- Email: [email protected]
Readers Discuss: the Business of Nursing
A
fter reading “Professional Sadness,” I experienced a plethora of thoughts and feelings, from sadness to anger, from frustration to encouragement. As a registered nurse for nearly 37 years, I know all too well the many changes we’ve faced in health care, regardless of the work setting. Changes in technology, payer systems, acuity of patients, culture, work force and the general pace of our lives have all colored, in some way, our dynamic and fluid health care work environment. However, despite these changes and environmental alterations, caring remains the core and essence of our nursing practice. My own belief is that, unfortunately, nurses and other members of the health care team have not kept pace with the “business” of caring. We have left that to management and administration, to “them.” Our schools prepare nurses poorly relative to the business aspect of health care. I had no information in my basic nursing education related to how monies are paid for health care services. My learning has been primarily through experience and, later, through formal education. However, nurses and caregivers can no longer focus exclusively on the “caring” side of nursing and ignore their role in a caring business and the direct impact that they have on the bottom line. The time is long past when caregivers can ignore the business aspect of care. Their excellence in practice, skill at developing relationships, efforts to work collaboratively as a member of a health care team, documentation of care provided to assist coders—all of these activities translate into business transactions for the hospital or health care providers. We are business agents for our organization and to deny that is to deny the business side of health care. Clinical excellence and superior care generates “customers,” as in physicians and patients. People want to practice in a superior clinical environment with excellent outcomes and exceptional staff. Physicians and health care providers want to bring patients to such an environment. Collaboration among caregivers yields excellent and improved outcomes. Working together to achieve these outcomes can result in shortened clinical stays and improved outcomes for the patients, which can result in improved satisfaction for the patient, family and the caregiving team. All of this affects the financial bottom line.
April | May 2007
How can you reduce human compassion and genuine care to some kind of monetary value?
Nurses are poorly served in a business model only when we insist on being recognized for how we feel, instead of what we do.
Nursing for Women’s Health
119
We, as nurses, must be the voice of caring woven into the business of health care.
Excellent relationships that evolve while nurses provide care foster loyalty and preference from the customer or patient, which can result in a lifelong relationship with a health care provider or institution. While Mr. Bingham “ . . . hoped never to see Michael’s parents again,” his clinical expertise and rapport with this family might influence a lifelong link to that health care organization. This is indeed a patient/nurse relationship, but it can also result in a lifelong organizational business relationship as well. Excellence in documentation translates into correct coding and billing for services that are provided, allowing for maximum reimbursement for care rendered. For nurses not to know how they impact an organization’s bottom line is simply beyond the realm of acceptability in this era of health care. Health care employees are all stakeholders in the financial success of their organization. We are called to be caregivers in the business of health care, in addition to understanding how that care is delivered and the role each of us plays in providing service and in the cost and quality of those services. It shouldn’t be us versus them: Us (nurses) doing the caring and them (business people) making business decisions affecting how the care
WE WANT
TO
is given. Basic nursing education must begin by providing students with a general business understanding of the very complex health care business environment. Orientation for new employees must help them see how their specific role can impact organizational success. Managers and administrators must share financial information and continually educate and reinforce employees’ roles in helping to achieve financial goals. Employees must own their role in this process and speak up, offering suggestions and ideas about better ways to provide care or cost saving ideas. The best ideas come from those closest to the patients! We, as providers of health care services to our community, must accept the fact that we are in this business of health care together. We must work collaboratively to achieve not only desired clinical outcomes, but also to work toward understanding and achieving organizational financial goals. We, as nurses, must be the voice of caring woven into the business of health care. We do make a difference and, indeed, we must make a difference. Susan Gehlsen, MA, BSN, RN, CNAA Ankeny, IA DOI: 10.1111/j.1751-486X.2007.00138.x
HEAR FR O M YOU !
Do you have an opinion about something you read in Nursing for Women’s Health? Then we want to hear from you! Send your letters to [email protected] and put “Letter to the Editor” in the subject line. Please include your full name, city and state, and a phone number where we can reach you should your letter be selected for publication. Letters are selected for publication at the discretion of the editor and may be edited for length and clarity.
