Speaking out can cost you your job and more...

The issues that nurses face are certainly more serious in reality than they are depicted in cartoons but images also get a message across to the public that might draw their attention to the work place.  Nurses are facing more challenges as the hospital systems merge.  I have written before about the problems that arise such as poor communication.  National Nurses United covers some of the controversy that nurses cannot escape if they are truly invested in patient care.  Tim Thomas is one such nurse who worked for 30 years and spoke out about barriers to patients receiving the quality of care that he saw diminishing due to higher costs and a culture that exposed patients to being confronted with payment at the time of admission - cash, check or credit card, causing families to become bankrupt.  The discussion with the interviewer included the question of why the hospital was charging more in a rural area and the answer was obvious but none the less enlightening because it adds to a movement of more informed decisions for nurses and patients to make important choices - the charges aren't congruent with other urban systems and where they don't have to compete they can charge what they like.  I would like to see how Medicare and Medicare respond to this dilemma for patients and nurses because not all patients will have the resources to cover payments out of pocket for the difference between coverage and their charges.
THIS IS RETALIATION - nurses are intelligent people and should be listened to especially during mergers.  I think the profession has been undervalued and there is an attitude from the corporate stakeholders that they can always get a 'replacement nurse.'  The approach to patient care must be holistic and not dominated by business models.  Nurses have expert skills in the areas of interpersonal communication, leadership - team building and collaboration.  They like to be included and become engaged as invested stakeholders.  I believe that hospital systems are the losers in the battle for dominance over patient care that is rooted in costs at the expense of quality patient care as Tim Thomas shared in his interview.
I hope nurses join organizations and help build communication links with other nurses to make their voices heard.  If you think that by remaining quiet the problem will go away I believe you are mistaken.  Be supportive of nurses who face challenges.

When it comes to money - money is important!  My very best wishes are with you as your look to starting your own business and succeed in business.  BON investigations can be lengthy and there may be restrictions on your license.  I recommend that you focus on personal development and earning money as quickly as possible.

Warm Wishes, Rita.