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Author Archives: Lorie A Brown, R.N., M.N., J.D.

  1. Is Travel Nursing A Great Option?

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    I did not realize that travel nurses make an average hourly rate of $120.00 per hour!

    In an article regarding travel nursing by the numbers, the R.N. vacancy rate is a full percentage point higher this year than in 2020.

    However, the number participating as travel nurses is declining because the cost of travel is so much more than it was last year thanks, in part, to rising fuel prices.

    Travel nurses made an average of $1,673 per week last year, and now make more than $4,000 per week in some cases.  In May 2020, the annual pay to travel nurses averaged $75,330 per year with the lowest pay for a registered nurse at a facility was $53,410 per annum.

    While it is great that travel nurses are pitching in and seizing the opportunity to fill in where staffing help is needed, this is a huge area where nurses can get into trouble.

    Nurses need to know the policies and procedures of the hospitals where they will be working.  Just because you worked at one hospital where things were done a certain way does not mean you can do the same things the same way at another hospital.

    Additionally, many nurses are not reading their contracts.  DO IT!

    I frequently receive telephone calls from nurses who say things like, “Well, they promised me this, but they didn’t deliver.”  No matter what they may say, if it is not in the contract, it is not going to happen!  You might be told that you will not treat CV-19 patients YET find yourself on a COVID floor. You do not have a choice unless it is specifically stated in the signed contract that you will be doing no such thing.

    Many travel nurses just sign on the dotted line without knowing what they are committing themselves to.  The contract may be canceled for any reason, even before they start.  So, an unknowledgeable nurse may move across the country to take a position only to find upon arrival that the position is no longer available.

    Another problem is that one may have to pay a fine should they decide to leave the position early.  Failing to read and understand a contract can expose you to a myriad of problems.

    It is my hope that all travel nurses seriously and deeply review their respective contracts when negotiating.

    As of now, many contracts are standard with no negotiation, but if until travel nurses band and stand together saying, “We are not going to sign this, we are not going to agree to it unless we have certain conditions in the contract,” it will never happen.

    Now is the time, as travel nurses are so needed, to band together and advocate for your protection with provisions in the contract that protect you.

  2. Full Practice Authority For Nurse Practitioners Is Growing

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    California has become the 29th state to allow nurse practitioners to practice independently.  New York, Massachusetts, and Delaware recently became full practice authority states as well.  However, in California, they must go through 3 years of physician oversight before they can reach the point of independent practice.

    This was a hard-fought battle that was settled with Governor Newsom finally signing the bill into law.

    The reason for the legislation was that many patients in the Golden State do not have ready access to physician care.  Despite its purpose to create an expanded envelope to provide greater care for state residents, the California Medical Association objected to the new law stating that physician-based care is the model that ensures the greatest patient safety.

    The Association also claimed that other states which have allowed full practice authority for their nurse practitioners have not shown any meaningful improvement in the access to care in underserved communities.

    That state’s Board of Registered Nursing will need to develop regulations to implement the particulars of this bill while the California Medical Association will remain involved.

    This is a huge step for nurse practitioners in the state which also affects physicians who, because of the bill, will now lose the fees they had been charging for clinical practice oversight of the nurse practitioners.

    Massachusetts and Delaware allowed NPs to practice due to the pandemic and recently passed permanent legislation.

    Nurse practitioners provide care in a holistic manner and take more time assessing patient issues. I believe their care is outstanding, and they take the time to speak with patients and get to know them. I am glad that nurse practitioners are getting the recognition they deserve to be able to have full practice authority.

     

  3. Do Titles Matter?

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    The State of Indiana just passed a law about transparency in healthcare because many healthcare providers who perform tasks like those done by physicians are not actually M.D.s.

    For example, nurse anesthetists call themselves “anesthesiologists” which can confuse the average person.  This new law requires that patients be informed of the specific qualifications of the healthcare professionals involved with their care.

    In California, where I reside, there is an urgent care service called M.D. Today.  People go there believing they will be seen by an M.D. but, most likely, the person will be seen by a Physician Assistant with no M.D. actually being in the facility.

    Several medical groups have opposed the misappropriation of medical specialty title.  In particular, the American Association of Nurses Anesthetists recently changed its name to the American Association of Nurse Anesthesiology (AANA).

    Opposing that name change was the American Society of Anesthesiologists (ASA) and the American Medical Association (AMA) asking for transparency.  According to the AANA, the name was changed due to rebranding.  “The notion of being pushed by the American Society of Anesthesiologists that rebranding and changing the name of the AANA will somehow mislead or harm patients or create discord among providers is absurd at best and false and inflammatory fearmongering at worst.”

    With so many different specialties in health care, a nurse practitioner who has a Doctor of Nursing practice, can call themself “doctor.”  But just because one is titled as “doctor” does not mean that the person is a physician.

    I believe the public has a right to know of the degrees their healthcare providers have earned but also, I question why that information would be hidden from the public.

    It is interesting that Indiana feels compelled to pass a law on this.

    How are health care professionals differentiated where you work?  Let me know your thoughts in the comments below.

     

     

  6. Competitive Hiring and Retaining Strategies

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    In a recent article of Becker’s Hospital Review, Cedars-Sinai apparently participated in a webinar hosted by Becker’s on the nursing shortage and how Cedars-Sinai is handling it.

