Hospital Greed is Destroying Our Nurses

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anbuitachi said:
cant compare healthcare to others since the government decides what the reimbursement is for millions of people and could care less if hospitals/practice survive or not. they are forced to consolidate to survive. guaranteed there'll be less consolidation if medicaid paid more than 10$ a hour
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then STOP Saying it's a free market when we know it's not. And the govt. indeed cares if hospitals go under that's why the ACA picked the winners and losers. And dont think for a minute that the feds are not behind all this consolidation.
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anbuitachi said:
haha i JUST got another raise!
one of the good part about anesthesiology is i can only cover 1 room by myself at a time.
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Ask yourself how your employer is paying for that raise in the face of 8% medicare cuts and balance billing legislation
 
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GassYous said:
GassYous said:
Ask yourself how your employer is paying for that raise in the face of 8% medicare cuts and balance billing legislation
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I see 2 possibilities.

1. They were stealing a lot of money before and are now willing to steal a little less to retain staff.


2. They’ve accepted that they will lose money on anesthesia and are now willing to kick over some facility fees to keep the factory running.
 
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GassYous said:
Ask yourself how your employer is paying for that raise in the face of 8% medicare cuts and balance billing legislation
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Instead of skimming 100% of the profits, they're just skimming 92%.

There is plenty of money to go around. Hospital administration is just loathe to give up a penny to staff. Employment cost is a black hole to them.

Other things like, buildings/equipment etc still show up as a positive on the balance sheet.

The health system I was previously employed with constantly talks about poor payor mix and need to cut costs etc. Yet 2 years ago they spent millions rebranding the health system.

When it came time to renegotiate new contracts with some of their employed physicians (OBGYN group) they claimed we were over paid and put a new contract that was a $25k pay cut. Half the group resigned and they are floundering, especially with call coverage.

Penny wise, pound foolish.

The stupidity and greed of administration never ceases to amaze me.
 
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anonperson said:
Instead of skimming 100% of the profits, they're just skimming 92%.

There is plenty of money to go around. Hospital administration is just loathe to give up a penny to staff. Employment cost is a black hole to them.

Other things like, buildings/equipment etc still show up as a positive on the balance sheet.

The health system I was previously employed with constantly talks about poor payor mix and need to cut costs etc. Yet 2 years ago they spent millions rebranding the health system.

When it came time to renegotiate new contracts with some of their employed physicians (OBGYN group) they claimed we were over paid and put a new contract that was a $25k pay cut. Half the group resigned and they are floundering, especially with call coverage.

Penny wise, pound foolish.

The stupidity and greed of administration never ceases to amaze me.
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This x100. They spend money on stupid **** like some pointless vein finder or sensors that everyone ignores that tells nurses to turn patients or increasing capacity but only cuts for the boots on the ground so they keep the c suite margin fat. It might play out differently if the employees controlled the hospital admin through some kind of board like a collective but then that would run afoul of stark laws.
 
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chessknt said:
This x100. They spend money on stupid **** like some pointless vein finder or sensors
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You have to understand, all that equipment you see: somebody at the hospital is getting a kickback for buying it. Just like all the operating rooms have pixis installed in them. You cant get anything out of it without punching in username and password. It used to be just a tool shed that was always open. You use the same ****ing medications for everyone why cant it stay open. pixis got together with the bean counters theyw orked out a deal that was favorable for everyone (cash under the table) and voila your life got a lot harder.
 
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OptionOffense said:
You have to understand, all that equipment you see: somebody at the hospital is getting a kickback for buying it. Just like all the operating rooms have pixis installed in them. You cant get anything out of it without punching in username and password. It used to be just a tool shed that was always open. You use the same ****ing medications for everyone why cant it stay open. pixis got together with the bean counters theyw orked out a deal that was favorable for everyone (cash under the table) and voila your life got a lot harder.
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They get a “referral” fee to keep the patient “safe”. Since you all were killing then left and right. On top of that keep the contraband away from those who will abuse or sell that **** on the street. You all need to “waste” that ****. Surprisingly, all my patient get 2 and 2.
 
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The problem is that hospital administration has no clue on what doctors actually do. We are the PP ortho group and we are negotiating with the hospital system a call stipend.

The administration said they would only agree to a call stipend if we are available to see ER consults. When we saw that request, we're like these people are fing clueless on what we do. (we currently take call without a stipend)

This makes it difficult in other negotiations because they don't know how medicine works and your negotiation is with idiots.

