The Economy and your job as a nurse

Andrew, RN · Feb 7, 2009

People are going to be stupid and skip on preventative measures in order to save money, then they will end up in hospitals for even longer and be even sicker. We'll always have a job.

Tait, MSN, RN · Feb 7, 2009

At my hospital in metro-Atlanta we had a little slump during the summer and closed down one floor of seven, moving us to a previously closed unit. However is seems, around here, the worse the economy gets the busier we are. However as we are taking cuts in staffing, and rearranging nurses, the patients we are getting are heavier and heavier.

So many people are waiting until they are completely dysfunctional before the come in for care. I have never seen so many TB isolations, rampant MRSA/ESBL, pneumonias and metabolically unstable patients.

Tait

mcknis · Feb 7, 2009

we just got a letter today from our interim CEO that our jobs will not be cut as of yet. We are still seeing many pts and our census is actually increasing as we have had to open up 2 extra rooms for additional pts. I feel that in time, if things do not imrpove that our jobs will be at risk, but for right now, i am glad to say that i dont have to see it too close yet. other hospitals in the area, are having this hit home big time and are laying off/on hiring freezes/etc. one place just laid off 10 management positions (and this is a small hospital-~20 med-surg beds with an ER/OR/5 bed ICU/extended care wing). keep up the good work, and keep on lookin up for answers!

Trauma Columnist · Feb 7, 2009

I'm an advanced practice nurse and eff Jan 1st, Medicare cut our reimburse for dialysis pts 5% which means we are expected to produce more. At my part time job in a small ER there are no full time openings for staff nurses but we (APNs and MDs) are doing okay.

stressgal, RN · Feb 7, 2009

Our facility experienced low census in the fall and eary winter. I was called off a few times requiring me to use PTO time to cover my hours. I started to get a bit nervous when I got down to 8 hours PTO, but census has picked back up and they are once again calling me on my days off for extra help. We are still hiring a few nurses, our night shift was very understaffed but we are only hiring nurses with previous experience or new grads with their BSN. The market in our area has become so saturated with new grads that we are able to be selective. I'm sure thankful for my position and am not planning on making a change in the near future. Just in case we start getting called off low census again I have accepted a position as a clinical nursing instructor one day a week and am teaching more ACLS classes. I'm either going to be about the same financially or very busy. I just don't want to take any chances of running short on income. I agree it is very scary right now.

eriksoln, BSN, RN · Feb 7, 2009

I can relate, in a couple ways.

I'm a travel nurse, I was very lucky to get signed on just before the real drought came. I'll be OK unitl April. After that, I hope to go staff.

My parents on the other hand, were not doing well right before the big drought and cant seem to get things together because of how bad its gotten. They had to move in with my sister. They didnt like it one bit.........sure they love seeing the grandchildren, but there is just something lost for them.

I hope things get better for you. I really mean that.

eriksoln, BSN, RN · Feb 7, 2009

At my hospital in metro-Atlanta we had a little slump during the summer and closed down one floor of seven, moving us to a previously closed unit. However is seems, around here, the worse the economy gets the busier we are. However as we are taking cuts in staffing, and rearranging nurses, the patients we are getting are heavier and heavier.
So many people are waiting until they are completely dysfunctional before the come in for care. I have never seen so many TB isolations, rampant MRSA/ESBL, pneumonias and metabolically unstable patients.
Tait

Somebody at work said somthing to me that was very interesting. I think it makes a lot of sense too.

With the economy getting bad, its the insurance covered/paying patients who have stopped coming. Those living on a lower incomes and the uninsured didnt have to quit coming, they never paid in the first place, nothing has changed for them. Its kind of like, if you owned a restaurant and all the people who just order coffe and spend the whole night there are still coming in, but the people who brought the whole family and got meals and dessert dont.

So, the hospital makes cuts because their bottom line is affected. Our ratios go up, and the number of unpaying cleints remains stable. Service overall, even to the paying patients, takes an unavoidable hit, and now the hospital is in trouble with loseing state/federal funding because of low PG scores.

Its a terrible loop to be in. I cant for the life of me imagine how that circle can be broken. I'm just gratefull my current employer has not done anything underhanded to save a couple bucks at my expense. In today's economy, thats all you can ask.

Faeriewand, ASN, RN · Feb 7, 2009

They are still hiring in my area but hospitals want one year of experience at least. But then you apply for the job and you never hear anything.

I've noticed at my hospital that it didn't get as busy as it usually gets in the winter. Census on the ward is okay but we are not full. I was only called off once and once when I was sick no one had to cover for me. But the ER wasn't overrun with people with a line out the door like it can get during the flu season. Everyone was remarking on how that just didn't happen this year and was amazed. I was saying that we are seeing the end of people coming in for hang-nails and the like.

