To all agency/registry/prn, and traveling nurses in the U.S. are you ready for this?

wildtime88 · Dec 30, 2001

Yes, I know about the staffing law in California. It is very good, but has there been actual agreement to the staffing ratios yet?

Now think about how long it took to just get this passed from start to finish And it took more than a year to take affect. There are 49 other states to go if this is done on a state per state basis. This is or was something that could have been accomplished with the power of the nursing shortage across the nation in record time.

Now put yourself in the hospital's CEO's shoes. More staff means more money paid out and less money to put in your own bank account. Would you not try and stop this kind of legislation or limit the amount of staff. That is what has happened in California. I understand that the Kaiser hospital chain had fallen somewhere in the middle range but was fighting the CNA's recommendations. If you had legislation that you could point to as a way of bringing in a mass amount of new nurses, would you not take advantage of it in every way possible to keep money in your pocket?

Another thing to remember is that the CNA has used a logical approach at getting things accomplished. It did not start a push to have legislation passed to replace experienced or recruit new nurses prior to actually getting the basic problems solved. Pretty much the rest of the country has been at the mercy of the ANA and it's illogical approach at this. California is already light years ahead of the rest of the country with what they have accomplished. Unfortunately this is federal legislation that can and will put a damper on their future efforts when it is passed. They are not immune to the future implications of this legislation or the legislation to raise the limits on foreign trained nurses.

When the hospitals in California can also use the benefits of the pending legislation, I think that you will see a much different atmosphere on their parts as well.

Have you read what has happened at the Cleveland Clinic and the surrounding hospitals? The name clinic is a misnomer in that it is a large facility.

Rustyhammer · Dec 30, 2001

I know the shortage affects us all but I am glad for the pool nurses. It allows an alternative to staff nursing and gives flexability that other professions will never have.

I understand Wildtime that you are passionate about this issue but I can't help but wonder if the quality of care will decrease if government hands out nursing licenses as an alternative to food stamps and commodities.

Agency and traveling nursing are GOOD things!

Yes we need more qualified nurses and yes the profession needs to be recognized. But I feel that one should enter the profession because they heed the call. That call comes from wanting to serve and be a nurse, and no other reason.

-Russell

mustangsheba · Dec 31, 2001

FYI: Big notice on the bulletin board where I worked last night. This particular hospital has hired seven new nurses AND they are offering their own employees (not agency nurses) pay incentives - $3,000 - if they will agree to fill certain positions for a year. Somebody is starting to get it! Note to Sunnybrook: One of the things I love most about agency work is that I can do my job without the politics. Also, I'm not giving up my time off to attend mandatory meetings whose main purpose usually ends up beating that poor, dead horse yet again.

Home Health Columnist / Guide · Dec 31, 2001

wildtime:12-28-2001 11:36 am
if you think that there is a shortage of candidates for this program, then maybe you need to do a couple of things.
you can start by going to your local health department and where ever the wic program office is and start a count. while you are standing in line at the grocery store pay attention to those that are using food stamps. at work see who is using medicaid.
now there is one other thing to remember is that there is nothing that says that these new nurses will not be transplanted for one geographic area to another.

rustyhammer 12-30-2001 06:54 pm
i understand wildtime that you are passionate about this issue but i can't help but wonder if the quality of care will decrease if government hands out nursing licenses as an alternative to food stamps and commodities.

i see now how misinformation spreads.

actual senate bill language:

s 1864

(b) preference- in awarding scholarships under this section, the secretary shall give preference to applicants with the greatest financial need, applicants who agree to serve in health care facilities experiencing nursing shortages in medically underserved areas, applicants currently working in a health care facility who agree to serve the period of obligated service at such facility, minority nurse applicants, and applicants with an interest in a practice area of nursing that has unmet needs.

(1) be accepted for enrollment, or be enrolled, in an accredited school of nursing, on a full- or part-time basis, to take courses leading to a collegiate or associate degree in nursing, or a diploma in nursing;

(2) submit an application to participate in the program; and

(3) enter into an agreement with the secretary, at the time of submittal of such application, to--

(a) accept the conditions of the scholarship and remain enrolled in a school of nursing;

(b) maintain an acceptable level of academic standing;

(d) serve as a nurse for a period of not less than 2 years in a critical nursing shortage area or facility, or the individual may complete such required period of service on a part-time basis subject to--

(i) an agreement entered into by the facility and the individual which is approved by the secretary; and

(ii) the individual agrees in writing that the period of obligated service will be extended so that the aggregate amount of less than full-time service performed will equal the amount of service that would be performed through full-time service.

some nurses may need to travel or move to an underserved area. however this is fully explained when signing onto an educational aggreement of this type.

the town next door to me...the city of chester, pa an impoverished area is classified as a medically underserved area.

on the outskirts next door chester is the largest hospital in my county and only trauma center. i've been visiting the homebound in this area for over 15 years and know how difficult locating a doctor practicing inside the city limits is...health clinic not open nights.

there are many opportunities out there to work. most cities have underserved areas/hospitals that would be classified as employment facilities.

