Vanderbilt Hospital In Nashville Has Nurses Doing Housekeeping

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NASHVILLE, TN (WSMV) –

Vanderbilt University Medical Center’s latest budget moves mean nurses will be responsible for a lot more than patient care.>

The Channel 4 I-Team has learned some Vanderbilt nurses will now be in charge of cleaning patients’ rooms, even bathrooms.

Sanitized environments in hospitals are critical to a patient’s health, but the new cost cutting measure has at least one nurse concerned.

“Cleaning the room after the case, including pulling your trash and mopping the floor, are all infection-prevention strategies. And it’s all nursing, and it’s all surgical tech. You may not believe that, but even Florence Nightingale knew that was true,” said a hospital administrator to staff in a video obtained by the Channel 4 I-Team.

The new cleaning changes were also detailed in an email sent to staff of the Vanderbilt Medical Center East team, which – according to a hospital employee – works in surgery areas and patient rooms.

A manager writes in the email, “We have undergone some major budgetary changes … this means we will need to pull together like never before.”

The email says nurses will now have to pull their own trash and linens, sweep up and spot mop. Nurses, care partners and nursing assistants will be responsible for all patient care areas.

“The priority will be what the patient sees,” the email states.

Also, in bold highlighted text, the email says, “Be sure to wear the appropriate [personal protective equipment] when doing any disinfecting – that includes, a cover up gown, gloves, mask and even an eye shield when necessary.”

Nurses were also told to “refrain from speaking negatively about this in an open forum where our customer can hear. If you need to vent come see me.”

The hospital employee did not want to be identified for fear of losing her job but wanted the public to be aware of the changes.

“This is our new reality. The work still must be done. We must still care for patients, and we must do so in an efficient manner,” the hospital administrator told staff in the video obtained by the Channel 4 I-Team.

The nurse to whom we spoke says before these changes, the hospital’s environmental services department was in charge of cleaning those patient areas and that staff does not have interaction with patients.

The nurse is concerned that doing both cleaning and patient care could lead to cross contamination.

The email obtained by the Channel 4 I-Team does say environmental services will still be handling some cleaning.

In a statement, Assistant Vice Chancellor John Howser, said:

“The safety of our patients is always of foremost concern. All decisions about operational process redesign at the Medical Center are being made in a patient-centric manner and will not affect the safety of patient care.”

The Tennessee Department of Health says it does not specify how a hospital chooses to clean, as long as the employees are appropriately trained and follow CDC guidelines.

If they do that, the state says there should not be any increased risk of infection.

We checked with Lipscomb’s nursing staff. The executive associate dean of nursing, who has been a nurse for 25 years, says she hasn’t heard of a hospital doing this before.

Copyright 2013 WSMV (Meredith Corporation). All rights reserved.

This really bothers me. As nurses, we already have hundreds of responsibilities, and I believe Vanderbilt’s choice to have nurses clean toilets and mop floors may lead to cross contamination as well as an increase in patient falls and medical errors. I am certain they are not going to decrease the nurse:patient ratio in order to make this change easier on the nurses. Vanderbilt is looking for ways to slash jobs, so they are getting rid of EVS because they can only legally get rid of so many nurses.

Especially insulting is the implication that Florence Nightingale would have wanted nurses to return to doing housekeeping in the hospital. Nightingale wanted nursing to move forward, not backward.

Please help me get this out on social media! Retweet, reblog. Post it on Facebook. Don’t let Vanderbilt harm patients and nurses this way! Use the #Vanderbilt hashtag.

About Grimalkin, RN

Trying really hard to be a decent person. Registered Nurse. Intersectional Feminism. Poet. Cat. Political. Original recipes. Original Stories. Occasionally Questionable Judgement. Creator of #cookingwithjoanne and #stopcock. Soulless Unwashed Carrot. This blog is dedicated to my grandmother, my beloved cat Grimalkin, and my patients.

Posted on September 16, 2013, in Nursing and tagged , , , . Bookmark the permalink. 185 Comments.

  1. Carissa Jenkins

    Really? Do you think you’re “above” cleaning a room? It’s all part of ensuring safe patient care. I work in a physician owned surgery center in Cincinnati. All the staff – nurses, surgical technicians, surgical assistants, and physician assistants – all contribute to caring for our patients. And that includes cleaning, mopping, and “turning over” the operating rooms.

    • Have you ever worked on a busy med surg floor?! Nurses have hardly enough time to pee let alone clean a patient room…

    • A surgery center is quite different to a hospital room, which are occupied for days/weeks at a time, or turned around every day or so. Also, when was the last time you had up to seven other patients relying on you for their total care while you are mopping floors and cleaning toilets. Don’t even try to compare.

    • I notice you did not say physicians… So apparently someone is “above” cleaning.

      – a future doctor, who hates hearing people act like this.

    • It’s not about being “above” doing this. I have always, on occasion grabbed a mop or cleaned a bathroom if EVS was not available and it was needed for safety. We are talking about nurses with 6-8 patients, total care, no CNAs, who don’t get to eat or drink for a 12 you shift, who are constantly bombarded with additional paperwork in the name of “patient safety”, constantly under scrutiny for errors (caused by exhaustion and not enough staff), constantly hammered over patient satisfaction scores, who now have been handed the additional (and INSANELY important) job of ensuring that rooms are cleaned to rigorous standards.

