It’s hard to believe that in my lifetime I’d ever see layoffs in the nursing field. Like many of you, I remember the good times when there were billboards around my city advertising signing bonuses for nurses at local hospitals. That’s all changing. Two recent articles in the Wall Street Journal(1)(2) and one in the Washington Post are focusing on the fact that, while there is still a nursing shortage, there is now a shortage of nursing jobs. That sounds like a contradiction in terms but it’s not.
In a March 2009 report, the AHA revealed that 53% of the hospitals surveyed were operating at a negative margin or in plain English, they’re losing money. Hospitals in some areas of the country are reducing hospital staff. Just a year ago hospitals that were taking just about any skilled nurse who walked through the door are now finding it easier to be selective in their hiring. In short, this ain’t your mother’s nursing profession anymore.
If the news from nursing wasn’t already bad enough, there’s a news story about Dean Health System which announced its intention to “immediately” lay off 90 employees. This included a nurse who was assisting in a surgical procedure and was called out of surgery to be told she was laid off! Okay, I can understand cost cutting, but don’t you think it’s a little extreme to lay someone off in the middle of a procedure? Has the world just gone crazy? What if they’d laid off the anesthesiologist? Or the surgeon? I shudder to think of the consequences (Dr. Smith, please report to HR, stat!).
The good thing about legal nurse consulting is that medical malpractice and personal injury litigation is recession proof. Now that we’re seeing financial stress on hospitals and doctors, I believe we’re going to start seeing more and more medical and nursing malpractice as well as the delivery of substandard healthcare.
A recent study in the New England Journal of Medicine, showed that a fifth of Medicare patients were rehospitalized within 30 days of their initial discharge! When the pressure is on to cut healthcare costs by reducing care, testing and length of stay; as nursing shifts come under more pressure with fewer nurses covering more patients; and as healthcare continues to devolve into what I call the “Dark Ages of Medicine;” you can be sure that Certified Legal Nurse Consultants will be on the front lines working with attorneys to redress the wrongs that are certain to happen.
One of the things I like best about being a self-employed entrepreneur is that the only person who can lay me off – is me (and that isn’t happening any time soon)!
8 thoughts on “Nursing Layoffs Are Getting Serious (and Sudden)”
I have been a nurse for over 42 years and I guess I can say I’ve just about seen everything. I started nursing in NY and I remember that there was a nurse shortage around the middle 1970’s. They brought in many nurses from different countries and then it became harder to obtain a position. However, what is going on now is very scary for our country. If we have universal care (socialized medicine) healthcare as we know it will be gone. The hospitals right now are employing what I have called 90 day wonders who may be able to give physical care, but have no idea what is going on. Because we let it happen, most patients don’t have a clue who is a nurse because there is no uniform to set us apart. I visit friends in the hospital and there ID badges are always turned over and you can’t see there title. Hospitals will be cutting corners wherever they can, and I’m sure there is going to be a lot of senseless malpractice cases which could have been avoided. My Mom is an active 85 year old, and will her care be rationed? Of course it will, but I’ll be fighting for her! Stand up nurses and be heard. There may not be many of us, but when we unite, I voices will be heard!
Well said Patricia. I work in LTC and I can’t imagine how it could get any more skimpier as far as resident/staff ratios. I have been in nursing long enough to see with my own eyes what happens to patient care when staff are stretched beyond what is reasonable and when facilities are in a state of constant staff turn-over.
I read a book recently by Jack Schroeder, Identifying Medical Malpractice. He states, “Plaintiff verdicts in medical malpractice cases are the principal impetus to change and improvement in the medical care delivery system. Plaintiff verdicts have done more to improve medical care, to correct abuses in hospitals, and to stop adverse drug effects, than any other force in this country.”
This is a powerful statement because as healthcare professionals, this is what we are striving for, better healthcare. But it is the legal community through litigation that is the driving force to improvements in the healthcare delivery system.
CLNC® consultants are in the best position to be a part of that driving force to effect change. Whether plaintiff or defense, our contribution: 1) raises the value of the stakes involved in litigation; 2) shines a spotlight on bad clinicians and administrative practices; 3) educates the legal community about excellence in healthcare; and 4) alerts the healthcare community to the importance of best practices.
