Why I hate people (chapter 1)

[EmmanuelGoldstein]

Some may not get this, some I know will.

I went to our mandatory staff meeting.

Most of the usual blah blah blah.

One of the points brought up by our manager is that it's been determined we give 9.5 hours of direct patient care per 24 hours. (which is ********; I often give that much in a 12 hour shift... but I digress) Anyway this amount of direct patient care hours 'justifies' the use of x number of staff per shift.

She then shows us a graph from last month that shows we actually averaged 12 hours per 24 giving direct patient care, and averaged 1.5 staff over what our matrix called for. She went on a long tirade about how, although charge nurses are allowed to staff for acuity, that this overstaffing was unacceptable. Blah blah blah. Derided us for being lazy in only caring for 4-5 patients, when we so obviously should be taking a higher load.

After she stopped, I asked, "Well doesn't the increase in hours spent giving direct patient care indicate a higher patient acuity?"

She got ****ed and said, "Absolutely not. 9.5 hours per 24 is the national average!!!"

Um. Ok.

She didn't accept any more comments, but after promising to "crack down" on us, proceeded to her next point.

Staff nurses "nickel and dime-ing" the facility by staying over their shifts by 15, 30 minutes to finish up their work. Continued on that rant for a while, too and ended with a promise to crack down on that as well.

I didn't bother to address her directly, instead choosing to whisper to my co-worker sitting next to me, "So am I understanding her correctly? She wants us to do more with less and get out exactly on time?"

"Yep."

"Ok. Just checking."

:evil:

[EmmanuelGoldstein]

I can guarantee you that after cutting back on staffing and pressuring the nurses to get more done in less time--- and they've made it clear their top priority is flawless charting, which of course cuts into direct patient care--- in a month or two, we're going to be chastised because "patient satisfaction" is going down the tubes. And that there's been an increase in pressure ulcers (because patients are not being repositioned in a timely manner). And that there have been an increase in falls. And that there have been an increase in infections. And that the surgeons are ****ed because their patients aren't getting walked. Etc.

[GA_LP]

Bean counters and bureaucrats, whether public or private employees, are always too busy quantifying the trees to notice the flowers, shrubbery or the forest. It never changes Emma, probably never will.

[EmmanuelGoldstein]

Oh, I know. It doesn't help that there is a "consulting" firm in house now, helping the hospital try to find where to cut corners. Which, of course, means nursing care.

I can understand the manager's position, to a point. She is getting it from above and below. But dammit, she should stand up for her staff in cases like this. She should stand up for the patients. There are studies that prove patient outcome is directly related to staffing. Of course, that makes sense... but the research was done to prove it. And it did.

[Spiked101]

I can totally and completely relate to this. At my company they have endless "process" meetings where they can measure a gnats ass but they can't get a handle for one minute on real customer service because they wouldn't know it if it hit them in the face. Way too many people measuring stuff and it's all about how "efficient" we are to their graph charts (think: Do even more with less people and follow these convoluted processes that are not people but numbers oriented). Completely aggravating. For God so loved the world he didn't send a committee..

[nortman]

Some may not get this, some I know will.

I went to our mandatory staff meeting.

Most of the usual blah blah blah.

One of the points brought up by our manager is that it's been determined we give 9.5 hours of direct patient care per 24 hours. (which is ********; I often give that much in a 12 hour shift... but I digress) Anyway this amount of direct patient care hours 'justifies' the use of x number of staff per shift.

She then shows us a graph from last month that shows we actually averaged 12 hours per 24 giving direct patient care, and averaged 1.5 staff over what our matrix called for. She went on a long tirade about how, although charge nurses are allowed to staff for acuity, that this overstaffing was unacceptable. Blah blah blah. Derided us for being lazy in only caring for 4-5 patients, when we so obviously should be taking a higher load.

After she stopped, I asked, "Well doesn't the increase in hours spent giving direct patient care indicate a higher patient acuity?"

She got ****ed and said, "Absolutely not. 9.5 hours per 24 is the national average!!!"

Um. Ok.

She didn't accept any more comments, but after promising to "crack down" on us, proceeded to her next point.

Staff nurses "nickel and dime-ing" the facility by staying over their shifts by 15, 30 minutes to finish up their work. Continued on that rant for a while, too and ended with a promise to crack down on that as well.

I didn't bother to address her directly, instead choosing to whisper to my co-worker sitting next to me, "So am I understanding her correctly? She wants us to do more with less and get out exactly on time?"

"Yep."

"Ok. Just checking."

:evil:
I thnk we work at the same hospital.

[pattyk]

you people that work in hospitals are angels. :hug:

[nortman]

I can guarantee you that after cutting back on staffing and pressuring the nurses to get more done in less time--- and they've made it clear their top priority is flawless charting, which of course cuts into direct patient care--- in a month or two, we're going to be chastised because "patient satisfaction" is going down the tubes. And that there's been an increase in pressure ulcers (because patients are not being repositioned in a timely manner). And that there have been an increase in falls. And that there have been an increase in infections. And that the surgeons are ****ed because their patients aren't getting walked. Etc.We might not work at the same hospital, unless I wok in what your hospital's future is. We have gone through numerous "staffing adjustments" in the time I have been an RN at my hospital (23 years). Each time, falls increase, satisfaction tanks and the staff gets more burned out. The administration gets ****ed because the patients wirte things on their satisfaction surveys about the stafing issues and administration hammers on the nurses about it with quotes like "you are not to discuss staffing with your patients". They don't seem to get that the patients aren't blind or stupid and they can see the nurses and other patient care straff rushing about trying to get everything done. I understand where you are coming from and will tell you that, yes, you are right about your future.

Just wait until they start cutting back on office supplies, patient care equipment, patient food, and other stuff that you "take for granted" if they haven't already done that.

[nortman]

Oh, I know. It doesn't help that there is a "consulting" firm in house now, helping the hospital try to find where to cut corners. Which, of course, means nursing care.

I can understand the manager's position, to a point. She is getting it from above and below. But dammit, she should stand up for her staff in cases like this. She should stand up for the patients. There are studies that prove staffing is directly related to patient outcome. Of course, that makes sense... but the research was done to prove it. And it did.
If it's a company called "APM", run for your life. They fed us all aline of ******** about how we were going to have a hand in determining how the hospital could run more efficiently, then proceeded to shove their changes down our throats.

[EmmanuelGoldstein]

If it's a company called "APM", run for your life. They fed us all aline of ******** about how we were going to have a hand in determining how the hospital could run more efficiently, then proceeded to shove their changes down our throats.
Not sure of the name, but that is certainly what they promised.

[nortman]

Not sure of the name, but that is certainly what they promised.
What they did to us was to get groups together of people who would come up wth ideas of how to "fix" things. But, they didn't get people who knew the jobs. Like, the people who made patient care decisions were people from x-ray, lab, security, etc. There were no nurses there. Then they listened to the "suggestions" of the APM people on how to set up the patient care model. It was all set up according to their numbers. They set it up that you would have "x" number of RN's for a certain level of patients. Patient acuity was NOT to be a factor because "You have some sick patients, but you have some who aren't as sick". Never mind that the acuity of patients is getting increasingly worse as those who are "not so bad" are being more and more treated on an outpatient basis. They eliminated nurses aides. they put in place "patient care technicians" who not only were responsible for aide duties, but also had to draw lab work and do EKG's. There was 1 PCT per floor (usual census of between 20-36 patients), and they were usually so busy doing the other stuff that they had to do, they weren't able to assist with baths. The staffin levels were set so that the RN's were on a 7-1 to 9-1 ratio with patients, and that included the charge nurse who had to handle desk duties. The LPN's were on a 10-1 to 12-1 ratio. Needless to say, it was pretty ugly. Since then we have ahad a couple of other groups come through and they have changed some things and it has gotten a little better.