The trend I've noticed on my job is nurses discussing the economy and everyone saying how grateful they are to have a job in these times. I think it is brought up more when someone might start to complain about something and another will say we should all be glad just to be working in this economy.

It does makes me wonder if I will be able to find a second job. I might be stuck at this low paying hospital for a long time and will just have to like it.

Quaffetti · Feb 7, 2009

I live near Seattle, and our hospital is still hiring, although they are not renewing any traveler/agency contracts.

Our CEO has been pretty up front with us about the economy. They plan to lay off 25-50 staff, none nurses. But things I never considered, the hospital system our hospital is a part of has money in the stock market just like I do and has lost a whopping large amount as the stock market has crashed, limiting thier ability to fund things.

They are also really begging us to limit our overtime, saying if they could decrease the overtime in nursing from 8% where it currently is, to 4%, that would equal those 50 layoffs they have to make.

So while I know sometimes overtime is unavoidable, I also know nurses who deliberately stay late for the extra money. I think we, as nurses, need to do our parts to help our hospitals out.

I know I have, in the past, had a kind of bad attitude toward the hospital about things like working short, and too heavy of pt loads, and while I'm not excusing that, I think when I see people around me losing their jobs it makes me see that I am very fortunate to have a fairly secure job and I do understand the hospitals' financial position a little more so I'm a more willing to work a little harder and try to do my part to help the hospital weather this tough economic time.

But right now, yeah, we get low census occassionally and there aren't many extra shifts. I think people are scared, and so people are conserving vacation time, putting off retirement, etc. Fortunately our hospital is so large that low census doesn't come around too often.

ND76 · Feb 7, 2009

I'm worried. I work for a hospital owned by a national healthcare company, and the hospital I work at is supposed to be one of their 'better' hospitals. But we're sinking FAST. Our benefits have been slashed, we've laid off over 40 people (mostly non-clinical positions) in the past two weeks, they aren't filling ANY open positions, and our staffing is cut to bare bones.

There is a general feeling of unrest because heads are rolling right and left, and for trivial things. The staff is getting quite desperate for hours, and there's a feeling of 'every man for himself' because we feel like management has utterly deserted us and doesn't really care about the staff OR the patients anymore....just the bottom line.

I almost wish we'd get sold or our parent company would file for bankruptcy and we could turn into a non-profit.

eriksoln, BSN, RN · Feb 7, 2009

I'm worried. I work for a hospital owned by a national healthcare company, and the hospital I work at is supposed to be one of their 'better' hospitals. But we're sinking FAST. Our benefits have been slashed, we've laid off over 40 people (mostly non-clinical positions) in the past two weeks, they aren't filling ANY open positions, and our staffing is cut to bare bones.
There is a general feeling of unrest because heads are rolling right and left, and for trivial things. The staff is getting quite desperate for hours, and there's a feeling of 'every man for himself' because we feel like management has utterly deserted us and doesn't really care about the staff OR the patients anymore....just the bottom line.
I almost wish we'd get sold or our parent company would file for bankruptcy and we could turn into a non-profit.

Do you think we are close to the point where we start turning each other in for having unclean shoes in hopes of getting someone else fired instead of being laid off ourselves? I wonder sometimes.

To be honest, I see some of this competitive one up-ing going on with travel nurses already. I can tell a few stories about backstabbing and such. No one wants to hear them though. Wish I had a couple about nurses supporting one another.

flightnurse2b, LPN · Feb 7, 2009

the thing that worries me is the huge rush for people to become nurses for job security. i was watching on CNN yesteday, they interviewed all these nursing students somewhere and every single one said "i am a computer programmer/musician/chef/retail associate and i need job security, and nursing is job security". there's nothing wrong with changing careeers for job security at all.... but all the "become a nurse for job security" advertising going on is scary.

it makes me nervous that even though they say there's a nursing shortage, that soon more new nurses will be popping out with no where to be hired since hospitals are cutting budgets.

the other thing that worries me about it, and don't take this the wrong way, is that you will have an influx of nurses who really only think about the paycheck and don't really care about actually nursing. i don't live, eat and sleep nursing, but i do really care and i do really love what i do. i am working with a few right now who they do their job and go home and could care less about what happens in the 8 or 12 hours they're at work, their clinical skills are really not good and they dont really get the thnking outside the box concept. one girl even had the nerve to say "well, it was easy bookwork". two RN's got let go last month from days for having horrible attitudes and making continuous very careless mistakes... one actually inserted a rectal tube with the pointy plastic cover still on...

sorry for the rambling.