We may need fewer nurses in the hospital...

[Chin up]

WCVB channel five Boston, is now airing, Healthcare Uncovered. A live panel show discussing healthcare and it's cost in Boston. The moderator, Timothy Johnson, MD. One of the panelist, Zane, the CEO of Tufts Medical Center whose 1100 RN's just voted 70%, to authorize a one day strike. This is what I just heard and this is verbatim.

"We may need fewer nurses in the hospital, but we will need more in the community, helping patients to stay healthy. so there maybe some modest job losses, I think there is a great opportunity to retrain caregivers in new professions."

"Doesn't the rank and file worry though, if I am dislocated as a healthcare worker. The job that may be available for me on the other end is nothing of the caliber of the job I trained for and gone to school for as a RN or whatever."

They avoid that question and go on about being unable to sustain the hospital budgets. Over half of budgets are employee salaries(nurses). We must address these salaries and benefits and look into job revocation. They go on to justify this thinking, due to small business unable to afford healthcare here in Mass and therefore leaving the state. There are great opportunities to shift our thinking from acute care to physician and patient remaining well. (paraphrase).

Helen Zane: what the trajectory we are on, the public will not tolerate. Better we get ahead of it. ( she is addressing nurses who want better nurse/ patient ratios). Fueling her position, against the nurses.

They go on and defend physicians who do needless test...talk about salaries and fraud in the same sentence. Implying, nurses must make sacrifices...my reading between the lines. Then go to prevention and teaching. Intervention is most important right now. (agree,but, where are nurses in this) Their focus, doctors, PA and NP.

You all need to watch this, there is so much more. Primary care doctors aren't paid enough, but no mention of professional nursing. Again, ANA where are you?? BSN's you are not being addressed at all. They are talking about eliminating your job. They are talking about retraining you and "retooling" your career. And you all are worried about the difficult patient? We need to get busy...are we even listening to what is happening right before our eyes? Are you all satisfied with your degrees when you have no say in policy? Do we even care?

The lie has been told so much, ever since I can remember 27 years ago. All we needed was BSN to get taken seriously...really?

[SummitRN, BSN, RN]

We pay college educated nurses to clean poop, make the bed, and empty the trash. How does that make financial sense? Maybe we need fewer nurses who spend more time doing that require their education and experience (assessment, RN skills, meds) thus better justifying money spent on their salary (which might even go up), and the unskilled tasks can be left to low paid techs.

(I know many of you are now looking for the ANTI-Kudos button for my post )

[linearthinker, DNP, RN]

Well we aren't going to agree on the solution wrt single payer, etc, but I think it is too late to save the present system. It is self destructing.

Are you suggesting that the answer is to levy heavier taxes on people who already can't afford any health care, lol?

[neuroms]

Sorry to say it but Mass is a single payer state. THAT is the reason for the collapse among many other reasons that should be obvious with the socialistic disaster that Mass has turned itself into.

Nope. Mandatory coverage, not single-payer. Also, Mass has pretty good quality per dollar returns.

I agree that these docs sound pretty eager to shove the rest of us out the door, but if we do one day get a lot better at preventative care, there won't be as many hospital, acute/recovery jobs en total. That means nurses and physicians. I can just hear the thoracic surgeons and hospitalists complaining now about how they will be forced into family practice.

[TheMoonisMyLantern, ADN, LPN, RN]

You hit the nail on the head. THERE IS NO MONEY!!!! 45% of America works and pays taxes the rest milk the system. The top 2% pays 50% of the taxes and the bottom 40% of tax payers pay 2.9%, you cannot sustain any social safety net when the entire system is nothing but takers and and very few givers.

Single payer would be the death of the best health care system to ever be! The entire world comes here for there care, no one flys elsewhere because it is better, NO ONE! I don't want the greatest care on earth destroyed.

There are over 311 million people in the United States as of now and you honestly think that NO ONE has ever gone or desires to go to a different country for health care?

Furthermore isn't it logical for someone who makes 1.2 million dollars a year to pay just a little bit more in taxes than someone who makes 28 thousand a year?

[tamadrummer]

There are over 311 million people in the United States as of now and you honestly think that NO ONE has ever gone or desires to go to a different country for health care?

