Tuesday, March 7, 2006

The Matrix--3/16

The question to ask: What does team nursing do for the administration? You know that they aren't going to do anything that will cost them money, but how does it save? The mix.

Team nursing while generally a good thing (more balance and less chance of one person stuck with a bunch of Q15s), but misused, it allows administration to use more lower-paid staff in the team. It hides the short staffing of RNs with a higher mix of LVNs and CNAs. It's particularily hard on staff when they float, since the others of the team have to pickup those patients out of their level of expertise (post-op ortho is far different than cancer patients).

But we can't talk about being short staffed, or floating nurses from ER to take high acuity patients, or all the temps, or the payscale, or "negative attitude"s (I can just hear the bells going off and the suspension days racking up the counter--I make it out to be 15, don't you?)

When you're pulling 12s, are beat to death, and then on your days off get the constant calls of, "Can you come in??", then you know something's wrong. You got into this because you felt you could make a difference for the patient, not someone's balance sheet. Yes, economics are a reality, but alienating your staff in such a large degree is not the way to promote nurse retention.

What does it come down to: Dissatisfaction. Dissatisfied staff, dissatisfied patients, dissatisfied physicians, and a hospital without a hope. Chicago Hope, nah, Paris No-Hope.

Until there is a radical change, the staff is going to continue to have call-screening a constant thing, and using the heck out of the sick days. (Does anyone remember PTO???) I'd say that folks were a lot healthier back in the days of two hospitals.

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