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?

Specializes in Clinical Research, Outpt Women's Health.

Less nurses, less quality care. You get what you pay for.

Specializes in Medical.

Back to the OP: first, I love that, despite mounds of research demonstrated a clear and consistent correlation between skilled nursing care and better health care outcomes (fewer errors, shorter stays, fewer complications, fewer readmissions), nursing is still always the first thing to go.

Second, I don't know how it is in the US but at my (tertiary referral) hospital shorter hospital stays and the growth of hospital-in-the-home services, combined with increased longevity and more co-morbidities means that our in-patient population is significantly more acute than it was even a couple of years ago.

This means we not only need nurses by the bedside but we now have a significant expansion in nursing roles; my ward is piloting a complex discharge co-ordinator position to facilitate quicker throughput of medically and socially complicated patients.

It would be nice to have any of the contributions skilled nursing care makes to patient wellness and recovery (as well as comfort and palliation) recognised by the people who debate our funding and determine our numbers.

It seems to me reducing the number of RN's in hospital is very old news. Where has the author of this article been cocooned?

They need to cut MANAGEMENT. The Assistant Director, and the Assistant Director's Assistant, and the other Directors of the Directors, and the Manager under the Director, etc., etc., etc. How many chiefs does the tribe need?

If they cut nurses, there will be more mistakes and death and LAWSUITS.

Specializes in ICU, PACU, OR.

Scary thought when you factor who we care for, the nursing shortage forecast for the next decade (nurses and instructors) and the constant articles related to the number of nurses needed for quality and safety. Will common sense prevail? Who will care for us when we succumb to the need for medical care? Everyone wants to be promoted away from the bedside, but when the pendulum swings-as it will- the beside nurse whether it be in the hospital or home will be desperately needed. We already see empty beds-limited care on specialty units-there are physical beds but not enough staffed beds. So I guess we have to wait and see what prevails.

the problem with mass system is insufficient federal repayment, capitation, and trying to coordinate the 3rd party payers. we need a single federal payer system, ala france, i.e. real socialized medicine. i think fewer nurses are inevitable either way. the money simply isn't there.

you mean the eu country that is closest to bankrupt? hmmm, sounds like a real solution, not!

Specializes in Spinal Cord injuries, Emergency+EMS.
You mean the EU country that is closest to bankrupt? Hmmm, sounds like a real solution, not!

France is not the EU state closest to bankruptcy , they haven't gone begging cap in hand unlike the Irish who maxxed out their credit cards and thought they'd found the pot of gold at the end of the rainbow

if they are going to have fewer nurses, then they need to have fewer patients. Oh, yeah, they will - people won't qualify for care and will die. For some reason the united states cannot take care of the elderly. Just let them die. That's the solution.

Specializes in ICU.
You mean the EU country that is closest to bankrupt? Hmmm, sounds like a real solution, not!

Heh...Have you looked around lately?

Specializes in ICU.
Wow.. you had me about the middle class being raped to pay for the health care of people below AND definitely ABOVE us too.. and with the preventative stuff. Now you just lost me. I don't know what "poor" folks you're seeing but my poor patients definitely werent' living on the high hog and driving brand new cars. hell, I was scrambling with case managemnt for taxi vouchers to take them back to the ghetto. You can get an ipod for 15 bucks now you know.

Here's a concept; how about making the biggest employer in the country, Wal-mart, provide coverage for their employees hospitalizations instead of sticking the rest of us with the bill. After all 17 of the Forbes richest 50 are Walmart heirs and spouses (IE, inherited wealth when Sam died). I'd say they can afford it more than I can. 'Course, I know , having those that can afford to pay is 'socialism' but dumping it on me isn't. Or something.

Anyway...

Yes, there will be reductions in nurses everywhere. Thats' how for profit business works and today, thanks to a host of factors from the Limbaugh radio show to the Tea Party, it's cheered and saluted even by the affected.

So, technology will continue forward to automate nursing functions; cheap immigrants will continue to be hired, Republican governors will continue to attack the nursing unions and state boards that are independent so they can have QMA's give meds instead of RNs' and so forth.

As you sound like your all for the results of crony capitalism, so clearly it's a good thing, right?

First they came for the autoworkers and you didn't speak because you weren't an autoworker..and besides business is business. Then they came for the air traffic controllers... the longshoreman, the high tech workers, the state workers in Wisconsin...and when they finally come for the nurses they'll be nobody left to speak for us.

Speak it. You're right on target.

To add:

Wal-Mart was the top Fortune 500 company in 2008 (beating out Exxon-Mobil, Chevron, and General Motors) and yet, according to the PBS documentary, "Is Wal-Mart Good for America", they actively encourage their employees (over 60% of which are not covered by the company healthcare plan because with the wages they earn, they can't afford it or because the quality of the insurance coverage is sickeningly low) to apply for public assistance to cover healthcare and other expenses. So basically, Wal-Mart doesn't have to pay out significant insurance premiums because tax payers are covering their insurance costs.

Don't people read anymore?

Edit: Turn off Fox News. It rots your brain. Seriously.

Specializes in ICU.
I agree with you. I worked in Canada a few years in the 90's. At the time the US economy was doing fabulously, President Clinton had closed the deficits and created 23 million private sector jobs and yet somehow over half the country tuned into Rush Limbaugh and hounded and hunted him. Having come from Texas, probaby the epicenter of it all, I'd been educated with plenty of rhetoric about the Canadian system.

Imagine my surprise when I got there and was as a worker immediately eligible for better health care than I'd ever gotten here. -granted my health was/is good and I wasn't exactly needing big ticket items. Still, I'd heard the crap about endless waiting lines and rationing - bunk - no more so than any HMO here. A friend there had a positive mammogram and they had her biopsied in less than 48 hours. The hospitals certainly weren't as fancy as many here - form follows function all the way. So what? I don't need fountains and artwork - I'm there for health services.

Hospitals had specialities usually and there would be one or two hospitals competing in a 20 mile radius for being the best in cardiology or cancer - not 5 - that's a real problem in the USA - the inflationary effect of so many redundant specialists. The other thing that turned out to be 100% bunk is that Canadian healthcare is socialized. Er, no, single provincial (state) payer plans is not socialized medicine - it's an efficient payment system.

The providers, pharmas, labs, et al are entirely private and driving their German cars too.

meanwhile the efficiency of single payer and above mentioned sensible practice and skipping worthless luxuries makes their healthcare system far far more affordable. We pay almost triple per capita for healthcare as a nation and still have , what is it now, 80 million uninsured people?

For the average person it is a far better system. Nobody files bankruptcy because a family member got cancer or their kid has an expensive illness. Nobody can raise your premium if God forbid you get these things so you are uninsured. The healthcare I and others got was on par with what i get here. It just cost less. A lot less.

The only problem I see is I think Canada is too generous in letting landed immigrants use the system.

Additionally, a bit of logic that tends to be overlooked is that a capitalistic healthcare or the 'healthcare as big business' model doesn't thrive when the population practices stringent prevention and educated, personal health promotion. Disease progression means increased interventions as the risk for complications increases. Anything that requires a complicated surgical procedure or a lengthy hospital stay is costly. Prevention and health promotion cuts into profits in the long term. It's a glaring conflict of interests.

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