    I think the insights from the session were particularly good.  During the online seminar, it was noted that the demand for health care is rising due to an aging population that is putting a strain on the health care system along with COVID-19.  He added that, by 2023, there is expected to be a national nursing shortage of 1,000,000 nurses.  He anticipates that average acute care nurse turnover rate to be 19% per year.

    These statistics are astounding!

    I started practicing nursing in 1982 while dinosaurs were roaming the earth; a time when every hospital had a nurse recruiter who always was, “hot on the trail,” to get you to join their hospital.  I always thought it would be interesting to be a nurse recruiter.

    Today, Cedars-Sinai believes that speed is everything in hiring.  The faster one can recruit, the more likelihood the applicant nurse will say, “yes,” to joining your facility.

    We live in an Amazon Prime type world where everyone wants things quicker and easier!

    The reasons why nurses leave jobs are for career advancement (51%), a more flexible schedule or greater balance (42%), to reduce commute time or relocate (26%) and better compensation (21%).

    To address these issues, Cedars-Sinai is investing in career development such as tuition assistance.  In addition, they are creating a positive work environment which is so important for nurses in all facilities.

    Though it would be great to make more money, some nurses are not necessarily motivated by extra cash.  Working in a positive environment is so important.

    When you go to a facility to work for 12 hours, it is important that you enjoy that work environment.  Cedars-Sinai is exploring changing from the traditional 12-hour work shifts to the less stressful 8, 6 or even 4-hour shifts.  I love this idea.  A 4-hour shift can provide for a great break nurse.

    Cedars-Sinai also is experimenting with placing nurses in the call center for 3 months as a break from bedside care.  This sounds like a great alternative to decreasing burnout.

    Of course, wages at Cedars-Sinai remain competitive and they offer sign-on bonuses plus annual retention bonuses.

    It is about time that nurses are treated and rewarded for the hard work that we do.  You cannot pay enough to many lay people to even consider entering a field such as nursing.

    I encourage you to look at the linked article and watch the online seminar as I am sure you will find it to be of interest to you.

    How about letting me know what your facilities are doing to remain competitive in attracting and hiring quality nurses?

     

  7. Are You Committed To Your Business?

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    Lorie Brown, Nurse Attorney, founder of Brown Law Office and Empowered Nurses, discusses the importance of being committed to your business in order for you and your business to become successful.

  8. Are Nurses The Modern-Day Slave?

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    In December, 11 members of an interventional radiology and cardiovascular team at ThedaCare Regional Medical Center-Neenah were offered new jobs at Ascension NE-St. Elizabeth Campus in Appleton, Wisconsin.  In the group were 7 healthcare workers of which 4 were R.N.s and the others were radiology technicians.  They were offered new jobs with better salary and benefits.  [Click for Story]

    ThedaCare filed a motion asking a court for a temporary restraining order and injunction to prevent the healthcare workers from transitioning to the other healthcare institution.  It is shocking that ThedaCare would file such a motion.

    Fortunately, the Judge in this matter denied that motion saying that there was not enough basis to prevent these employees from going forward.  “ThedaCare has only itself to blame for failing to maintain a competitive working environment for its medical staff, opting instead to underpay the essential workers and even refusing to make a matching offer to these employees when given ample opportunity to do so.”

    It is sad that nurses are becoming the pawns of these and similar actions.  These nurses were not allowed to work until this matter was resolved.

    Hospitals had better hunker down and figure out how to keep their nurses or nurses are going to continue to leave in droves.  This may be the right time to revisit my Nurses Bill of Rights, a critical listing that I created years ago.

    Nurses are not asking for more money, but they are asking for things that hospitals can do right now such as to allow nurses to speak their minds, have reasonable and fair assignments, pay more for higher acuity patients and, at the end of the day, leaving them to go home feeling like they have done a great day’s job, just to note a few.

    Nurses get to choose where they want to work.  Nurses are not slaves and should not be restricted from going to a competitor.  This is a free market and nurses can decide where they want to work and under what conditions they find acceptable.

    Click here if you would like your own personal copy of The Empowered Nurses’ Bill of Rights.

  9. Did You Get A 5.9% Raise in 2021?

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    It is no surprise that if you have been to a gas station lately, the price for a gallon of gasoline has skyrocketed.  Of course, you noticed that your groceries are also costing more.

    According to the Social Security Administration, they gave all its recipients (70 million people) a record breaking 5.9% increase.

    When I look at employment records for nurses, I noticed how small the raises were each year.  It is no wonder that nurses are leaving the profession!

    Regarding new tactics such as sign-on bonuses for new staff, why not pay more money to the existing loyal staff who have been there through it all?  They know the policies and procedures of the health care facilities.  It costs less to retain an experienced nurse than to hire a new nurse.

    The average orientation for a new nurse to the facility costs anywhere from $37,000 to $58,000.

    Every time a nurse leaves, it costs a facility more to train someone new.  Let’s get this money to the nurses we already have with us.  Treat them better!  And pay them more!

    If you have not received of raise of 5.9%, ask your coworkers and get together and share if their Social Security is getting raises for people who do not have other income, why shouldn’t the hospital raise your salary?

    I’d like to hear your comments below.

     

  10. Are You A Perfectionist?

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    Lorie Brown, Nurse Attorney, discusses why you can’t be a perfectionist and have a successful LNC Business. If you are interested in a one-on-one call with Lorie, please visit www.CallWithLNCMentor.com to schedule. If you are interested in one of Lorie’s LNC Retreats, please visit www.LNCRetreat.com.

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