[EmmanuelGoldstein]

We might not work at the same hospital, unless I wok in what your hospital's future is. We have gone through numerous "staffing adjustments" in the time I have been an RN at my hospital (23 years). Each time, falls increase, satisfaction tanks and the staff gets more burned out. The administration gets ****ed because the patients wirte things on their satisfaction surveys about the stafing issues and administration hammers on the nurses about it with quotes like "you are not to discuss staffing with your patients". They don't seem to get that the patients aren't blind or stupid and they can see the nurses and other patient care straff rushing about trying to get everything done. I understand where you are coming from and will tell you that, yes, you are right about your future.Well, I've only worked here for a couple of years. But in the last 25 years, I've seen this happen time and again. And yeah, we got yelled at because patients and families were actually going (not simply writing) to administration to complain about our understaffing. You're absolutely right about that too; they know the nursing staff is overworked and understaffed. They aren't idiots. So I can guarantee it will happen here. It's just a matter of time.

Just wait until they start cutting back on office supplies, patient care equipment, patient food, and other stuff that you "take for granted" if they haven't already done that.Oh they have. Patient nutrition and snacks have been cut to the bone. We have stopped stocking any supplements of any type. We've got juice, milk, crackers and peanut butter. Occasionally will have a few ice creams and some applesauce. On a freakin' oncology unit.

Hospital has refused to supply staff OR patients/visitors with coffee, so we bring in our own (and against health regulations, are expected to give that to patients and visitors when they ask). We get written up if we use hospital sugar or creamer packets, though.

Office supplies are non-existent. Secretaries supply most of their own.

In the meeting she showed yet another chart graphing our falls over the last month. 6 of them. However this total included one particular patient who fell 4 times; the powers-that-be refused to allow this person to be a 1:1 with a sitter, and God forbid we use a restraint, so they kept climbing out of bed and falling. We were told we should have kept a 'closer watch' on this person.

She then told us she had 2 chair alarms for high fall risk patients who we would want to get out of bed once in a while. Two. For a 28 bed unit. She said this with a big smile on her face like we were supposed to applaud her or something. But who gets to tell angry families and docs why the majority of our patients are not getting out of bed? And who will be berated when these same people develop complications from extended bedrest? (you seem to be psychic, I bet you know the answer to this one too)

And finally, she told us we MUST make rounds hourly. Now barring anything major going on, I do eyeball them once an hour. But this is to be far more than simply looking to make sure they're in bed and appear comfortable.

We are already supposed to wake patients up every 2 hours and ask them if they have to go to the bathroom (I **** you not). Now we are expected to do it every freaking hour. Well, **** that.

These people have a hard enough time getting sleep. I work hard to make sure they DO get as much sleep as possible. I'll be damned if I'm going to wake someone up every hour (or even every two hours) to ask them if they have to potty. She talked about people being confused and trying to get out of bed. Did it EVER occur to these morons that sleep deprivation causes confusion?

[ThrowCop]

I make my living improving efficiencies & processes and reducing system waste and I do a good job. One thing I know is that without the help & buy-in of those responsible for the processes, I will fail every single time.

It sounds like the company that has been hired to help the hospital is really, really bad at what they do. I spend much more time with the, "lower-level" employees than all of those in management combined (at least at first).

[johnrocks]

lol, Emma, this is one of the reasons I'm such a libertarian leaning individual, you can't get 4 people to go to lunch at a work place without at least one hardass in the bunch let alone a bunch of peeps that make policy where all is content..."but I don't want Burgers, I want fiiiiiish" or whatever, go get your own damn food then,grrrr!

[EmmanuelGoldstein]

What they did to us was to get groups together of people who would come up wth ideas of how to "fix" things. But, they didn't get people who knew the jobs. Like, the people who made patient care decisions were people from x-ray, lab, security, etc. There were no nurses there. Then they listened to the "suggestions" of the APM people on how to set up the patient care model. It was all set up according to their numbers. They set it up that you would have "x" number of RN's for a certain level of patients. Patient acuity was NOT to be a factor because "You have some sick patients, but you have some who aren't as sick". Never mind that the acuity of patients is getting increasingly worse as those who are "not so bad" are being more and more treated on an outpatient basis. They eliminated nurses aides. they put in place "patient care technicians" who not only were responsible for aide duties, but also had to draw lab work and do EKG's. There was 1 PCT per floor (usual census of between 20-36 patients), and they were usually so busy doing the other stuff that they had to do, they weren't able to assist with baths. The staffin levels were set so that the RN's were on a 7-1 to 9-1 ratio with patients, and that included the charge nurse who had to handle desk duties. The LPN's were on a 10-1 to 12-1 ratio. Needless to say, it was pretty ugly. Since then we have ahad a couple of other groups come through and they have changed some things and it has gotten a little better.
Holy crap.

That sounds a lot like my last job. And why I went traveling.

Well, they are threatening to form committees like you describe and they've been cross-training secretaries and NAs. And we were told today that 'acuity is not an issue and doesn't factor in to the staffing matrix'. Surprise, surprise.

Speaking of cross-training, this is the same hospital that trained their housekeeping staff to start IVs. Yeah, you read that right, it wasn't a typo --- housekeeping staff. Well, word got out to the public, there was an (understandable) uproar and that was nipped in the bud.

Other areas are being shorted as well. I have patients who are not getting their ordered respiratory treatments (for example) because you can't expect a handful of RTs to cover a 1000+ bed trauma hospital. Same for PT and other ancillary departments. Personally, I think we should write it up every damned time a med is late or PT/OT/SP or RT gets missed. Only of course that means the employee will get smacked and they won't address the root of the problem.

As far as our staffing goes, I have always felt that oncology is a critical care area. These are the sickest patients in the hospital outside of the ICU (and sicker than some IN the ICU). And it should be staffed accordingly.

Yeah, I know. Dream on.

[EmmanuelGoldstein]

I make my living improving efficiencies & processes and reducing system waste and I do a good job. One thing I know is that without the help & buy-in of those responsible for the processes, I will fail every single time.

It sounds like the company that has been hired to help the hospital is really, really bad at what they do. I spend much more time with the, "lower-level" employees than all of those in management combined (at least at first).

They are ONLY dealing with management (people who couldn't pour **** out of a urinal with the instructions written on the bottom... who wouldn't even know what a urinal IS, who've either never been in patient care or are so far removed they have no clue whatsoever what our shift entails). NONE of us peons have even laid eyes on them.

[EmmanuelGoldstein]

lol, Emma, this is one of the reasons I'm such a libertarian leaning individual, you can't get 4 people to go to lunch at a work place without at least one hardass in the bunch let alone a bunch of peeps that make policy where all is content..."but I don't want Burgers, I want fiiiiiish" or whatever, go get your own damn food then,grrrr!