      How would you feel if you had to wait 30 minutes or longer for pain medications because your nurse was in the middle of a terminal clean? Really?

    • Ya but you don’t have multiple patients. Just prepping the OR for another patient is different than working on a busy medsurg floor where nurses have MANY patients or an ICU where nurses have sick and incubated patients.

    • Shirley divens

      I have been a RN for 29 years and in the OR is so different than caring for 2-4 critical care pt with many orders to be done titrating life saving drips trust me this is not a good practice for any hospital to adopt

  2. It most certainly less to errors and before slashing jobs like cleaning why don’t you take a look at upper administration positions before slashing jobs at lower level see how much they are getting paid. You most likely find upper admin positions in hospitals get paid way too much. Slash the pay for the fat cat jobs. I know I won’t be visiting Vanderbilt hospital for any of my health needs!

  3. Are you kidding? Did you go to school for 4 years to get a BSN so you could mop floors? I bet the doctor you work for is laughing all the way to the bank. He gets to put more money in his pocket since he doesn’t have to hire janitors. Do you wash his clothes, cook for him and bring him his coffee? Way to take us back 100 years.

  4. THIS IS THE MOST OUTRAGEOUS , DELETERIOUS, IGNORANT Hospital administration decision I have seen over the 50 years that I’ve been an RN!!!!!!!! I mistakenly thought that I had SEEN IT ALL!!! The public needs to be aware of how dangerous this will be to the patient!

    I’m not concerned about the cross contamination issue…we, as nurse’s, have always jumped in and helped clean beds to expedite the admission of a patient that has been sitting in the ER for MANY hours, waiting for an empty bed to become available. Working in busy ER’s, I can’t tell you how many times I’ve mopped up blood, urine and vomit. Cleaning a room and gurney immediately, when a patient was discharged, and the housekeepers were cleaning other rooms, was routine, so that patients sitting in the waiting rooms FOR HOURS, could be brought in as soon as possible, I have even had ER SUPERVISORS hauling trash, mopping floors, cleaning rooms when were slammed. I’ve never had the misfortune of working with nurse’s, who were “too good” to pitch in, when the situation called for some extra help! AND believe me, we appreciate the hard work, and under pay of the house keeping staff. Yes, nurse’s are fully aware of preventative measures to prevent cross contamination!

    Implying that Florence Nightingale would applaud nursing responsibilities to include all house keeping duties is ignorant and deplorable!! Florence, in her wildest dreams, could NEVER conceive the advancements that have been made in the medical world over the last 50 years! I watched it unfold, and I CAN’T BELIEVE IT!!

    Besides keeping the patient room “tidy”…the nurse of today is the front line “safety net” for the patient!
    They are the first to pick up on SUBTLE changes, and ACT before it becomes a dangerous and life threatening crisis for a patient! During the 12 hour shift the “routine” responsibilities include; medications to be administered…..many of the medications used to be administered BY PHYSICIANS ONLY! You not only give the medications, but you also have to monitor the response…. and of course, there are protocols in place to cover untoward responses, (more medications to administer), many times the potent medications are in the form of IV drips, that require constant observation, frequent patient assessments, heart monitors, IV pumps, ventilators, vital signs, urine output, and LOOKING AT THE PATIENT!! (Sometimes, these marvelous machines don’t tell the whole story)… Basically, the sicker the patient, the more monitors you have to keep an eye on CONSTANTLY! And then there are patient’s that are not on monitors, that can suddenly crash…..You have got to have the time (and adequate staff) to provide a SAFE level of observation and intervention. There are also lab results, radiology reports, doctors orders: Multiple information sources to review that are critical in providing care. We can’t forget the time needed to interact with the patient and the patient’s family,,,,,,, you NEVER have “a patient”….. the family is part of that patient! They need “nurses time and caring” too.

    I’ve only scratched the surface, so far. There aren’t many jobs I can think of that can be as physically and emotionally draining,,,,,,, and NURSING IS HARD WORK!!!! More times than not, the average nurse doesn’t get a break, or lunch…and many times if they do get lunch..they are charting while they are scarfing down their food. We train our bladders to be emptied every 12 hours! TOO FREQUENTLY, you don’t have time to pee!

    Oh yeah, I won’t even get into the charting!!! You wouldn’t believe how time consuming it is to get all of the “required” charting completed, on cumbersome computer programs, a lot of redundant items….

    I LOVED nursing! I retired 2 years ago…after 48 years…it’s hard work, but challenging and rewarding!
    I can not image the outcome of adding mopping and cleaning bathrooms and “all house keeping” to the nurse’s already over burdened load! The added stress that a patient may crash while I’m cleaning a bathroom!! Excuse me, I just said “bathroom” as if I only had one patient and one bathroom to worry about!!

    Nurse’s need to unite on this issue. The public needs to be made aware of the potential dangerous consequences, and support the nurse’s efforts to stop this deplorable action!! SPREAD THE WORD!!!

