“Hospitals are businesses!”
If you’re a health care professional, I’m sure you’ve heard this phrase more times than you can count. Nursing is our nation’s largest health care profession, and most nurses are employed by hospitals. Therefore, if you’re a nurse reading this, it’s imperative that you understand the business function of hospitals. Why? Because, by definition, businesses are entities that’re engaged in commerce. To pay your salary, hospitals must make money. A threat to a hospital’s financial standing is a threat to its survival. As such, hospital administrators will implement policies and engage in practices to protect the entity by any means, and to keep revenue coming in. Unfortunately, that sometimes occurs at the expense of hospital staff. As I recall those 50-cent annual raises from my days working in direct patient care, I can’t help but roll my eyes hard. However, all health care professionals – especially nurses – should remember where they fit in on the hospital continuum.
What does this mean for nurses?
First, thoroughly research your facility’s policies regarding all issues related to nursing. Read the policies to ensure that you understand the parameters that you’re required to work within. I recommend that you print out these policies so that you’ll always have access to the hard copy. Store them in a safe place and periodically check for updates, as needed. Second, research malpractice insurance. I realize this is a controversial topic. Some nurses are opposed to it because they feel it will make you a target. Others are price sensitive and don’t want to pay out-of-pocket for the insurance. During my tenure at bedside, I made a few medical errors, but none were serious enough to jeopardize my nursing license – thank God. As a result, I learned from my errors and made adjustment to how I practiced. It’s important to note that I didn’t carry my own malpractice insurance. I never jeopardized my license because I also didn’t override medications in non-emergent situations. However, as a black nurse working in critical care, I knew that if things went wrong, the hospital wouldn’t protect me. I was prepared to pay for my own legal defense if I ever needed to. Nevertheless, I’m the queen of knowing and using policies to fight my battles. That’s why knowing hospital policies will protect YOU regardless of where you stand on malpractice insurance. As I’ve told the doctors that I worked with, “If you want to do xyz, YOU DO IT! We worked too hard for our licenses to play games with ego-driven health care providers.” Therefore, if having malpractice insurance makes you feel better, then you absolutely should obtain it.
I understand and empathize with the pressure that nurses are facing to handle things quickly because patients, families and providers are demanding. What everyone needs to remember is why patients are in the hospital in the first place. For nursing care, it begins and ends with you. To successfully advocate for your patients, you can’t just go along to get along. Although it’s intimidating and an unpopular stance, speak up when your intuition is telling you NOT to do something! If you have questions, ask. Check your ego at the door and don’t let the fear of others looking down on you stop you from ensuring that you have the information needed to effectively carry out your duties. To hell with what people think; safety over popularity.
Considering recent developments, I’ve seen many emotionally-charged social media posts and discussions suggesting that nurses should leave the profession if medication errors will result in criminal charges. I say this with love: if you didn’t leave at the onset of the pandemic when hospitals enforced protocols that demonstrated a lack of concern for nurses’ safety, why would you leave over a multi-layered situation that resulted from several independent decisions made by one staff nurse? It’s important that every nurse reads all materials related to legal cases for themselves before publicly taking a position on an issue. I support nurses leaving toxic work environments. I built a coaching program to help nurses use their clinical skills in corporate nursing. As a nurse, you have career options outside of hospitals and clinics. Nonetheless, I want nurses to stop allowing emotions to dictate their responses to trending topics and events. This is where critical thinking is absent, strategy is ignored and mistakes are made. I’m not saying your feelings aren’t valid. The organization in question should face accountability. Yet, we can’t forget that large medical institutions have power and lots of it. Sadly, nurses (or other staff) have always been the scapegoat when medical errors result in a disastrous patient death. The solution isn’t to leave the profession altogether because, honestly, who would that benefit? Organizational change occurs through people!
I challenge you to harness those feelings and focus on making your nursing career work for you! Take some time to reflect on where you’d like to see your nursing career in the next few years. If you’re extremely passionate about minimizing medical errors, devise solutions the institution and/or unit where you currently work. Take the initiative to start a project where the goal is to provide a root cause analysis of medical errors with fresh eyes. Reverse engineer the events that led to errors and find solutions. Yelling into the vortex gets old. Those who truly seek to correct these wrongs are the true heroes. And no matter what, please protect yourself and don’t practice with rose-colored glasses.
If you’re seriously ready to walk away from direct patient care, I invite you to bring your brilliance into the boardrooms of corporate nursing! Many companies need your clinical expertise to make products and services better for patients and health care professionals. I would love to see you redirect your nursing trajectory to this pathway and I’m excited to partner with you to help you accomplish this goal.
Let’s keep the discussion going. I would love to hear from you. Connect with me on LinkedIn, Facebook, Instagram and Twitter!
Great blog Lexi. Love your positive twist and spirit of inquiry. We all need to know what is really going on before we start making a fuss. Data, information, knowledge, wisdom.