The ceo goes to some conference that says they need X or Y, and now they try to get X without any medical knowledge on what X is or how do negotiate for it.
 
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ChiDO said:
The problem is that hospital administration has no clue on what doctors actually do. We are the PP ortho group and we are negotiating with the hospital system a call stipend.

The administration said they would only agree to a call stipend if we are available to see ER consults. When we saw that request, we're like these people are fing clueless on what we do. (we currently take call without a stipend)

This makes it difficult in other negotiations because they don't know how medicine works and your negotiation is with idiots.

The ceo goes to some conference that says they need X or Y, and now they try to get X without any medical knowledge on what X is or how do negotiate for it.
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Understand completely. Our administration STILL has no clue how anesthesia billing works (start points, plus time points, and drastically reduced Medicare/Medicaid compensation vs. private insurance).

They REFUSE to spend an extra $25k to hire a scheduler who actually KNOWS what they’re doing (which costs the hospital, the surgeons, AND us thousands in lost productivity EVERY DAY). They also can’t understand why we keep bitching about the “extra business” (ALL Medicare/Medicaid) they’ve been bringing in, which THEY make money on, the surgeons make SOME money on, but WE LOSE money on...

One hour turnovers, poor scheduling practices with gaps/down time all over the place, and cases that don’t even pay $100 an hour (less than prevailing CRNA wages) when the cases DO get going. Then they wanna know why the stipend can’t be reduced???
 
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DirtDocMD said:
Understand completely. Our administration STILL has no clue how anesthesia billing works (start points, plus time points, and drastically reduced Medicare/Medicaid compensation vs. private insurance).

They REFUSE to spend an extra $25k to hire a scheduler who actually KNOWS what they’re doing (which costs the hospital, the surgeons, AND us thousands in lost productivity EVERY DAY). They also can’t understand why we keep bitching about the “extra business” (ALL Medicare/Medicaid) they’ve been bringing in, which THEY make money on, the surgeons make SOME money on, but WE LOSE money on...

One hour turnovers, poor scheduling practices with gaps/down time all over the place, and cases that don’t even pay $100 an hour (less than prevailing CRNA wages) when the cases DO get going. Then they wanna know why the stipend can’t be reduced???
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why come robot turnover 10 min outpatient but 60 min hospital?
 
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I told one our general surgeons in dept leadership our payor mix…she then understood hahah.
 
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OptionOffense said:
You have to understand, all that equipment you see: somebody at the hospital is getting a kickback for buying it. Just like all the operating rooms have pixis installed in them. You cant get anything out of it without punching in username and password. It used to be just a tool shed that was always open. You use the same ****ing medications for everyone why cant it stay open. pixis got together with the bean counters theyw orked out a deal that was favorable for everyone (cash under the table) and voila your life got a lot harder.
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We leased Pyxis anesthesia carts because they convinced our pharmacy bean counters that they would capture more charges. They weren’t bad carts. I didn’t mind them. Then the hospital realized the Pyxis lease($500/cart/month) was not saving them any money so we went back to Armstrong carts 😂.


Also our OR gets an annual capital budget that needs to get spent or is lost. I think that’s why we have so many glidescopes, ultrasounds, and disposable bronchoscopes.
 
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nimbus said:
We leased Pyxis anesthesia carts because they convinced our pharmacy bean counters that they would capture more charges. They weren’t bad carts. I didn’t mind them. Then the hospital realized the Pyxis lease($500/cart/month) was not saving them any money so we went back to Armstrong carts 😂.


Also our OR gets an annual capital budget that needs to get spent or is lost. I think that’s why we have so many glidescopes, ultrasounds, and disposable bronchoscopes.
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Pyxis carts are also about mitigating diversion as much as capturing charges.
 
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dr doze said:
Pyxis carts are also about mitigating diversion as much as capturing charges.
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Yes we still get our controlled substances out of smaller Pyxis medication dispensers, even though we no longer have the full anesthesia carts. But it would still be incredibly easy to divert if anybody was inclined.
 
nimbus said:
Yes we still get our controlled substances out of smaller Pyxis medication dispensers, even though we no longer have the full anesthesia carts. But it would still be incredibly easy to divert if anybody was inclined.
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The key word is mitigate. I am sure that there is a lot of undiscovered diversion. E.g., The light recreational user.
The ones that seem to get caught increase their documented administration or wasting over time. Pyxis software can flag or search for that. Absent devoting major resources, e.g., assaying unused excess syringes turned into the pharmacy routinely, etc. Any system that I have ever worked under can be defeated. Pyxis is somewhat less vulnerable.
 