  5. Look , the point is to provide good SAFE care. Nurses long ago didn’t have the responsibilities or as complex tasks we have now. Its not that anyone is too good to do a task- its who has the main responsibility for the task at hand. Housekeeping is an integral part of the health care team! They have a very big responsibility in a hospital. Just cleaning” what the public can
    see” should be a very big red flag!!! Its what you can’t see that is most likely to cause harm. Does this hospital want all of their best nurses to leave? Who is going to give the expert nursing care? The hospital won’t get accredited and they will lose Medicare funding. All to save a housekeepers salary? How do the Physicians feel about this move? next time they are looking for the nurse when a patient of theirs hasn’t had good wound care- or the IV ABX or is de-compensating – the nurse may say” well I was cleaning this toilet getting ready for my new admission” ” I didn’t hear the alarm or the call light”.. Guess who will get blamed? The Nurse. Never the Administration who has never had to do one lick of hard work on the floor a day in their life. Perhaps the housekeeping duties could be added to their daily tasks. That way the Nurses could get on with what really matters- patient care!

  6. I am a nurse practitioner after working for several years through school-CNA-LPN-ADN-BSN-MSN. I have done everything for the care of my patients and it is not “below me” to assist with toileting, clean up a spill, etc; however, this is ridiculous!!!! We are already overloaded with computer charting and the demands of nursing. I for one do not want a nurse that just cleaned a toilet to come and insert an IV, hang my meds, etc. Seems to me it has all become part of the almighty dollar corporate greed-do more with less at the expense of risking the patient’s health!

    • Amen! I clean my bathrooms at home then I go jump in the shower and scrub! Are they going to provide showers & time for us to do that? Don’t think so.

  7. Nurses are not “above” cleaning. What do you think we do for most of our shift? We bathe and clean patients and the messes they make all the time. But pulling a nurse away from patient care to clean a room is ridiculous. This is not going to help their patient satisfaction scores at all. In order to not cross contaminate, nurses will need to use proper PPE. So if a patient requires their nurse while they are cleaning a room, they will have to pull everything off and run. I am an ER nurse, and we clean our own rooms all the time. But when it comes to isolation rooms and bathrooms, evs takes care of that. The way nursing is going is scary. My hospital system just cut 60% of night shift differential to help with their money spending problems. So to all you nurses out there that work for a hospital, C.Y.A., go back to school so you aren’t stuck on a floor somewhere doing three different peoples jobs!

  8. You know would be a great idea? panic the entire community with outrageous comments and complaining, so that no one comes to the hospital, and it closes, and no one has a job.. Awesome keep up the good work!

    • What a ridiculous comment. I doubt that Vanderbilt hospital will be an empty institution. If there are budget issues, maybe someone needs to take a pay cut or the big boys need to come clean some toilets.

      • What I think is funny is that the health care industry keeps talking about being financially strapped….but then they turn around and build hundred million dollar new facilities with all the comforts of a convention center.

        How about skipping the convention center, and just focusing on keeping adequate staff to take care of the facility they already have?

    • You ignorant twit. Yes, people will just wait until their heart attack subsides at home and fix it at home with the help of google. Dipsh*t.

  9. So, James, are you saying that nurses should NEVER discuss bad policy among themselves, for fear some nonnurses might be frightened into avoiding hospitals altogether?

    Sorry, but that’s emotional blackmail, and totally false. Today’s nurses are held accountable for many things that are beyond their control, but I refuse to allow you or anyone else to hold me accountable for any hospital’s financial failures, simply for telling the truth.

  10. The goal is to get a policy change! Nurses need to unite, get the facts out to the public. A little public pressure will go a long way in solving the problem.

    • Unfortunately hospitals are bracing for ACA implementation. I don’t think that nurses realize how much this is going to impact our profession & not necessarily in a good way. Hospitals are going to have to cut cost and corners. The first to be laid off will be nonessential staff. So who do you think will pull the slack? This is beyond nursing. This is revamping of the healthcare. This is what we voted for as a nation….Obamacare…because it will make everything so much better lol. Welcome to our new reality. Glad I got my NP.

      • With all due respect, Lynn, why would you assume that health care reform is going to make hospitals worse? Before reform, fully 1/6 of the U.S. population had NO health insurance at all. Those people don’t magically stay well, just because they can’t afford health care. They show up in the ER, often with big problems resulting from little problems that didn’t get treated when they first showed up. And people with big medical problems tend to get admitted, sometimes for long stays.

        Now, when someone with no insurance and no money ends up with a $50,000 bill, what do you think happens? Some pay on it for years. Others get their bill reduced or written off. Still others, who already have bad credit and feel they have nothing to lose, simply stiff the hospital.

        Please explain why you feel that’s going to enhance the hospital’s Bottom Line more effectively than making sure that most (if not all) patients have insurance.

