Here is an open letter to any and all hospital administration who cares to listen.
Dear Administration Team:
We nurses understand the importance of Press Ganey, HCAHPS, patient safety initiatives and fiscal responsibility. The business of health care has become more cutthroat than ever before. But somewhere along the way the lines became blurred and you forgot that the business of taking care of others cannot be accomplished unless you take care of those who take care of you.
I won’t insult your intelligence, so you are probably aware that a fine balance between recruitment and retention is paramount to the success of any company. We all know that it takes more resources and deeper purse pockets to hire and train employees, than it does to retain those whom already have shown some allegiance and loyalty. Anyone and everyone’s ‘system’ can be bled dry by a high turnover rate percentage.
I thought I might suggest ways to increase your retention and quite possibly eliminate this system exsanguination:
- Learn how to give more positive feedback. We always hear negative.
- Stop finding the time to point out what we are NOT doing, and find the time to thank us for the job we ARE doing – EVERYDAY.
- While a pat on the back is fine and dandy, how about a lil more tangible feedback for your appreciation? We all love a free meal now and then.
- Stop micromanaging – please.
- Adopt and enforce ‘The No Assh*le Rule‘. This includes ANYONE with a G.O.D complex (no matter what their credentials say).
- All work and no play makes Jack and Jill very dull boys and girls. Ever heard the saying ” A family that plays together stays together?” – ‘Nuff said.
- Just because it looks good on paper, does not mean it will work well at the bedside.
- When an employee makes the extra effort, or goes the extra mile, – find a way to give them an extra-ordinary thank you.
There is no predicting why or when someone chooses to leave. I guess we all fall prey to the possibility of greener pastures. If any of the above suggestions are followed, we most certainly would already be standing on the correct side of the fence.
I don’t think anyone can find their true dream job, because quite honestly everyone’s dreams continue to evolve.
Please keep in mind, that while we often feel we never get paid enough – our choice to pursue this career was never about the money. It’s not just a job for many of us, it’s a lifestyle.
Sincerely,
A Nurse
Care to add anything to this open letter? Share in the comments section below.
This article was republished with permission from SCRUBS Magazine.
Many of those in charge were once nurses but it seems like they are obsess with pleasing the ones who has never been a floor nurse instead of informing them as to how nurses truly work. Everyone seems to want to improve how we work without truly understanding what we do. Having the patient dictate everything is the worst idea they have come up with in a long time. Patients are in the hospital to be treated not to tell me how to do my job.
I can’t believe corporations cannot see the writing on the wall. The patients now have the power to dictate your reimbursement depending on the hcap and press Ganey scores. So if you want happy patients and high scores you are going to have to pay and increase staff to achieve this. It’s economics 101. Happy staff equals happy patients equals excellent scores and millions of dollars in reimbursement. Spend thousands to make millions. My er is currently going thru major mass exedus of nurses and medics. Many have gone back to school to obtain pa or np degrees due to poor middle management , horrible staffing ratios micromanaging and bullying. It needs to stop. Nurses do not receive the respect we deserve. With the baby boomers retiring nurses are going to be in demand but the millennials are too smart to tolerate this profession. We need to start working together. Enough middle management. We need more people caring for our patients. Every time our er volume increases to the next level all we get is another manager or nurse leader assigned to sit in an office and print reports. We need bedside care!!! Acuities are getting higher, charting is more intense. We have more and more tasks and benchmarks that need to be met to meet stroke guidelines and stemi guidelines. They want a-1 care but no help to deliver. Accountability for staff but no accountability for management allowing dangerous conditions in critical areas on a daily basis. I for one feel government needs to step in and set safe guidelines for staff ratios. Corporations are far too greedy and it’s very sad.
Sunshine, you hit the nail on the head. Everything you’ve mentioned is 100% correct. Put administration to work in the ER. They won’t last 1 hour. We had a nurse return to our ER after a 1 year sabbatical. She could not finish her shift. She never came back. Administrators seem to hallucinate about perfect care etc. Bedside nurses live in the real world. The only thing we might hallucinate about is having enough staff and an actual lunch break.
Great letter, I would add as a nurse who has worked for 10 years. It seems like more and more especially, though not exclusively, on dayshift there are things being added on to the expectations to improve the patient care experience…. for example multidisciplinary rounds st the bedside with various specialties who are or are not directly involved with the patient, I.e. Social work, case management, nutrition, and the managers themselves. It seems like more often than not it is just a waste of time that interrupts the time you have to care for your patients and chart said care. Could this be done another way? It just seems like we’re talking about things that could easily be discovered by a discussion with the patient themselves or a look at the chart.
Another example being bedside nursing report or as my current hospital is now implementing a virtual report through an iPad where you see the patient coming, their IV and introduce yourselves. Whatever happened to just knowing your patient, giving an accurate report and going from there? You have to know what kind of IV someone has, how it’s doing, and what they have running and their last set of vitals and any issues they’re having if not, why not? Did you get a bad report are you just trying to get rid of the patient? We have lost the art of report because we have to many other things to do that keep us from being able to just focus on patient care which is what most of us are here for.
And last but not least, as you may be realizing, we nurses are not just a number or a replaceable asset. You may be realizing this but you need to do better. We’re overworked and understaffed, burning out, professional waitresses and waiters. Bring back the support positions you eliminated like people who can pass waters, stock, remake unoccupied beds, LPN’s, you name it. Just because we make decent money doesn’t mean we can absorb the work of every other eliminated position.
You need to look at the big picture if you want to change things. Healthcare is not about numbers and stats and requirements and “customer appreciation” it’s about trust, improving lives, doing what is right no matter what, and patients knowing where they can go when they’re sick. If we’re too busy wasting our time with meaningless things that make you feel like you’re doing your job then nurses will leave, patients will suffer and the whole system will eventually collapse.
A great letter and only the tip of the iceberg. For those of us who have been in healthcare for many years this is a hard reality to face: from hospital care to hotel service. More so is the survey criteria in which reimbursement is based. Anyone with any intelligence knows It is a setup for failure and yet we are being forced to give these results credence as a reliable indicator of the patients experience. The variables are many which make the results unreliable: such as thinking an 8 is a very good score, the patients not understanding healthcare terminology, or including dietary issues as part of the patient units responsibility. The list goes on and it is the nurses who are burning out over the day after day sharing of survey results by management. This is the whole focus of patient care. Incredible!
Nursing is a calling, but you have to pay the bills also.
What a wonderfully worded letter! I would add something about stopping with all the little “extras” that have made patients begin believing they’re in a 5-star hotel instead of a hospital. For example: the glorified “admission” kits with the high-dollar shampoos, lotions, & etc.; the “room service” that’s available 24/7 with their choices of anything & everything, despite what types of diet the patient is supposed to be on; MAKING us provide multitudes of snacks & drinks to families/friends visiting, & the like. All this has gotten out of hand – we are healthcare facilities – NOT luxury vacation resorts!
Based all decisions that are practice related on the input of the true practitioners. this means you will have to present the question with a truly open mind. Work hard to get the input of the practitioners, go to them and make responding simple and confidential. Do not just take the word of the available nursing leadership or the few who attend the shared governance meetings. take time to explore the end effect of the change and follow the nursing process. Assess, plan, implement, evaluate.
Could not have stated it better myself!! So appropriate!! In a world where loyalty is missing on both sides- perhaps we need to read and re read this article and perhaps post it in our lunch area!!
Thank you from an Old school Nurse 🙂