nursing & the economy

[cgSN2010]

in what ways have you noticed the economy affecting nursing care in the hospital? i have personally noticed a lot of nurses coming up with creative ways to avoid charging patients for extra supplies.

[classicdame, MSN, EdD]

that is called stealing, unless they personally own the supplies

We have noticed that even though the economy is turning around a little, there is still fallout from people being out of work and/or no insurance. Our collections are down.

[cgSN2010]

Thanks for replying. I didn't really think about that aspect of it.

[Tweety, BSN, RN]

If the extra supplies are given to the patient, who is paying for them? Ultimately there is a cost.

The facility I work with has dealt with the tough economy by laying people off, and making the rest of us work harder.

[caliotter3]

My employers use the economy to explain why they don't provide work to employees. The icing on the cake is when the nonworking employee throws in the towel and applies for unemployment, the employer lies to the employment people and tells them the employee quit the job. Not one peep about not having business and thus no work for the employee.

[HeartsOpenWide, RN]

I work for a for profit hospital. Those extra supplies get figured into our pay. The hospital has a program to help the cash paying patient. It is not the nurses job to skim on the patients bill. As some one else mentioned; that is stealing.

[cherrybreeze, ADN, RN]

We've a recent "campaign" at my hospital to make SURE supplies get charged for...or more so, just not wasted. Most supplies (toothbrushes, dressings, etc) aren't charged individually anymore (has been that way for a while). The more we waste, give away, etc, the more it hurts our bottom line, and that will further affect things like staffing...the money has to come from SOMEWHERE, to pay for these things!

Do you coworkers realize they're actually making their own situation worse, by skimming supplies??

[DeeAngel]

If someone gets transferred or dies, the patient census changes and they will send a nurse home halfway through her shift and reshuffle assignments. They do this to 1-3 nurses daily and frequently to the night nurses, I've been sent home at 2 am before. They will also call before you leave for work if the census is down and put you on "standby" which mean you are on call for the rest of the 12 hr shift. If you fail to answer a call while on standby it's put down as a no call now show - get 3 of these and you are terminated.

They do this to us yet have the nerve to try and call me on my days off to come in and "help out" because they are busy. I don't think so and it's why all my phone calls go to the machine.

[313RN, BSN, RN]

I don't think it's about the economy, but one thing I recently learned from another nurse is a way not to charge (or steal) for flushes.

10 ml saline flushes are kept in the pixis and are billed to the patient. What this nurse does is use a 10 ml syringe, crimps a patients IV line below the first leurlock port and fills the syringe from the bag of .9NS.

I look at this as pretty benign. The hospital doesn't get to bill the patient $30 for a flush, but the patient is paying for the saline she takes out of the bag.

Yes, there's a cost for the syringe (I have no idea what that is) but I suspect it's fairly small. She doesn't do it for every patient and she doesn't do it often, so I tend to feel that what she is doing is not costing much more than if she were to drop a syringe or have to get a second Colace because it shot out of the blister pack and onto the floor when she opened it.

[traumaRUs, MSN, APRN]

Central IL:

1. Hiring freezes at all hospitals.

2. No hospital contributions to 401k's.

3. Shift differential cut.

4. Clinical ladders programs now require more education/CEUs with less reward.

5. No continuing education money.

6. No tuition reimbursement except at the hospital-affiliated school of nursing.

7. No loan repayment.

8. No sign on bonuses..

9. Pay structure rolled back - meaning new grads don't make what new grads made a few years ago.

10. Doing more with less and less and less!

[cgSN2010]

I guess I should clarify on the part about creative ways of using things.... I mean they use the supplies already charged to the pt. but they are more creative with the way they are used for example setting the pump to flush with NS after meds instead of charging the pt. for a flush, and stuff like that. small things that tend to add up on pts. bills

[cgSN2010]

# 10 doing more with less and less is what i was talking about in my original post. reading it now i realize i worded it kind of backwards but ultimately that is what i meant. coming up with ways to make the most out of things so as to not run up costs for the hospital or the patient. thanks for the reply!