Wednesday, May 31, 2006

In the Defense of Agency/Travelers/Temps...6/10

Had a lot of email about temps. There are good and bad, some are temps because of the situation like ours, some are because they like to be, and some are because they can't get hired any other way. This one seems like the first kind.

I read your comments about agency nurses and I would like to add some of my own, as well as steer you straight about we agency folk.

While it's true that agency personnel are temporary by nature, it isn't quite true that we have no vested interest in the patients in a certain facility. I am a former PRMC employee/refugee, currently working as an agency medical technologist. While I do not stay at any one place for longer than, say, 26 weeks, I do care about the quality of my work and how it affects the patients of the client facility I may be at. The same is true for most of the agency nurses. Granted, I have not yet found a place I care to stay permanently, and granted I have no desire to stay at my current post past my contract time, but one thing I pride myself on is turning out good work. I felt the same way when I was a former McCuistion employee, and even under the Christus and Essent regimes.

OK, so much for defending my career, now for some numbers:

I'm not sure how much agency RNs bring in on an hourly basis, but I can tell you that it costs the facility a pretty penny not only hiring an agency person, but add in the salary, insurance, per diem, car allowance, housing (paid for by the client in the fee paid to the agency) and whatnot, and it ain't cheap. Multiply that by all the agency folks contracted out by PRMC, and that's an awful lot of coin going out the door. As a contract medical technologist, I spent 20 weeks at the VA center in Augusta, Maine. I was told that the VA was paying my agency on average of 75 dollars per hour to have me there. I paid no bills or rent, my utilities were paid, and all I had to buy was food (and the occasional adult beverage if I desired), gas, and stuff for personal maintenance. RNs historically get paid more than medical technologists (could be all the P&Ming their group has done over the years), so I'll bet 75 bucks an hour is darn cheap- probably higher for the nurses.

Again, we are temporary- once our contracts are up, unless we get extensions we're gone. Training time (which takes up considerable amount of contract time), & money out the window, which has got to be invested for each new temp.

Here's an idea, radical tho it may be- spend the coin to improve the wage & bennie package, change the facility culture, and make the place more attractive to we allied health personnel to want to stay. I was happy during my time at McCuistion, and even tho we sniped with the St. Joe lab, we helped each other out when we ran short of certain reagents, let each other run specimens on our analyzers in a pinch, and had a friendly rivalry with little hostility. THR screwed that one up, resulting in the merger of facilities and eventual purchase by Essent.

It could be the only way to change culture is to change ownership.

I know- well, duh.......

PS- I know how to post to blogs and all, but the computer I use at work to answer email prohibits access to weblogs. My wife was kind enough to copy & paste some of the jucier parts & send 'em to me in an email. It's good to know that there are some other employees there in Paris that aren't bending over when Essent tells 'em to. Perhaps someday I'll tell you how I came to be an ex-PRMC employee, but for now keep up the good fight, and chinga Essent!
By the way, did I mention that I worked agency many, many, moons ago? When I was, I worked where I wanted to, because they wanted me. The ones that E$$ent wants...don't want them...Frank.

Monday, May 29, 2006

Pro-active: Suggestions for the Hospital...8/24

Okay, I'd like to see them gone, but if we could make it better while they are here....

How 'bout serious suggestions? That way they can't say it was never offered up to them ('cause let's face it, this is prime reading for directors--they might find out here first that they were fired!)

Yes, the picture has been re-used, but it was just too good and fitting not to...I did replace it with another.

Thursday, May 18, 2006

This Bud's for You, Hud....5/29

A new quote from cyberspace:

"Paris Imaging Center is now open for business--and you know that Hud has to be really, really, chapped.... A professional, new, up-to-date facility, (on the loop, yet!) surely can't sit well. It's like a maple sap spigot that's jammed into E$$ent's side, and there are plenty more to follow.

When La Quinta made their announcement that it would be used for patient recovery and their families, for the new "physician's offices" next-door, I had my suspicions. I figured it wasn't going to be the standard family practice/ internal medicine suites. Well, it sailed through the rezoning with only minor contention from the other hotel/motel owners. I figure that outpatient surgery center is not the exclusive province of the hospital...something tells me it's a GI/Bariatric surgery center. When Dr Dickey dropped his privileges at the hospital, he divorced himself from the possibility of divided loyalties. Now he has privileges at Clarksville (and he's not the only one checking out the territory. You'd be surprised....)

I figure that it's not Ortho, and Cardiology is still looking at their own--and trying to sell space. Maybe general surgery, or plastics, but it doesn't seem likely.

No, I'd say it's a niche hospital/surgical center, and it's going to hit E$$ent hard--right in their insurance claims.

