Outpatient Chemo...Hospital or Dr.'s office?

[mappers]

I recently started working at a Heme/Onc practice doing outpatient chemo. This practice is very large and was private up until a year or so ago when it was purchased by a hospital chain in our area. Apparently they had been struggling for years and the nurses hadn't had pay increases for a long time, but loved the practice, loved the patients, etc. I was not there then.

So now, we're owned by this hospital who also owns a lot of PCP offices around town. Apparently this is the first time they've purchased a practice as large as ours and they didn't quite know what to do with us. They are paying us the PCP Office Nurse rate which is lower than the hospital rate. We are employed by the PCP branch of the company, not the hosptial branch of the company, which means our pay is different, our benefits are different, etc.

Here's the rub....The facility is now considered and outpatient part of the hospital and is "owned" by the hospital (aka Not-for-profit) side of the business. This means we now have to follow TJC rules, follow hospital rules and red tape, etc. The patients are no longer paying their $20.00 office copay to come have a lab draw and a phlebo or a neulasta shot, but are now paying hospital rates, must meet deductibles first, are being charge 3 & 4 times more than before, etc. We have a lot of patients who now request to have their protimes done at their PCP who faxes us the results, so that we can manage their coumadin, because of this.

They are not paying us at the higher pay rate because we are "office nurses". However, we are all chemo certified and many of us are OCN. You bet your bippy they use that nice little statistic toward their "Magnet" status. We are administering chemotherapy to patients everyday and handling lots of emergency and urgent situations - reactions, patients coming in with dehydration needing fluids, etc.

Some of our nurses have worked or are working at other similar places in town owned by other hospital systems. They are paid hospital rates. They have housekeeping and nurses aides to help (just like at the hospital). We do not. We have to make all the beds and box up all our trash every night. The hospital is across a pedway from us, not on the other side of town.

Does something seem wrong about this picture? I mean, I seriously doubt the nurses in outpatient endoscopy at the hospital are paid a lower rate than the floor nurses. The hospital has an outpatient infusion center and an ACU where we send pts for blood products and for chemo on days when we are not open(ie...a 5-day Dacogen tx, might get sent there on Thanksgiving Day) , and for their weekend injections. I'm sure those nurses are paid hospital rates.

Anyone else work in this type of set up? It just feels like the hospital wants to have their cake and eat it, too.