Bless your heart... I've read this three times and I still don't know what you're saying :lol:

[ThrowCop]

They are ONLY dealing with management (people who couldn't pour **** out of a urinal with the instructions written on the bottom... who wouldn't even know what a urinal IS, who've either never been in patient care or are so far removed they have no clue whatsoever what our shift entails). NONE of us peons have even laid eyes on them.Then they will fail & fail miserably.

I spent many years in the paper & film coating / printing business from the ground up from the lowest operator to director of US operations and even when going into a printshop, I would STILL spend much of my time with operators & supervisors to learn their system. I never rely on the biased, untrained eye of management. My results are only as good as the data I gather & analyze. The only way to get that data is from the source. One thing I do is a baseline survey of where management thinks they are at with their current data & then get true data & show them just how wrong they are. That never fails to open eyes.

The company your hospital hired seems to be working backward. It appears that they were told by management what was wrong & are setting out to find evidence to support those conclusions. That simply doesn't work even in the smallest of businesses.

[EmmanuelGoldstein]

Oh. They're going to be having inpatient hospice for those patients at end of life, but it will not be a separate entity. The patient will remain on our unit (just like they've been all along) and will be "discharged" from the hospital and "admitted" to hospice (never leaving their room, of course). They will then not count in our numbers (because remember --- they are no longer considered to be 'admitted'), yet the same nursing staff will spend the same amount of time providing the same care. It just won't count. She said they wanted to do this "to reduce the hospital's mortality rate". Can't have those terminal cancer patients dying in OUR facility, now can we?

****ing morons.

[EmmanuelGoldstein]

Then they will fail & fail miserably.

I spent many years in the paper & film coating / printing business from the ground up from the lowest operator to director of US operations and even when going into a printshop, I would STILL spend much of my time with operators & supervisors to learn their system. I never rely on the biased, untrained eye of management. My results are only as good as the data I gather & analyze. The only way to get that data is from the source. One thing I do is a baseline survey of where management thinks they are at with their current data & then get true data & show them just how wrong they are. That never fails to open eyes.

The company your hospital hired seems to be working backward. It appears that they were told by management what was wrong & are setting out to find evidence to support those conclusions. That simply doesn't work even in the smallest of businesses.

Oh, I'm sure that's what happened. Management told them to find out where they can cut corners, and it will be in nursing care. That's a given.

[johnrocks]

Bless your heart... I've read this three times and I still don't know what you're saying :lol:

lol, I forget what I was trying to convey:doh:

[EmmanuelGoldstein]

lol, I forget what I was trying to convey:doh:

:))

That's ok John. I'm so worked up and ****ed off now I'm sure my blood pressure's through the roof. And I have to go see the doc tomorrow LOL.

Well, he did his residency in this hospital. If my pressure IS up, I'll just mention the name. He'll understand :lol:

[EmmanuelGoldstein]

I make my living improving efficiencies & processes and reducing system waste and I do a good job. One thing I know is that without the help & buy-in of those responsible for the processes, I will fail every single time.

It sounds like the company that has been hired to help the hospital is really, really bad at what they do. I spend much more time with the, "lower-level" employees than all of those in management combined (at least at first).

Potomac Hospital in Woodbridge VA.

Small (about 150 beds or so). If it wasn't so far away or in NoVA, I'd be there in a heartbeat.

I worked there while traveling. They built an entire new facility that opened shortly before I arrived.

OMG. It was stunning. The manager took me on a tour and I was simply speechless. The nurses helped design the units and patient rooms. And they listened and did what they suggested. I won't bother with the details on what all they did, but suffice to say it was amazing. I can't say enough about the place. Patients were happy. Staff was happy (well, there's always a grump or two anywhere you go). In 25 years, I've never seen anything like it. Ever.

[smyrna]

It looks like **** still rolls downhill.

[nortman]

Well, Emma, I have to admit that things have gotten a little better for me. I am now working in our outpatient oncology unit. We give our Adriamycin/Cytoxan/Taxane/whatever else and then let the person go home. Staffing is still pretty pathetic on some days, but at least we have the satisfaction of knowing that our patients appreciate what we do. I end up in med/surg on occasion (like today), but it is a much more enjoyable atmosphere in my new digs.


BTW, at least they didn't try to get the housekeeping staff to start IV's. I don't think I have ever heard anything that idiotic. I thought our administration had pulled some bad stuff, but geeze.

[hatman]

Emma, I can completely relate to the madness you encountered. I see crap like this all the time in my company.

I'm in IT, and our new CIO has initiated a new performance measure: Lines of Code Written per Month!!!!!

Many of us wrote to him that this was a universally debunked metric 30 years ago. He finally 'relented' and decided to go with a 'pilot project'. Some manager volunteered his organization. I was secretely hoping it was a ploy to smoke out the most stupid, or most sychophantic manager, but alas, doesn't appear to be so.

I swear, Scott Adams must work at my company (but a lot of people in other companies feel the same).

[neoINDIE]

Oh, I know. It doesn't help that there is a "consulting" firm in house now, helping the hospital try to find where to cut corners. Which, of course, means nursing care.

I can understand the manager's position, to a point. She is getting it from above and below. But dammit, she should stand up for her staff in cases like this. She should stand up for the patients. There are studies that prove staffing is directly related to patient outcome. Of course, that makes sense... but the research was done to prove it. And it did.

Oh God - the "C" word.

I feel for ya.

[CaptainPike]

EmmanualGoldstein,

Do you think once Obama takes over healthcare, that he might offer some fix for the problems you experience?

[CaptainPike]

I make my living improving efficiencies & processes and reducing system waste and I do a good job. One thing I know is that without the help & buy-in of those responsible for the processes, I will fail every single time.

It sounds like the company that has been hired to help the hospital is really, really bad at what they do. I spend much more time with the, "lower-level" employees than all of those in management combined (at least at first).

You're not a 6 Sigma guy are you???

[Wookinstien]

Don't worry! Obama will fix it!


http://i274.photobucket.com/albums/jj241/Wookinstien/Laughing_goofy.gif



I can't believe I just typed that! :)

[jimjames418]

I didn't bother to address her directly, instead choosing to whisper to my co-worker sitting next to me, "So am I understanding her correctly? She wants us to do more with less and get out exactly on time?"

"Yep."

"Ok. Just checking."

:evil:
I had a sign, 30x60 inches hung above my desk. It read:

"I have done so much with so little
for so long that
I am now qualified
to anything with nothing."

Feel free to make up one of your own and hang it behind the nurse's station. It might open some eyes. ;)

[nortman]

Don't worry! Obama will fix it!


http://i274.photobucket.com/albums/jj241/Wookinstien/Laughing_goofy.gif



I can't believe I just typed that! :)I can.:))

[EmmanuelGoldstein]

Oh God - the "C" word.

I feel for ya.

Thanks. I noticed in the post of mine you quoted I typed it backward; I suppose it means the same thing, but I fixed it anyway.

There are studies that prove patient outcome is directly related to staffing.

[EmmanuelGoldstein]

EmmanualGoldstein,

Do you think once Obama takes over healthcare, that he might offer some fix for the problems you experience?

