Monday, August 26, 2013

You can't handle the truth!

Dr. Ali and I were talking about our recent (constant) staffing problems last night. I said I couldn't figure out why a unit with patients with things like GBS and big MCA strokes (one makes you not breathe, the other can make you have fatal heart arrhythmias without warning) wasn't considered a priority in staffing. I mean, we had a code a couple of weeks ago when some poor sod went into ventricular fibrillation (non-medical definition: your heart quits beating and just shivers: very bad), and only one nurse on the floor. It was touch-and-go, but we got said poor sod coded, stabilized, and later discharged.

Dr. A. told me something he'd heard earlier this week from a VP of development: that the neurocritical care unit is only important in that we bring in money for the neurosurgical service.

(Imagine me standing there, open-mouthed, silent.)


Sunnydale General is supposedly going for a comprehensive stroke certification, but the department that handles everything from strokes requiring TPA to non-surgical neurological emergencies is considered worthwhile only because we send the occasional patient to the surgery guys for a cartotid endarterectomy or aneurysm clipping.

I asked Dr. Ali how he'd responded. He told me he'd told the VP of development that our unit was making plenty of money on its own, thanks, and that he didn't like to refer patients for surgeries that weren't proven to work. (That last is some obscure insult referencing some sort of study on CEAs, I guess; I don't know the details.) It was a calm, intellectual burn from one doc to another.

Still, to be told flat out that the unit that you're working on, that you've been helping to develop for umpteen years, isn't considered important by the big uppity-ups. . . .is disheartening. Although it does explain why we're having such a hard time getting funding for equipment and staff.

In other news, I worked with a patient care aide this weekend who was concerned about her ability to get a job after she graduates nursing school in December. She's been doing externships and internships and has great grades, but hasn't even had a nibble on the job front.

We went over all the things she was doing right, and all the things she might be doing wrong, and then I took a look at her resume.

She's graduating from a for-profit school that is not accredited.

Again, imagine me standing there, open-mouthed and silent.

This woman will owe more than $50,000 for two years' worth of classes from a school that lacks even the most basic accreditation from any authority. She therefore will not be able to get a job anywhere but the LTAC that employs her part-time now, and maybe not even them, as an RN. Add to that that her chances of getting into a decent nursing school for a BSN are practically nil, except if she goes back to Consolidated Larnin' Collidge, and she's screwed.

I can't. . .I can't even. Talk about predatory marketing: they promised her that in just under two years, she'd have earning potential that nobody in her family has ever had. They told her that the job market for nurses is hot, which it is--provided you've got a degree from a recognized school and are willing to slog for a few years. They then helped her get loans that are about four times what I paid for a degree from an accredited program, but didn't happen to mention that a) the interest rates are huge, and b) her education would be worth practically nothing.

She's not stupid, but she's not well-educated. She's poor, she's got a GED, and she took the only offer she got. She's a hard worker and driven as hell, but she's hobbled herself with a bullshit "degree" from a place that has classes in a storefront.

It was a demoralizing week at work.


Anonymous said...

That is really sad in all fronts. The "place" that employs myself and others requires a BSN. If you happen to be working there as a CCT before you sign a contract to have said BSN within 5 years. Someone has a JOB of keeping track of these "students". Shameful! On my unit, you cannot tell the difference between BSN and ADN, truth telling, some of the BSN trained are poorly trained in patient care.

Cr0w$C@lling said...

Time to have a chat with the Texas AG. Sunnydale seems to have ample places in the surrounds who will tell potential students that they are in process of being accredited.

Anne said...

Did you tell her what the issue was? That is incredibly unscrupulous and I would even venture illegal, money is king, eh? :(

clairesmum said...

i often wonder what senior leadership at my agency is thinking....after reading the first part of your blog, i think it is probably a good thing i don't know what they are thinking...would probably make my brain explode....

and that girl did get so screwed...does Texas have any kind of consumer protection stuff? which institutions had the clinical placements for this 'school' - maybe they could be shamed to stop participating?
stay cool.

Comradde PhysioProffe said...

That is disgusting what that school is doing.

Stefanie said...

Yeah, surgery always seems to be the sexier child that gets all the attention. Except maybe cardiology. Strokes just aren't very sexy, you know. The patients end up drooling and look like jibbering idiots, so they don't make very good photo ops. On the other hand, the surgeons get to look like the conquering hero who've flown in to save the day just in the nick of time. Patients still intact, smiling and speaking in full sentences.

You have my sympathies.

Unknown said...

Take some time and read "The rape of Emergency Medicine" it might be a little old but what this free book says really opened my eyes as to the "business" of hospitals.

As for the aide who will have a pretty well useless non-accredited degree. It's horrible and down right awful. I have had some Paramedic buddies start down this road on bridge courses only to find out the school is NOT accredited.

For those of you reading this blog interested in nursing degrees do research on the school and ask "Who are you accredited through?" Then check their accreditation.

Dr. Alice said...

...I just. That poor woman. That's horrible. I agree with the other posters, she should report that school. And regarding the attitude of your hospital's management toward your unit, somebody should ask them what they'd do if their parent/spouse/partner/child had a sudden neurologic emergency. I mean, WTF??

Anonymous said...

I feel so awful for that poor woman. That's horrible. Horrible.

Did you tell her what the problem was? I don't know that I would have figured out what to say.

Penny Mitchell said...

I'm so sorry about the situation with your unit. I...can't imagine. I'm sitting here trying to sum up in words my thoughts on health care in the United States in general, and the only thing I can come up with is: Fuck This Shit and The Shitty Horse This Shit Rode In On.

I am SO thankful I don't have children. I think the situation in your department is going on everywhere, and just another symptom of flames encroaching whilst we fiddle away.

As for the "nursing" student: There are, at my last count, eleven nursing schools in the Denver Metro Area. The last time I counted was about three years ago, so it's quite likely that number has increased. The University of Colorado program is stellar. Regis University is a distant second. There are two community colleges that offer ADNs: They used to be quite highly regarded and their grads did well.

Then the for-profit schools swooped in. They are spewing out grads once and even twice a year. Even if they were GOOD schools, logic would dictate that there just aren't going to be enough nursing jobs in even a major metropolitan area for all these grads. Couple that with the fact that a lot of people want to live here, and the ADN grads from the community colleges are waiting tables. Most of them can't even get jobs in long term health care centers. The grads from these for-profit schools...are completely out of luck. I don't understand why these for-profit schools are allowed to even operate.

And now, oh joy! Denver has a for-profit MEDICAL school!

Shoot me.

Carin Diaz said...

Somebody has to tell her.

Anne D. said...

Your staff development guy reminds me of our administrator, who, years ago, told me that departments like radiology and respiratory make money for the hospital, whereas nursing costs the hospital money.

Alfreda Hindbaugh said...

It's sad that all the hard work out in by the girl is being dismissed simply because the school she went to isn't accredited. If employers really do pay attention to the resume, they would see that she's put in every bit of effort, right? Or is that just naivete on my part?

Kis said...

I am in a school that is regionally accredited but not NLN accredited. Its still a lot of work :( I feel bad now.

gorochan said...

Alfreda, no accreditation = no NCLEX exam = no RN.

gorochan said...

oh no, I lied! I went and looked it up, your school doesn't have to be accredited for you to be able to do NCLEX. Just looks bad on resume.