  11. I just worked a 14 hr shift on a med surg floor with no breaks or a lunch break. I opened and closed my charts on the patients that I discharged at the end of my shift and finished the ones on the other patients.. We did not have an assistant and was a nurse short and we do not have unit clerks. I started with a team of six patients, two that was very high acuity. I discharged three, admitted two direct admits and had two surgeries and transferred one to icu. There was no way I could possibly clean a room when I couldn’t even get my meds out on time or give any baths or make a bed. This is a typical day now for the last six months due to the new staffing. I have been a nurse for over 20yrs and have never worked in such dangerous settings as I have in the last six months and I fear for the patients. The nurses have voiced there concerns. Patients are placed on floors where they are not getting the care they should. A fresh stroke patient on a pediatric floor for example because they also take medical adults but have never had stroke patients…they take asthma, pancreatitis etc. Nurses don’t think they are too good but these duties that keep getting pushed on us are not what would be nursing duties… it takes away from patient care that we went to school to educated on to deliver safe patient care. In our hospital they preach patient safety but will follow through only if it doesn’t cost them money

    • I Agree! I have worked in several Hospitals. Pts. are not getting the care they are paying for.Why? because we are understaffed. And managers want you out on time. A Pt. can crash when least expected. A code blue can set you way back. Some Pts. want pain meds right now. Drs orders stacked up. Pts familys calling you to the phone.IV pumps beeping. Charting on all Pts. Sometimes I would have 8-10 pts on med surg.

  12. The hospital I worked for in the early 90’s tried this when the fear of DRG’s hit. We were in a very busy L&D and we refused to go from cleaning up on person delivery and then go take care of another pt’s new baby. It didn’t last to long.

  13. During my very busy 12 to 16hr shift I often go without breaks, and lunch is sometimes soda and a cookie. I could not do this to my patients. I could not deny them care so that I could clean a room. What the article doesn’t mention is daily care; who cleans the patients room while they are there? What let me hook you up to this IV while I clean your toilet?

    • And, if and when the hospital’s rate of nosocomial infections goes up (and treatment for those infections isn’t reimbursed by insurance or Medicare), who do you suppose they’ll turn around and blame?

  14. The Institute of Medicine’s 2008 report, “The Future of Nursing: Leading Change, Advancing Health,” recommended that “nurses should practice to the full extent of their education and training.
    Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States.”
    While cleaning isn’t “beneath” a nurse, it is not a logical use of that highly-trained person’s time and will compromise patient care.

    • In the ER, we’re expected to strip beds, drain and remove IV bags and tubing, remove any equipment (used suturing supplies, etc.) and dispose of specimens to help out.

      I have no problem at all with this (although, when it’s really busy, we really need to be focusing on patients, not cleaning up after they leave), or with wiping up spills, etc., for the safety and comfort of the patient. But I do have a problem with making housecleaning the nurse’s job and responsibility. For one thing, nurses have too many distractions and interruptions to be able to do the job properly; and, for another, it will inevitably cut into their already limited time still further.

      And, yes, I realize that Florence Nightingale wasn’t above scrubbing floors and cleaning bedding. She wasn’t above laying fires, either, but I don’t think that’s the wisest use of a nurse’s time. And I think, if Florence Nightingale had had to do all the jobs that modern nurses do—starting IVs, hanging drips, doing EKGs and collecting lab specimens and giving telephone report and documenting size and character of wounds and inserting catheters and checking for MRSA and filling out consent forms and explaining care plans to families and fetching drinks and blankets and pillows and giving medications—she would have agreed.

      If cutting staff is such an issue, how about if upper management models the desired behavior by cleaning rooms during their own lunch breaks? They can carry portable phones, and do their executive work while cleaning out those toilets and wiping down those mattresses.

  15. let us remember that Ms Nightingale was not even allowed to take a blood pressure….she made broth, bandaged and held hands…..we titrate medication, start ivs, monitor heart rhythms and breathing…….and are hard pressed to keep up with all the necessary things much less clean patient rooms…and i wonder how the family will feel seeing the person responsible for their wound care wielding a toilet brush?????

  16. I’ve worked in American hospitals in the past and have experienced changes to cost cutting, but never in my 25 years have I ever seen changes of this magnitude.

    Wow, I can’t believe this is happening! This is a blatant devolution of nursing care and the leadership at Vanderbilt should be ashamed of themselves. The nursing leadership at Vanderbilt needs to grow a backbone, as I find it hard to believe that another nurse of any kind would condone these changes. The nursing staff need to stick together and fight these changes – use your training. Present to the leadership a strong case on how this change will be detrimental to the hospital and patient care. Research has shown that HAI’s are vastly as a result of cross contamination. I don’t believe the hospital has done it’s homework well enough, and at the end of the day the cost of HAI’s, lawsuits, injuries etc. is going to far outweigh the savings. Maybe they need to get used to lower profit margins. I thank my lucky stars that I don’t have to worry about these things working in a Canadian hospital.

  17. I understand budget cuts. Why don’t you have Vanderbilt executives & chancellor step up & clean those rooms!

    • Here is a direct quote from Vanderbilt’s CEO, Jeff Balser:
      “If we go through a process where we figure out that we can actually deliver the same care, the same research, the same education, or even better, with fewer people,,,,how the individual feels about that having happened is different than if that was irrational.”

      Clueless.

  18. Seriously???? Inefficient and ineffective use of skills and training of nursing staff, never mind the cost effectiveness and possibilities for infection control dangers. Patients will see the jeopardizing of their care and safety in favor of the almighty dollar.
    It never fails to amaze and trouble me that those handling company/organization finances consistently feel that eliminating positions at the bottom of the employee structure, the actual “feet-on-the-ground” workers and professionals is not always the answer to providing more cost effective services?? Would it ever occur to management decision makers that a cut in either their hierarchy wages or numbers would effect the savings needed to retain the people and positions now being eliminated? The added bonus would be in not destroying the morale of the staff.
    Vanderbilt should be prepared for an exodus of their “valued” nursing staff.