Vickie is right. We are going to see the aftermath of some incredible financial and administrative stressors in healthcare that will injure patients. We need to keep ourselves as CLNC® consultants positioned so that our impact will be huge and lasting.
Nurses and layoffs does kind of sound like an oxymoron. I understand that with census down because of more Americans being uninsured due to rising unemployment rates and many putting off elective surgeries that hospitals see an opportunity to cut back on nursing floors, but where is the intelligence and strategy in cutting staff in an area where the supply will fall short of demand by some estimates of more than 800,000 nurses over the next 10 years. Just because the economy is in a recession doesn’t change the fact that demand will continue to outstrip supply in the healthcare industry. I see a day when hospitals will experience a serious whip-lash and mad scramble for talent once the economy bounces back. What kind of taste did you leave in the mouths of local nurses when times were tough? I see this as a time for hospitals to build loyalty programs and present themselves as a preferred employer that sticks by it’s people through tough times. While I understand that a strong bottom-line allows a hospital to put more into providing better care, I don’t think that there’s a facility on earth that can underestimate the power of VALUE when it comes to showing how you feel about your nursing staff. After all they are your first line of defense.
The hospital where I work has not laid any nurses off yet… but they have been making cutbacks in other ways. They called all the housekeeping personnel in one day and said they no longer have a job and that they were starting to subcontract with a company that would provide the services to the hospital. They were also told that they could reapply with this company but they had to take a 3.00 an hour cut in pay and no benefits at all were going to be offered. To say the least, our hospital does not have enough housekeeping staff to do what is needed and the nursing staff has to pick up the slack in that area.
Also, they have cut back in the lab personnel, which is causing the nurses to pick up the slack there also. We now have to draw the blood on most of our patients.
In nursing departments, instead of layoffs, they have decided to just put a freeze on hiring anyone to fill positions when someone quits. Therefore we are working severely understaffed most shifts, in addition to doing the jobs of lab and housekeeping on top of it.
Pharmacy used to have 2 pharmacists on each shift due to the size of our hospital, now only one each shift. They are very overworked and I really hate to say this, but lives are at risk here.
A few weeks ago, I was called by a NICU nurse, to please come help. When I got there, the NICU nurses were coding one of their babies in full cardiac and respiratory arrest. This baby was supposed to go home the next day. It was the least sick baby in the whole unit and was only there for antibiotics, which was being completed that night. The baby was able to be revived with aggressive intervention after about 10 min.
When the neonatologist got there, received report on the baby, realized the baby had full cardiac and resp. arrest during an administration of an antibiotic , she ran downstairs to the pharmacy, demanded to see where the pharmacist had mixed the meds that the baby received. Her worst fears were realized when she looked at a bag of normal saline hanging right beside a bag of potassium chloride. The pharmacist had mistakenly mixed the antibiotic in a syringe full of potassium chloride instead of normal saline. Certain antibiotics are given to the baby’s slow IV push directly from the syringe and I guess this was one of them. The neonatologist’s fears were confirmed when the baby’s stat labs came back with a potassium level of nearly 8 (normal 3.5-5.0).
Thank goodness they were able to bring the baby back, but you wonder is that baby going to have brain damage???
So many more errors are occurring that would never have occurred if everyone was not so understaffed and overworked.
I am concentrating on keeping myself and my family healthy as possible and out of the hospital and to work extremely hard to build my business up so I can go full time at my legal nurse consulting business. We have always had nursing shortages, but this is ridiculous and it is only going to get worse in the future.
It’s brutal for nurses to work in a hospital setting today. I recently left critical care after nine years. I did not want to resign, I’m a great nurse. I was so stressed due to staffing and passive aggressive behavior I had no choice. I went up the chain of command and even battled with administrators a year ago about the poor staffing and they promised there was not a hiring freeze. Well my suspicions were correct. I thought I was going crazy. And yes it is true, nurse/patient ratios have increased. The ancillary staff is cut back, the hospital is filthy dirty. I now work in long term care. So far, it’s been a much better work environment. I’m not stressed out on a daily basis and devalued like in the hospital setting. Nurses we need a hero. It sounds like legal nurse consultants will be major players in the future. Does any one know of nurse advocates besides the local nurse associations?
