War is coming, the lines have been drawn!

[outptsurgeryrn]

War is coming and the lines have been drawn. Management says we need to cut payroll. Flex people off. We are being looked at by "Corporate" for low numbers and high payroll. I work in a hospital in a very very depressed area. Most patients are medicare and medicaid if any ins. at all. I work in outpt surgery area and Endoscopy area. 5 yrs ago a nurse had 3 pts to check in for surgery and take back postop. Some went to recovery if general anesthesia used and others returned to out patient surgery if IVM anesthesia. This week they want 5 patients per nurse. Nurses are angry, upset and saying that is not safe and they dont feel safe! Trying to check in two pts due at 615 to get ready for surgery at 715. Taking your postop pts back while trying to check in more preop pts. Its horrible. Supervisor for area ready to quit and so are the others. But it was made VERY clear in the staff meeting (first in months) that $$$ is the deciding factor. Too much payroll for the "numbers". Bottom line, cut payroll.

CAN THE NURSES REFUSE THE ASSIGNMENT? Would they be fired, written up because they dont feel safe, because they are not giving pts (preop and postop) the attention both types of pts need??

Example: be checking in a 10am pt and have a ivm postop pt come back directly to you with nausea, pain of 8 then have a postop pt come within 20 min of last postop doing fine - already have had a postop pt waiting to be discharged--and another preop patient expected to arrive within 45min.

Whispers of a walkout or going around. Whispers of people looking for another job but very few can do that since the next closest hospital is 40 min away and owned by same company. Next closest is 1 hr away in different state or 1 1/2 hr same state.

This post condensed down so not to take up so much of your reading time. Thanks for the forum.

[dudette10, MSN, RN]

We were told to "come up with a better solution"

This irks me. You know why? Management is responsible for identifying problems, recommending solutions, getting buy-in from staff and higher-ups, piloting a chosen solution, tweaking it based on pilot data, and implementing an improved version on a permanent basis with continued reevaluation. Management 101, regardless of industry.

While good leadership always engages front-line employees in solving problems, what you were told reeks of throwing the sole responsibility for solutions on the front line. Ridiculous.

[roser13, ASN, RN]

roser13, how many pts per nurse? this sounds good to me. I would be for it. We were told to "come up with a better solution".....

inshallamiami....there is no hope of union, too small and most have given up and just want out

A pre-op nurse traditionally takes one OR and so by definition is only admitting one patient at a time (an OR can't have more than 1 patient at a time in it). If the admit doesnt take the whole time period before the next patient, she is helping others with their admits. Or if the case is 2+ hours, she will definitely have other admits of her own.

The post-op nurses tend to have 2-3 patients apiece at any one time. The managers really keep an eye on those RN's who might tend to drag their feet in discharging so as to not to receive a new post-op. Those who try that soon find themselves with 4 or 5 post-ops simply because they have not managed to discharge anyone.

This system beats the heck out of trying to admit patients at the same time that others are flowing out of PACU and wanting to be discharged. Plus, it allows the nurses to sort of "specialize" if they choose. Most of us definitely have our preferences as to which position we prefer.