Furthermore isn't it logical for someone who makes 1.2 million dollars a year to pay just a little bit more in taxes than someone who makes 28 thousand a year?

They don't fly to thialand for sex change because it is better, they do it because it is cheaper because their governments aren't regulating the holy bejesus out of them and they can experiment on people and not be sued to bankruptcy.

Not because our doctors and nurses cannot take care of them or do a better job. Same reason folks go to Germany for multiple level lumbar disc replacement. Not because they are better, because the FDA does not stop them from doing it because they have no authority.

[linearthinker, DNP, RN]

Guess she hasn't heard of medical tourism either, lol. France has the best health care in the world, not the US.

[caroladybelle, BSN, RN]

Single payer would be the death of the best health care system to ever be! The entire world comes here for there care, no one flys elsewhere because it is better, NO ONE! I don't want the greatest care on earth destroyed.

What world are you in?

The US consistently rates much lower than many other nations, on most indexes that measure health. Just because we can get many (often unnecessary) tests and procedures quickly doesn't mean it makes us healthier, better off or that we have a good system of delivery.

And large numbers of Americans are going to other nations for procedures. Ever heard of medical tourism?

[nurse2033, MSN, RN]

I think prevention is a pipe dream that will take generations to make any progress. The people I see in my community are just trying to get by. Getting them to change their eating or exercise habits when they don't have enough money to pay the rent is a waste of time. With hospitals pushing the customer service experience to the hilt this will in no way allow a reduction in staff. Hospitals are constantly adding services to pull in customers. The opposite should be happening, they should be cutting services to cut costs. One hospital should be the trauma center, another the stroke center and so on. And the only way to approach the Canadian or European model is to ration care, and I can't see that every happening here. Who is going to be the tough guy and say if you exceed a certain BMI, for example, or you are over a certain age, you don't get to be admitted to the hospital? I don't pretend to have the answer but it is obviously eluding our communal best efforts as well. The problem is the payer and the consumer are not the same entity. One orders services not caring how much they cost because they aren't the ones paying. If we bring those together, people will then care how much things cost. What if the doctor had to personally pay for all the test they order, then pass the cost to the patient? That would lead to unequal care which would upset our sense of justice. The rich could pay for everything and the poor nothing, just like India for example, which leads us nowhere.

[linearthinker, DNP, RN]

Rationing care is logical and also, inevitable. It will happen either formally or informally. I think formally would be more even handed. I don't know what you mean by cutting services, so I can't elaborate on that point. Preventive services are the way to go, no question.

[nurse2033, MSN, RN]

Guess she hasn't heard of medical tourism either, lol. France has the best health care in the world, not the US.

Are you French? A few years ago I took an American tourist off a plane with a broken hip. He fell in Paris. The ambulance took 40 minutes to reach him. He didn't get any pain meds until he had been on the floor for several hours, never mind the ambulance or the ER. So from injury to morphine was about 18 hours according to him. Then, five days later he was still waiting for surgery- and bailed, arranging to fly home. I was transporting him from the plane to the hospital, seven days after his injury, in constant pain, with an unstable hip. This did not impress me.

[linearthinker, DNP, RN]

No, not French. I am from Mackinac Island (Michigan), and there were French fur traders here 300 years ago, that is about as close as I get. France has better outcomes at lower cost. People live better, longer. One might argue that they are also better dressed.

[martymoose, BSN, RN]

ok- I dont how the focus could change to prevention- seriously?????How many of us have taken care of patients in the hospital that we try to "teach" ?In the day and age to self- entitlement at all costs , we are just being told" I dont want to hear it.- Im not quitting smoking, Im not changing my diet, Im not going to quit smoking crack"despite that being their 3rd mi this year.What makes anyone think that teaching in the field is going to help? these people have experienced the consequence of their behavior first hand and still refuse to change- and get mad at the nurse even so!!

I just wish all those nurses could walk off the job for a week or so. Lets see that hospital work then. Maybe they'll realize that the unlicensed personel cant administer meds. Or assess. But they'll be able to provide customer service in the mean time-Pt is in VT, but no one is around to do any thing about it.But I can fluff your pillow!! Lets see how long the hospital lasts.