Monday, February 26, 2007


What might end up as an axle-high speedbump to Essent is the legislation under consideration by Texas lawmakers for mandating safe nurse/patient ratios. However, in their sneaky little ways, they have already been preparing for some of that: Support staff lay-offs.

The way it goes is like this: Support staff was 'invented' to free nurses from non-nursing duties. Essent is cutting support staff. Result, nurses will be forced to do more of their own support. Remember the example of how things have changed?

The following job description was given to floor nurses by a hospital in 1887:

In addition to caring for your 50 patients, each nurse will follow
these regulations:

  1. Daily sweep and mop the floors of your ward, dust the patient's furniture and window sills.
  2. Maintain an even temperature in your ward by bringing in a scuttle of coal for the day's business.
  3. Light is important to observe the patient's condition. Therefore, each day fill kerosene lamps, clean chimneys and trim wicks.
  4. Wash the windows once a week.
  5. The nurse's notes are important in aiding the physician's work. Make your pens carefully; you may whittle nibs to your individual taste.
  6. Each nurse on day duty will report every day at 7 a.m. and leave at 8 p.m. except on the Sabbath on which day you will be off from 12 noon to 2 p.m.
  7. Graduate nurses in good standing with the director of nurses will be given an evening off each week for courting purposes or two evenings a week if you go regularly to church.
  8. Each nurse should lay aside from each pay day a goodly sum of her earnings for her benefits during her declining years so that she will not become a burden. For example, if you earn $30 a month you should set aside $15.
  9. Any nurse who smokes, uses liquor in any form, gets her hair done at a beauty shop, or frequents dance halls will give the director of nurses good reason to suspect her worth, intentions and integrity.
  10. The nurse who performs her labors and serves her patients and doctors without fault for five years will be given an increase of five cents a day, providing there are no hospital debts outstanding.
As nursing shortages plague our country, nurses become a valuable commodity. So why is Essent attempting to drive off the good ones?????

We might end up with good ratios, but if we are bogged down with the other things, where do the patients fit in? If we aren't careful, the windows we'll be dealing with will be Pella, not Microsoft....


Anonymous said...

I think the legislation is wonderful.
I don't think it will pass in Texas and here is the reason why. California has not (at least of yet) enacted tort-reform legislation so it behooves them to keep the patients safe.
Texas has. If you are poor in Texas and die at the hands of incapable/overstaffed nurses, your life is simply worth nothing. It happened to a friend of mine at Zale Lipshy--one of the finest hospitals in Texas. Nurse didn't recognize pulmonary edema...spent the night suctioning her and silencing the pulse ox alarms. When the Doctor rounded the next morning, not much left to do but put her on a ventilator of which she stayed for close to a month.
She ended up dying. However, in what should have been clear malpractice (as stated by 3 different attorneys), her income didn't allow her to sue because in the eyes of the tort reform legislation, she didn't make enough to matter.
Her family received nothing for her death.
So...unless we as a nation understand that we are obligated to force our legislators to FIX the mess that is healthcare...and the only fix is single-payer healthcare. It is obscene that insurance companies made record profits last year while we worked understaffed and under appreciated.
If this doesn't happen..with the legislation that is already in place in Texas, what you will see is a return to hospital wards for the "have-nots" Since their lives don't matter and they cannot sue, they will be stuck in crowded conditions while the "haves" will be afforded the nicer private rooms and health care at a safe ratio.
The healthcare corporations (can't even acknowledge them as hospitals) recognize bottom-line thinking.
Bottom line...if you can pay for health care, you get it. If you can't, you don't.
I believe that healthcare workers should join hands across the country and DEMAND an end to the madness.
We should be the largest lobby group in the country fighting for patient AND health worker rights. Do you really think it is an ACCIDENT that we are limited by the state we live in? Why not have a national board of nursing?
Because we would be more powerful than the insurance lobby or the corporate hospital lobby. End of story.

Anonymous said...

So THAT is where Dud is getting peronnel policy've quoted the new PRMC nurse's policy word for word. Well, except for the raise part, remember, hospitals don't give raises these days. It's true- ask Little Richard.

Anonymous said...

Yeah, for sure Essent is a speedbump in the road of life, sic 'em Frank!

Anonymous said...

The negative responses have been trickling in to the Snooze, and (miracle of miracles) they've even printed two letters that aren't full of sunshine and puppies:

To wit:
To the Editor:

I read the article on staff reduction and budget cuts at Paris Regional Medical Center. Evidently those persons on the committee have not had to use that facility themselves and experience the lack of quality care being provided. Recently both of my parents were patients in your hospital.

