We don't need your kind here

I firmly believe that most of the things you mention ultimately have their roots in the US government. It is the truth that Medicare/Medicaid are the largest money pockets for any given hospital, and now that reimbursement is being tied to patient satisfaction scores, hospitals have to keep those scores high to stay afloat. Who cares if you are late giving Mrs. Smith her BP medication - if your patient Mr. Jones across the hall is complaining, he is the priority because his scores might drop if you don't go in there right then.Tying reimbursement to patient satisfaction scores is a horrible, horrible idea. The people that are the most aware of their surroundings and who will be able to say the most about their care are the LEAST SICK patients. A patient going downhill that's half in and half out is not going to remember if you talked up your oncoming nurse, but the patient who you put off because of the patient going downhill will remember you never being in the room... because you're saving someone else's life. Do they know that? No. Does HCAHPS care if you were saving a life instead of waiting on your stable patients hand and foot? No. It really makes me angry thinking about it!

Excellent writing. Very true, very on target. You hit the nail on the head as to the state of nursing today.

Very well said. Only a nurse sees the reality of the insanity of HCAHPS scores.

You bring up a good point. As a longtime patient, I have seen it all and done it all. The thing that sticks out most for me is the fakeness of everything. Nurses (and doctors) seem fake. Like, I hear the same tired out words all the time. In fact, I could tell you EXACTLY what they say. "Kmmurphy? Hello, yes, come this way. We are ready for you." And if they were running behind, they throw in a standardized apology. If I am lucky. Mostly, it goes like this. "We're running behind today." That is all. Sad but true. Thank you for this wonderful story. Now I know that I'm not the only one who thinks this.

I see nothing wrong with how you are greeted or what they say if they are behind. What exactly is it you're expecting?

Patient satisfaction scores are a way for Medicare to get out of paying. First off- the score needs to be a 100 percent positive. Not 90 or even 99 percent- it must be 100. Last I heard 90 Percent was a pretty good grade in school. The method has unrealistic expectations but so doesn't all of nursing. The demands on nurses and Drs are unrealistic also so this should come as no surprise. This makes me so upset because Medicare knows it is a ridiculous standard. I don't know how they got this implemented in the first place. Oh right- probably from some one who does not work in health care and has no idea of what they are talking about.

I think the system could really benefit from a severe nursing shortage. Do we have a glut right now?

Agree with you on most points, but please remember: BSN-prepared nurses are not "higher-licensed" and ADN and diploma-prepared nurses are not "lower-licensed". And RN is an RN and a would-be magnet hospital may prefer the BSN candidate but that RN license is the same no matter how you got there. Same test, same scope of practice.

I agree, Emmy. And I don't think that it is right in the least that there's a same NCLEX for all, however, more and more facilities are pushing for BSN's--and each of the other degrees/diplomas have taken and passed the same exact test.

I continually hear hospital executives use the phrase "quality care", while doing things behind the scenes to ensure that it is almost impossible for the staff to deliver it. The "more is better" mentality is behind a lot of what is going on in health care. Hire only BSNs because they have more education - never mind that the ADN you laid off to hire one has years of experience, is at least equally smart and can work rings around most of them. As long as you can say in your ads that all your RNs are bachelors-prepared, the public will believe that they are better. Perception, not reality. And you can't just be XX Hospital anymore. You have to be XX Hospital Medical Center. You have to be both, not one or the other. The more words in your name, the better the facility is. It's about image, not results.

Alas for your theory, those BSN nurses will have the time-in-grade and gain the attendant experience eventually-- and they aren't all new grads, anyway-- but the ones without the BSN will not gain the education as the years roll by.

Quote from GrnTeaAlas for your theory, those BSN nurses will have the time-in-grade and gain the attendant experience eventually-- and they aren't all new grads, anyway-- but the ones without the BSN will not gain the education as the years roll by.