On the surface, this is a separate issue. But this is a large, regional trauma center. A number of our patients are "self-pay", meaning the hospital likely isn't going to see a dime (and must spend money to attempt to collect). So if everyone is covered, it stands to reason the hospital is going to have more revenue and therefore have less reason to hassle the nursing staff over some of these issues. A single payer system would decrease their costs even more. Then again, our CEO earned just under $3 million last year, so it might just end up in his pocket.

Another thing to consider is that with routine, maintenance preventative care, these conditions and complication would be caught earlier and could lead to a less acute patient population over time. We wouldn't spend our time putting out as many fires. Of course, that is down the road a ways.

So to answer your question, yeah. I can see where a reform of our current system would impact my job (or those coming up behind me).

[EmmanuelGoldstein]

I had a sign, 30x60 inches hung above my desk. It read:

"I have done so much with so little
for so long that
I am now qualified
to anything with nothing."

Feel free to make up one of your own and hang it behind the nurse's station. It might open some eyes. ;)

lol

One of my co-workers at my last hospital got written up for "bringing down staff morale" because of a cartoon she'd taped to her locker. It was captioned, "Where are we going and why am I in this handbasket?"

:rolleyes:

[curtis123]

The more I have to do with people, the more I love my dog.

[jeepers]

For those of us burned out by the system, this thread should come with a warning label and a dose of Xanax.

I lived this. I went through four downsizes and three mergers and this drek was threaded all of the way through it.

I did the four RNs on with a couple of aides on a 36 bed unit, PM shift thing. Most of the time, responsible for TEN. Night shift got 12-13.

Let me translate what this really means:

We don't give a **** about you. The bean counters need to cut costs and it's going to come out of your ass. They don't care what it takes to literally do the job, they don't have a clue what it takes to do the job. The spread sheets say 'cut this much' and this is how we're going to do it. And in order that you don't revolt, we're going to blow smoke up your ass and break out the thesarus and come up with a complicated way of saying 'this is good for you' but they're lying. And we're so inept we'll hire a 'consulting firm' and spend MILLIONS to help us do it. Consulting in this context is really marketing.

Literally it looks like: Less trained staff and fewer overall resources. You clock in for 8 hours, you stay for 10 and you don't talk about it and don't put in for the pay. If anyone bucks the system, they'll get written up. And if you talk about it, you'll get pressure.

The bean counters are wrong. The Administration is wrong. The consulting firms are wrong. Why?

Because they have never ever put their hands on a patient. They do not understand their own business. They do not understand the widgit that they provide because they are merely the shell in which the really widgit operators work.

[jimjames418]

And we're so inept we'll hire a 'consulting firm' and spend MILLIONS to help us do it. Consulting in this context is really marketing.
Ever notice how those "expert" consulting people usually don't know squat about that for which they are paid.

My defination of "expert" is someone who is 1,000 miles from where ever you are, being paid $400 an hour plus expenses, and using language that no one understands. And then the peons get to clean up the mess they leave when they go some place else.

[jeepers]

Ever notice how those "expert" consulting people usually don't know squat about that for which they are paid.

My defination of "expert" is someone who is 1,000 miles from where ever you are, being paid $400 an hour plus expenses, and using language that no one understands. And then the peons get to clean up the mess they leave when they go some place else.


This is very true in the context of healthcare. My point is not only that they don't know, the administrators really don't know, either.

It's like the difference between *******s in Washington talking about Iraq and a soldier with boots on the ground. Listen to the solider and become wise. Listen to Barbara Boxer and watch your IQ drop in real time.

This is ONLY about money in this context. There is no other context. It's about cost cutting and how to sell it. And the only way to do it is to pretend that they're offerring something important to the staff, and then to get the staff to work at warp speed and not get completely compensated for it.

I literally mean that the way that it sounds. Gone are the days of cutting fat. There isn't any fat. There might be some waste, but that usually isn't very true (unless you're talking about remodeling some *******'s office). You need to get the staff to the point where they want to keep their jobs and are willing to work and not get paid for it. Because THAT is the bottom line of all of this nonsense.

I'm not being facetious, I lived this. Started at the end of the 80's and just has gotten worse. Did it in California and now, just like California economics, it's spreading...

This reveals that the rest of the country is catching up. You want universal healthcare? It will only speed up the spread. This is where I part opinion ways with Emma. I see this as WORSENING and becoming the acceptable norm, not a sudden influx of hard cash into the system that will ease the burden on staff.

again, it's like Washington. Congress won't pass a law to make life easier, they pass laws to make life harder and to make sure that lobbyists' nests are feathered. Meanwhile they stick it to the taxpayer.

Hospitals stick to the patient and to the staff. Money that comes in will not ease the workload.

Do more with less. Well, the trouble iwth that is that the staff has ALWAYS tried to do more with what they have. There is a point where you cannot do the job at all and that is what concerns me. We're not that far from the edge.

[EmmanuelGoldstein]

For those of us burned out by the system, this thread should come with a warning label and a dose of Xanax.

I lived this. I went through four downsizes and three mergers and this drek was threaded all of the way through it.

I did the four RNs on with a couple of aides on a 36 bed unit, PM shift thing. Most of the time, responsible for TEN. Night shift got 12-13.

Let me translate what this really means:

We don't give a **** about you. The bean counters need to cut costs and it's going to come out of your ass. They don't care what it takes to literally do the job, they don't have a clue what it takes to do the job. The spread sheets say 'cut this much' and this is how we're going to do it. And in order that you don't revolt, we're going to blow smoke up your ass and break out the thesarus and come up with a complicated way of saying 'this is good for you' but they're lying. And we're so inept we'll hire a 'consulting firm' and spend MILLIONS to help us do it. Consulting in this context is really marketing.

Literally it looks like: Less trained staff and fewer overall resources. You clock in for 8 hours, you stay for 10 and you don't talk about it and don't put in for the pay. If anyone bucks the system, they'll get written up. And if you talk about it, you'll get pressure.

The bean counters are wrong. The Administration is wrong. The consulting firms are wrong. Why?

Because they have never ever put their hands on a patient. They do not understand their own business. They do not understand the widgit that they provide because they are merely the shell in which the really widgit operators work.

As usual, you hit the nail on the head.

You clock in for 8 hours, you stay for 10 and you don't talk about it and don't put in for the pay.People do not realize how very common this is in hospitals. Somewhere I had read that according to the DOL, hospitals and the like are by far the biggest culprits when it comes to violating state and federal wage and hour laws. This includes not paying staff for working through meal times uninterrupted (what the hell is that???)

Nurses know this, but simply shrug because the alternative is being fired for not getting your work done on time. I ask them what do they think is going to happen if they make an error or harm a patient while working off the clock? Think the hospital and their own liability insurance is going to cover them? Hell no. Heck, by their records, you weren't even supposed to be there. And what happens if you're injured (nursing has one of the --- if not THE --- highest injury rates of any job)? Think WC is going to honor your claim if you weren't on the clock? Hell no.

When I was night charge, I was counseled and written up for telling my staff they were absolutely, positively NOT to clock out until they were ready to walk out the door, and that they were to clock out 'no meal' if they didn't get one. No surprise.

