Confessions of a Hospital Administrator - page 3

Gallup announced the results of its annual "Honesty & Ethics in Profession" recently. I was so pleased to see nurses ranked number one in the survey because they certainly deserve the honor. With... Read More

  1. by   trauma_icu_rn
    Sadly, this is not the typical mindset of most CEOs, or any C-level hospital administrators INCLUDING Chief Nurse Executives. The "not-for-profit" hospital I work for has a CEO that approves massive cuts over his nursing staff's benefits, salary, and PTO, all the while requesting that the board provide him additional compensation to his over 4.5 million dollar per year salary. He LOVES saying "health care is business." I hope I get the chance to take care of him when he's on his deathbed someday. I'd love for him to experience the low level of caring that his "business" decisions foster.
  2. by   luvRNs
    guttercat, so sorry to hear of your experience. Staff input is a critical patient AND nurse safety aspect when building and occupying a new facility.I was responsible for the building , education and staffing of 4 units in a new Critical Care Tower. Each Unit developed a team ( nurses, CNA, unit clerks, MDs etc) to explore their workflows, equipment needs, and staffing pattern. They and i met together frequently during the build, and updated/ obtained input from other staff as needed. Thanks to our collaboration the opening went well. Our efforts were commendedby the ANCC as a best practice in opening new facility. most importantly, safety for all was enhanced.
  3. by   sarmedic70
    I am temporariily on a sabbatical from nursing. I am a forensic psychiatric RN and worked at a state hospital. The reason I am on sabbatical. The stress of the job. Why the stress of the job? Yes, patients are part of it, but MOSTLY due to administration/nursing management. We staff/charge RNs who are the core RNs of our units are expected to run the units smoothly and keep the units (staff and patients) safe, ensure that the hospital policy and procedures are abided by and enforced, report violations, etc. OK, that makes sense; however, the major issue we RNs have is that the psychiatric technicians know that we RNs do not have any "power" and all we can do is report issues; however, when you have unit nursing management, when things are reported, do NOTHING (of which is most of the time), we RNs have no backing, support, etc., and the staff know it. Prior to me being reassigned from one unit to another (and the reason was to help "fix" issues of this particular unit due to my background in leadership, etc.), a couple of months prior, 3 RNs were adminsitratively removed from that unit due to the psych techs, and essentially no support (as it was found out) from the unit nursing director). I did as was asked and reported issues (via emails, etc.) about what was going on with the staff. Bottom line: No support from the UND at all. Staff retaliated (like they did with the other 3 RNs). As I told our hospital risk management, who was also aware of "issues" on this particular unit, that what should have been done the first time was the staff should have been removed, since they are the initial problem(s), and then the unit nursing director who does not support the unit nurses at all. the other 3 RNs (two night shift and one other day shift RN) do nothing to ensure that staff follow policies and procedures in that they are too afraid to do so, etc. The unit nursing director has admitted that has handled things poorly, but yet nothing changed (and from friends I still remain in contact with, said things remain the same, etc., and staff continue with their antics and the nurses do not get the support needed). It starts at the top with the hospital superintendent and the hospital nursing director who do nothing to resolve issues overall. There is so much empty talk about supporting us, but when it comes down to it, it doesn't happen at all. More RNs would leave if they were not so invested in their retirement at the hospital and lose it, but they are sick and tired of nursing adminsitration and lack of support, yet more and more demands placed on our shoulders as a result. i have several years of leadership/management experience (non-nursing) as a result of the military, etc., and what I have seen in nursing leadership (lack thereof) amazes me. I refuse to compromise my ethics, standards, ethics, honour, etc., just to keep my job/position, etc.. So for now, I am on a sabbatical, focusing on my additional/continued education (non-nursing related) for what I want to do in the future, etc. (that could possibly include nursing). I am fed up with the status quo! I am also fed up (especially at this hospital) how some people management to get into key leadership positions. Head scratching time! OK, end of rant!
  4. by   luvRNs