My 80 year old mother had pneumonia. At the admitting desk, no wheel chair was provided nor an escort to her sixth floor room. She was told the room number and “to take the elevator”. She sat in a chair in that room for over 45 minutes with no help to prepare for bed. This she did on her own.

A lab person spilled blood on her sheets during the admitting process and even after asking for clean linen, she did not receive them for two days. This is only a couple of incidents that occurred during her week’s stay. How will patients be treated when staff is cut? Where is the compassion, courtesy, and caring professionalism that the Paris medical community is so noted?

And this one:

Health care in Lamar County has had a steady decline for the past several years. Now they want to cut staff? This is not a rational choice for the health care providers in that area. Public Relations, quality of service, and proper management is what is needed the most in that area. Thank God I live in Dallas.

Names have been removed to insure anonymity, but rest assured the general public knows things are going to hell in a leaky bucket at PRMC thanks to Hud and his cast of idiots.

Not sure how many more letters the Snooze will publish, but the cat is out of the bag. Now is the time to put the pressure on. Let your friends & neighbors know why and who is responsible for the sad state of healthcare in your city.

And even if the Snooze sticks it head back into the sand, we still have a very powerful weapon in our hands called word-of-mouth. Any businessman worth his or her salt will tell you that folks will spread news of bad experiences faster that news of good experiences. If you wanna stay in business, you have to make sure you have have as many satisfied customers (and as few unsatisfied ones) as possible.

That last area is where Essent has failed badly. Their business model stinks like a week-old diaper, and everyone can smell it. No amount of air freshener will cover up the stench.

As a lab employee, I apologize on behalf of my profession for the spilled blood on that poor woman's bedsheets. I'm also very sorry her parents had to go through that ordeal. THAT is not the hospital I remember and used to work for. Sadly, the compassion, courtesy and caring proffesionalism the first letter-writer wonders about is still there, and is still followed & believed in by the staff, but is overcome by a new policy- that of bottom-line-itis.

Anonymous said...

At one time in my life, I thought I had a handle on the meaning of the word "service." "It's the act of doing things for other people." Then I heard these terms which reference the word Service:

Internal Revenue Service
Postal Service
Telephone Service
Civil Service
City &County Public Service
Customer Service
Service Stations
Essent Healthcare

Then I became confused about the word "service. "
This is not what I thought "service" meant.

So today, I overheard two farmers talking, and one of them said he had hired a bull to "service " a few of his cows. BAM! It all came into perspective. Now I understand what all those "service" agencies are doing to us. I hope you now are as enlightened as I am.

fac_p said...

Hey Austin, I won't tell that you're still logging on....frank

Anonymous said...

Thanks for printing that fac-p. I hope everyone reads the legislation link, and contacts their representitives.

This is the chance for people on the blog to do something very constructive in healthcare. This is our chance to try to make a difference.

No I don't think this bill will pass. The hospitals, CEO's and even the ANA are against it. But we can send this to everyone we know, and try.

Everybody will eventually be a patient. This is for patients, every bit as much as it is for nurses. More so.

Hospitals have a responsibility to provide safe care. If they can't afford it, they don't need to be open. Some might say a bad hospital is better than no hospital at all. The older I get, the more I wonder about that.

fac_p said...

Just wait, Essent will come up with a PR release that the Snooze will print saying "We're taking these measures in anticipation of having to hire more nurses...yeah, it's for you, not us...yeah, we're losing money by getting rid of these people...yeah, we're really good guys....yeah....that's the ticket!!!!"

Anonymous said...

Well, it wasn't a nickle a day, it was a nickle an hour. And I only had to wait two years, not five! Thank you E$$ent, thank you Mr. Scrooge, er, I mean Mr. Connery. Lick your boots, sir?

Anonymous said...


they may come up with a press release on how the ANA and the Hospital associations are against this bill.

I really hope people read the bill and don't just take their word on the reasons why they are against it.

Anonymous said...

You know, I don't think we have as much of a nursing shortage as we have nurses unwilling to work at the hospitals.

So many nurses are so tired of the understaffing, and inability to do their job-to their satisfaction because of high pt. ratio's.

Anonymous said...

It is apparent that the big picture is being missed, E$$ent does not CARE about healthcare, compassion, service that is a faciad. This is a business like any other used car business, bottom line did we make a dollar. (sorry,no offense to car salesmen)

Anonymous said...