As an older RN of age 55, working with the “younger generation” ie:, age 22 to 30, in the Emergency Room I have experienced quite often, disrespect in tone, dissertation and lack of caring in educating the younger RN who is making blatant mistakes in basic nursing care. They seem more interested in texting on their cell phone, socializing, playing on the internet and then crying about how hard their day was and they leave soo much undone work that is hours old on the orders for the next shift. They rely on the equipment to assess their patient and when the computer goes down they get upset because all their vital signs are lost. Even though they haven’t done them for the entire shift at bedside which is REQURED every 2 hrs. It seems that upper managment tolerates this for the sake of having staff on the schedule but now seems to be “picking” on the older RN’s in order to get rid of them. They say we need to be more tolerant and talk to them nicely. Yet when you try to talk to them nicely, they just say: I dont care! Write me up! I say this from personal experience. I have been an RN for 30 years and do not say this with any malice or intent to discriminate. I am concerned about who is going to take care of me one day. I am really concerned about what type of RN’s will be out there in the future. They hid their names because they don’t want anyone to know their names in case that patient becomes upset with the nurse. I know this first hand. And these will be the future Managers!!!?#@%@@!
We are now constantly reminded that a hospital is also a business and will do what it needs to do to stay afloat, keep the stockholders happy and the board members happy as well as provide a community service. Because it is a business, cutbacks will always be in the service sector first, ie:, housekeeping, food preparation, case management then nursing.
I believe it would help the hospitals to maintain staffing to provide quality care as it should be. Bonuses should be eliminated, hire on bonuses should be eliminated and administrative bonuses should be eliminated. We need to accept the fact that if you need and want a job at a hospital, go for it with the understanding that they are still in operation which is good for the community and not with the intent of collecting bonuses. Administration has made it quite clear that all personnel are replaceable.
The shortage will continue. The demands on nursing will be greater and the “paper pollution” required for documentation is more now than ever as a result of legal litigation which in the long run, helps to identify where the weaknesses are in nursing, management and administration. I truly believe that if every nurse went back to the basics of nursing, 90% of law suits could have been avoided. As far as universal healthcare, I am not in agreement. I believe a capitalist society is the back bone of the economy.
I truly believe there is a place for the older and more experienced RN in the hospital system, in healthcare overall. There are alot of hospitals who have not adopted this trend, there reasons being that older RN’s cost more due to the probability of future health concerns Well, duh!!!!!
That doesn’t mean we don’t have a brain, that is still working.! So many are working in critical care areas and are physically tired, NOT BURNED OUT. 30 to 42 years in DIRECT PATIENT CARE is tough on anyone. Alot of the “younger” nurses can’t handle the pressure, go on and get higher degrees, become managers without what I would call “real experience” and then write directives on patient care. Mandatory education in the hospitals has gotten way out of control taxing the bedside nurse to the point that her private time is constantly interrupted with “Manadatory” meetings, educational seminars, educational fairs, mandatory dept. education requirements. Most of it so the hospital can collect more money from organizations or the government. Gone are the days, when you coulde go to work, take care of your patients, go home and that was it!.
I beleive education should be unit based and kept to a minimum with the option of taking additional courses at the RN’s discretion for her own educational growth. Most RN’s prefer this. Inspite of all these educational requirements now mandated, there really is no compensation. When a course takes 6 yo 7 hrs to complete and you are only paid 3 to 4 hours, that is just plain wrong. So, when I say the nursing shortage will continue, these are just a few reasons why. Nursing wont change until you have nurses at the bedside who arent afraid to show their name, turn off the cell phone, use the computer for only work, stick to the basics of nursing care and most importantly, nurses that are hired really want to be a nurse.
My husband recently found out that his maternity unit will be closing in the next 60 days!! 22 labor and delivery nurses to be layed off. He is (was) the chief of OB and was not even involved in the decision making process. Not included in the board meetings. The CEO decided to tell him while my husband was in between surgical cases. The reason–the hospital has a 800K deficit in the OB department. What has happened to community service. My husband said it felt like a punch in the stomache. He has been there for the past 20 years and has over 10K patients.
