As hospitals compete for the almighty health dollar, decisions are being made to do whatever it takes to make patients happy. In our hospital, administrators do daily rounds to ask patients how things are going, if there pain is being controlled...so you have non medical people dealing with patient care.
There is a trend in ERs to get people back to rooms asap, a noble idea. Rachedy talks about it in a blog post. We are headed for a time when there will be no triage. The problem with this is that is when no one initially talks to someone, you really don't know who is the sickest. You are treating everyone the same and we all know that all ER patients are far from the same. We are also using up our rooms, could have an influx of REALLY SICK patients and then everybody is screwed.
These decisions are being made without the input of nurses, the ones who actually do the bedside care. They are made by administrators whose bottom line is money. They are being made by doctors whose bottom line is satisfaction surveys and money. They don't ask the people whose bottom line is patient care: us.
Nurses are losing control of our practice in this age of profit and satisfaction surveys. We are becoming factory workers on an assembly line of patient care. Task monkeys. Is that what we want? In the end, it is our liability that increases with these decisions. Will we allow this to go on?
Your thoughts?
Unfortunatley the Press Ganey scores are dictating more than just nurse work load. I work in a hospital pharmacy and have noticed a disturbing trend in the aspect of just giving everyone what they want to make them happy. We used to run a narcotic list only twice per day, and now must run it up to 4 times per day just to keep up the inventory in our Pyxis machines. That is just one example of the mass stupidity of administrators making decisions to keep everyone happy,EXCEPT the employees.
ReplyDeleteWe just started the same process. The nurses including myself are not happy with it. In fact nurses have quit because of it. I would say 30% of our beds are filled daily with the "chronics" patients who come to the ED once every couple of weeks. So patients with real emergencies have no beds. I am pretty much done with working in the ED.
ReplyDeleteThat's exactly what's happening in education. More's the stress and more's the pity! And the students are the ones to suffer and that meager learning experience will impact their whole future!
ReplyDeleteOne of the NP's that I work with was hopping mad the other day. He said that he was talked to about his press ganey scores. He was low in the patient satisfaction with pain control and pretty much told by the group MD that if that didnt come up he would be let go. So basically its give the patient whatever narc he wants as long as your press ganey score comes up. This was an eye opener for me since Im currently in school to advance from RN to NP. I wont be a drug pusher. Time to rethink the medical field all together. Really wish I would have been shown the reality of nursing/medicine 10 yrs ago.
ReplyDeleteAgreed! My mom is an RN and patient care, or non- care, was the reason she left the hospital setting. She is now a very happy director of nursing at a private care facility. More money, less work. I am a teacher, and our jobs are quickly going the way of nursing. We have no control over what goes on in our classrooms, as far as student behavior and involvement. We are not allowed to discipline a child unless we follow the county mandated "behavior plan". Which is useless, and the kids know it!!
ReplyDeleteThis will not have effect as a matter of fact, that's what I suppose.
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