Overheard at the coffee shop

[JustBeachyNurse]

I stop for coffee to relax between clients. I'm sitting here and some people are louder than others. Apparently a young lady is having a "training session" to become a medical device sales rep. Clearly neither have a clinical patient care background as they are taking in circles about the product. They are sales reps. It's an interesting conversation how he's telling her how to strong arm her way into the facility to witness the device insertion procedure claiming the physician is expecting her. How to talk patients into letting her into the room if questioned. How to get physicians to improve productivity. How to talk around non-FDA approved off label uses. How they are going to lose money if people do preventative care rather than treatment for co-mobirdities later. How to try and sell physicians on off label use by scripting, and coaching her how to answer any road block or question put forth by the physician. Pushing the cost of care to support their view.

Scary. It's funny how they are skirting reality by using sales tactics.

[Orca, ADN, ASN, RN]

Most administrators I meet with are PASSIONATE about patient care and their nurses, they just may not have the best ideas or ability to implement them.

We must meet different administrators. The ones I meet give the outward impression of being passionate about patient care and their nurses, but at the end of the day it's all about the money. These administrators repeatedly throw around the phrase "quality care" while making it impossible for their staffs to deliver it. Corners are cut in every possible area, from understaffing to replacing experienced nurses with nurses who will work for less. They staff with travelers so that they don't have to give out benefits.

Sorry, hospital administrators is a sore topic with me, the single biggest reason that I no longer do hospital work.

[Asystole RN]

We must meet different administrators. The ones I meet give the outward impression of being passionate about patient care and their nurses, but at the end of the day it's all about the money. These administrators repeatedly throw around the phrase "quality care" while making it impossible for their staffs to deliver it. Corners are cut in every possible area, from understaffing to replacing experienced nurses with nurses who will work for less. They staff with travelers so that they don't have to give out benefits.

Sorry, hospital administrators is a sore topic with me, the single biggest reason that I no longer do hospital work.

I am sorry you have had such a hard time with your leadership.

Never attribute to malice that which is adequately explained by stupidity.

What a lot of nurses do not realize is that most hospitals float with a profit margin of around 1-2%. Could you imagine your paycheck paying all of your bills within 1-2%? Not a comfortable situation.

I used to think my admins were all greedy profit driven people until I got to this side of things and started working much closer with them. The issues and choices many of them face are complicated, long reaching, and usually do not have perfect solutions. Like I said, if the admins only cared about money then my work would be much easier. Hell, I could retire tomorrow if price and profit was the only consideration.

[la_chica_suerte85, BSN, RN]

When I was desperately unemployed, I considered the pharm/medical tech sales rep route. But then I realized I wasn't a ho and couldn't debase myself like that. Especially in the pharm rep industry, there are some questionable practices in terms of moving product. I've already felt compromised working in high-end retail so....I've had enough.

[Asystole RN]

When I was desperately unemployed, I considered the pharm/medical tech sales rep route. But then I realized I wasn't a ho and couldn't debase myself like that. Especially in the pharm rep industry, there are some questionable practices in terms of moving product. I've already felt compromised working in high-end retail so....I've had enough.

Like any job, there are those who are ethical and those who are unethical. A job does not dictate whether someone is ethical or not. Do you not steal money simply because it is not available to you or because you are not a thief?

I know a lot of sales reps in the medical device and pharma side of the house. All the nurses that I know in sales take their positions in sales very seriously and are all extremely ethical. There are those however who are a bit more scandalous or used car salesmenish but generally those are not nurses and fortunately definitely do not represent the majority. People who are unethical tend not to last long in sales, no matter what company you work for you still have the same small pond of customers. Doesn't take many bridge burnings until you are stranded.

Most of us that work in industry do so for the express purpose of helping other healthcare professionals help their patients. I know this sounds strange but I personally have a much larger impact on patient care in my current job than I did working the floor.

A large part of representing industry is getting the research and resources into the right people. I routinely am consulted (unfortunately sometimes directly authoring) policies and procedures. I currently am working with three different hospitals and two systems on updating their practice to reflect the latest evidence. The majority of my time is actually spent educating nurses and getting resources in the hands of those who need them.

When I joined the industry I did so as a registered nurse and I remain a registered nurse with the same priorities and ethics that I have always had. I take my role within the profession of registered nursing seriously, as do many of my colleagues.

[icuRNmaggie, BSN, RN]

Corruption is like C-diff. Once one person has it, unless you are very careful, the whole hallway eventually has it.

Best we can do sometimes is keep our own hands clean.

Excellent analogy and so very true.

[la_chica_suerte85, BSN, RN]

Like any job, there are those who are ethical and those who are unethical. A job does not dictate whether someone is ethical or not. Do you not steal money simply because it is not available to you or because you are not a thief?

I know a lot of sales reps in the medical device and pharma side of the house. All the nurses that I know in sales take their positions in sales very seriously and are all extremely ethical. There are those however who are a bit more scandalous or used car salesmenish but generally those are not nurses and fortunately definitely do not represent the majority. People who are unethical tend not to last long in sales, no matter what company you work for you still have the same small pond of customers. Doesn't take many bridge burnings until you are stranded.

Most of us that work in industry do so for the express purpose of helping other healthcare professionals help their patients. I know this sounds strange but I personally have a much larger impact on patient care in my current job than I did working the floor.