This hospital is the only one in the county that still does OB. You can imagine the emergencies and chaos that will occur in the ER. The ER docs were told they will get some “training”. I can just imagine the lawsuits as this transpires. The director of nursing did not want to tell the nurses until the last minute. Our two midwives are worried about their jobs because one of the big conglomerations that is willing (and looking forward to more business) is not midwifery friendly. It happened so quickly that even as the news transpired it was too late to change the boards decision.
As a CLNC® consultant I can only say how sad I am that nurses are so undervalued. How hospitals just see money as the bottom line. (Found out the CEO got a 300K bonus last year.) What ever happened to patient care and community service? Many of the residents are low income and sometimes have difficulty getting to this hospital. Now the closest to deliver and get ER care is 30-40 minutes further. I do feel that this world is going crazy. How else can you explain what is happening all across the country. Nursing leaders need to start screaming at the tops of their lungs so the suits will hear them. I have always been an instigator–for just causes. In this situation I have spoken to reporters, will have my husband interviewed on the local news and speak to any one and every one about this situation. Bottom line, the poor patients.
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I have been a nurse for over 42 years and I guess I can say I’ve just about seen everything. I started nursing in NY and I remember that there was a nurse shortage around the middle 1970’s. They brought in many nurses from different countries and then it became harder to obtain a position. However, what is going on now is very scary for our country. If we have universal care (socialized medicine) healthcare as we know it will be gone. The hospitals right now are employing what I have called 90 day wonders who may be able to give physical care, but have no idea what is going on. Because we let it happen, most patients don’t have a clue who is a nurse because there is no uniform to set us apart. I visit friends in the hospital and there ID badges are always turned over and you can’t see there title. Hospitals will be cutting corners wherever they can, and I’m sure there is going to be a lot of senseless malpractice cases which could have been avoided. My Mom is an active 85 year old, and will her care be rationed? Of course it will, but I’ll be fighting for her! Stand up nurses and be heard. There may not be many of us, but when we unite, I voices will be heard!
Well said Patricia. I work in LTC and I can’t imagine how it could get any more skimpier as far as resident/staff ratios. I have been in nursing long enough to see with my own eyes what happens to patient care when staff are stretched beyond what is reasonable and when facilities are in a state of constant staff turn-over.
I read a book recently by Jack Schroeder, Identifying Medical Malpractice
. He states, “Plaintiff verdicts in medical malpractice cases are the principal impetus to change and improvement in the medical care delivery system. Plaintiff verdicts have done more to improve medical care, to correct abuses in hospitals, and to stop adverse drug effects, than any other force in this country.”
This is a powerful statement because as healthcare professionals, this is what we are striving for, better healthcare. But it is the legal community through litigation that is the driving force to improvements in the healthcare delivery system.
CLNC® consultants are in the best position to be a part of that driving force to effect change. Whether plaintiff or defense, our contribution: 1) raises the value of the stakes involved in litigation; 2) shines a spotlight on bad clinicians and administrative practices; 3) educates the legal community about excellence in healthcare; and 4) alerts the healthcare community to the importance of best practices.
Vickie is right. We are going to see the aftermath of some incredible financial and administrative stressors in healthcare that will injure patients. We need to keep ourselves as CLNC® consultants positioned so that our impact will be huge and lasting.
Nurses and layoffs does kind of sound like an oxymoron. I understand that with census down because of more Americans being uninsured due to rising unemployment rates and many putting off elective surgeries that hospitals see an opportunity to cut back on nursing floors, but where is the intelligence and strategy in cutting staff in an area where the supply will fall short of demand by some estimates of more than 800,000 nurses over the next 10 years. Just because the economy is in a recession doesn’t change the fact that demand will continue to outstrip supply in the healthcare industry. I see a day when hospitals will experience a serious whip-lash and mad scramble for talent once the economy bounces back. What kind of taste did you leave in the mouths of local nurses when times were tough? I see this as a time for hospitals to build loyalty programs and present themselves as a preferred employer that sticks by it’s people through tough times. While I understand that a strong bottom-line allows a hospital to put more into providing better care, I don’t think that there’s a facility on earth that can underestimate the power of VALUE when it comes to showing how you feel about your nursing staff. After all they are your first line of defense.