LindaHP · Dec 31, 2001

Unless the government can ALSO make the exact same number of people sick or in need of nursing care on each and every day, there will always be a need for per diem, part time, and registry nurses.

Census can run high or low. And unless every hospital and health provider wants to keep a full time staff on and then let them sit around and do nothing when the census is low, then there will be a need for per diem staff.

As far as legislation to encourage increased enrollments in nursing schools. That's fine. It sure beats all those idiotic ideas to replace nurses with "technicians" on hospital floors.

wildtime88 · Jan 1, 2002

LindaHP,

I agree that there will always be a need for fill ins for regular staffing, but how many hours and at what pay rate is the unanswered question.

Right now there is hardly any competition for the available hours because there is plenty to go around if the hospital or LTC is using supplemental staffing.

As the hours begin to dry up and the competition between nurses heats up for the available hours, then what? When you can not guarantee a certain amount of income each month, then what? When there are a number of nurses in competition for the available hours, then what?

Each person has to answer that for him or herself. Do you know what happens to prices in a competitive market?

Did you read what is happening at the Cleveland Clinic right now?

Rustyhammer · Jan 1, 2002

hmmm....

So how is nursing going to become an attractive profession.

How is this going to sound like a "good deal" to those who are looking for a new career? Scholarships are readily available for a wide range of scholastic endeavers now. Why should someone choose nursing. For the great pay? For all the paid holidays off? I mean... we as nurses should really be promoting the biz ourselves if we want to alleviate the shortage. I'm sorry but I have little confidence in this whole thing.

I can't see in the immediate future a scenario of so many nurses that we need no agency workers, consultants or travelers.

What nursing needs is not a quick fix but something else.

LindaHP · Jan 2, 2002

wildtime,

you make a good point about supply and demand.

I read an ad that paid a 50,000 dollar bonus for nurses in Texas.

That would never happen if there was not such a shortage.

I have been a nurse for almost 20 years. When I got out of nursing school I could not find a job. I was laughed at when I called hospitals. IT was a different time.

So our pay will go down if the supply is met.

wildtime88 · Jan 2, 2002

"december

Junior Member

Registered: Dec 2001

Location:

Posts: 7

Alert!

This is the first time I have heard of this. I think this is so dangerouos. It seems the free-market in healthcare applies to everyone except nurses. I know what happened in Chicago, but this is different. Much different. State regulation!!!???!!! If this is true and becomes a national trend, it will be the final insult to me and I will drop out of nursing.

http://www.mankatofreepress.com/arc...n_briefs.html#2

Temp nurses to see slash in pay

BEAUFORD - The new year is going to bring a big cut in pay for Ann Johnson.

The nursing home nurse, who works for a Bloomington-based temp agency, learned recently that new state regulations that limit the amount temp agencies can charge nursing homes for nurses will go into effect today.The law was supposed to go into effect at the end of August, but dozens of Minnesota temp agencies sued in federal court saying the law infringed on their constitutional rights. The federal judge who granted a temporary restraining order the day before the regulations took hold has not extended the stay.

That means the $23 per hour Johnson has been making as a temporary nurse at nursing homes in the Twin Cities, Faribault and other areas will drop to between $14 and $17 per hour."

Is this a sign of things to come. This might be long term care today, but everything has it's beginning.

swmn · Jan 3, 2002

I am not even a little worried about this. Not one iota. I graduated and passed the NCLEX in 1996. At the time I could spell internet and got snapped up by a computer company that called around to local hospitals to see what new grads made so they could make me a higher offer. The highlight of that job was the day a co-corker shut his hand in a car door, so I took a pay cut to go be the nurse I am.

After a year of third shift charge on 120 stepdown neuro beds I got a day job in endoscopy, started travelling in 02 of 01. I don't know of a single endo unit in the country that isn't booked _solid_ for the next four months. If you are not actively bleeding and demonstrably anemic, we'll get to you sometime in April.

You can import every RN in the Phillipines and South Africa if you want, hire every last one of them, I will still have a job. You can require every welfare recipient in all 50 states to apply to nursing school to keep their benefits coming, and I will still have a job.

