[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.

[jbdlfan]

Just curious, do you see this as a problem state-wide or unique to TV due to the age of the population? My wife is venturing into the profession as a mid-life career change. It's nice to stay informed!

[The Buckeyes]

I don't dispute any of the claims but it is hard to believe deficits are so high when on March 16th I visited the er and was seen a PA (physicians assistant) for no more than 10 minutes who spent at least half that time trying to figure out the computer program to enter info. Botton line my insurance company was charged $779.00 for this! Can you imagine what the cost would have been if I was seen by a "REAL" doctor?

[gomoho]

Originally Posted by The Buckeyes

I don't dispute any of the claims but it is hard to believe deficits are so high when on March 16th I visited the er and was seen a PA (physicians assistant) for no more than 10 minutes who spent at least half that time trying to figure out the computer program to enter info. Botton line my insurance company was charged $779.00 for this! Can you imagine what the cost would have been if I was seen by a "REAL" doctor?

What your insurance company was billed and what they paid are usually two different matters and usually the difference between night and day.

[Mack184]

Originally Posted by jbdlfan

Just curious, do you see this as a problem state-wide or unique to TV due to the age of the population? My wife is venturing into the profession as a mid-life career change. It's nice to stay informed!

While the brave new world of the "Affordable Care Act" is making for new surprises virtually every single day in the healthcare world, TVRH has the dubious honor of receiving more per-capita medicare dollars than any other US hospital. Fully 88% of their revenue stream comes from Medicare where the US average is around 36-40%. Since many other hospitals can boost their bottom line with elective surgeries, maternity, pediatrics and so on, TVRH cannot. It's P-1 demo is 65+ and Medicare is the payer. It's not an enviable position to be in.

As far as your wife is concerned, if she doesn't mind driving, she'll do better elsewhere..but..if she's just starting out, no matter what her age she's a "new grad" which means she'll be at the bottom of anybody's pay scale.

[ilovetv]

Originally Posted by The Buckeyes

I don't dispute any of the claims but it is hard to believe deficits are so high when on March 16th I visited the er and was seen a PA (physicians assistant) for no more than 10 minutes who spent at least half that time trying to figure out the computer program to enter info. Botton line my insurance company was charged $779.00 for this! Can you imagine what the cost would have been if I was seen by a "REAL" doctor?

This mess (all medical orders by computer) is what is mandated by government, for all hospitals and providers, and the software is designed and sold by many different companies making it different in every clinical setting and thus, a nearly insurmountable learning curve for every nurse, PA, doctor to wrestle and beat into submission WHILE they are trying to take care of a patient---AKA "a PERSON who is sick and vulnerable and in need of a doctor, not a data entry technician with eyes fixed on a computer". Also, the software is billing oriented, and NOT patient care oriented.

But unknowing people keep on voting for campaign promises of government-only, single-payer healthcare, and this is what we're getting. And it's only just begun.

[Mack184]

Originally Posted by ilovetv

This mess (all medical orders by computer) is what is mandated by government, for all hospitals and providers, and the software is designed and sold by many different companies making it different in every clinical setting and thus, a nearly insurmountable learning curve for every nurse, PA, doctor to wrestle and beat into submission WHILE they are trying to take care of a patient---AKA "a PERSON who is sick and vulnerable and in need of a doctor, not a technician with eyes fixed on a computer". Also, the software is billing oriented, and NOT patient care oriented.

But unknowing people keep on voting for campaign promises of government-only, single-payer healthcare, and this is what we're getting. And it's only just begun.

My wife refers to this computer mess as "Caregiving By The Pinks". At her previous hospital any computer item that wasn't filled out came up the color pink. So mostly the people were trying to make sure there weren't any "pinks" on the computer. Didn't really matter if the patient died, as long as the "pinks" were filled in. Then, in the case the hospital got sued, they could pull their computer transcripts and proudly announce that everything was A-OK!

[dotti105]

I am a RN with 20+ yrs experience and am building a home in Gilchrist. I love my job and have considered working part time after we move. But after seeing the salary at TVRH, I know I will be commuting, probably to Orlando, to work a couple of days a week.
Salaries do vary by region, and Nursing has always paid very low in Florida. But TVRH is exceptionally low.
I agree that hospitals need to compensate the experienced among us in order to assure excellent care today and tomorrow. There is no way to place a monetary value on an experienced, well seasoned bedside RN. And as a RN I want to work with others who are also experienced so that newer nurses can be mentored and draw upon the experience of the team as a whole.
Experienced nurses are working because they love the career AND because they need/want the paycheck. If they are not compensated fairly, they will leave, choosing instead a hospital that values (pays) them more.
That is the cold hard truth!
Sad state of affairs at TVRH.

[Indydealmaker]

I predict that this problem will spread across the nation to all hospitals as private insurers pressure healthcare providers for lower costs to offset the new government regulations. The future is less care for more cost, just like any other government structure.

[blueash]

Originally Posted by Indydealmaker

. The future is less care for more cost, just like any other government structure.

Not so sure about that low cost for government payment to private companies. I do believe that Mr. Snowden, a high school dropout, was paid $122,000 / yr as a starting salary at his job. <snark>

[ilovetv]

Originally Posted by blueash

Not so sure about that low cost for government payment to private companies. I do believe that Mr. Snowden, a high school dropout, was paid $122,000 / yr as a starting salary at his job. <snark>

That, too.

[ilovetv]

Originally Posted by dotti105

I am a RN with 20+ yrs experience and am building a home in Gilchrist. I love my job and have considered working part time after we move. But after seeing the salary at TVRH, I know I will be commuting, probably to Orlando, to work a couple of days a week.
Salaries do vary by region, and Nursing has always paid very low in Florida. But TVRH is exceptionally low.
I agree that hospitals need to compensate the experienced among us in order to assure excellent care today and tomorrow. There is no way to place a monetary value on an experienced, well seasoned bedside RN. And as a RN I want to work with others who are also experienced so that newer nurses can be mentored and draw upon the experience of the team as a whole.
Experienced nurses are working because they love the career AND because they need/want the paycheck. If they are not compensated fairly, they will leave, choosing instead a hospital that values (pays) them more.
That is the cold hard truth!
Sad state of affairs at TVRH.

The well seasoned bedside RN is being pushed aside by cheaper, computerside staff who have grown up with their eyeballs screwed into a computer and smart phone screen, and typing with their thumbs.

Actually, a robot is what is demanded by this growing (nation-wide) "System".....Not a thinking, caring human being.

[Chazz]

Very disturbing!

[rubicon]

Mack184 your post (#1) is very disturbing and brings into question the media blitz in the Daily Sun about the Marcus Welby Center.

Blueash Snowden was making $200,000 and was only holding a GED.
( source WSJ) Mack184 I am sorry you and the other staff are facing those challenges.

To all of us God help us when the Affordable Healthcare law takes hold.

[Mack184]

Originally Posted by rubicon

Mack184 your post (#1) is very disturbing and brings into question the media blitz in the Daily Sun about the Marcus Welby Center.

Blueash Snowden was making $200,000 and was only holding a GED.
( source WSJ) Mack184 I am sorry you and the other staff are facing those challenges.

To all of us God help us when the Affordable Healthcare law takes hold.

I am not on staff there. Russ Boston is. My wife is an NP, although not at TVRH. However like any profession there is a grapevine and a friend shared the hospital letter with her asking for her advice. That's how I know.