The hospital where I work has not laid any nurses off yet… but they have been making cutbacks in other ways. They called all the housekeeping personnel in one day and said they no longer have a job and that they were starting to subcontract with a company that would provide the services to the hospital. They were also told that they could reapply with this company but they had to take a 3.00 an hour cut in pay and no benefits at all were going to be offered. To say the least, our hospital does not have enough housekeeping staff to do what is needed and the nursing staff has to pick up the slack in that area.
Also, they have cut back in the lab personnel, which is causing the nurses to pick up the slack there also. We now have to draw the blood on most of our patients.
In nursing departments, instead of layoffs, they have decided to just put a freeze on hiring anyone to fill positions when someone quits. Therefore we are working severely understaffed most shifts, in addition to doing the jobs of lab and housekeeping on top of it.
Pharmacy used to have 2 pharmacists on each shift due to the size of our hospital, now only one each shift. They are very overworked and I really hate to say this, but lives are at risk here.
A few weeks ago, I was called by a NICU nurse, to please come help. When I got there, the NICU nurses were coding one of their babies in full cardiac and respiratory arrest. This baby was supposed to go home the next day. It was the least sick baby in the whole unit and was only there for antibiotics, which was being completed that night. The baby was able to be revived with aggressive intervention after about 10 min.
When the neonatologist got there, received report on the baby, realized the baby had full cardiac and resp. arrest during an administration of an antibiotic , she ran downstairs to the pharmacy, demanded to see where the pharmacist had mixed the meds that the baby received. Her worst fears were realized when she looked at a bag of normal saline hanging right beside a bag of potassium chloride. The pharmacist had mistakenly mixed the antibiotic in a syringe full of potassium chloride instead of normal saline. Certain antibiotics are given to the baby’s slow IV push directly from the syringe and I guess this was one of them. The neonatologist’s fears were confirmed when the baby’s stat labs came back with a potassium level of nearly 8 (normal 3.5-5.0).
Thank goodness they were able to bring the baby back, but you wonder is that baby going to have brain damage???
So many more errors are occurring that would never have occurred if everyone was not so understaffed and overworked.
I am concentrating on keeping myself and my family healthy as possible and out of the hospital and to work extremely hard to build my business up so I can go full time at my legal nurse consulting business. We have always had nursing shortages, but this is ridiculous and it is only going to get worse in the future.
It’s brutal for nurses to work in a hospital setting today. I recently left critical care after nine years. I did not want to resign, I’m a great nurse. I was so stressed due to staffing and passive aggressive behavior I had no choice. I went up the chain of command and even battled with administrators a year ago about the poor staffing and they promised there was not a hiring freeze. Well my suspicions were correct. I thought I was going crazy. And yes it is true, nurse/patient ratios have increased. The ancillary staff is cut back, the hospital is filthy dirty. I now work in long term care. So far, it’s been a much better work environment. I’m not stressed out on a daily basis and devalued like in the hospital setting. Nurses we need a hero. It sounds like legal nurse consultants will be major players in the future. Does any one know of nurse advocates besides the local nurse associations?
As an older RN of age 55, working with the “younger generation” ie:, age 22 to 30, in the Emergency Room I have experienced quite often, disrespect in tone, dissertation and lack of caring in educating the younger RN who is making blatant mistakes in basic nursing care. They seem more interested in texting on their cell phone, socializing, playing on the internet and then crying about how hard their day was and they leave soo much undone work that is hours old on the orders for the next shift. They rely on the equipment to assess their patient and when the computer goes down they get upset because all their vital signs are lost. Even though they haven’t done them for the entire shift at bedside which is REQURED every 2 hrs. It seems that upper managment tolerates this for the sake of having staff on the schedule but now seems to be “picking” on the older RN’s in order to get rid of them. They say we need to be more tolerant and talk to them nicely. Yet when you try to talk to them nicely, they just say: I dont care! Write me up! I say this from personal experience. I have been an RN for 30 years and do not say this with any malice or intent to discriminate. I am concerned about who is going to take care of me one day. I am really concerned about what type of RN’s will be out there in the future. They hid their names because they don’t want anyone to know their names in case that patient becomes upset with the nurse. I know this first hand. And these will be the future Managers!!!?#@%@@!