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dr doze said:
Pyxis carts are also about mitigating diversion as much as capturing charges.
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I dont think it has ANYTHING to do with discovering diversion. SPend millions of dollars per year to catch 0.2 users every 10 years. No way. plus you dont need a pixis for that. you can catch someone diverting easily if he is using.
 
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OptionOffense said:
I dont think it has ANYTHING to do with discovering diversion. SPend millions of dollars per year to catch 0.2 users every 10 years. No way. plus you dont need a pixis for that. you can catch someone diverting easily if he is using.
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Agree. How does catching diversion make the hospital money or make up the cost of this system?
 
Guillemot said:
I dont know if a screening test can. The UDS results I see at least are just opioid. They could likely run additional assays if there were a need to distinguish.
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just wonder how useful it would be for detecting diversion if the person doing the diverting takes prescribed opioids.
 
Now hospital CEOs are seeking relief from congress to protect them from those greedy nurses. When market conditions favor workers, the captains of industry are the first to seek intervention by big government. Where was Congress when regional health behemoths were swallowing and destroying private practices and their smaller competitors. Now these hospital mega systems want relief from Congress? In the United States, we have a free market economy. We should let the market decide how much nurses are worth.



B69CE650-0D59-4B1A-B3E3-0EAF9F289C43.jpeg
 
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nimbus said:
Now hospital CEOs are seeking relief from congress to protect them from those greedy nurses. When market conditions favor workers, the captains of industry are the first to seek intervention by big government. Where was Congress when regional health behemoths were swallowing and destroying private practices and their smaller competitors. Now these hospital mega systems want relief from Congress? In the United States, we have a free market economy. We should let the market decide how much nurses are worth.



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It's cool if a ceo gets 50 mil because that's the going rate and you have to keep them competitive but how dare these nurses and their agencies step out of line and demand pay at the market rate?!
 
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nimbus said:
Now hospital CEOs are seeking relief from congress to protect them from those greedy nurses. When market conditions favor workers, the captains of industry are the first to seek intervention by big government. Where was Congress when regional health behemoths were swallowing and destroying private practices and their smaller competitors. Now these hospital mega systems want relief from Congress? In the United States, we have a free market economy. We should let the market decide how much nurses are worth.



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It sure is reassuring to see some bipartisan support for this very serious issue. If they can’t build another tower for the cardiologists they just might not be able to buy that new helicopter for the VP and that would be a huge ****ing shame for the capitalism that we all love so dearly and has done so much good in our medical system.
 
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nimbus said:
Now hospital CEOs are seeking relief from congress to protect them from those greedy nurses. When market conditions favor workers, the captains of industry are the first to seek intervention by big government. Where was Congress when regional health behemoths were swallowing and destroying private practices and their smaller competitors. Now these hospital mega systems want relief from Congress? In the United States, we have a free market economy. We should let the market decide how much nurses are worth.



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It’s not even clear what they are asking for. Outlaw staffing agencies? Put limits on how much money a nurse can be paid? A good old fashioned cash bailout?
 
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chessknt said:
It sure is reassuring to see some bipartisan support for this very serious issue. If they can’t build another tower for the cardiologists they just might not be able to buy that new helicopter for the VP and that would be a huge ****ing shame for the capitalism that we all love so dearly and has done so much good in our medical system.
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Yep. New tower $1B, Epic $1B. Not sure why paying nurses $150/hr makes them so upset.
 
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nimbus said:
Now hospital CEOs are seeking relief from congress to protect them from those greedy nurses. When market conditions favor workers, the captains of industry are the first to seek intervention by big government. Where was Congress when regional health behemoths were swallowing and destroying private practices and their smaller competitors. Now these hospital mega systems want relief from Congress? In the United States, we have a free market economy. We should let the market decide how much nurses are worth.



