Tuesday, March 07, 2006

The Matrix--3/16

The question to ask: What does team nursing do for the administration? You know that they aren't going to do anything that will cost them money, but how does it save? The mix.

Team nursing while generally a good thing (more balance and less chance of one person stuck with a bunch of Q15s), but misused, it allows administration to use more lower-paid staff in the team. It hides the short staffing of RNs with a higher mix of LVNs and CNAs. It's particularily hard on staff when they float, since the others of the team have to pickup those patients out of their level of expertise (post-op ortho is far different than cancer patients).

But we can't talk about being short staffed, or floating nurses from ER to take high acuity patients, or all the temps, or the payscale, or "negative attitude"s (I can just hear the bells going off and the suspension days racking up the counter--I make it out to be 15, don't you?)

When you're pulling 12s, are beat to death, and then on your days off get the constant calls of, "Can you come in??", then you know something's wrong. You got into this because you felt you could make a difference for the patient, not someone's balance sheet. Yes, economics are a reality, but alienating your staff in such a large degree is not the way to promote nurse retention.

What does it come down to: Dissatisfaction. Dissatisfied staff, dissatisfied patients, dissatisfied physicians, and a hospital without a hope. Chicago Hope, nah, Paris No-Hope.

Until there is a radical change, the staff is going to continue to have call-screening a constant thing, and using the heck out of the sick days. (Does anyone remember PTO???) I'd say that folks were a lot healthier back in the days of two hospitals.


Anonymous said...

I keep hearing the song "We're not gonna take it," going off in my head. I wish everyone would stick together, and confront administration.

It would be very hard because, when it comes right down to it, people who really need their jobs, and those who think they can get ahead by agreeing with administration, will cow down during the meeting. Been there done that, and gave up.

It can work, but like the cath lab you need a united front, maybe just short of a picket line. I'm cheering for ya though. JUST DO IT!


I'd love to come back if it could be fixed. I hate that ya'll are stuck there doing the dirty work, but I don't think many people saw where all of this was going when I left. I think many were still waiting for the rewards of sticking it out with Essent.

Has anyone who quit from PRMC had there PRMC reference checked by a reference company?

Anonymous said...

How 'bout a T-shirt: PRMC, E$$ENTially--No Hope

Anonymous said...

Am pending on the reference check with PRMC. God only knows what will happen on that end. However, Essent is legally able to say "rehire", "no rehire" verification of your employment dates, duties, etc. As per state and federal guidelines, if any defamatory information is given on an employee, Essent is liable for a lawsuit. Period. The only problem is proving it. Most companies have outside firms that verify the basics such as this, and also handle the background checks as well. Make sure when interviewing, you not only have a list of personal/business references, but letters of reference as well from that same group. It's basically covering your bases, as a letter of recommendation from Essent will not happen. Understand somewhere ont the site it was mentioned, that Essent is re-hiring the "no rehires". Don't know the validity, but would question why someone would want to return to that living hell!

fac_p said...

The only way I could do t-shirts is by doing ad-sense, or another commercial spot ad source. At which point I could give away promotional items.

I'd rather keep it non-commercial (non-profit??) and possibly drop it back to you--a contest for the best t-shirt design...no profanity, porn, or the like...submissions by email...displayed on the site and voting done by comment.

I might be able to do a prize for the winner, but in any case, the image could be downloaded and done up by a commercial t-shirt press or at home using an iron-on one that you get at Office Max or Wal-Mart. Just think of the possibilities: T-shirts, jackets, ...scrubs....

This kind of goes back to the generic naming contest that Essent had for each of the hospitals...none of which included the name of the parent company. I'm sure it could be prominent here.

Anonymous said...

What is the cost of a new hire? We have the obvious things: Backround check, hiring bonus, recruiter fee, and orientation, but what about the cost of unfamiliar people working in a short-staff environment? It takes far longer for a new person to find just the basics on a floor.

If it's a new grad, it's even worse. They don't have the experience to fall back on.

So, everyone else has to take up the slack--leaving pissed off staff.

The only thing worse is a temp--the hospital is paying 2-3x as much for a body that's unfamiliar with procedure, computer system, floor, and on and on. Isn't the temp's fault, but the load on the existing staff and the knowledge that the cost of all the temps would have been enough to pay for across the board staff raises just galls.

It doesn't seem to change, and I don't know if it will. How many applications have YOU filled out?

Anonymous said...

there is a job fair next Tues 3/14/06 in Arlington...


I'm already registered!

Anonymous said...

I know that legally they aren't supposed to say anything but hire or no rehire, but I know how the good ole boy system works and the off the record remarks.

