Manager Bonuses

Specialties Management

Published

I was wondering if the Nursing Supervisor gets a bonus for coming in under budget? It seems like that would be the only reason to run short staffed or increase patient/nurse ratios. With reimbursement being partially based on patient satisfaction, from what I heard, l can't figure out what other motivation there is to decrease staffing. Do you think it would be better to give the bonus to the staff if the Unit is under budget but short- staffed say 25% of the time or more?

But all of those things being equal, increasing an assignment 50% gives the HOSPITAL 2-3% profit and is that WHY the supervisor chooses to email staff how bad patient satisfaction is and then increase the work load? Just curious about that rumored bonus.

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Decisions are based on managers/DON who have little to no bedside experience, so really believe that they understand what a bedside nurse does. And "can't believe!" that 8 patients is not feasible. Because they have never had to do it.

Even managers who have the experience, can only advocate so much, then it is "if you will not do it, we will find someone who can" and then we are managed by 2 nurses who have never worked a unit. Oh, then the "fun" begins in that scenario.

If one "sticks to the script" it is all robotics and improv. What they fail to understand is that "I have the time" then begins the hotel like requests and the requests a nurse can not always fufill.

I am not sure that there's any bonus, however, there is no loyalty, so people can be replaced with a more "business model" so that the bottom line is the focus, and not the patient.

Because at the end of the day patients are just pesky with the fact that they have to be happy in order for the facility to be paid, and it always, always falls on the nurse to make that happen. Because a nurse can also be replaced.

So if the darn nurses would stop the caring part of their profession, it would be so much better.....:sarcastic:

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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?
on nights? At some places yes. IN a union facility? No.

I know of telemetry floors that are a 1:5, 1:6 on nights. Med surge is mostly 1:8 at night. No one has their "own aid" the aids are on the floor and assigned patients.

Staffing is an issue and that is why here in MA they are trying to pass a safe staffing bill https://www.massnurses.org/legislation-and-politics/safe-staffing

Now about those bonuses....some places may be doing this...I personally have never received one. I have had my job threatened if I didn't staff accordingly and remain on budget. I have been reminded to not be too supportive of the staff then reminded "which side of the toast is buttered and by whom".

Be kind to your manager you have NO IDEA what goes on behind the scenes. Many of my friends that have done administration for a long time have left those positions in the last 5-8 years...they couldn't do what was being asked and secretly supported mandatory safe staffing.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
But all of those things being equal, increasing an assignment 50% gives the HOSPITAL 2-3% profit and is that WHY the supervisor chooses to email staff how bad patient satisfaction is and then increase the work load? Just curious about that rumored bonus.
Your facility may be giving bonuses. That may very well be true. I personally have not heard of bonuses at the mid level. Upper management.... sure they get bonuses.

Talking about satisfaction scores? Yup they are going to harp on that and Senior management doesn't care if the nurses are suffering and the patients don't get good care I mean after all.... it isn't their family. TRUST ME when I say this when it IS their family you bet that floor gets better staff.

Your supervisor is e-mailing you because they have to....they are greeted every meeting with their failure as a manager for bad scores. I wish I could emphasize how bad it has become... with more and more managers/directors/administrators that are hired with little to NO bedside experience the empathy/dilemma for/of the bedside nurse is vanishing.

I am genuinely concerned where this is going to lead. I am even more convinced that nurses need to pay attention and collective bargain...NOW! There IS strength in numbers. BUT! I am just one little person and it is just my opinion.

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Specializes in FNP, ONP.

I managed a 30 bed University SICU some years ago. I never received a bonus for meeting or exceeding budget goals. People throughout the system were fired for failing to meet them, however.

I think that is largely a conspiracy theory with little truth to it.

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Specializes in Critical Care, Education.

OK - here goes. I have been in bonus-eligible positions. In healthcare organizations I am familiar with . . . the farther a manager gets from the bedside, the less his/her salary is connected to clinical metrics. First line managers are evaluated on patient satisfaction, compliance with budget expectations, etc. Nurse managers don't usually move into 'bonus' territory unless they are in a Service Line Director (multiple units) role. It's not as great as it seems. Bonus-eligible positions usually don't get a merit raise. The only annual increase is related to the "bonus".

As you move up the ladder, there is increasing opportunity for "pay at risk" (e.g., bonuses) based on operational outcomes. Not unusual for C-Suite jobs to be eligible for bonuses that are nearly equal to their base salary. There are very specific goals that have to be met in order to receive the bonus.

Bonus calculations are based on multiple weighted factors such as meeting patient safety goals, staff turnover, controlling patient length of stay, re-admission rates, etc. I have never seen a bonus calculation that did not include some aspect of budget performance... since (as a PP already stated) the most easily controllable aspect of the budget is labor. So when push comes to shove and expenses need to be cut, labor is an easy target.

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There are probably some health systems that give bonuses for that, but generally, staffing cuts are related to budgets. People don't realize there is a lot more to staffing budgets other than just numbers of people on the floor. There's the pay, of course, but then also the cost of any benefits (like federally mandated health insurance), the cost of the employer's share of your taxes, etc. Being in that position is very difficult because you're always seen as selfish or uncaring because you don't want "enough" staff on the floor. Many times when I've heard people complain they are "understaffed", but when you look at the acuity and the patient load, they really aren't. It's a tough job to care for patients, and most of us wish we could have more people in direct patient care positions rather than working in offices fulfilling all the paperwork requirements of the federal/state governments and insurance companies.

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