Nursing Voices

Thursday, March 15, 2007

Bottom Line Therapy

I went to a staff meeting today, and I left feeling angry. I’m in a sour mood.

The meeting started off fine. We ate cookies, and talked about a few problems that popped up during the week. Most of us hate the new VMAR machines. JCAHO mandated that we use these things when we pass medications. We were told that the new system would make passing medications less cumbersome and improve patient safety. Someone told us a big fat lie. We are now spending less time with our patients and more time trying to figure out the machine. VMAR is a piece of crap. Thanks, JCAHO.

Then we moved on to the hospital’s new pet project. We are now going to run our adult day treatment program during the weekends as a way of generating more revenue for the hospital. Our boss gave us some written information about the expanded program. You would think it would mention how this is going to benefit our patients, but it didn’t. The first item on the sheet revealed how much more money the hospital would glean off of each patient per month. Yes, I understand about needing to meet payroll and paying for other expenses like Mr. Grinch’s expensive new office furniture, but can we still please pretend, just a little bit, that the patients are still the focus of the program? And of course, we were told that we will be doing this extra work with less staff. The hospital can't make extra money if they have to pay for additional staff.

Here’s what I see: More patients - additional nursing staff to help run the program = burnout. Here’s what the hospital sees: More patients + more billable hours = more money. I call this bottom line therapy. And people wonder why nurses are leaving the profession.


Blogger poody said...

Did yo ever see the movie Pink Flamingos with Divine? I love the movie because it is about who is the nastiest person alive. One part of the movie shows Divne and company going to their competitors house and licking everything. I was just thinking how funny it would be to get into the grinches new fancy smancy office and just lick everything! The desk,phone,keyboard,pencil holder, EVERYTHING!!!! I gotta go now because the Talker sitting next to me is now telling me homeless people are just scamming!! Excuse me while I go lick everything on her desk!!!It would be best to lick everything after eating soemthing with garlic or onion!

12:06 PM  
Anonymous N=1 said...

Form a nursing self-governed organization.

Not that this N=1 is paranoid or anything, but the Pentagon, the US Senate Sergeant at Arms, the Army Medical Command, NPR and the NY Times have all been visiting my blog recently. I keep on "dragging my fingernails on the chalkboard" via blog posts about intolerable nursing practice conditions.

Keep on blogging about it, and there's a possibility that the story will get told. Form a NSGO, and there's the ability to take back nursing power.

3:20 PM  
Blogger Calabar Gal said...

Oh Oh!! Someone's not very happy with the 'new inventions' being churned out at work. Thats the modern day nursing for you Nurse Ratcheds.

3:59 PM  
Blogger The Curmudgeon said...

Better get Paris through nursing school in a hurry, MJ, so you can get her posse working for you!

4:33 PM  
Blogger The Angry Medic said...

Aww...I'm sorry that it's happening over there too. I'm in the middle of burnout so I know how it feels, but it must be worse when you're a dedicated, experienced nurse just trying to do her job whilst inept baboons try and tell you how to do it and appoint a pasta-brained turkey to oversee you. My sympathies, Momma Jones. You'll ride it through :)

6:14 PM  
Blogger jaz said...

MJ, I can remember listening to idealistic recent public health grads speak at conferences about "how much money could be saved if we fixed the health care system."

My reply always stayed the same: the people on the receiving end of all that money will see to to it that things keep going exactly the direction they want things to go.

And they will.

6:44 PM  
Blogger Bohemian Road Nurse... said...

Amen--you're so right about that "bottom line"...

7:39 PM  
Blogger 911DOC said...

i continue to maintain that medicine is not a business. a business is as follows.

customer: "i want that car."
salesman: "it's $3000."
customer: "i'll give you $2700."
salesman: "deal."

cash and goods are exchanged.

medicine today is like this.

patient: "i'm sick."
provider: "you need x,y, and z and i have no idea how much it will cost."
patient: "ok."
provider: "super!"

provider does x,y, and z.
patient recovers or dies.

bills swirl around. fee schedules are consulted, a wave breaks on the shore of a distant beach,
JCAHOs 38th revision of its 2002 policies are smashed together in a atomic collider with the latest iteration of HIPPA and EMTALA and the provider is reimbursed 23 cents on the dollar which actually is taken from the proceeds of a drug bust in Yuma, Arizona. Simple really, but a business?

9:20 PM  
Anonymous Anonymous said...

That tornado pic looks like the female reproductive organs. Heh.

10:07 PM  
Blogger Forgotten Blue Line said...

More patients on the weekends= more potential problems. If you think the nurese will get burnt out imagine the security department.

11:29 PM  
Anonymous may said...

bottom line indeed. money talks. and it talks too loud sometimes, it is deafening.


3:46 AM  
Blogger Mother Jones RN said...

Hey guys, thank you for your comments. I'm feeling better after having time to read them.

n=1 : I think it's great that those organizations are checking out your blog. We need to get the word out to the Powers That Be.

Poody: You make me laugh. Yes, I love Divine. Licky, licky:-)

calabar gal: I don't want to be a modern day nurse. This old dog is having trouble learning new tricks

Curmudgeon: Do you have Paris' phone number? We need to get that girl out of the bars and into a fast track nursing program.

My sweet Angry Medic: Thank you for your words of encouragement. Your mama jones loves you:-)

Jaz, Doc 911, and Road Nurse: You guys are right. The people who are making money aren't going to change the system. Refer to my post about Karma. They are in BIG trouble.


10:29 AM  
Blogger Deacon Barry said...

The pursuit of money can have totally divergent results. There, they want you to open at the weekend, here they've closed our ward at the weekend, and we're now shunted to the Infirmary on Friday afternoon. Bizarre!

10:53 AM  

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