[Mack184]

For as long as I have been reading TOTV there have been pages upon pages of gripes about the waits and care at the TVRH-ER. The vast majority of these gripes come from people who have virtually no knowledge of how a hospital functions in general and an ER in specific. Most of the "knowledge" in these gripes come from people who have watched too many episodes of Marcus Welby, ER, Trapper John MD, Diagnosis Murder, MASH or St. Elsewhere and think that's reality.

Both Russ Boston and I have repeatedly told the story that TVRH's problems are three-fold. A lack of beds, a lack of staff and a dwindling revenue stream due to TVRH being heavily dependent on Medicare reimbursements that are being continually reduced. Most of the complainers don't like these facts and they prefer to stick to their fantasies of why TVRH does not conform to their world.

What I am now about to say is NOT rumor or conjecture, nor have I been busy playing a tune on the opium pipe. This is the truth. Taken DIRECTLY from a letter to the TVRH professional staff from the hospital administration.

According to that letter the hospital is facing a 5 million dollar operating deficit as they go into their next fiscal year. The letter indicates that the deficit will grow as more cuts take effect as directed by the Federal Affordable Care Act.

After "serious thought" the hospital administration has effectively decided to balance their books on the back of the hospital nursing & professional staff!

What this means is that TVRH will no longer grant pay bonuses for experienced nurses who have advanced education and certifications. The vast majority of hospitals pay percentage bonuses to nurses who upgrade their degrees, get advanced certifications in important care areas such as Emergency/Trauma, Critical Care, OR and so on. Those types of bonuses help to assure that a hospital will attract the best and the brightest. The fact that TVRH will no longer provide that sort of financial bonus puts a HUGE "unwelcome" sign out to quality, experienced nurses and other professionals. It also puts the pay level down to a point where the only people who will likely look for a job at TVRH are fresh, green graduate nurses.

This is not to bad mouth those new young grads. But as in so many other professions you need a balance. The older, more experienced nurses are able to mentor young people just out of college making them better, more effective healthcare givers.

TVRH pay for professional nurses is some of the lowest in the profession. People who have come south from any comparable sized hospital in the north or west have found that the pay is 30-50% lower for the same job that they were doing. That is not exactly a big incentive to work at TVRH.

Recently there was a front-page article in The Daily Sun announcing that the hospital would soon open many more beds. Fine. One problem. Staffing. They cannot currently attain correct staffing levels at the hospital. They have a giant turnover due to the low pay and chaos in the hospital ER. So how exactly are they going to staff all these new rooms when they cannot currently safely staff what they have?

With the decision by the hospital administration to balance it's books on the backs of the nursing staff, it's going to make it doubly hard to keep qualified, experienced nurses to staff what they have now. The idea that they will somehow come up with even more staff at lower pay levels than they pay now is pure folly.

Furthermore the letter goes on to cap the amount of accrued vacation, sick & personal time for long-time employees and in some cases outrightly steals accrued time from them.

They go on to say about some of "wonderful" extra benefits they have added to make up for this, which of course don't amount to anything but a handful of magic beans.

The bottom line is, that TVRH is going to attract less and less professional people in general and far less experienced staff in specific. If you don't like the present, you're going to HATE the future!

Not enough beds, not enough staff, poorly paid staff, dwindling revenue. And so it goes.