120
Nursing for Women’s Health
Volume 11
Issue 2
fter reading “Professional Sadness,” I experienced a plethora of thoughts and feelings, from sadness to anger, from frustration to encouragement. As a registered nurse for nearly 37 years, I know all too well the many changes we’ve faced in health care, regardless of the work setting. Changes in technology, payer systems, acuity of patients, culture, work force and the general pace of our lives have all colored, in some way, our dynamic and fluid health care work environment. However, despite these changes and environmental alterations, caring remains the core and essence of our nursing practice. My own belief is that, unfortunately, nurses and other members of the health care team have not kept pace with the “business” of caring. We have left that to management and administration, to “them.” Our schools prepare nurses poorly relative to the business aspect of health care. I had no information in my basic nursing education related to how monies are paid for health care services. My learning has been primarily through experience and, later, through formal education. However, nurses and caregivers can no longer focus exclusively on the “caring” side of nursing and ignore their role in a caring business and the direct impact that they have on the bottom line. The time is long past when caregivers can ignore the business aspect of care. Their excellence in practice, skill at developing relationships, efforts to work collaboratively as a member of a health care team, documentation of care provided to assist coders—all of these activities translate into business transactions for the hospital or health care providers. We are business agents for our organization and to deny that is to deny the business side of health care. Clinical excellence and superior care generates “customers,” as in physicians and patients. People want to practice in a superior clinical environment with excellent outcomes and exceptional staff. Physicians and health care providers want to bring patients to such an environment. Collaboration among caregivers yields excellent and improved outcomes. Working together to achieve these outcomes can result in shortened clinical stays and improved outcomes for the patients, which can result in improved satisfaction for the patient, family and the caregiving team. All of this affects the financial bottom line.
April | May 2007
How can you reduce human compassion and genuine care to some kind of monetary value?
Nurses are poorly served in a business model only when we insist on being recognized for how we feel, instead of what we do.
Nursing for Women’s Health
119
We, as nurses, must be the voice of caring woven into the business of health care.
Excellent relationships that evolve while nurses provide care foster loyalty and preference from the customer or patient, which can result in a lifelong relationship with a health care provider or institution. While Mr. Bingham “ . . . hoped never to see Michael’s parents again,” his clinical expertise and rapport with this family might influence a lifelong link to that health care organization. This is indeed a patient/nurse relationship, but it can also result in a lifelong organizational business relationship as well. Excellence in documentation translates into correct coding and billing for services that are provided, allowing for maximum reimbursement for care rendered. For nurses not to know how they impact an organization’s bottom line is simply beyond the realm of acceptability in this era of health care. Health care employees are all stakeholders in the financial success of their organization. We are called to be caregivers in the business of health care, in addition to understanding how that care is delivered and the role each of us plays in providing service and in the cost and quality of those services. It shouldn’t be us versus them: Us (nurses) doing the caring and them (business people) making business decisions affecting how the care
WE WANT
TO
is given. Basic nursing education must begin by providing students with a general business understanding of the very complex health care business environment. Orientation for new employees must help them see how their specific role can impact organizational success. Managers and administrators must share financial information and continually educate and reinforce employees’ roles in helping to achieve financial goals. Employees must own their role in this process and speak up, offering suggestions and ideas about better ways to provide care or cost saving ideas. The best ideas come from those closest to the patients! We, as providers of health care services to our community, must accept the fact that we are in this business of health care together. We must work collaboratively to achieve not only desired clinical outcomes, but also to work toward understanding and achieving organizational financial goals. We, as nurses, must be the voice of caring woven into the business of health care. We do make a difference and, indeed, we must make a difference. Susan Gehlsen, MA, BSN, RN, CNAA Ankeny, IA DOI: 10.1111/j.1751-486X.2007.00138.x
HEAR FR O M YOU !
Do you have an opinion about something you read in Nursing for Women’s Health? Then we want to hear from you! Send your letters to [email protected] and put “Letter to the Editor” in the subject line. Please include your full name, city and state, and a phone number where we can reach you should your letter be selected for publication. Letters are selected for publication at the discretion of the editor and may be edited for length and clarity.
120
Nursing for Women’s Health
Volume 11
Issue 2