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aren't these the same turd CEO's who give themselves multi-million dollar bonuses?
**** them
 
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nimbus said:
Now hospital CEOs are seeking relief from congress to protect them from those greedy nurses. When market conditions favor workers, the captains of industry are the first to seek intervention by big government. Where was Congress when regional health behemoths were swallowing and destroying private practices and their smaller competitors. Now these hospital mega systems want relief from Congress? In the United States, we have a free market economy. We should let the market decide how much nurses are worth.



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This letter is so unbelievably tone deaf. Some select grievances:
-no mention of why there is a nursing shortage in the first paragraph. This would be a good time to mention how the hospital systems treated them like garbage and made them reuse N95s for 3 weeks and wear trash bags.
-any real investigation of 'anticompetitive activity' could come to no other conclusion than that the hospital systems themselves have true monopoly power that summarily depresses healthcare worker wages and raises costs to the public
-if 40% is really going to staffing agencies as profit I'll agree that's a real problem. But if this cost to, ultimately, taxpayers and insurance plans is going to be regulated, why stop there? What about hospital administrator pay, limits on profit on prescription drugs, artificial joints, etc?

I really don't know if barking up the wage/price control tree is what these guys want to be doing, but I admire the chutzpah.
 
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ambiturner said:
This letter is so unbelievably tone deaf. Some select grievances:
-no mention of why there is a nursing shortage in the first paragraph. This would be a good time to mention how the hospital systems treated them like garbage and made them reuse N95s for 3 weeks and wear trash bags.
-any real investigation of 'anticompetitive activity' could come to no other conclusion than that the hospital systems themselves have true monopoly power that summarily depresses healthcare worker wages and raises costs to the public
-if 40% is really going to staffing agencies as profit I'll agree that's a real problem. But if this cost to, ultimately, taxpayers and insurance plans is going to be regulated, why stop there? What about hospital administrator pay, limits on profit on prescription drugs, artificial joints, etc?

I really don't know if barking up the wage/price control tree is what these guys want to be doing, but I admire the chutzpah.
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They also neglect to mention that hospitals have always had the option to retain their permanent staff by giving them a competitive wage and bypass staffing companies altogether.


We’ve had fantastic, experienced, long-term nurses leave over $10/hr. Then they’re replaced by temps who are paid 2x but don’t know the routine and take twice as long.
 
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nimbus said:
They also neglect to mention that hospitals have always had the option to retain their permanent staff by giving them a competitive wage and bypass staffing companies altogether.


We’ve had fantastic, experienced, long-term nurses leave over $10/hr. Then they’re replaced by temps who are paid 2x but don’t know the routine and take twice as long.
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Reminds me of a local asphalt company that posted a bunch of anti unemployment slogans on their website and went on a rant about how nobody wants to work anymore when they were offering 15/hr without benefits in extreme weather condition of extremely physical labor like that was some incredible deal when McDonald’s offers the same thing.
 
ambiturner said:
This letter is so unbelievably tone deaf. Some select grievances:
-no mention of why there is a nursing shortage in the first paragraph. This would be a good time to mention how the hospital systems treated them like garbage and made them reuse N95s for 3 weeks and wear trash bags.
-any real investigation of 'anticompetitive activity' could come to no other conclusion than that the hospital systems themselves have true monopoly power that summarily depresses healthcare worker wages and raises costs to the public
-if 40% is really going to staffing agencies as profit I'll agree that's a real problem. But if this cost to, ultimately, taxpayers and insurance plans is going to be regulated, why stop there? What about hospital administrator pay, limits on profit on prescription drugs, artificial joints, etc?

I really don't know if barking up the wage/price control tree is what these guys want to be doing, but I admire the chutzpah.
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Staffing agencies will also charge nurses to "find assignments". So they are dipping their toes in the water twice. Similar to how a recruiter will take thousands from both a group and a doctor to match them up. Quite a nice setup for minimal effort.
 
If these guys really cared about healthcare, protecting patients, and promoting workers...

They would submit a bill requiring the hospitals to state what wages they pay the permanent nurses (regular and OT), what their staffing ratios are, what they pay the agencies for travelers, what the agencies skim off the top, and what precent of nurses at a facility are permanent vs travelers (kick it up a notch to force listing over the past 5 years).

Bonus points for also requiring disclosure of the salaries and benefits of the top 50 paid people in the hospital. The transparency would fix everything.

Any effort to suppress nurse wages is outright offensive.
 