    A follow-up, post implementation story would be of interest.

    • My prediction is that there will be such an uproar that administration will be forced to backpedal. They’ll make some public statement like, “we never meant anyone to interpret this directive as meaning that nurses were going to take over the cleaning staff’s job,” and follow it up with a song and dance about how very much they respect the professionalism of their nurses.

      Whether or not they’ll continue with their plan or abandon it at that point, will depend on whether or not they think they can get away with it.

  19. My grandmother graduated nursing school in 1925, and they had to do it all; dietary, cleaning, pt care, the works. It’s just going round full circle. I thought it might come to this, 20 years ago….want a nursing job? Be prepared to work harder than you already do….ps, when I was in midwifery school, we had to do our own stocking, cleaning, as well as client care…it’s exhausting. But it had to be done, so we did it…

  20. I may never be a patient at Vanderbilt, but if this really happens I wouldn’t want to be a patient or a family member of a patient. It will probably be very difficult to get a response to a call for a nurse when they have added responsibilities. When my Mom was alive and in the hospital, we had to wait quite awhile for the nurse when we called, which I suspect was because they are already overworked. This seems like a very poor decision.

  21. Nurses need to close the place down! I’ll bet the administrator’s salary would cover the cost of the whole janitorial staff!

  22. It’s time these nurses organize and demand to be treated as the highly trained medical professionals they are. If your facility is owned by a for profit company whose allegiance is primarily to the stock holders, it is a conflict of interest. They are ony hurting the backbone of your institution and putting patients, their own family and friends, at risk because of greed. We organized at St. Louis University Hospital this past year and things are getting better. We were tired of ever increasing demands and staff shortages. We were doing the jobs of at least two nurses, secretaries, care partners, transporters, etc., and they were still expecting more. It is time we all take the lead from our fellow nurses in California and across the nation and organize with the NNU to put a stop to this minimalizing and degrading of our noble profession. Staffing ratios, better pay, and the respect we deserve can be acheived as evidenced across the country. Contact the National Nurses Organizing Commitee / National Nurses United at http://www.nnoc.net. You have the power when you bargain collectively.

    • While I don’t agree with Vanderbilt’s decision, this is where healthcare in our nation is going–doing more with less. Organizing and unions is not the answer either if you would like to have a say so; unions take that from you when they become your voice.

      • And what is the answer, if it is not unions?

      • Tammy, if I had to choose between a union speaking for me and administration forcibly silencing me while creating policies that had the potential to harm both nurse and patient, I’d choose the former every time.

      • Yes- I would definitely trust the Union over hospital administration. No brainier!

  23. This is crazy. Im a Nurse Tech and a Medication tech. Our jobs are to do total patient care between that and all the charting when are we supposed to clean toilets? Thats not right. Plus who only has 6 to 8 patients to take care of? I have alot more than that!!

  24. At my hospital, I am typically assigned 9 (yes you read that correctly) patients a shift. Between passing meds, doing assessments, charting in the 15 different places, helping with baths and feeding, and dressing of patients, I’m lucky if I sit down all day much less eat or use the bathroom. There is no way I would have any time at all to clean especially properly a patients room. I’m lucky if my patients actually get their pills on time. We complain frequently about how unsafe it is to have 9 patients each but nothing ever changes.
    This is ridiculous and definitely not good for good safe patient care.

  25. I totally agree that nurses have enough to do with patient care. They do not need to be cleaning rooms. Having said that, it doesn’t mean they cannot do it if available. I worked 16+ years in the OR. I cleaned rooms to help turnover cases anytime I could. If I had time I always helped, but if I needed to get my room ready ( counting sponges, instruments etc. ) to be ready to go I did whatever it could. My first responsibility was to my patient. It is not beneath me to clean a room but I am also to take care of patients first. It takes a team!
    .

  26. I wonder if this change would happen in a more male dominated field? I highly doubt it.

  27. Excuse me its not about being above a maid. Its about not having enough time to give a awesome sponge bath or the extra attention your patient needs. There are time limits and restraints constantly being put on us. Whos monitoring my patients on ventilators when I am gowned up mopping the floor. Nurses should not be doing this and the nurses at this hopsital need to stand up and enough is enough.

  28. This is really unbelievable. In one fail swoop Vanderbilt has pushed nursing back 100 years. Let’s keep nurses at the bedside critically thinking and intervening in care and not mopping the empty room next door.

  29. You people are only thinking of your hospital to cut cost….. But that is not thinking of the Nurses, they have a lot to take care of the patients, not cleaning……. You better think about this a lot . It is not the nurse respobelity so quit thinking of all the big bucks cause you get staff infection in one patient you guys could get in big trouble, so stop cutting jobs get real…..,

  30. It’s not about being too good to clean the room. It’s about the almighty dollar.

    Pencil pushers say slash the budget, lose EVS let the nurse be in charge of making sure it’s clean, for the next patient. What they neglect to say is that nurse is getting paid more than the EVS personnel and while she/he is cleaning the room she’s not doing the job she/he is educated to do, which is assess the patient and implement a plan of care.

    Vanderbilt will not hire more nurses to replace the EVS staff, it will be another task for the staff nurse to complete.