You know why? Because as a traveller I am finally getting paid what I am worth to knock out 15 cases a day. Usually I only get 10 or 11 actually done; but when the prep nurses get done arguing about which drawer of the code cart should have the mag sulfate in it, and finally agree on how many of which size airway to stock; when they get done with all of that crap and actually get my cases ready on time I can and do actually earn my pay. Just ask one of my docs. They know I am expensive but they also know I am worth it.

And since I am actually earning the money I am worth, I am going to be ready to retire about the time this shortage wraps up and we get re-glutted with nurses and send all the Filipinos back home. I'll have several hundred thousand dollars sitting in a nice, fat, safe US gov't savings bond, free of federal income tax. I'll be 40 years old, and I will have nothing left to do besides play for the rest of my life, buy a house and get a job with enough hours to make my mortgage and keep me in health insurance until medicare kicks in. My knees will be shot, and my back is almost gone, but I won't be stroking out in the meantime because I don't have to play at hospital RN politics anymore.

The only way the federal government can hold me back is to cut into MD reimbursement some more. If they do that deeply enough to hurt me as an RN there is going to be a huge shortage of gastroenterologist endoscopists. A huge enough shortage I'll look into becoming an RN endoscopist before I just quit. If I quit I'll cash in one of my big bonds and play the stock market from home in a bathrobe and fuzzy slippers.

No matter what, I am _done_ playing turf wars with other RNs as a staff nurse. I am here to help patients, not play silly head games. If old dubya would like to forgive my existing student loans I'll be happy to go work in an "underserved" geographic area for two years. I am sitting on about a $29,000 balance and if he would like to know how my BA in anthropology has improved my nursing practice he can have up to 50 pages double spaced at the end of this week.

If you were wondering, a $300,000 US Savings Bond pays $12,000 dollars in interest annually, at the current despicable rate of 4%. That 12,000 is not subject to federal income tax, and the amount doesn't go up or down with the stock market. Outside of housing expense I can live very comfortably on that. In fact, I am doing it now.

The money is great. Moving every three months and having to start all over finding the grocery store and making new friends is a huge emotional drain. I might go teach if I ever bother with an MSN. Never say never, but I have no intention of ever working as a staff nurse anywhere again.

Scott

Burden of Proof · Jan 3, 2002

Wildtime: Have you worked inside a hospital lately? Put down your crack pipe and get real! Hospital administrators view truth as an option guided by the imperative of convenience.

wildtime88 · Jan 3, 2002

Burden of Proof,

I have work in many hospitals over the last 3 years. And you know what I have seen traveling from one hospital to the next. Pretty much the same thing.

I have seen all the cut corners, the reduction in staffing, and the false promises which were dependent on the bottom line.

I have seen staff work short handed with plenty of agency nurses available to come in and work. I have seen nurses Mandated to work an extra 8 hour shift even though they were hired to work 6-12s per 2 week pay period. I have seen nurses get their vacation requests denied due to staffing shortages. I have seen nurses have to come in and make up a sick day instead of it coming out of their sick bank and they were told what day they had to work on. I have seen many breaks and lunches that were not used. I have seen hospital after hospital cut back on agency and travel nurse usage and tell the regular staff unless they want to work short they will have to pick up the overtime. I have seen how they have continued to drop staffing of ancillary and support personnel and added their responsibilities on to the backs of already over worked nurses. I have seen staffing ratios continue to rise even though there were available nurses to work. I have seen nurses get sent home at the start of a shift instead of being used to lighten the load with decreased nurse to patient ratios. I have seen nurses smile and say but we were above our numbers or our numbers do not dictate additional staffing.

Yes, I have worked in a hospital lately.

And working in the ER I have seen patients that were originally and rightfully on their way to critical care suddenly get sent to a floor against a physician's judgement. This is the other scam that has been used on nurses. Although there are more and more sicker patients coming in, the number of critical beds has not change much in many areas of the country. In some places there in not enough staff or nurses available to cover them, but in other areas there are. The bottom line is there is less nurse for the buck. Why convert more rooms to critical care and assign one nurse to two patients when you can send patients to the floor and have a higher nurse to patient ratio? This amounts to saved money. I can tell you how quickly you can convert any room into a critical care room. It does not take much time at all. We do it in the ER all the time.

If you are an agency, prn, or travel nurse and do not believe that the legislation the president will eventually sign will directly affect you, then I want some of the crack you are smoking. And if you think that all of a sudden that the working conditions will get better after nurses time and time again have proven that they will and can function under todays condition, then I want a little more. i think what you will hear mostly out of staff nurses and other nurses is "it could be worse".