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ambiturner said:
-if 40% is really going to staffing agencies as profit I'll agree that's a real problem. But if this cost to, ultimately, taxpayers and insurance plans is going to be regulated, why stop there? What about hospital administrator pay, limits on profit on prescription drugs, artificial joints, etc?
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Yeah, that's about what they take from us travelers, usually. Sometimes less. Have a news article.

Not that I really care tbh. The hospital I was staff at paid me 35/hr, refused us additional pay for being short staffed, and gave us 1 N95 "for the duration" (until it broke) and garbed us in trash bags so they could give the CEO a multimillion dollar bonus. Screw 'em, pay me. It's nice to have leverage for once, as ephemeral as it is. If the agencies didn't have things sewed up I'd form my own LLC to negotiate for the bill rate as my own agency. Save them some money and fill my own pockets.
GassYous said:
Staffing agencies will also charge nurses to "find assignments". So they are dipping their toes in the water twice. Similar to how a recruiter will take thousands from both a group and a doctor to match them up. Quite a nice setup for minimal effort.
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Maybe we're talking about different situations, but I've worked a good dozen contracts for multiple companies and nobody has ever charged me up front.
 
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ToliBro said:
Yeah, that's about what they take from us travelers, usually. Sometimes less. Have a news article.

Not that I really care tbh. The hospital I was staff at paid me 35/hr, refused us additional pay for being short staffed, and gave us 1 N95 "for the duration" (until it broke) and garbed us in trash bags so they could give the CEO a multimillion dollar bonus. Screw 'em, pay me. It's nice to have leverage for once, as ephemeral as it is. If the agencies didn't have things sewed up I'd form my own LLC to negotiate for the bill rate as my own agency. Save them some money and fill my own pockets.


Maybe we're talking about different situations, but I've worked a good dozen contracts for multiple companies and nobody has ever charged me up front.
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Good for you and all the other travelers. bring the system to its knees and show them what you're worth. I wish docs had the gumption to do the same thing :(
 
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kidthor said:
If these guys really cared about healthcare, protecting patients, and promoting workers...

They would submit a bill requiring the hospitals to state what wages they pay the permanent nurses (regular and OT), what their staffing ratios are, what they pay the agencies for travelers, what the agencies skim off the top, and what precent of nurses at a facility are permanent vs travelers (kick it up a notch to force listing over the past 5 years).

Bonus points for also requiring disclosure of the salaries and benefits of the top 50 paid people in the hospital. The transparency would fix everything.

Any effort to suppress nurse wages is outright offensive.
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top 50 admins. people who leech off the front line staffs work.
 
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I want to see the letter written to congress when locums want 200 more an hour than the usual rate to compete with the travel nurses.
 
ambiturner said:
This letter is so unbelievably tone deaf. Some select grievances:
-no mention of why there is a nursing shortage in the first paragraph. This would be a good time to mention how the hospital systems treated them like garbage and made them reuse N95s for 3 weeks and wear trash bags.
-any real investigation of 'anticompetitive activity' could come to no other conclusion than that the hospital systems themselves have true monopoly power that summarily depresses healthcare worker wages and raises costs to the public
-if 40% is really going to staffing agencies as profit I'll agree that's a real problem. But if this cost to, ultimately, taxpayers and insurance plans is going to be regulated, why stop there? What about hospital administrator pay, limits on profit on prescription drugs, artificial joints, etc?

I really don't know if barking up the wage/price control tree is what these guys want to be doing, but I admire the chutzpah.
Click to expand...
You are right. There is no mention of the reason for the nursing shortage namely annointing the doctor status to nurse practitioners without having them fulfill the most basic requirements. Now most bedside nurses are bullied by being called disappointments if they dont pursue nurse practitioners. What do they think will happen? Until they address this, (which they wont) the pain will continue to worsen for them. These people are akin to BOzo the clown.
 
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Everyone who signed that letter should resign in disgrace
 
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OptionOffense said:
You are right. There is no mention of the reason for the nursing shortage namely annointing the doctor status to nurse practitioners without having them fulfill the most basic requirements. Now most bedside nurses are bullied by being called disappointments if they dont pursue nurse practitioners. What do they think will happen? Until they address this, (which they wont) the pain will continue to worsen for them. These people are akin to BOzo the clown.
Click to expand...

Nurse practitioners education is a joke. Just see all these advertisements on Facebook, 100% online, only thing they talk about is how short and how little the tuition is. Nothing about quality
 
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