Not the professionals that provide care. The JCs running healthcare facilities.
In the midst of the pandemic, hospital leaders have blamed everyone but themselves for not having enough nurses. They blamed a national nurse shortage when nursing schools are graduating close to 180,000 new nurses every year, a 250% increase since 2000, suggesting the problem is not supply but objectionable working conditions. They blamed nurses for leaving the profession in droves, even though less than 5% of nurses say they plan to leave nursing — though more than 20% say they intend to leave their hospital jobs. Hospitals blamed supplemental staffing agencies for driving up nurse salaries, even complaining to the Federal Trade Commission and to Congress.
And hospital leaders conveniently overlook the fact that many hospitals furloughed nurses without pay after the first wave of Covid-19, after they had risked their lives to care for tens of thousands of critically ill Americans. Such labor practices do not engender employee loyalty.
In the U.S. hospitals are big business. It is time to change how they conduct that business. For decades, the hospital industry has failed to voluntarily implement safe nurse staffing and failed to police those hospitals that commonly violate evidence-based staffing norms.
About a month ago, I had my meniscus taken care of as outpatient surgery at one of the Mass General Brigham surgical centers. I was in and out in about 4 hours. Not sure what the bill will be. Today I received an invitation to donate to their “Caregivers Support Fund”. According to Wikipedia, in 2017 their revenues were $13.4 Billion.
Not exactly true. Long story short, the is a “nurse staffing” formula that is heavily influenced by Medicare/Medicaid regulations. Just like private insurance reimbursement is heavily influenced by M/M rates.
And like everything, the devil is in the details. What I witnessed throughout my career, a few hours before shift change, the nursing supervisor would go around looking at patient census, patient severity, etc., plug those numbers in and get result back. This unit will need 3.8 nurses upcoming shift. So it got staffed at 3 nurses. And every unit in the hospital would get rounded down and in essence have zero in-house backups to pull if one unit got busy. And they never took into account certain units could go from quiet to slam packed in 60 minutes.
The biggest issue is one of demographics. Baby boomers are retiring. Healthcare is no different. And plenty of older nurses, etc., are leaving the hospital setting for less stressful offices and clinics. Anyone could see that coming 20 years ago.
