Hospital: a business with a cult mentality

Happy Nurse’s Week

I’m doing my favorite thing in the world; sitting through hospital orientation. It’s difficult not only because I loathe orientation, but also because it’s one I’ve sat through under a year ago. *cue internal screaming*

I’ve come to many conclusions about being a nurse and being in the hospital setting.

1) this is a business.
While healthcare, the administration of care, the care of patients and families shouldn’t be a money making scheme; bottom line is it is indeed a business.

While I don’t like it, hospitals have to make money in order to keep the lights on. Frankly, I’d like to get paid for what I do, so the hospital has to bring in cash (however that looks) in order to pay their bills on time. Part of that is part satisfaction and jumping through hoops to accommodate government entities that control reimbursement.

The unfortunate thing, in my humble opinion, is it makes the conversation more about money as opposed to giving good care. It always comes across as doing something so the doors stay open. Perhaps that’s me being jaded.

There have been so many strides and improvements in healthcare in just the decade I’ve been a nurse. Great advances that I’ve seen in my travels that make me excited for how they increase the health and well- being of patients. Healthcare has to morph to accommodate, but I can’t help feeling that some of the brokenness of the system comes down to how much money may or may not be made. It makes it tough to want to continue in the hospital setting because the last person receiving consideration is the nurse.

Which leads to my next point.

2) nursing is a cult.
Or maybe nursing is a cult because hospitals molded us into it? Stop me if you’ve heard this before…

I remember teaching and thinking that. Like the military, we have rules and a way of thinking far different than laymen. We use terms foreign to most people and process that would make no sense outside of the context of nursing. Even within the different specialties, there is language and behaviors we do. I know a little bit about hearts, but if we start talking arrhythmias then I glaze right over. I know some ICU nurses get weird when you start talking about the fundus.

Where I get kinda, antsy is the loss of self or total disregard of person that comes with stepping into a hospital.

You must do this for patient satisfaction and this to keep the doctor happy. What about me as the nurse? We make up the large majority of the hospital work force, but the once yearly recognition of Nurse’s Day with the occasional gift thrown in doesn’t make me feel valuable or important.

I know, I know I talk about this a lot. Part of why I continue traveling is because no where treats nurses with any kind of respect outside of what must be done to make the hospital happy. For all our knowledge base, no initiatives are geared toward making us important components of the process. Not do this, but you are important.

Maybe this has little to do with cult mentality, but maybe it does. It does have everything to do with satisfaction of nurses. We exit the hospital in large numbers and the shortage is real. Why is that? Why is retention and attrition a continued issue in hospital settings? Why is no one really trying to fix it beyond handing out sign on bonuses?

You want longevity and good patient care? Take better care of your nurses. The hospital that gets me to stop traveling will be special and if they have a good retention rate, I’ll call out all the reasons why.

I can’t help coming back to this point over and over. It seems to bother me more than is should and is part of why I’m constantly debating leaving the hospital setting all together.

Back to orientation. Always back to orientation.

Travel on, road warrior

Stop me if I’ve said this: nurses who aren’t satisfied leave

Actually, just go on and let me talk. 

Day 4 of orientation and I’m still processing my feelings about day 2. Day 1 or 2 tends to be the day upper management and administration speaks so you know what was discussed as per the last post. 

Anyway, one thing I got stuck on was JOB OWNERSHIP. 

My loose definition of that is a sense of pride that comes from doing what you do, feeling valued enough in it, that you remain and are retained and produce out of your satisfaction with your work. You promote your business as though you’re the CEO and draw outsiders in because of your love. 

Fancy terms thrown around here are attrition, retention, and recruitment. You hear these terms in hospitals, colleges, big business. Everywhere that numbers play a huge role in the health (and wealth) of an institution. 

So why do people leave? Why do specialized, skilled individuals who went to school specifically to help people leave? It all starts with job satisfaction.

To save myself and you the extra read, check out this article on Why Employees Quit. Go on, I’ll wait. 

That says everything I’d say anyway, but I want to put some emphasis on value. I’ve worked so many jobs and I always think about why I’ve left them. It comes down to value.  My first year out of school I had few coworkers who cared if I sank or swam on a shift. By the subsequent years on OB, I found a family I loved working with, but wasn’t satisfied anymore just working the floor, school followed, and then I started teaching. I left because I felt under appreciated by administration. Yea, the students drove me nuts, but no support and no push to be more burned me out. 

So now I travel and I’ve learned to detect staff dissatisfaction quick. Some of it’s selfish because dissatisfied employees will make terrible coworkers. 

Let me say it again: people who hate their job will not be good team players. 

I don’t have time for that mess so I try creating as much camaraderie as I can. Help me and I’ll help you. But that’s just my own thing. 

They complain about staffing. That the manager won’t come in. What do I hear? No one cares if we put our lives or licenses or patients’ lives in jeopardy. Inadequate staffing sends a message. 

They complain they aren’t valued for their skills. They hear things like “we can train a monkey to do your job.” Comments about people being replaceable send a message. We don’t care about you in your current position. 

Soapbox: First, nursing is a skilled profession and second we suffer from a shortage. You take me with nearly a decade of experience who can hit the ground running or the new grad you have to train. Or you get no one. Pick. But stop treating me as though I’m expendable when I’m not. 

You can tell the satisfaction by the rate of turnover. If you’re losing 14 people in a month and replacing them with 8 you have to train from the beginning, you’re losing. You want to know how you lose? By being forced to spend more money to recruit. Bonuses get people but don’t keep people. You’re also losing knowledge base. It’s your seasoned nurses who leave, leaving brand new nurses with no one to raise them up. 

I could go on, but I won’t. Shoot, I’m not even scratching the surface of what goes into keeping people. Know that employee value is important. Caring about your employees above patient satisfaction is important. If your employees know you care, they will go above and beyond for you. If not, they leave and you’re left with no one to run your business. 

Again, you are valuable. 

Travel on, road warrior.