase the nurses' work loads by 50%. So the hospital can have more profit, is that the goal?

but the nurse isn't the only caregiver. Labor accounts for about 2/3rd of a hospital's costs, including benefits. The $75 nurse costs a $100 or more when you add benefits.

http://www.aha.org/content/12/CostofCaring2012.pdf

Add the cost of the CNA, housekeepers, engineering, security, receptionists, OR staff, infrastructure, IT, utilities, etc.

And in the not for profit setting, profit isn't the goal. The goal is to bring in enough $$$ to attract quality staff, provide quality care, and to keep the doors open. That's been my experience for the past 30 years.