A large part of representing industry is getting the research and resources into the right people. I routinely am consulted (unfortunately sometimes directly authoring) policies and procedures. I currently am working with three different hospitals and two systems on updating their practice to reflect the latest evidence. The majority of my time is actually spent educating nurses and getting resources in the hands of those who need them.

When I joined the industry I did so as a registered nurse and I remain a registered nurse with the same priorities and ethics that I have always had. I take my role within the profession of registered nursing seriously, as do many of my colleagues.

I agree that, especially for salespeople who have a nursing background, they are crucial to getting good equipment to the places they know need it the most. Now that I'm in nursing school, I can see how fascinating and awesome it could be to bring the latest tech to the floor. It's the laypeople that get into it that I wonder about.

[macfar28]

What a lot of nurses do not realize is that most hospitals float with a profit margin of around 1-2%. Could you imagine your paycheck paying all of your bills within 1-2%? Not a comfortable situation.

And yet amazingly they are able to find their hefty quarterly bonus in that 1-2%!!!

I think nurses "realize" a lot more than you might think, Asystole.

[DeeAngel]

Thats all sounds pretty typical to me for a salesperson or a person training them. That's not to say I approve, but it sounds like standard practice to me.

[Asystole RN]

And yet amazingly they are able to find their hefty quarterly bonus in that 1-2%!!!

I think nurses "realize" a lot more than you might think, Asystole.

I didn't realize the margins and operating costs hospitals had to deal with when I worked on the floor, nor did my cohorts, nor do many nurses that I meet and speak with, you and your cohorts must just be more informed.

I think many people assume that the hospital is making just bazzillions of dollars in profit when in reality many are just making it by. That's not to say that administrators are not doing well for themselves though.

I personally sit down with and speak to many administrators as a routine part of my job. I find that most are extremely concerned with the welfare of their staff and their patients. They may not make the best decisions or execute the visions that they have planned out very well but most mean well.

I know it is easier, and far more popular, to think of the admins as Monopoly Men sitting in a smokey room twisting their mustaches thinking about how best to screw their nurses but I have found a very different image once I had more time to actually communicate with them.

Just my own personal experience.

[nursel56]

I didn't realize the margins and operating costs hospitals had to deal with when I worked on the floor, nor did my cohorts, nor do many nurses that I meet and speak with, you and your cohorts must just be more informed.

I think many people assume that the hospital is making just bazzillions of dollars in profit when in reality many are just making it by. That's not to say that administrators are not doing well for themselves though.

I personally sit down with and speak to many administrators as a routine part of my job. I find that most are extremely concerned with the welfare of their staff and their patients. They may not make the best decisions or execute the visions that they have planned out very well but most mean well.

I know it is easier, and far more popular, to think of the admins as Monopoly Men sitting in a smokey room twisting their mustaches thinking about how best to screw their nurses but I have found a very different image once I had more time to actually communicate with them.

Just my own personal experience.

I think that is most likely dependent on how far up the corporate chain of command you go. I've got personal experience in what happens to a company as it is swallowed up and merged upward until whatever heart the first company had was completely obliterated in around 5 years. It's pretty sad, actually. I still have my bronze commemorative paperweight from the "partnership". Reality very quickly made the friendly images on that paperweight something of a joke.

Next time you meet with the suit-wearers, please tell them making nurses say, "Is there anything you need right now? I have the time" is really d-u-m-b. I appreciate that you are willing to present a view that is probably going to meet some resistance.

[elkpark]

I think many people assume that the hospital is making just bazzillions of dollars in profit when in reality many are just making it by.

That's an easy mistake to make when one reads about the salaries and bonuses paid to the top executives at many hospitals -- which also makes it difficult to sympathize when those same executives poormouth the hospital and carry on about how we all need to cut costs and save money.

I had a job in the past, as a hospital surveyor for my state and CMS, in which I traveled all over my state and talked to administrators in hospitals large and small all over my state. I did not find that many of them had any particular interest in the welfare of their staff. I found them to be primarily concerned with the financial "bottom line" of the hospital. But maybe you're meeting a nicer class of hospital executives.

[Asystole RN]

I think that is most likely dependent on how far up the corporate chain of command you go. I've got personal experience in what happens to a company as it is swallowed up and merged upward until whatever heart the first company had was completely obliterated in around 5 years. It's pretty sad, actually. I still have my bronze commemorative paperweight from the "partnership". Reality very quickly made the friendly images on that paperweight something of a joke.

Next time you meet with the suit-wearers, please tell them making nurses say, "Is there anything you need right now? I have the time" is really d-u-m-b. I appreciate that you are willing to present a view that is probably going to meet some resistance.

I don't know, I do not think the higher up you go has much to do with how much you care about the patients or the staff. I think it comes down to some people caring and some not caring. I deal a lot with both hospital administrators and corporate level C-suite people and most seem to deeply care about their decisions and how they impact the floor staff.

I like to think of them as parents. We as parents are rarely perfect, as our parents were not perfect. It does not mean that we do not care deeply about those under our care, we just are human and simple decisions tend to have large impacts upon those under us.

My company regularity acquires smaller companies and there is definitely a process to first eliminate the culture of the smaller company and then bring them into line with the parent. Sometimes it is sad, sometimes it is greatly needed. I am proud that I work for an ethical and conservative company. Some of our acquisitions were in sore needing of culture change.

Wow, that saying really is dumb. I will try to pass the word on

I just think it is my ethical duty as a registered nurse to speak the truth as I have witnessed it. I think I just have a rather unique view amongst my professional cohorts.