    This discussion is turing into a sad situation. There is heartache on both sides. My job in administration often placed me between a rock and a hard spot , and trying to please both. The ultimate loser was me. That said, look for SOLUTIONS not problems...START by ASKING HOW and WHYexample: I was a manager on a CCU where staffing was determined by an acuity system. The system seriously. undercaptured the workload of cardiac nurses, and my unit staffing was always recommended low. My staff and I became EXPERTS on the crietria for the staffing tool. We then documented 95% of recommended vs. needed staffing AND the classification errors that caused the difference. Turned out the staffing tool was in error, and my nurses got fully supported staffing back. ASKING WHYA surgical ICU I covered as a nursing director consistenly lst hugh $$, after making money for years. I asked why.... When are charges posted, what is covered in a charge, when did the loss begin. Tured out to be that the interface between the electronic chart and the hospital charge siystem had never been tested. when computer charging went live, once an ICU patient got transfered to other floors. he charge was wiped from the bill .... No one asked why for OVER 2 years. Finally SHAREAs nurses we are only as strong as our communication. If you know of a solution to a problem SHARE it, and follow it up. The whole best practices movement is BASED on sharing and utilizing the successes of others. We can initiate solutions to our problems
  5. by   luvRNs
    EXCUSE my typos above... formatting here is difficult
  6. by   ServantLeader
    Wow - two years to discover charges were being lost in transfer. Too bad administration did not listen to you sooner. As I noted, if a problem needs to be fixed, ask the nurses. Greats story THX for posting.
  7. by   Chiggysmom
    I say BRAVO and agree with other nurses on here as well that we definitely need more CEOs with your heart and mind set! We used to have a wonderful CEO until he retired and was replaced by a more "modern" thinking one who's only concern seems the bottom line with NO REGARD WHATSOEVER about the nurse's opinions. We are NEVER included in any decisions the administration ever makes any more (which we are mostly the ones that usually carry out said decisions or new policies!). It has made me so glad that I will only work for approximately 6 more years (at age 60)and then after that I want to just forget I was ever even a nurse. I think the Gulf of Mexico could use me more!
  8. by   Chiggysmom
    Wow MonkeyBug, your commentary "hits the nail on the head" EXACTLY!
  9. by   sarmedic70
    That is awesome it worked out for you. Been there, done that; however, the attitude of this particular nursing administration is that they don't want solutions or new ideas. They are perfectly content with the status quo et al. It is a complicated situation that is also layered with nepotism and favourtism et al. I am one who likes to present solutions not create further problems; however, unfortuntaley, it doesn't work well with this hospital. What needs to be done is an entire change (from the top on down) overall.
  10. by   JerzeeMike
    Too bad 99.9% of hospital CEOs will never follow this advice. They're more concerned about the bottom line and getting their million-dollar bonuses (as opposed to the nurses measly 2%) than they are about quality patient care.
  11. by   bristolrover
    WOW.Finally after nearly half a century as a nurse a CEO who makes sense and well appreciated I am sure by all of those hard working nurses throughout the world,who in my opinion,deserve the reputation of being voted almost annually the most respected of all professions.Your comments should be published and a copy given to every hospital CEO and CNO in the country.Your comment about"one day being the patient" has rung true in my experience several years ago .When working in the largest and much heralded hospital in Dallas,the hospital administrator was one of my 15 patients I was caring for on an intensely busy cardiac floor.In all the hustle and bustle of a normal,understaffed night shift,the gentleman had a life threatening cardiac arrhythmia requiring immediate IV meds that saved his life.Later the other nurse remarked jokingly"that was a good time to ask for a pay raise".Please note that each of us had 15 cardiac patients each a regularly occurring event that that hospital deemed'okay' to the detriment of staff and patient health alike.Fortunately comments like yours will go a long way toward treating nurses health as well as patients.Thank you again for your encouraging words
  12. by   NutmeggeRN
    Great read Thx! While not in a hospital but many years in LTC, a recent administration has been so difficult.

    Census based staffing, with no consideration for acuity.
    Knee jerk reaction via email blasts to situations instead of discussing what ACTUALLY happened.
    Always talking about money concerns but planting a multitude of annual plants outside THREE Times a yearwhen perennial planting would be prettier (IMHO).

    I could go on and on
  13. by   GaleSRN
    I am so grateful that I work for a company whose CEO and COO regularly meet with nurses, nurse managers, and techs. They really do listen and we feel it at the clinic level. Satellite Healthcare. "Not for Profit" Dialysis Company.