The high cost of healthcare is in part due to our suit-happy society. I grant you, there are true cases of malpractice and these should be dealt with, but you've all seen the ads--like the one for the "Texas Hammer" who gets folks money for whatever they claim. The only ones getting that money are the lawyers and they should be limited on their fees. There should be a review board for such cases to see if malpractice actually happened. The trouble is that most folks that sit on juries don't understand that medicine is not an exact science.

Anonymous said...

Well ,we finally have the answer to the Health care crisis;A SINGLE PAYER SYSTEM ,WITH UNIVERSAL COVERAGE. That is the answer to nursing errors ,physician misdignosis and a pleathora of other problems (including,no doubt, piles)Anyone who has been in the army medical corps can tell you what this type of medicine looks like. It dosnt look like Zale Lipshy ;it ;looks more like their neighbor Parkland.Doctors and nurses have many motivations for doing what they do ; long tedious hours ,incredible stress to always have a good out come,(they always get well on TV) sacrifice much of their home life and seeing their kids grow up; these motivations are not ;I assure ,you money, power or sex .The BRAINiac that wrote this first post may very well get what they ask for.I just bet it wont be the answer to their complaints that they imagine.What profession in the US still retains the shreds of true concern and dedication that is struggling to survive in physicians and nurses?Is it lawyers , politicos,cab drivers?
Think about what a single payer would in fact pay; look at England where a board certified surgeon is lucky to make$ 60,000, and a unionised college teacher about the same.The above writer needs to see single payer in action before he/she speaks too highly of that solution.When your efforts are not rewarded monitarily you take your pay in time off and perks ,both of which add up to less access to care by MDs and more care by nurse practitioners and mid wives.That is the universal situation in every country inthe world that has adopted this solution; lots of ulilization and lots of poor care; this is also associated with a crushing tax burden to pay for the whole entitlement.You may have some gripes about the capitalist methods that underpin our system , but you know not what you are asking for with SINGLE PAYER UNIVERSAL ACCESS!

Anonymous said...


We know Essent doesn't care about quality healthcare--but the big picture is to look at house bill 1707 and tell your representitives what you think about it.

If the law does go into effect, Essent probably won't be compliant with it, and will probably get more fines, whistle blowers will be better protected, and it will be closer to getting care for the people of Paris.

The problem here is bad, but they have some of the same problems at rural communities everywhere.

Many hospitals only have 1 ER nurse. This law provides that their must be 2 ER nurses in the ER if there is one pt. ( or that's the way I understood). For the saftey of the nurse and the pt. this is a good idea.

Some of the problems that we have extend to other hospitals for sure. To help with this bill, in my opinion is the big picture. It could help more people than just us.

We can sit here and gripe about what's happened to us until the end of time--lets do something.

Anonymous said...

And the person that wrote this should educate themselves with something other than Right Wing talking points.
Just have to laugh because the entire diatribe was just a little much to make it through. And for your information, I AM acutely aware of single payer systems that work. But wait a minute...the single-payer boogieman is going to steal ALL of your hard earned tax breaks...booga booga booga.
Hey, I bet you even fell for the crap they sold you when THEY begged the docs to jump on the Tort reform bandwagon. You know, the one that promised you lower malpractice rates? Guess what? THAT didn't happen either.

Anonymous said...

5:35 PM,

If you want to see shining examples of your brand of healthcare, go look north in Canada. Folks in cities close to the US border often cross into the States when they need healthcare.

We went down this road with the previous Democratic president and her spouse, and I don't care to go that way again.

What say we drop the political diatribe, or better yet continue it on another blog. The subject at hand here is the state of healthcare in Paris, and how far it has degraded thanks to Hud and his minions.

Anonymous said...

Hey 5:35 PM

You Said "I AM acutely aware of single payer systems that work."

However, you conviently forgot to list any so that we could laugh at you. Single payer systems kinda remind me of other entitlement programs like WELFARE, and we all know how good that one works. The problem with you liberals is you will never stop trying to take more away from my family so you can give to those that YOU think deserve it. I went to school, I paid for it, and I got a job as a nurse to support my family. Leave my paycheck alone. I use it to support my family without government handouts. If you want socialism and socialized healthcare move to Europe!!!!!

Anonymous said...

I know from friends in other countries that have socialized medicine that it leaves a lot to be desired. Think that waiting time in the ER was bad before? Also you can forgot getting any kind of quality healthcare. Nurses, docs, techs and other healthcare professionals that went to school and trained hard to learn their craft won't be taking care of you. In England, nurses are a minimum wage job--just like working a chippie van. Xray techs and lab techs? Hired off the street with maybe a high school diploma.
Get your socialized medicine. I'll working in another field then!