Now the question is: Who's going to buy the intervening space between the Imaging Center and the La Quinta? Maybe E$$ent will resort to the old Monty technique of buying the competition...after all, that's what got us into this fix."

Monday, May 08, 2006

A new victim in the making....6/4

Okay folks, got an email. One takes what comes through here with a grain of salt, so let's leave off the hysterics and reply with candor and tact. I was going to reply (and will, but in a comment), but I figured you all needed a chance. Personally, I think that they should run, not walk to the nearest exit from that experience.

Read with interest the blogs on E$$ent. Our Board is considering leasing to E$$ent or another group. What advice would you give? What questions should be asked of the company? It seems like you have some disgruntled ex-employees blogging - or who knows maybe they are enlightened employees. Your board had glowing reports about ESSEnt....

How has patient care changed? How has staffing ratio nurse to patient changed? How have physicians received the change? What has been patient reaction - your board seems to have only glowing reports? How has the census been since the change over? Have you seen an increase in transfers out of your facility? How many people did Essent lay off when they came in? Have they kept their promises for expansions and infusion of capital?

How did they handle accrued benefit packages (accrued days off, accrued sick time, retirement benefits, etc) upon take over. Did all employees have to reapply for their jobs? What happened to CEO, CFO, CNO, other upper management and department heads? What did they consolidate - HR, IS, Accounting, etc???? Is there planned union activity?

Any info provided will be helpful. Our employees are scared, concerned about their future, and upset that our Board is considering such moves. No one wants us to see us lose local control. But it appears that the Board is moving rapidly in that direction.

Wednesday, May 03, 2006

Is Radiology Self-Destructing?--6/22

Well, you thought they couldn't get worse, but look Virginia, they are!

Had a pt this weekend.... Multiple PE's shown on the CT....didn't get a report or find out for 6 hours... That's right... 6 HOURS

Good job radiology
And did we suddenly drop back to 4 hour coverage on the weekend? (That's four hours total, Virginia....)
The fudge factor doesn't seem to be working in radiology these days. (Nope, it's in MIS! I 'C' how it is....)

It would seem that the radiologist de jour turned up MIA this weekend... couldn't be located. They got another to come in for two of the 48 hours, and then split. Fortunately, they aren't too busy these days!

Larry, Moe, and Curley must be very proud... but oh! They don't even come in when their on call so I guess it doesn't matter!
May 19th should prove interesting for Radiology employees. A mandatory staff meeting has been called for that date.

Will it be another hour-long screamfest where Rad employees will be told how worthless they are? Or will Bev just finally go completely postal and gun them all down? Will they be told that she'd prefer temp techs to seasoned professionals? (Again.) Or will she start foaming at the mouth? (Kind of like the way she treats her hubby....)

Perhaps her superior will be there to quell rumors about his sweetie getting a job he is totally not qualified for and was posted for a fleeting second.

(Is this the way he gets out from under???)
It should prove verrrrrrrry interesting. Stay tuned. Film at 11.

Monday, May 01, 2006

PRMC: Reverse Polarity-- 5/29

If you've followed some of the links that are available on the site, you might have clicked on the ABC News dealing with infections. In it, the writer gives some standard advise on how to choose a hospital. This was a quote:

"A number of sites rate hospitals and provide information on diagnosis and treatment, the procedures that are performed, and how the patients fared. There are also "nurse magnet" hospitals where the best nurses work, the morale is the highest, and the hospital has the most resources. You want to be where nurses want to be."
Does this sound like PRMC? I haven't seen this many temps since working in a brand new medical center. There, they had an excuse: New hospital, immediate staffing needs. By the time they were one year into it, there were less than 6 temps working...heck, PRMC might have that on two floors in one shift!

The Radiology director has been quoted as saying she'd rather have all temps...but even the temps don't really want to stay. Seldom do they renew.

I had comments about a boutique hospital in Dallas. There, the staff is well treated, meals are gratis, and they actually get bonuses...novel idea. Their retention rate is almost 100%--no one wants to leave. Contrast that to here: Almost everyone is looking for an alternative....

Why does administration like temps? They have no vested interest in the hospital. They couldn't care less about policy, administrative responsiveness, or even much about conditions...because they aren't staying!

Our problem is that we are. Our families are here, we have roots, and to leave would be to be beaten by E$$ent. My worst fear is that family or friends would be subjected to "E$$ent care", or lack there of.

I don't think that they could ever rise to the standard of a magnet, nor would they want to. The telling reason is this quote from an article in Nursing World:
"Magnet facilities are required to respond to the complaint, and an immediate site visit is scheduled and investigation launched when the complaint involves a health and safety threat to patients or nurses."
Could they afford an "immediate" site visit? I think not.