    Then look at your turn over time. turn over time for the surgical suit is going to escalate, then someone will complain about that not meeting the productivity goals.

    The amount of money it will take to hire and train new employees to replace the ones you will lose ( the EVS employees and the nurses who resign), what is it now $80,000 to hire and complete the orientation process per each new employee.

    Hello, let the nurses be nurses.

  31. Oh my heavens!!! This goes way beyond crazy!! I can’t imagine working under these conditions! A mass exodus of nurses would take care of this moronic decision. I have never been in favor of unions, but this is one time that a nurse’s union would be a good thing. A strike of the nursing staff would quickly resolve this issue! Vanderbilt must really be in bad shape. Not sure I would like to be a patient in a hospital like that!!

  32. I agree with some cleaning. Like changing linens and taking them out of rooms, wiping equipment down and counters. But to have to sanitize a whole patient room and bathroom seems extreme. That would include scrubbing toilets, and scrubbing floors….that would interfere with patient care, also patient turn over rate. Think about discharging a patient, all the paper work, getting them out, then scrubbing their room top to bottom while taking care of 3+ other patients. Or let’s say ur scrubbing a room down, but ur call light for another patient goes off? Now you gotta stop take off all the PPE and go attend to that patient after scrubbing a toilet. Or what if u r stuck in other patient row doing actual nursing care and the room sits dirty after discharge. While the nurse was attending to patients a janitor could have already cleaned the room and had it ready for a new admission from the ER. I am not saying I am above basic cleaning and maintenance of a unit, but my 1st priority should be patient care and for a hospital to say that having nurses now completely sanitize rooms won’t interfere with patients or care is ignorance. Hey don’t be mad if it takes your nurses longer to answer your call bell, or she is late on meds, discharging you, helping u to the bathroom, taking you to a procedure, doing woundcare, etc. the hospital was cutting costs so now your nurse is also a janitor. This is offensive to nurses too, we go to college and earn degrees….how come other staff aren’t being asked to scrub toilets and help? we need janitors and their work is essential. Are all these nurses getting a pay raise for the added responsibility? I mean janitors were getting paid to do the jobs, so shouldn’t these nurses get a couple more bucks an hour to now do the job someone else got paid to do? Are the nurse patient ratios going to change to help allot time for this added task that needs to be done correctly and sanitary? Probably not and that isn’t fair to nurses or patients in that hospital. Also this has nothing to do with patient care, sanitizing rooms has to do with hospital maintenance and that is not a part of a nurses job description just like it wouldn’t be for a doctor, child life specialist, or hospital nutritionist, etc. Like I said I get wiping down equipment, changing linens and taking them out of rooms, wiping counters….not scrubbing a rooms top to bottom, floors, showers, tubs, and toilets.

  33. Labor and Delivery Nurses have been doing this for years at the hospital I work. The only time we are allowed to call housekeeping is if it is a “STAT” we don’t like it, but I suppose it’s job security!

  34. Another ridiculous ‘fat cat idiot’ decision and by the way, I am not a nurse. Sounds like Vanderbilt needs an overhaul ‘at the top’ just like our government. Too many of these morons making decisions who don’t have a clue what’s going on in the real world.

  35. This to me (especially being from that area) is extremely disturbing and depressing. I am a travel RN and go all over the US trust me the cuts are being made everywhere and placing every duty on nursing, secretary, telemetry monitoring, CNA work ect. All the while not decreasing patient ratio. Most nurses came into this job with a goal to help the sick, we already are counselors, mediators, advocates, teachers, babysitters and disciplinarians on top of our actual nursing job requirements of stabilizing patients, obtaining consents, translating, passing medications, helping the Techs, calling Drs, taking orders, performing procedures, signing and witnessing documents, hanging blood, titrating medications, chart checking, rounding and soooo much more. How in the world ANY hospital can speak on behalf of keeping Patients safety or the needed amount of time to perform all of these listed and more is insane to me. On average nurses will have 3-8 patients a night. How does adding more work on the nurse help the patient? As it is we are rushed as hell often unable to barely know our PTs. We are juggling everything and failing everyday to make patient care priority! It’s amazing how little the general public knows about what we go through in just one shift much less time to even chart and cover ourselves legally by documenting in case of law suit. I myself have been to Africa as an RN where 1000’s of people were there to treat and it was fine because we weren’t rushed to “chart every detail”. I was in heaven there I could do my real job of nursing and truly be a part of my patients recovery. Now we are told to be the tech, secretary and apparently housekeeper when in the meantime being told “not to stay late to chart ect because that’s overtime. Really?

