Replying to a message of Roy Witt to Bob Ackley:

 BA>> Historically, physicians have *not* been employees of a
 BA>> hospital. They have always billed separately.  That
 BA>> situation, however, is changing as younger physicians now
 BA>> have no problem with being ordinary wage slaves working
 BA>> for somebody else - in point of fact,

 RW> I've been in the hospital twice in the last two months and
 RW> that isn't the case here. Even my nurse charged seperately.

It may be that nurses work for an agency rather than the hospital, and
the agency agrees to supply the nurse required staffing.  When I worked
in an Omaha hospital, the hospital had a core of nurse employees and
contracted with local agencies if they needed more; AFAIK the patients
weren't billed separately by the agencies.

That arrangement can cause staffing problems, though.  In order to keep
busy many nurses work for multiple agencies and may not be available
if they're already on a job for another agency.  The use of 'float' nurses
is to reduce staffing costs, as they don't have to be paid when they're
not working and they don't receive employee benefits.  When the patient
census is down this is a good thing, because the hospital doesn't have to
lay anyone off; unfortunately if the census suddenly spikes the hospital
has to scramble to get the help it needs.

Shortly before I left Bergan Mercy there was a short squib in the employee
newsletter thanking a couple of dozen Bergan nurses for volunteering to
work overtime one weekend at Immanuel Hospital (Immanuel was in the
process of taking over Bergan Mercy).  Seems that Immanuel was 24 nurses
short that weekend, and there hadn't been a catastrophe or epidemic; somebody
had screwed up royally WRT nurse staffing that weekend.  When I pointed out
that apparent screwup I was told I had an attitude problem.

If you recall several years ago when that DC-10 crash landed up in Sioux City,
IA; the administrator at Bergan called the administrator of the Catholic hospital
in Sioux City and asked him if he needed help.  Answer was yes, Bergan sent
a busload of staff nurses to Sioux City to help out, and they stayed there about
ten days; all paid for by Bergan, including overtime.  That wouldn't happen today
because hospitals don't have the funds available to do that sort of thing (plus the
idea wouldn't occur to Alegent management, Alegent is the name of the outfit
that took over Bergan Mercy and they have a monomaniacal fixation of cutting
costs, as I noted to the former head of Bergan Mercy: someday that cost
cutting is going to kill somebody - if it hasn't already).

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