[supreme_war_Pig]

I can guarantee you that after cutting back on staffing and pressuring the nurses to get more done in less time--- and they've made it clear their top priority is flawless charting, which of course cuts into direct patient care--- in a month or two, we're going to be chastised because "patient satisfaction" is going down the tubes. And that there's been an increase in pressure ulcers (because patients are not being repositioned in a timely manner). And that there have been an increase in falls. And that there have been an increase in infections. And that the surgeons are ****ed because their patients aren't getting walked. Etc.

Wow EG, you have posted stuff like this before, and it's been just as bad. I am really sorry it's like that for you. I doubt you have ever treated me, but on behalf of your patients, allow me to say: "thank you, and I am sorry you have to work in a Dilbert cartoon".

[EmmanuelGoldstein]

This is very true in the context of healthcare. My point is not only that they don't know, the administrators really don't know, either.

It's like the difference between *******s in Washington talking about Iraq and a soldier with boots on the ground. Listen to the solider and become wise. Listen to Barbara Boxer and watch your IQ drop in real time.

This is ONLY about money in this context. There is no other context. It's about cost cutting and how to sell it. And the only way to do it is to pretend that they're offerring something important to the staff, and then to get the staff to work at warp speed and not get completely compensated for it.

I literally mean that the way that it sounds. Gone are the days of cutting fat. There isn't any fat. There might be some waste, but that usually isn't very true (unless you're talking about remodeling some *******'s office). You need to get the staff to the point where they want to keep their jobs and are willing to work and not get paid for it. Because THAT is the bottom line of all of this nonsense.

I'm not being facetious, I lived this. Started at the end of the 80's and just has gotten worse. Did it in California and now, just like California economics, it's spreading...

This reveals that the rest of the country is catching up. You want universal healthcare? It will only speed up the spread. This is where I part opinion ways with Emma. I see this as WORSENING and becoming the acceptable norm, not a sudden influx of hard cash into the system that will ease the burden on staff.

again, it's like Washington. Congress won't pass a law to make life easier, they pass laws to make life harder and to make sure that lobbyists' nests are feathered. Meanwhile they stick it to the taxpayer.

Hospitals stick to the patient and to the staff. Money that comes in will not ease the workload.

Do more with less. Well, the trouble iwth that is that the staff has ALWAYS tried to do more with what they have. There is a point where you cannot do the job at all and that is what concerns me. We're not that far from the edge.

No, we're not. We're teetering and have been for some time.

I haven't done 'nursing' for years. I put out fires and chase my ass for 12+ hours a night. They tell us we're "autonomous" and yet I have less decision making capability than ever. They micromanage everything we do.

And something that has ****ed me off more than anything are the overt threats. Our manager told us last month of yet another goofy ass irrelevant policy designed to make our lives even more difficult (but hey! it looks good on paper!), and seeing the reaction told us, "I have a dozen applications sitting in my desk right now. You CAN and WILL be replaced."

Nice to know we're appreciated.

I've been in this profession for 25 years. I've seen this time and again. Right now the economy is sluggish and people are signing on to nursing schools because they see it as a stable career. The hospitals know this, and put the screws to their staff because after all, we CAN and WILL be replaced. Openings begin to dry up somewhat, more competition for what is left, and then people start looking elsewhere for a career. Then hospitals start needing us again, and begin to schmooze us, promising us the world. They start actively recruiting nurses, and the cycle repeats itself.

There isn't a 'nursing shortage', no matter what the media tells you. There is a shortage of nurses willing to put up with this ****. Nurses that have either burned out after fighting this crap for years, or new nurses finding out what the real world of nursing is really like and saying 'to hell with this', then returning to school for another degree. I believe the number is in the neighborhood of half a million nurses not working in the field.

My daughter (who would make a wonderful nurse) asked me if I would recommend her going to nursing school. My answer was short and to the point. HELL NO.

[EmmanuelGoldstein]

Wow EG, you have posted stuff like this before, and it's been just as bad. I am really sorry it's like that for you. I doubt you have ever treated me, but on behalf of your patients, allow me to say: "thank you, and I am sorry you have to work in a Dilbert cartoon".

:))

Thanks. When it's just me and my patients, I'm happy as a clam. Those days of feeling like I really helped anyone are few and far between anymore, though. Most mornings I go home thankful that they simply lived through the night. And that's sad, really.

[RTchoke]

:))

Thanks. When it's just me and my patients, I'm happy as a clam. Those days of feeling like I really helped anyone are few and far between anymore, though. Most mornings I go home thankful that they simply lived through the night. And that's sad, really.

I have no idea how you stay sane having to work in that kind of atmosphere. :confused:

I've always loved the "you will do this cuz i gotta line of people out the door waiting for your job" crap. Way to make friends and influence your enemies while lifting the overall morale of your staff. huh? :doh:

[EmmanuelGoldstein]

http://www.amazon.com/Nursing-Against-Odds-Stereotypes-Undermine/dp/080147292X/ref=pd_sim_b_14

I highly recommend this book. As one review says:


"Nursing Against the Odds" was extremely hard for me to read...emotionally. It has taken me months of picking up and putting down the book...especially getting through "Part 3" in such chapters as: "Mangling Care" and "Nurses on the Ropes".

I felt such rage reading what I know is to be so true.

Suzanne details the many players who are " not just supporting good [nursing] practice, they are undermining good practice" and notes that "when nurses believe that exit is their only option, they are really expressing their profound sense of defeat."

And exiting with their feet, they are.
It's deafening and deadly.

I understand what she means; I too found it emotionally draining. It's an excellent book for anyone interested healthcare issues.

[mysticbeauty_nbeast]

For those of us burned out by the system, this thread should come with a warning label and a dose of Xanax.

I lived this. I went through four downsizes and three mergers and this drek was threaded all of the way through it.

I did the four RNs on with a couple of aides on a 36 bed unit, PM shift thing. Most of the time, responsible for TEN. Night shift got 12-13.

Let me translate what this really means:

We don't give a **** about you. The bean counters need to cut costs and it's going to come out of your ass. They don't care what it takes to literally do the job, they don't have a clue what it takes to do the job. The spread sheets say 'cut this much' and this is how we're going to do it. And in order that you don't revolt, we're going to blow smoke up your ass and break out the thesarus and come up with a complicated way of saying 'this is good for you' but they're lying. And we're so inept we'll hire a 'consulting firm' and spend MILLIONS to help us do it. Consulting in this context is really marketing.

Literally it looks like: Less trained staff and fewer overall resources. You clock in for 8 hours, you stay for 10 and you don't talk about it and don't put in for the pay. If anyone bucks the system, they'll get written up. And if you talk about it, you'll get pressure.

The bean counters are wrong. The Administration is wrong. The consulting firms are wrong. Why?

Because they have never ever put their hands on a patient. They do not understand their own business. They do not understand the widgit that they provide because they are merely the shell in which the really widgit operators work.

OMG...You really did work in Cali as a nurse! Sounds like my last three jobs here! (j/k) :doh: Sickening..but so 100% dead on right!

I swear, I was on a 12 hour shift rotation that never rotated due to nursing staff issues. Working 14 hour shifts that were called 12...having to clock out and go back and finish charting/wound care whatever. Silly stuff. We get a new crew in..usually still wet behind the ears...and bam...out the door in under a week or month they went. Admin sticking you with a 10 to 1 ration on respiratory/cardiac step down unit...12 to 1 on oncology floors....9 to 1 on intensive care units. :pray: I was run ragged.

