Nsg home administrator vs the nurse.

tewdles, RN · Nov 6, 2009

You are describing the realities of for profit healthcare delivery. Non medical people making medical decisions and choices regarding what will and won't be paid for, provided, or allowed for patients is the standard today. Decisions in this environment are not based upon what is best for the patient but, rather, upon what is more profitable. You are correct in refusing to bend rules and laws in order to insure improved profits for your facility. If the administrator wants someone to incur the liability of transporting a patient he should put himself on the short list of volunteers. He has the "right" to make these decisions about meds and ambulances because there is no law that says he can't...we have (as a country) allowed the "free market" to control this and now we have a system which provides increasingly less service for increasingly more money. Until we have meaningful legislative reform we will continue to see this pattern and people will become more and more accustomed to nonmedical panels of people making important healthcare decisions for patients and families based upon profitability rather than risk/benefit for patient.

pagandeva2000, LPN · Nov 6, 2009

Of course, we see some really insane things that occur in health care because of the almighty dollar. Transporting patients improperly is one of them because the driver of the vehicle can be liable if something happens, and of course, the vehicle is not equipped to deal with a possible emergency nor is the driver trained to intercede if there is one. One of the main arguements that medical personnel such as nurses and doctors have is that they are now interacting with administrators that are not licensed providers themselves...they may not have a full understanding of what risks are involved for the licensed providers due to their intervention.

But, another reality is that the administrator is usually in charge of the budget. In this economy, where it is a worldwide economic shortage, one does have to look at alternative methods of achieving the same thing for less. We do it at home, the hospitals have to as well. If money is wasted, it can lead to the reduction of beds, furlough of hours (such as reduction of hours to work), lay offs, closing of the entire facility. I don't know of too many situations where staff nurses are ultimately responsible for what particular drugs are available in the hospital. An example of this may be that instead of using namebrand Tylenol, acetomenophen is prescribed instead. There is some budget person that will assist the pharmacy by saying that one type of drug that is cheaper can achieve the same result...so, in essence, the administrator may, in fact, have a role in this somehow, but we don't see how decisions are always made on our level.

**canoehead, BSN, RN** · Nov 6, 2009

Solution to the transport problem. Have the hospital put her in a cab and then meet the cab at the door with a wheelchair.

sasha2lady · Nov 7, 2009

Good input !we just got two living room floors redone coated six grand and the new time punch clock coated thirty grand both are nice but we didn't need them yet somehow meds fall short it is what it is but I do feel better and I'm still glad I chose not to get it dc'd I just want this pt to be in some kind of comfort while in my care even if it means I have to endure a verbal lashing for it from the powers that be