Corporate health care is not helpful to nurses and patients are the biggest losers
Nursing is a stressful profession. Nurses manage life and death situations; body fluids; deadly bacteria and viruses. They experience aggression from patients; threats of being sued; insane long hours and insane patient loads; lack of sleep and no time to eat or use the bathroom are common. They are responsible for administering dangerous medications that can potentially harm patients. Few professions offers such rich variety of stressors.
Now there is a new stress now – Corporate nursing. For profit corporate management is here to stay; and will only intensify with Trump’s administration. Corporate nursing comes with a built in conflict: what is good for patients Vs. what is good for company profits. In a complex business such as health care – profit generation comes directly out of patient’s well being, and the reason is quite simple – health care requires all available resources. And the profit margin should be a small one.
Profit based health care also damages collaboration between staff. Hospitals lately are not providing safe and effective environment for nurses to work because attention has been shifted to running a profitable business. Instead of having a supportive atmosphere, managers use tactics that dis empower nurses in every possible way to maximize their productivity as if hospitals were factories.
Cutting costs is the rule number one for profit making. Nurses are forced to work impossible patient ratios, finish tasks without proper time allotment and face increasing lack of resources because there isn’t enough staff to perform the work that is needed in order to achieve patient safety and care.
Working relations have also deteriorated. Nurses are not well respected, and leadership lack real meaning when nurses are not taken seriously when ask for backup. Benefits are being cut and pay diminished. As nurses, young and old are usually at the threshold of burn out, and retention of nurses diminishes.
A survey by Vickie Milazzo President of a nurse legal consulting business called my attention. The survey is called “Are You Way Too Stressed Out?” Survey Results. Even though it is geared to attract nurses seeking an alternative to hospital nursing; it remains a valid insight on nursing today. Her vision into the current nursing workplace is pristine and to the point, and offers viable positive alternatives. So, I am using some of its contents as a base for my argument and commentary.
The survey ultimately denounces how corporate health care is basically destroying nursing culture. Nurses are being overworked, and disrespected by management at a time when the opposite should be happening. They are unable to have a personal life or strike a healthy work-life balance. Nurses are not able to deliver the quality of care they know their patients need, because they ultimately lack support from their employers. Nurses are stressed not only by the poor conditions at work but deal with an insensitive and aggressive management who prioritizes profits above all.
The survey was intended to draw attention to the deteriorating working conditions nurses are facing. It is based on the answers from 3,312 respondents. Fifty percent of nurses surveyed had more than 20 years’ experience, 23% between 11 – 20 years, 15% 5 -10 and 12% less than 5 years. Stress was noted not only on older nurses but also young ones entering the profession. The survey point out to how the undermining of nursing profession can put patients at risk and create nursing shortages which could take years to repair.
Stressed nurses impact on patient care
The aggressive corporate style management we have in place today is not improving health care in any way. By not being supportive of nurses, they undermine the profession and put the patient population at risk.
Aggressive management geared to generate profits create dangerous patient safety issues:
1) it interferes with team play. A health care organization without a strong team play is like an army with no cohesion. Its strength which lies in its soldiers is severely weakened when individuals are fighting for their grievances rather than trying to finish their tasks.
2) direct effect on care: employees who are not happy where they work and where their profession is going are more likely to perform poorly or leave the profession entirely
3) med errors: nurses who are overworked and sleep deprived are more likely to make med errors.
4) create lack of proper training: hospitals are denying new nurses proper training. To cut costs, hospitals have eliminated new grad programs. Today only a few, taking few new grads are still in operation. Hospitals instead rely on travelers even though they are costly and have uncertain background and training.
Nurses represent the largest percentage of healthcare industry workers, with more than 2.7 million in the U.S. (Source: U.S. Bureau of Labor Statistics, April 2014). Nurses are in the forefront of healthcare. It is unimaginable that the health care system would do anything but to help nurses.
The trend however is to undermine nursing as hospitals find themselves with an upper hand on nurse’s availability. Because older nurses are postponing retirement and a surge in new graduate nurses exist, hospitals experience an oversupply of nurses. However, this advantage could be short lived as baby boomers get older.
Corporate profits and irresponsibility
When health care is turned into an industry to generate profits we have a problem. The United States have the most expensive health care in the world and not much to show for. The United States spent $7,960 per capita in health care in 2009 and is the most expensive health care system in the world. Americans are not getting the service they pay for according to a survey.
Health care and profits are incompatible. Any profits in health care compromises care quality. Hospitals are cutting staff and reducing pay, since 60% of their expenses are nurse’s payroll. Patients are secondary to profits in this new style of management. Hospitals also have the perfect way out of scrutiny because care quality is difficult to measure and study results are easy to fudge.
Patients are unable to determine what is safe and reliable care. Only health care professionals can evaluate what can and what can’t be done. But doctors and nurses are unable to work with the public because their bosses are not on the same page.
At the end of the day, nurses must fight an entire corporation to provide good care. Hospitals who are supposed to be “not for profit” are also making record profits; CEO’s are making record profits. The billions of dollars in excess profits by upper management and CEO’s has a direct impact in the quality of care because it reflects lower staff numbers.
Nurses vulnerable position and media stigmas
Unfortunately, nurses are stuck between a rock and a hard place. They are expected to be forgiven and compassionate and at the same time are blamed if the work is not delivered to expectation. This concept get mixed in the public’s mind. But corporate health care is never to blame because they are virtually invisible to the public.
- “Are You Way Too Stressed Out?” Survey Results
- Stress causing psychosomatic illness among nurses
- Violence Against Nurses and its Impact on Stress and Productivity
- International Comparison of Spending on Health, 1980–2009
Image credit: Stewart Black