So...as it happened just before I was bitten by ole Mr. Brown Recluse...I called in California Labor board on three different sites; including the big boy at the time, Sutter. I knew the threats from admin were idle..I had them on the ropes...and was going to go all the way..even if it meant never nursing again. 2 weeks into it..I got bit..and down for the count I went. Some of the gals I worked with would call me and let me know what's going on...made things better for a month or so...until the labor board fined and cleared the establishments ...and right back to their low staff, penny pinching ways they all went. Made me wanna scream!

What still spins my head...is how much money is brought in by insurance and state monies to these large hospitals. How on earth any of these places could be running on fumes is just beyond me. Perhaps a full dis closer of what their middle management and upper management make would enlighten us? I don't see doctors taking a pay decrease...if anything their pay is on the increase. Doesn't make sense does it?

I feel for new nurses going into this mess. It sounds as though the rest of the country is going the way of California in health care..to which all I can do is offer my condolences.

~Mysty

[EmmanuelGoldstein]

I have no idea how you stay sane having to work in that kind of atmosphere. :confused:

I've always loved the "you will do this cuz i gotta line of people out the door waiting for your job" crap. Way to make friends and influence your enemies while lifting the overall morale of your staff. huh? :doh:
Indeed.

What's really sad is this unit in particular used to have a hell of a reputation among the local nurses as an amazing place to work. There were rarely any openings, because the staff was so content and well-treated. I can see a difference just in the 2 years I've been there in how the management is treating their staff and how the staff is responding. People are starting to leave in droves, looking for greener pastures. I've been around long enough to realize those simply don't exist.

[Gaetano "Tommy" Lucchese]

Some may not get this, some I know will.

I went to our mandatory staff meeting.

Most of the usual blah blah blah.

One of the points brought up by our manager is that it's been determined we give 9.5 hours of direct patient care per 24 hours. (which is ********; I often give that much in a 12 hour shift... but I digress) Anyway this amount of direct patient care hours 'justifies' the use of x number of staff per shift.

She then shows us a graph from last month that shows we actually averaged 12 hours per 24 giving direct patient care, and averaged 1.5 staff over what our matrix called for. She went on a long tirade about how, although charge nurses are allowed to staff for acuity, that this overstaffing was unacceptable. Blah blah blah. Derided us for being lazy in only caring for 4-5 patients, when we so obviously should be taking a higher load.

After she stopped, I asked, "Well doesn't the increase in hours spent giving direct patient care indicate a higher patient acuity?"

She got ****ed and said, "Absolutely not. 9.5 hours per 24 is the national average!!!"

Um. Ok.

She didn't accept any more comments, but after promising to "crack down" on us, proceeded to her next point.

Staff nurses "nickel and dime-ing" the facility by staying over their shifts by 15, 30 minutes to finish up their work. Continued on that rant for a while, too and ended with a promise to crack down on that as well.

I didn't bother to address her directly, instead choosing to whisper to my co-worker sitting next to me, "So am I understanding her correctly? She wants us to do more with less and get out exactly on time?"

"Yep."

"Ok. Just checking."

:evil:

UMPC, the medical giant that dominates all of Western Pennsylvania, has been firing doctors left and right for lack of billable hours. They've even fired two transplant surgeons for not having enough. And this from a supposed nonprofit.

(The reason the transplant surgeon thing is so unbelievable, for those who don't know, is that transplant surgeons are the elite of the elite, as they are basically dual-specialty surgeon/internists, and UPMC has possibly the finest transplant department in the country, just Google "Thomas Starzl.")

[5thIDSoldier]

Oh, I know. It doesn't help that there is a "consulting" firm in house now, helping the hospital try to find where to cut corners. Which, of course, means nursing care.

I can understand the manager's position, to a point. She is getting it from above and below. But dammit, she should stand up for her staff in cases like this. She should stand up for the patients. There are studies that prove patient outcome is directly related to staffing. Of course, that makes sense... but the research was done to prove it. And it did.

As a healthcare HR professional who is married to an OB/GYN RN, I feel your pain. My wife delivers babies all day. The hospital where she works has a hiring freeze on due to the number of uninsured people they have coming into the ER....yet they must provide a highly positive experience for the patient.....all of them.....

My argument is thus: Why do we need 300 overpaid managers on the payroll anyway?
They are the ones sucking the money out of the pot. Get rid of 50% of them and you can afford more real staffing, the people who provide the care and generate the revenue.

[nortman]

lol

One of my co-workers at my last hospital got written up for "bringing down staff morale" because of a cartoon she'd taped to her locker. It was captioned, "Where are we going and why am I in this handbasket?"

:rolleyes:I'll see if I can find the email about hospital staffing cuts and post it here. Something that is funny and can get you into trouble.

[EmmanuelGoldstein]

And while I'm bitching lol....

Something else that really chaps my butt is how they do all they can to advance the myth that nurses are altruistic, self-sacrificing angels of mercy. ********. By playing that up, all they're doing is attempting to guilt us into accepting their abuse. How dare you leave your shift before your work is complete? Sure, we're open 24/7, but think of your coworkers! What makes you think you have a right to a break? Or a chance to go to the bathroom? People neeeeeeeed you!!!

Not only because of what management is doing recently but because of my own issues, I've had enough. I was diagnosed with diabetes a couple of months ago. There are things I HAVE to do to keep this under control and keep myself healthy. And they are bucking me all the way. Doc told me I must eat something every 4 hours. Not a full meal, mind you, but something like crackers and cheese (or whatever). Takes maybe 5 minutes, tops. I did that and immediately caught grief for sitting down for those few minutes "while your coworkers are so busy". Again, screw that. If I don't get my break, or have to stay over for whatever reason, I am on the clock and will get paid for my time.

I. Don't. Work. For. Free.

Simple as that.

[EmmanuelGoldstein]

I'll see if I can find the email about hospital staffing cuts and post it here. Something that is funny and can get you into trouble.

Yay!!

[EmmanuelGoldstein]

UMPC, the medical giant that dominates all of Western Pennsylvania, has been firing doctors left and right for lack of billable hours. They've even fired two transplant surgeons for not having enough. And this from a supposed nonprofit.

(The reason the transplant surgeon thing is so unbelievable, for those who don't know, is that transplant surgeons are the elite of the elite, as they are basically dual-specialty surgeon/internists, and UPMC has possibly the finest transplant department in the country, just Google "Thomas Starzl.")

Good grief.

And people get upset at our 'dark humor'.

Without it I'd go crazy.

[mysticbeauty_nbeast]

And while I'm bitching lol....

Something else that really chaps my butt is how they do all they can to advance the myth that nurses are altruistic, self-sacrificing angels of mercy. ********. By playing that up, all they're doing is attempting to guilt us into accepting their abuse. How dare you leave your shift before your work is complete? Sure, we're open 24/7, but think of your coworkers! What makes you think you have a right to a break? Or a chance to go to the bathroom? People neeeeeeeed you!!!

Not only because of what management is doing recently but because of my own issues, I've had enough. I was diagnosed with diabetes a couple of months ago. There are things I HAVE to do to keep this under control and keep myself healthy. And they are bucking me all the way. Doc told me I must eat something every 4 hours. Not a full meal, mind you, but something like crackers and cheese (or whatever). Takes maybe 5 minutes, tops. I did that and immediately caught grief for sitting down for those few minutes "while your coworkers are so busy". Again, screw that. If I don't get my break, or have to stay over for whatever reason, I am on the clock and will get paid for my time.

