A nurse’s perspective on the hospital business

I have been a registered nurse for the last 30 years, working the majority of those years in a busy ER in Berkeley, CA. Recent developments are disturbing to me and my colleagues in regard to the contentious environment between employers and nurses.

People come into a hospital because they require nursing care. That may sound arrogant, but as medicine has become more “efficient,” many tests and treatments can be safely done as an outpatient.  Only the sickest patients are admitted into a hospital for specialty care that can only be performed by highly trained professionals.

The days of unquestioned payment and huge profits are over. To save a few dollars, many hospitals throughout California have outsourced nursing care by hiring travelling nurses. Hospitals quickly realized this was a beneficial loophole in the law and a solution to their problems.

Travelling nurses are often employed by companies from out of state — thus, the problem of benefits, overtime pay and workers’ compensation costs are outsourced as well.

This has become a dangerous practice because these nurses get minimal training and orientation before being allowed to work in critical areas like ICUs and ERs.

From our standpoint, the hospitals are utilizing a disposable work force of mercenary nurses that are here for the money they can’t make at home. California still has a nursing shortage, but many hospitals have hiring freezes and refuse to hire new graduate BSN nurses because they lack experience.

I know the public is torn on the issue of nurses striking over pay and benefits, as many people are out of work.

As hospitals have felt the squeeze, they have passed this along to the patient via the registered nurse. Medical errors and unexpected outcomes happen when staffing is not adequate, education is lacking or support services have been slashed.

When hospitals tried to replace RNs with other workers, the result was disastrous as medical errors soared and patient satisfaction was low. California then instituted the first in the nation safe RN staffing laws that are suggested as a minimum standard.

When I work, to some degree I am your pharmacist, your housekeeper and your social worker, just to name a few.

All the money hospitals spend on extra travelling nurses during strikes would pay for benefits for those nurses already in the system, and invest in the next generation needed to replace those near retirement.

Going forward, hospitals need to embrace a culture of change and a just culture to ensure your ongoing safety during your hospitalization.

You deserve adequate, qualified nursing care that is not outsourced by those interested in contract work only.

Your nurse should have a reasonable workload and access to best practice nursing education by Clinical Nurse Specialists, not computers. And in turn, we promise to have your back when you are sick and need our help.

And as always we serve you, not our employer.

— Karen Boucher, RN
Castro Valley, CA