Dear Nurse Beth,
I work in a20 bed MICU that decided to lay off our PCT and only have one unit secretary. This means the RNs have to transfer patients, wash down the monitor leads, restock our nurse supply chart, remove the linen and garbage. We have a tight RN staff according to the number of patients. That means more responsibility for the RN that the PCT did for patient care, blood draws, blood sugars, help with turns, wound dressing changes, Of course we can do this, but it gave us time to spend more time with the patient and their family. Is this the future of nursing? What can we as the RN staff do to make the administration understand this is not working and need our valuable PCTs back?
Dear No PCTs,
Every RN knows the value of PCTs and CNAs. We love them. They keep our patients clean and cared for. They assist RNs so we can work at the top of our licensure. No good can come of getting rid of PCTs. It's a shame when admin sees them as disposable and an extra cost.
Admin looks at the bottom line and is concerned about quality measures to the extent that they affect reimbursement. Often decisions are made that are short-sighted and costly in the long run but money is "saved" in the short term. It flies in the face of logic to enlist the highest-paid employees (RNs) to empty trash and stock supplies.
As my Dad would say, it's stepping over a dollar to pick up a dime.
Cutting support staff can result in higher RN turnover and lower patient satisfaction scores. Pressure injuries can develop from lack of turning-all to save the cost of paying a PCT's salary. One complex pressure injury can cost the equivalent of a year's salary.
Nursing leaders have a responsibility to advocate for their staff and for patients, but this can fall on deaf ears, and some leaders are afraid to speak up. The structure and politics of a hospital can mean that the PCE's vote is not equal to the CFO or CEO's vote. Eager CFOs rush to show that they can save the organization money, and nursing concerns are trumped.
Historically, poor decisions like this are reversed when poor outcomes start to happen, and the pendulum swings. Again, it is driven by the bottom line.
Let your manager know your concerns. If you have a unit based council or shared governance, express your concerns through that structure. Be specific about tasks that are not getting done, such as regular turning or mobility.
Use any change in metrics to show that care has suffered, such as pressure injury prevalence or falls. Best wishes.
Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!