I. Don't. Work. For. Free.

Simple as that.

Nor should you 'work' for free. :snooty: Potty breaks...you'd think you were letting patients die the way admin reacts! Take a few moments to glom something down so you don't pass out on the floor? You selfish selfish person...people 'need' you. Just starve until you get home:rolleyes: Mean while..the a.d.o.n or d.o.n is out having her nails or hair done..going out for 1 hour lunches..and admin is closed and outta there by 4:30...5pm at the latest! :rolleyes: Makes me so mad....:twisted:

Like any decent/good nurse, I'm sure your running yourself at ragged edge making sure your patients are attended too. Why they make it more difficult to do so much with so little is just counter-productive and doesn't save a damn dime! Seems 20+ years haven't changed the scenerio...sad..very very sad. the almighty dollar wins again. Wonder how much these hopistal spend in litigation and law suits? hmmmmm.

Hang in there Emma...your only one person honey...follow your conscience, do what you actually can do and you'll never go wrong. ;)

~Mysty

[EmmanuelGoldstein]

As a healthcare HR professional who is married to an OB/GYN RN, I feel your pain. My wife delivers babies all day. The hospital where she works has a hiring freeze on due to the number of uninsured people they have coming into the ER....yet they must provide a highly positive experience for the patient.....all of them.....

My argument is thus: Why do we need 300 overpaid managers on the payroll anyway?
They are the ones sucking the money out of the pot. Get rid of 50% of them and you can afford more real staffing, the people who provide the care and generate the revenue.

But that would make sense.

Within a month after announcing yet another cut in merit pay increases (gotta tighten that belt!), a big article came out about our CEO and his nearly $3 million annual salary (due to a massive raise and far and away more than any other makes in this area). Needless to say, it didn't sit well with the employees.

[EmmanuelGoldstein]

Nor should you 'work' for free. :snooty: Potty breaks...you'd think you were letting patients die the way admin reacts! Take a few moments to glom something down so you don't pass out on the floor? You selfish selfish person...people 'need' you. Just starve until you get home:rolleyes: Mean while..the a.d.o.n or d.o.n is out having her nails or hair done..going out for 1 hour lunches..and admin is closed and outta there by 4:30...5pm at the latest! :rolleyes: Makes me so mad....:twisted:

Like any decent/good nurse, I'm sure your running yourself at ragged edge making sure your patients are attended too. Why they make it more difficult to do so much with so little is just counter-productive and doesn't save a damn dime! Seems 20+ years haven't changed the scenerio...sad..very very sad. the almighty dollar wins again. Wonder how much these hopistal spend in litigation and law suits? hmmmmm.

Hang in there Emma...your only one person honey...follow your conscience, do what you actually can do and you'll never go wrong. ;)

~Mysty
Well maybe one day I'll win the lotto and can call in rich. (first I'd better start playing it though lol)

I see new (and some older) nurses wailing "I didn't even get a bathroom break!" and such. Well, sorry. I used to be like that---they had me fooled into thinking I was somehow indispensable. Guilted me into working sick. Guilted me into working when there were family emergencies. The whole nine yards. No more. Because I see it for what it is now. They don't give a damn about us, they simply use us up and toss us aside, then hire another young idiot they can guilt into taking their abuse. So now my family and I do come first. Probably too late, in some respects. This job has taken its toll on me big time, physically and emotionally. I hope I survive 'til retirement...

[jimjames418]

This job has taken its toll on me big time, physically and emotionally. I hope I survive 'til retirement...
As a young person I set my priorities. Family first, my health second, job comes in a distance third. And every interview I went on I laid it out just like that. And you know what, I usually ended up with jobs after the first interview. And it wasn't because I worked cheap either. ;)

[EmmanuelGoldstein]

As a young person I set my priorities. Family first, my health second, job comes in a distance third. And every interview I went on I laid it out just like that. And you know what, I usually ended up with jobs after the first interview. And it wasn't because I worked cheap either. ;)

Hell, there are nurses who buy into the whole 'angels of mercy' crap and get seriously upset at those who would dare to defy the traditional view of nursing as a calling. Some look at me like I've grown a third eye when I tell them I went into nursing for a reliable, consistent paycheck. I was a single mom, and this was a career I knew would support myself and my kids no matter what.

Do I love what I do? Do I care for my patients and their families? Oh absolutely. This is my niche and I couldn't imagine doing anything else with my life. But I also love my paycheck and having a roof over my head.

[mysticbeauty_nbeast]

Well maybe one day I'll win the lotto and can call in rich. (first I'd better start playing it though lol)

Couldn't happen to a nicer person imo. :mrgreen:

I see new (and some older) nurses wailing "I didn't even get a bathroom break!" and such. Well, sorry. I used to be like that---they had me fooled into thinking I was somehow indispensable. Guilted me into working sick. Guilted me into working when there were family emergencies. The whole nine yards. No more. Because I see it for what it is now. They don't give a damn about us, they simply use us up and toss us aside, then hire another young idiot they can guilt into taking their abuse. So now my family and I do come first. Probably too late, in some respects. This job has taken its toll on me big time, physically and emotionally. I hope I survive 'til retirement...

Oh can I remember those days. Run ragged...oh yeah..you betcha. Guilt? Oh yeah..you betcha. At some point, we look up and realize just how much crap we take...while our pay stays the same...while more patients are piled onto our work load...while expectations keep rising...and they wonder why we are such a jaded group? Hmmmm...not to hard to think of several reason's why is it?

I was 'almost' tempted to re-enter the nursing field. Wound care therapy...which really isn't 'floor nursing'. I thought...I bet I could do that. So I inquire what the patient load looks like on any given day or month. My eyes near bugged out at the list of 'multiple' hospitals, 12 hour days five days a week, on call every other weekend...some home duty nursing for wound care...and all for the wonderful 'salary' of 35 thousand a year. I laughed at the doctor and his nurse manager. Told them both I don't 'do' wound care for less then 32 an hour...which is what I was making almost 15 years ago in the same field! (And yes..I was that good..lol)

It would take an act of God to pull me back into the field I once so loved and thrived in. I'm not as young as I once was, ; not as naive as I once was; Won't put up with the politics of manager/admin like I once did. So really...not a good fit for me anymore. Makes me so mad when I think of how much I put into school, continuing ed units and pushing to be the best nurse I could be. What a waste....:doh:

~Mysty

[EmmanuelGoldstein]

Couldn't happen to a nicer person imo. :mrgreen:



Oh can I remember those days. Run ragged...oh yeah..you betcha. Guilt? Oh yeah..you betcha. At some point, we look up and realize just how much crap we take...while our pay stays the same...while more patients are piled onto our work load...while expectations keep rising...and they wonder why we are such a jaded group? Hmmmm...not to hard to think of several reason's why is it?