    On any given day or night you may have a patient code or have rapid response, have to call Drs. in middle of night only instead of being thanked for catching mistake or caring for your patient you are yelled at because the Dr on call got woken up!! Last night for example I had 4patients one on multiple drips, one pooping themselves non stop, one crazy that keeps being non compliant and is now belligerent and attacking you because of withdrawal or lack there of, code patient and have a team of nurses that are too overworked and bitter or lack of time causing decline in teamwork. Last night I was punched, spit on, peed on and cussed like a dog! But wait let’s add housekeeping to the nurses already unbearable responsibilities.
    Every patient thinks they are the only one or most important as they should to an extent. However, your RN is truly the “only one” and has multiple challenges and factors to consider. For example I have literally been doing CPR on a PTs during a code blue all of us struggling to save this one life when the person in the bed next to them is screaming over and over how “they have to pee and dammit someone better take them right now!” Even though they can see us shocking and pounding on someone’s chest. My point is RNs face challenges of their own tolerance everyday, they learn to prioritize, to multi task but also to become what we call in nurse world as “drowning” where we haven’t stopped running, we ourselves haven’t peed (and honestly don’t have to because we haven’t had time to take a drink yet are scolded for even daring to keep a sealed water or drink on the floor to sip on), we haven’t even thought of food though our stomachs are growling, only to be yelled at,spit at, punched and often worse by demented PTs that should have a sitter but don’t.
    We are the go between between patient, families, pharmacies, Drs, rehab, physical therapy, respiratory therapy ect and it’s honestly contrary to most thinking not that much $$! However we still do it as we love it!

    Yet hearing this makes me cringe and instantly feel anger. I work 12-16 hr nights only to what now add an hour or so to that to clean a damn toilet are you insane!!!

    I have to add in conclusion that it isn’t that we give a shit to clean toilets really if you think that is the issue you haven’t listened. We clean up puke, urine, bowel, sputum, blood ect we will do So then try to shove a granola bar down our throats but bottom line “WE DON’T HAVE TIME!!” We are not weak we are understaffed, over worked and taking on 3-5 jobs for same pay and same amount of time. The two that suffer? RNs and the patients! How do you expect quality care in this manor? I grew up respecting this hospital they actually saved a friend of mines life but they also had time to sit with him console him help the family ect. Hospitals are a business now and owned by corporations with little to no medical background who seem to think RNs just sit around knitting all night and need more tasks? Damn right I’m angry and every RN at this hospital should go on strike because enough is enough!

    Cross contamination occurs everyday! Every single day wether by Drs, Techs, RNs, Lab ect and now you want to add to that contamination well why not gives the hospital more business right? We take precautions but it still happens so the argument is not even valid in my opinion of increasing that cross contamination by making this move.

  36. This has been done before. At Lakeland Regional Medical Center in Lakeland, Florida. Not only did nurses have to clean the rooms, they were no longer RN’s but multi skilled practitioners. This hospital got rid of central transport, EKG techs, unit coordinators, phlebotomy, we had to cook the meals on the floor kitchens and serve the patients. It was a mess. This cubortion was called Patient Focus Care and the Nurse was responsible for everything. It was a nightmare. If you didn’t like it or voiced objection you would find yourself either on a floor you didn’t want or just fired. The result of this experiment was LRMC was one of the first – if not the first- hospital in Florida to adopt a nurses union. Good luck – This was done in the 90’s.

    • Hopefully, the nurses at Vanderbilt will speak up and Unionize over this. That is the only way the jack-ass CEO is going to learn his lesson.

  37. Michael Rumage

    Are you serious. Geez I wish as a server i only had to bring people food. Ooh wait that’d be stupid and ridiculous. You’re a nurse. You signed up for RESPONSIBILITY. You are there to care and provide safety and cleanliness. Perhaps, and I’m just throwing thoughts out there but, if we had fewer people running in and out of every room in the hospital your argument of cross-contamination would not be an issue. See where this is going?

    • Michael, most infections aren’t caused by hospital personnel “running in and out of a room.” Germs don’t jump from one person to another.

      Now that we’ve got that settled, you seem to be saying that someone who chooses to become a nurse is obligated to surrender his or her right to talk about it after an unpleasant shift. And that’s nonsense. We didn’t take a vow of silence—in fact, quite the opposite. It’s not only our right, but our RESPONSIBILITY, to speak up against policies that could cause harm to our patients.

      I suspect that, if this blog featured military personnel, or police officers, or miners venting about difficult work shifts, we wouldn’t be seeing all these well-you-wanted-the-job-so-stop-complaining-about-it arguments. Somehow, the public seems very uncomfortable with the idea of nurses speaking up or making waves. That seems to be the case with most traditionally women’s occupations. Go figure, huh?

    • Michael, Because we are RESPONSIBLE, we are loathe to cross contaminate your wound with the crap you left in the toilet. The public, much like administration has this skewed view of nursing. That we are just hanging out at the nurses station with the docs eating bon bons, while the docs are deciding when is tee off time. This isn’t “Grey’s Anatomy”. The docs are worked to death some not having a day off for 16 days in a row and being on call at night – so sleep deprived at that. When I am working in Florida in the step down unit I have 5-6 patients – other states the ratio is 4 patients due to the acuity of these type patients. 6 is dangerous, but it’s a money maker for the hospital – they get double the room charge for putting you in a step down or pcu unit. I have gone for months without ever getting a lunch (it’s okay if I do take one I have to stay over 30 minutes to catch up) oh and not to worry, they don’t pay us for that half hour that we are supposed to get for a 12 hour shift. We can only hope that while I am cleaning your toilet that the IV with an irritant drug doesn’t infiltrate in the room next door, the patient having some ectopy doesn’t decide to just go ahead and code or the confused patient 2 doors down doesn’t fall on the floor and break a hip because I wasn’t there to help him to the bathroom. Oh and by the way your potassium is really low, but I don’t have time to check things like that in a timely fashion, because I now have 6 rooms to clean on top of everything else. Does that clarify anything for you Michael? It’s not an “I’m too good or lazy” If you want me to be a housekeeper for the day instead of a nurse and are going to still pay me my salary I’ll do it. Years ago one hospital needed a nurse from the float pool to be a transporter because they were short – of course I did it. But they didn’t ask me to perform my nursing job at the same time. Patient safety must be the bottom line, and this practice they are instituting is NOT safe. All I can say to these nurses, is send an email stating your objection, keep a copy and go get some private malpractice insurance.

