Reply With QuoteRe: the new nurses getting shifted into the ER if/when hired, read this story: http://www.ultimatenurse.com/forum/f...rses-nd-35855/
The Medicare/Medicaid payment 'mess' is a big factor, IMHO.
Where do you think nursing is headed in bad economic times?
I have been a nurse for 15 years and I am beginning to become concerned about the nursing field lately. Presently, I am a traveler on my third assignment and I have begun to notice some disturbing things during my travels:
1. Hospitals are beginning to eliminate travel positions since they are too costly. Many hospitals are losing some of their most talented nurses for this reason and are deciding to put non experienced new grads into acute assignments in which they simply don't belong. For instance, one facility I know of is taking new grads and giving them a three month orientation into the ER and ICU. I believe they are forcing them to sign 2 years contracts stipulating that they stay to recoup their educational expenses. The problem is that the vast majority of experienced nurses are travelers and when they leave they will be left with few experienced RNS in that specialty. I have nothing against new grads but the fact is that the quality of education of our new grads is at best inconsistent. To ensure that RNS know how to operate independently in an acute care setting, they will need far more time than 3 months to possess the skills needed to be assured and confident in critical situations. I have worked in similar situations where I was the one with experience leading several new grads and the results were nothing less than disastrous. The new grads simply could not handle acute patients and I ended up taking most of them and running a 24 bed adult/peds unit. I eventually quit do to burnout.The hospitals which institute such programs can be assured that the quality of care will probably suffer. In addition, most of those who are trained will leave after 2 years since many hospitals are seeking trained nurses thus making the training programs a financial loss in the long run.
2. Salaries are beginning to drop and bonuses are beginning to dry up unless the institution that is offering them is in severe trouble. Travelers have noticed that they can no longer make ends meet with the little amount of money being paid to them . Hospital travel jobs are diminishing in number forcing travel nurses to compete against one another for the few that exist and hospitals are well aware of this negotiating lower and lower salaries and expecting more and more of their travelers including floating, more travel experience, etc. Many of us realize that these diminished salaries don't consider the cost of living increases so many of us are deciding to take ourselves back home where we can at least work another job if needed which can not be done on a travel contract.Many nurses with one to two years training are seeing the dismal conditions associated with travel and are opting to stay home.This means that travelers can expect salaries to stay low for some time until hospitals realize the futility of their efforts as permanent RNS burn out. Many hospitals know that there is quite a few new grads looking for jobs yet the hospitals don't want to hire them due to the educational expense of training them and the lack of retention in this field. Yet, hospitals can drop salaries stating that they will use new nurses if forced to thus making it difficult for us to negotiate. It also means that hospitals have the upper hand stating that that if a person doesn't line their job, they can always quit. Does this mean we can see patient to nurse ratios climb and the work become more difficult as we see hospitals lay off CNAs, Respiratory therapists, phlebotomists etc. much like they did 15 years ago? Does any one remember that nightmare? I know that California has instituted ratios but much of rest of the country has not. Do we honestly think that management will care when money is the bottoms line? i don't mind hard work but I refuse to go back to the days where the RN was forced to clean floors! I would but I think I am getting too old for it...
I know that things will probably turn around at some point but I expect that things will stay pretty much the same for a year or more. I don't want things to return to the way they were 15 years ago. Patient care was dismal and nurses burned out quickly. I love my job but quite frankly, I think I would leave nursing and work a government job for a while if needed. Having a degree in disaster management may help me in the long run. But what about all of the other nurses out there? Do you think things are as bad as I think? What should we do to turn things around? Is there any thing we can do to circumvent mangement's attempts to take advantage of us?
Re: the new nurses getting shifted into the ER if/when hired, read this story: http://www.ultimatenurse.com/forum/f...rses-nd-35855/
The Medicare/Medicaid payment 'mess' is a big factor, IMHO.
Most of the hospitals here are at a hiring freeze. They over built. Four of the three have cancer centers and two of the four have heart centers. With no jobs or lack of health insurance these are sitting empty. The hospitals in an effort to keep their heads above water increased what they are charging to the insurance companies and are now cutting staff and pay. My wife not only lost her COLA, but also took a 4% pay-cut.
The nursing school I am at is very worried about students leaving the area and state for better job opportunities. They are so worried the Dean sent a message to students. Why they are worried is that it is expected that there will be a large turn over of retiring nurses within the next five to ten years. Many of those nurses were planning to retire sooner, but their husbands who had factory work have been laid off and now the nurses are the sole bread winner.
Barry Manilow didn't write I Write The Songs. Bruce Johnston did.
Squid, I just had a thought: the hospitals that are non-profit have to spend their $$$ somehow, and tend to build/revamp, etc. Think that tax break got them in trouble?
I doubt it. I've never herd of a hospital that was overflowing with cash. The theory of hospitals being non-profit is they would provide care for people who couldn't pay, but clearly that doesn't happen. They cost shifted the cost to the people with insurance or drove those that couldn't pay into bankruptcy.
Having a number of friends that are accountants...non-profits do not have to spend to have a zero balance at the end of the day. The non-profit insurance company in this state has an over $200 million dollar "war chest" and is asking the state that they be allowed to raise their rates.
Cancer and cardiac centers were built to make money for them selves, and since they are relatively empty, they have become a money looser for them. Perhaps the most telling thing is that the cardiac centers aren't the best in the region. 1 hour south is a cardiac center of excellence, which none of the local ones are. But with all the advertising these hospitals have done the majority of the public doesn't know that they would get better care in K-zoo and not GR.
Barry Manilow didn't write I Write The Songs. Bruce Johnston did.
its already affecting my area...the hospital in my town laid off 31 postions. thru out the hospitals 127. the other hospitals not withing the my group had 149 layoffs. I know that some of them were nursing...not clinical nursing but more admistration. But still they were with the company 15 yrs or more. They are on a hiring freeze cut out overtime. So who does this affect the pt of course...:nurse-soapbox:
~I Battle the Angel of Death 40 hours a week. What do you do? ~Author Unknown~
Layoffs here have been admin personel for the most part. However, one hospital nearby laidoff all the LPN's. I guess the LPN's were told a year or so ago that they were going to an all RN nursing staff and those that did not complete thier RN (with tution assistance from the hospital) were fired. However, that hospital did not fill the terminated LPN positions with RN's.Originally Posted by LivingDeadNurse
Barry Manilow didn't write I Write The Songs. Bruce Johnston did.
Relevent points, everyone. It will be interesting to see just how things develop. One thing is for sure, it's getting increasingly more difficult for leaders in government, reimbursement and the healthcare delivery system to keep pushing the problems foreward. It's time to deal with the monster before it eats everybody.
R
As I mentioned in another thread, until healthcare costs get under control by using evidenced based practices everything else is pretty much small potatoes.
Barry Manilow didn't write I Write The Songs. Bruce Johnston did.
Re: Where do you think nursing is headed in bad economic times?
To add to all of this, I am tired of hearing about the "nursing shortage" when nobody is hiring! I have been unemployed for the first time in my 28yr career (since Dec.08). I bet I have applied for 30 jobs minimum (although it accounts for about every job open in this area). I am lucky if I get a call for an interview and more times than not, I hear absolutely nothing. Yep! There's a shortage but there always will be as long as nobody is hiring!:nurse-rofl:
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