I wonder if you can be a no rehire, and don't even know it with these people. I had an excellent work history, and wonderful evaluations, except for the last one that was done almost 3 months late, after I had turned in my resignation, done by a boss that had not been there but 3 months, and had really not even worked with me.

When I did my exit interview, I told exactly why I quit. It wasn't pretty. I wonder if they would make you a no rehire because of an exit interview.

Has any body ever checked there work history record from personell?

Has anybody ever hired one of those reference check companies to have their PRMC reference checked?

Anonymous said...

Love the T-shirt issue........think a little levity would do a lot of us some good. And, am definitely NOT opposed to wearing it in public. Sometimes, laughing at despots makes their heads spin so much, they have a tenedency to self-destruct. Don't think they have this town tied up enough to get the Paris police to do T-shirt patrol.........HA!

I say, go for the contest, ALL OUT!! Would imagine a lot of us need some humor at this point!

Anonymous said...

How bout this


RN's and

Anonymous said...





Anonymous said...

How about PRMC Management- Ain't that a kick in the head.

If someone were creative, they could finish the song. It could be the PRMC fight song. Ha ha.

Anonymous said...

I've got the Ultimate T-Shirt


R-Respond to our

Anonymous said...

Only if you had it in a balloon...with a pin in the hand of the Paris Eifel.

Anonymous said...

PRMC.........YOUR wallet is OUR wallet!

Anonymous said...

I am very glad to despense of the R.R.V. radiologists' group from P.R.M.C. Personally, I think they have drained the hospital enough by stuffing their pockets with money which could have been used by the hospital. Obviously, the hospital needs community support but they also need to supply a better medical staff than these blood thirsty tyrants. What happened to patient care?? did that just leap out of the window?? These so called doctors only care about what goes into their pockets...not what happens to the well being of patients. If P.R.M.C. can secure a group of Rads. out of Baylor Hospital I, for one will rejoice!! Essent...get the ball rolling...staff upscale R.N.s Dr.s Rads. and BEEF UP the E.R. ...time is essential!!

Anonymous said...

Yes, we've seen what Essent thinks is acceptable care --4hours by a locum, per day on the weekends. An interventialist that hasn't done interventional work in 10 years.

And what happened to the one hour turn-a-round? It turned around.

If you are waiting for results to make a significant decision in a patient's care, just trot on down to x-ray. Your pictures are in one of several piles--that won't get read until tomorrow--from

Hud admitted that PRMC couldn't match the RR folks, and profit motive? Excuse me, what does this hospital stand for????$$$$$

Anonymous said...

Well RRR may not have been perfect, but they were established and they met the demand. The main point is: if it ain't broke, don't fix it!

Anonymous said...

JR's little tirade is tiresome at best, psychotic at worst. "stuffing their pockets with money which could have been used by the hospital"? To what, buy Andrew another Rolls?

Certainly isn't to pay nurses...or replace that 30 year-old portable x-ray that shakes its way through ER.

Or maybe just to buy more ads in the Paris Snooze....

Anonymous said...

Do you think the RRV docs may have left the hospital BECAUSE they were concerned for patient care... or the lack there of at PRMC!

And exactly who is linning their pockets by overcahrging patients for their exams... $350 for a chest X-Ray ...and that's just the hospital charge (Medicare pays ~ $10 to the radiologist to read).

It's not the doctors, nurses, or patients that are the problem... it's the hospital administration!!

For the sake of this community, I sincerely hope that the hospital can find competent docs to staff radiology so that hospital patients get accurate interpretations ...but if the last three weeks since RRV left are any indication ...don't walk to Dallas ...RUN!!!

Get a clue Andrew!! How much longer can you point the finger of blame at everyone but yourself?

But then again... this is nothing new for E$$ent ....as according to Hud, it was the young patient population that resulted in the demise of their Crossroads facility in St. Louis ...ya ...right! And I still believe in the Easter Bunny!

By the way, I don't think dressing up as Patton, and conducting field drills with management is working. Maybe you should try a clown costume... after all ... according to one of your former staff "this is all a joke"!

Anonymous said...

MANY of the radiologists in RRR did their residency at Parkland and were the top of their class. They are decent,hardworking, patient conscious, family men who truly enjoy what they do in the field of medicine. Do you REALLY know anything about the radiologists in RRR? I can assure you that "blood thirsty tyrant" and stuffing their pockets with money is way off the mark.

Anonymous said...


This schmuck keeps surfacing like a bad case of hemorrhoids, ya'll.