I was 'almost' tempted to re-enter the nursing field. Wound care therapy...which really isn't 'floor nursing'. I thought...I bet I could do that. So I inquire what the patient load looks like on any given day or month. My eyes near bugged out at the list of 'multiple' hospitals, 12 hour days five days a week, on call every other weekend...some home duty nursing for wound care...and all for the wonderful 'salary' of 35 thousand a year. I laughed at the doctor and his nurse manager. Told them both I don't 'do' wound care for less then 32 an hour...which is what I was making almost 15 years ago in the same field! (And yes..I was that good..lol)

It would take an act of God to pull me back into the field I once so loved and thrived in. I'm not as young as I once was, ; not as naive as I once was; Won't put up with the politics of manager/admin like I once did. So really...not a good fit for me anymore. Makes me so mad when I think of how much I put into school, continuing ed units and pushing to be the best nurse I could be. What a waste....:doh:

~Mysty

Honey, you're not telling me anything I haven't heard over and over again from others. I have a friend who quit nursing altogether some time ago and when she finds herself pining will call me and ask for a description of my last few nights at work.

And what I posted above is a big part of the problem. Until nurses begin to see themselves as worthy, legitimate and necessary rather than all this altruistic ********, this is never going to change.

[Blindeye101]

Emma, I can completely relate to the madness you encountered. I see crap like this all the time in my company.

I'm in IT, and our new CIO has initiated a new performance measure: Lines of Code Written per Month!!!!!

Many of us wrote to him that this was a universally debunked metric 30 years ago. He finally 'relented' and decided to go with a 'pilot project'. Some manager volunteered his organization. I was secretely hoping it was a ploy to smoke out the most stupid, or most sychophantic manager, but alas, doesn't appear to be so.

I swear, Scott Adams must work at my company (but a lot of people in other companies feel the same).

Yea the Lines of Code does not work.

Who is better a person who can code 1k lines (i am using low numbers) with little errors vs a person with 5k lines with typos everywhere.

[Blindeye101]

I have a Cousin who left the Radiology Area after he got burnt out.

He says the hours and being on call all the time is not fun.

[nortman]

I'll see if I can find the email about hospital staffing cuts and post it here. Something that is funny and can get you into trouble.

Here ya go, Emma:

New Hospital Policy


--------------------------------------------------------------------------------


MEMO TO: All Hospital Staff
FROM: Administration/Groundskeeper
SUBJECT: New Cost Cutting Measures

Effective January 1 this hospital will no longer provide security.
Each charge nurse will be issued a .38 caliber revolver and 12 rounds
of ammunition. An additional 12 rounds will be stored in the
pharmacy. In addition to routine nursing duties, Charge Nurses will
rotate the patrolling of the hospital grounds. A bicycle and helmet
will be provided for patrolling the park areas.

In light of the similarity of monitoring equipment, ICU will now take
over the security surveillance duties. The unit secretary will be
responsible for watching cardio and security monitors as well as
continuing previous secretarial duties.

Food service will be discontinued. Patients wishing to be fed will
need to let their families know to bring something, or may make
arrangements with Subway, Domino's, etc., before meal time.
Coin-operated telephones will be available in the patient rooms for
this purpose as well as for other calls the patient may wish to make.

Housekeeping and physical therapy are being combined. Mops will be
issued to those patients who are ambulatory, thus providing
range-of-motion exercise as well as a clean environment.
Family-members and friends of patients and ambulatory patients may
also sign up to clean the room of non-ambulatory patients for special
discounts on their final bills. Time cards will be provided.

As you can see on the "FROM" line above, administration is assuming
groundskeeping duties. If an administrator cannot be reached by
calling his/her office it is suggested that you walk outside and
listen for the sound of a lawn mower, weed whacker, etc.

Engineering is being eliminated. The hospital has subscribed to the
TIME-LIFE "How to..." series of maintenance books. These books can be
checked out from administration, and a toolbox will be standard
equipment on all nursing units. We will be receiving the series at a
rate of one volume every other month. We already have the volume on
Basic Wiring, but if a non-electrical problem occurs, please try to
handle it as best as you can until the appropriate volume arrives.

Cutbacks in the phlebotomy staff will be accommodated by only
performing blood-related lab tests on patients who are already
bleeding.

Physicians will be informed that they may order no more the two
x-rays per patient stay. This is due to the turnaround time required
by Eckerd's photo lab. Two prints will be provided for the price of
one, and physicians are being advised to clip coupons from the Sunday
paper if they want extra sets. Eckerd's will also honor competitors'
coupons for one-hour processing in the emergency situations, so if
you come across any coupons, please clip them and send them to the
ER.

In light of the extremely hot summer temperature the electric company
has been asked to install individual meters in each patient room,
office, etc., so that the electrical consumption can be monitored and
appropriately billed. Fans will be available for sale or lease in the
hospital gift shop.

In addition to the current recycling programs, a bin for the
collection of unused fruit and bread will soon be provided on each
floor. Families, patients, and the few remaining employees are
encouraged to contribute discarded produce. The resulting moldy
compost will be utilized by the pharmacy for nocosomial production of
antibiotics. These antibiotics will also be available for purchase
through the hospital pharmacy and will, coincidentally, soon be the
only antibiotics listed on the HMOs' formulary.

[EmmanuelGoldstein]

:)) :)) :clap:

I particularly like this one:

Cutbacks in the phlebotomy staff will be accommodated by only
performing blood-related lab tests on patients who are already
bleeding.

ROFL!!!

[Spiked101]

:)) :)) :clap:

I particularly like this one:

Cutbacks in the phlebotomy staff will be accommodated by only
performing blood-related lab tests on patients who are already
bleeding.

ROFL!!!

:))
Hilarious

[george kaplan]

Some may not get this, some I know will.

I went to our mandatory staff meeting.

Most of the usual blah blah blah.

One of the points brought up by our manager is that it's been determined we give 9.5 hours of direct patient care per 24 hours. (which is ********; I often give that much in a 12 hour shift... but I digress) Anyway this amount of direct patient care hours 'justifies' the use of x number of staff per shift.

She then shows us a graph from last month that shows we actually averaged 12 hours per 24 giving direct patient care, and averaged 1.5 staff over what our matrix called for. She went on a long tirade about how, although charge nurses are allowed to staff for acuity, that this overstaffing was unacceptable. Blah blah blah. Derided us for being lazy in only caring for 4-5 patients, when we so obviously should be taking a higher load.

After she stopped, I asked, "Well doesn't the increase in hours spent giving direct patient care indicate a higher patient acuity?"

She got ****ed and said, "Absolutely not. 9.5 hours per 24 is the national average!!!"

Um. Ok.

She didn't accept any more comments, but after promising to "crack down" on us, proceeded to her next point.

Staff nurses "nickel and dime-ing" the facility by staying over their shifts by 15, 30 minutes to finish up their work. Continued on that rant for a while, too and ended with a promise to crack down on that as well.

I didn't bother to address her directly, instead choosing to whisper to my co-worker sitting next to me, "So am I understanding her correctly? She wants us to do more with less and get out exactly on time?"

"Yep."

"Ok. Just checking."

:evil:

heh ... I showed my ex-wife your op & subsequent post. She said, "That's why I don't work in a hospital."

:lol:

Question: Why aren't you working for an insurance co. or the like?

[EmmanuelGoldstein]

heh ... I showed my ex-wife your op & subsequent post. She said, "That's why I don't work in a hospital."

:lol:

Question: Why aren't you working for an insurance co. or the like?

Because, in spite of all their (administration's) efforts, I love bedside nursing.