We are now constantly reminded that a hospital is also a business and will do what it needs to do to stay afloat, keep the stockholders happy and the board members happy as well as provide a community service. Because it is a business, cutbacks will always be in the service sector first, ie:, housekeeping, food preparation, case management then nursing.
I believe it would help the hospitals to maintain staffing to provide quality care as it should be. Bonuses should be eliminated, hire on bonuses should be eliminated and administrative bonuses should be eliminated. We need to accept the fact that if you need and want a job at a hospital, go for it with the understanding that they are still in operation which is good for the community and not with the intent of collecting bonuses. Administration has made it quite clear that all personnel are replaceable.
The shortage will continue. The demands on nursing will be greater and the “paper pollution” required for documentation is more now than ever as a result of legal litigation which in the long run, helps to identify where the weaknesses are in nursing, management and administration. I truly believe that if every nurse went back to the basics of nursing, 90% of law suits could have been avoided. As far as universal healthcare, I am not in agreement. I believe a capitalist society is the back bone of the economy.
I truly believe there is a place for the older and more experienced RN in the hospital system, in healthcare overall. There are alot of hospitals who have not adopted this trend, there reasons being that older RN’s cost more due to the probability of future health concerns Well, duh!!!!!
That doesn’t mean we don’t have a brain, that is still working.! So many are working in critical care areas and are physically tired, NOT BURNED OUT. 30 to 42 years in DIRECT PATIENT CARE is tough on anyone. Alot of the “younger” nurses can’t handle the pressure, go on and get higher degrees, become managers without what I would call “real experience” and then write directives on patient care. Mandatory education in the hospitals has gotten way out of control taxing the bedside nurse to the point that her private time is constantly interrupted with “Manadatory” meetings, educational seminars, educational fairs, mandatory dept. education requirements. Most of it so the hospital can collect more money from organizations or the government. Gone are the days, when you coulde go to work, take care of your patients, go home and that was it!.
I beleive education should be unit based and kept to a minimum with the option of taking additional courses at the RN’s discretion for her own educational growth. Most RN’s prefer this. Inspite of all these educational requirements now mandated, there really is no compensation. When a course takes 6 yo 7 hrs to complete and you are only paid 3 to 4 hours, that is just plain wrong. So, when I say the nursing shortage will continue, these are just a few reasons why. Nursing wont change until you have nurses at the bedside who arent afraid to show their name, turn off the cell phone, use the computer for only work, stick to the basics of nursing care and most importantly, nurses that are hired really want to be a nurse.
My husband recently found out that his maternity unit will be closing in the next 60 days!! 22 labor and delivery nurses to be layed off. He is (was) the chief of OB and was not even involved in the decision making process. Not included in the board meetings. The CEO decided to tell him while my husband was in between surgical cases. The reason–the hospital has a 800K deficit in the OB department. What has happened to community service. My husband said it felt like a punch in the stomache. He has been there for the past 20 years and has over 10K patients.
This hospital is the only one in the county that still does OB. You can imagine the emergencies and chaos that will occur in the ER. The ER docs were told they will get some “training”. I can just imagine the lawsuits as this transpires. The director of nursing did not want to tell the nurses until the last minute. Our two midwives are worried about their jobs because one of the big conglomerations that is willing (and looking forward to more business) is not midwifery friendly. It happened so quickly that even as the news transpired it was too late to change the boards decision.
As a CLNC® consultant I can only say how sad I am that nurses are so undervalued. How hospitals just see money as the bottom line. (Found out the CEO got a 300K bonus last year.) What ever happened to patient care and community service? Many of the residents are low income and sometimes have difficulty getting to this hospital. Now the closest to deliver and get ER care is 30-40 minutes further. I do feel that this world is going crazy. How else can you explain what is happening all across the country. Nursing leaders need to start screaming at the tops of their lungs so the suits will hear them. I have always been an instigator–for just causes. In this situation I have spoken to reporters, will have my husband interviewed on the local news and speak to any one and every one about this situation. Bottom line, the poor patients.