Mr Wesson Oil is the least of our worries. Let's address issues like (good one here folks) hiring a locum Rad for 4 hours on a Saturday and 4 hours on a Sunday. Oh yeah, it doesn't take a mental giant to figure out what transpired this weekend. I am sure Doctors eyes were rolling back in their heads over this one. And someone had the unmitigated gall to, (nothing like being redundant) to point the finger AGAIN at the "root of all evil RRR". COME ON, RRR was there and performed, your crummy locum Rads haven't done squat other than be unable to do interventional, making pincushions outta patients don't count as interventional Bubba, not be able to speak English, dictate all day long, and NOT HAVE THE DICTAPHONE ON, so that everything that this person read, had to be repulled and resubmitted and reread. Oh yeah, nothing like a little organization here ya'll. AND did anyone in the immediate area of management even think to CHECK on these guys during the course of the day???? When you have to hold the hands of locum Rads to make sure the job is at least halfway done, ya gotta problem. And that's just scratching the surface. As someone said in an earlier post, "Don't GO to Dallas for healthcare........RUN!!!!

And while I'm thinking about it, if they are only contracting locum rads on the weekends for four hours each day, does this mean that Essent is up to their noses in red ink, with only one nostril showing? Yep, maybe all those agency people are beginning to take their toll, hmmm visions of Christus float before my eyes!!

Anonymous said...

To whom ever posted at 8:22 pm I would just like to say as a nurse and FORMER employee of essent that if they cant keep the great staff they had what makes you think that people from baylor making $ 30-40/hr why they would want to come to prmc where not only is there crappy pay (lvn starts @ 11.38 and rns @ 18) you get crapped on. When I was there MY pts loved me but they knew I did everything possible for them. I actually had a pt call me and when I finally got to his room he asked why I was so sob. Why u ask b/c instead of getting more nurses and helping us and keeping us happy they continued to short us nurses, nurse aids, and anything else they could do to screw us. So please unless you can say that you really know whats going on at essent which seems to be running out once fine hospital into the ground, please get a clue!!!!

Anonymous said...

Figure Mr.8:22 was admin, and admin couldn't buy a clue, much less generate one--probably actually is JR.

The policy that no one is to talk about policy, that there are spies anywhere and that everything is fine--OHYEAH.

Essent has stripped any feeling of loyalties from the organization, from either side. When the nuns were here, at least you felt that they actually cared, while now, if you dropped over dead, they'd say you were riding the clock.

Anonymous said...

What is meant by "upscale RN's?"

The RN's in this community, are the ones that want to take care of their own people. They are the upscale RN's.

They have a stake here. A reputation in the community. That is why a number of upscale RN's in this community have left PRMC.

They are sick of hearing community complaints of bad care. It makes them sick when they can't give the best of care, because they are overloaded.

Does it make you upscale if your certified? I'm an RN certified in 3 areas. Do you think I'm working for Essent? No way. Not anymore.

Try magnet status PRMC---Find the American Nurses Association---start trying to fix this mess. Magnet status is holding on to your RN's instead of turn overs by the hundreds.

Anonymous said...

"I am very glad to despense of the R.R.V. radiologists' group from P.R.M.C. Personally, I think they have drained the hospital enough by stuffing their pockets with money which could have been used by the hospital."

HUH?!?!?!?! Used for what?!?!?! Pay raises for management, while the working masses get insulted with the pittances they've handed out and expect us to be exceptionally grateful for? Don't know where YOUR head is at( well maybe I do, but it's impolite to type that here!)but this is the REAL world Bub! Get a clue! You have a work force that is SEETHING! Our bennies suck, pay raises are a joke, representation is non-existent (we are at the mercy of madwomen/men management) Hire upscale RN's, Doc's and beef up the ER. While pile of sand do you have YOUR head in? Essent has run off so many of the aforementioned it isn't funny. AND securing a group of Rad's out of Baylor, have you lost your ever-lovin' mind???? Do you not realize that Essent's reputation has preceded itself, and this site is read on a daily basis by the folks at Baylor? I would imagine your post had them running down the Baylor hallways, shrieking in laughter!! Oh and let's not forget the "patient care" issue you brought up..................gah, you are dense!! Essent does NOT want that period, they threw that out the window a long time ago!

Anonymous said...

The leaders who work most effectively, it seems to me, never say "I." And that's not because they have trained themselves not to say "I." They don't think "I." They think "we"; they think "team." They understand their job to be to make the team function. They accept responsibility and don't sidestep it, but "we" gets the credit…. This is what creates trust, what enables you to get the task done. ~Peter Drucker