We may need fewer nurses in the hospital...

Nurses General Nursing

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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?

Ummm, a midwife is not qualified to take care of babies outside of the immediate resuscitation window after birth.

Not quite sure what you mean there. I'm not talking about medical care as in diagnosing and treating an illness.

Maybe it's different where I am, but midwives can and do give advice and reassurance on common problems that occur with babies, screen for various conditions, and know when the baby needs to be seen by a doctor.

I don't understand all of your interjections, but in general, I must agree with the point that hospital budgets are unsustainable. I think their plan to downsize the nursing staff is probably inevitable across the board. It's unfortunate, but when the money isn't there, it isn't there. We need a single payer system in this country, but I suspect it will take a complete collapse of the present system before everyone realizes it.

"The complete collapse of the system" will certainly be escalated by downsizing the nursing staffs in hospitals.

Hospital budgets are unsustainable because of the bad choices almost every hospital CEO has made in the last 15 years.

Every "boutique" birthing center, every "Luxury hospital suite', cost a nurse, or a phlebotomist or a CNA a job. It's not so nice to lay in a wood paneled suite, if there is no one to answer your call bell.

Specializes in Sub-Acute/Psychiatric/Detox.

Keep in mind Tufts nurses are in heavy contract negotiations, etc.

Also this Zane lady is retiring.

Until some nursing organization starts ADVOCATING for what Nurses do (besides stuff seen on TV drama BS) things will not get better.

Example (this maybe extreme but true) Nurse's are the eyes and ears of the doctor and are constantly assessing a patient...

Where as the $8 an hour PCA (no offense to them) is more task oriented. Gee the dressing is bleeding..

Whereas the Nurse will realize...a tube or drain is leaking or becoming infected... critical thinking goes into over time.

I want to think that if "out come based" payment systems that I have been hearing about ever go into effect that the role of nursing will be understood better by administrators..

In a perfect world If suzy nurse sees something something small and reports it to the doctor and the doctor writes an order or does surgery (speaking in very general terms) the patient will be healthier and hospitals save money.

Now for the real world.. As far as I know "never events" as they called for an example include fall prevention, infections, and UTIs. Or something... so if this event occurs while pt is in your facility.. your facility eats the cost.

Now one would think.. hire more nurses.. have inservices.. etc... the real fact of the matter is Administration will bash the nurses and blame them for everything.

Its not looking good for hospital (and most nursing in general) right now..

I heard lack of nursing jobs travel in cycles and I believe they do. I end my posts r/t to these topics always with this statement. I do believe the nursing shortage will return... but the days of sign on bonuses in non-specialized, non-extremely rural settings are long gone.

Yes there will still be a need.... But one has WANT to be a nurse and deal with the BS involved. Just like their are too many law schools... there are too many nursing schools.

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

My understanding, according to a few people that went there, is Cuba is pretty good too. But hey, I guess people would rather die than be "socialist.":rolleyes:

Specializes in Critical Care,Recovery, ED.

As heath care is changing, some would say evolving, nursing has to change and adapt as well. Hospital centered care as been the mainstay of health care for most of the 1900's and as a result it was the main employer of nursing. As health care is evolving away from the hospital so to must nursing. There will always be a need for hospitals and bedside care but the numbers have been shrinking for decades and will continue to shift away from the hospital. However those patients that are in the hospital are more complex and require far more RN time then has been the historical norm. See the studies linked on previous posts with regard for the number of patients a RN can safely care for. Administrators do not get this or if they do can't figure how to pay for it.(maybe they don't want to as it increases marginal costs thus decreasing profits).

The nurses at Tuft's are correct and need our support. But we do need to address the acuity mix of patients. There is a difference in caring for 6 patients that will be discharged as compared to 6 that are being admitted in acute distress. (just took the number 6 at random not advocating that number or any number).

Specializes in Med surg, LTC, Administration.
I'm really not trying to "school" anyone. Just taking every opportunity I can to remind fellow nurses that there is an alternative to the MIA ANA.

Sorry, I forget everyone is not "schooled" in today's vernacular. Because that is what it means, sharing information. Peace!

Specializes in Geriatrics.

Naturally things aren't perfect in our health system, far from it, but all things considered, I'm happy with it. Oh, and yep, this isn't really 'free', we pay for it with our taxes. But that's the thing, everybody pays and it's there for everybody.

Herein lies the problem in the USA, The majority of taxes are paid by the "Middle Class", who do not qualify for the services thier tax money is paying for. Simply put, the Middle class makes enought money to be taxed to pay for free healthcare, but, they make to much money to qualify for said free healthcare.

Teaching people about preventative care may help a few, but, the majority of people are going to continue thier current lifestyle requardless of the outcome. I believe the reason they do this is because they know they will be taken care of:

1. Drink too much & killed your liver?? We'll get you a new one. (and while your waiting we'll pay for Dialysis to keep you alive)

2. OD'd on you drug of choise? Free hospital stay (for you, we pay for it) we'll make you all better then send you out to do it all over again.

3. Full blown Diabetic, (had all the teaching (dietary & selfcare)to care for yourself) but now your leg needs to be amputated? No problem.. we'll put you in rehab, give you a prothetic, reteach you, get your BGL's back to where they should be, send you home (and keep a room set for you when you come in to have the other leg amputated because you went right back to your old ways as soon as you left us)

People took better care of themselves when they knew the cost of thier healthcare was not covered by the rest of society. Granted we didn't live as long, but we knew we had to eat right, excersize, listen to what the Dr told us.

I know I'm a bit burnt out at this stage, I'm not saying to stop all coverage for the poor. But, when I see the "poor" coming in with Blackberries, I Pods, hair done by a hair stylist, beautiful new fake nails, designer purses, more jewelry than I own (and thiers are real stones/gold not the Avon I own) driving a brand new car, with thier bags from Taco Bell/ Mc Donalds/ KFC. (I can't afford this stuff, and I work full time!) I just know something has to change, and I don't think changing how we provide healthcare is it.

The ANA has abandoned bedside nurses a long time ago. The only nursing organization that speaks with true authority for bedside nurses and gets things done is the CNA/NNOC, and they are making inroads across the country. ANA is an organization of a by-gone era.

If the ANA has abandoned bedside nursing as you state, then who do they have now?

Specializes in Oncology; medical specialty website.
Sorry, I forget everyone is not "schooled" in today's vernacular. Because that is what it means, sharing information. Peace!

I know what it means.

Specializes in Oncology; medical specialty website.
If the ANA has abandoned bedside nursing as you state, then who do they have now?

Reread the post. It states quite clearly who has stepped up to the plate.

Specializes in geriatrics.

Although the Canadian health care system also contains numerous flaws, the US could benefit from adapting a similar model. Canadians enjoy a high standard of health care, accessible to all and largely funded by taxpayers and our government. in addition, Canadian nurses are unionized, and the pay is fairly standard for nurses throughout the country. While Canadians are also grappling with recession, it hasn't been nearly as devastating here.

I don't know what the answer is, but clearly, the US system has not been working well for some time. In any case, health care should be a right for everyone, not a privilege. I never fully appreciated Canadian health care until I began to learn about those who are forced to do without.

Reread the post. It states quite clearly who has stepped up to the plate.

I took that as "who does the ANA have".

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