  38. Are you kidding me? I don’t even have time to pee sometimes.

  39. For those leaving comments about nurses having time to clean(mop,etc.) they have apparently never walked in a nurses shoes. I already see substandard care going on everywhere due to short staff and ridiculous patient ratio’s. It does no good to list to most non nurses the very long list of responsibilities a nurse has, while some sympathize until they do it they will never understand the pressure of life and death literally being in your hands and having all the many distractions going on that can cause errors and oversights. As a nurse I can honestly tell you I do wear every hat in the building on a daily basis, from housekeeping to maintenance to dietary to the business office to social services, mental health even directory assistance. Big corporations are raking in the dough and letting the “nurse” be the scape goat for anything that goes wrong. Until the government, public and nurses take some control back this will only get worse.

    • I agree. I was a nurse on a psychiatric floor. Between giving medications, doing nursing assessments, and documentation of your patient care the shift was full of activity. Add in new orders, calls from family, crisis intervention, etc. and the day is too full. Add in housekeeping duties and you have a recipe for disaster. The feds have been taking a long hard look at nurse to patient ratios and hospitals have had to tighten up in this department. This is just a way to milk the nurses a bit more.

      • I think it would be so dangerous to have nurses on a psych floor doing housekeeping duties because who is watching the patients, especially those with violent tendencies on locked wards, while the nurse is cleaning with chemicals that could be harmful?

    • windy — well said

  40. If I was another hospital in that area u would take out several ads and bill boards that said….. “Come to us… Cleanest hospital around… We have special trained staff just to clean because we care about your health!” Think if nothing worse this is a terrible marketing mishap Vandy has chose to leave their hospital wide open to lose patients…. I know I would not want a nurse touching me after she just cleaned a toilet!

  41. I don’t know any nurses at Vanderbilt who have time on their hands to add this into their routine while still providing optimal patient care. Vanderbilt is a wealthy university and it seems the higher ups are crying poor and making a big mistake by putting more pressure on nurses and techs. Vanderbilt is supposedly an elite medical center. What will the chancellor say the first time a parent of a small child is looking for the nurse for pain medication and the parent is told “the nurse will be in as soon as he/she is done cleaning the bathroom” and the parent becomes upset? It seems like Vanderbilt’s leadership is not as concerned with patient care as they claim. It would be interesting to hear the rest of the story from the higher ups… that is if the rest of the story presented is the truth.

    • Unfortunately, Bill, the blame will fall on the nurse, not the institution. The hospital will hire a consultant, who will receive a large fee for showing management how to deliver pep talks to the nurses to do more with less. Departments will set quarterly goals to achieve this, and when they fall short of their goal the nurses will be lectured for not trying hard enough. And patients and their families, who can’t see what the nurses are doing when they’re away from the bedside, will assume that they’re playing Candy Crush Saga in a “canteen” somewhere, rather than rushing around cleaning a room for the new admission waiting in the ER.

      Meanwhile, the ER will be stacked up with patients, because the rooms upstairs aren’t clean, which will result in ER patients sitting in the waiting room because the ER nurses are all tied up caring for patients who should have been taken to the floor an hour ago.

      There’s just no way this policy is a good one, not even if Vanderbilt’s nurses work their heads off and never utter a complaint about their duties.

      • I would just like to point out here that when I made this initial post about Vanderbilt’s new policy months ago, I was questioned by Vanderbilt’s media staff on Twitter, who demanded to know my real name and where I worked. Of course, I did not share this information, but I had real concerns that someone at Vanderbilt would try to contact my own supervisor. Vanderbilt’s email to it’s staff, leaked by a very courageous and anonymous nurse, made it clear that dissent would not be tolerated.

  42. You are so right. But they do it cause we let them. I wished we stuck together but rarely do. We need to organize a society, not a union, a forum of nurses to talk out these issues and form responses that don’t gave to do with compensation.

  43. The fact remains: a nurse CAN do a housekeeper’s but a housekeeper CANNOT do a nurses job!!!! Now Vanderbilt wants their nurses to clean too??? And with the budgetary cuts mentioned you can be sure they won’t increase the nurse’s wage that is performing the job of at least one other person but also can be sued for even more things that can go wrong!

  44. More responsibilities, less time for actual patient care. All for the bottom line so a fat cat administrator can get his bonus and an “atta boy”.

    OR Staff RN

  45. This is an outrage! I am an OR nurse, but also work med/surg PRN, so I have hands-on experience with both. There’s no comparison between turning over an OR suite and terminally cleaning a hospital room. The time difference for each is roughly 15 minutes for a surgery room vs 30-40 minutes for a hospital room. Med/surg nurses have heavy patient loads, especially during the flu/pneumonia season, with barely enough time to make hourly rounds and finish med pass. I’m certainly not “above” cleaning anything, and do lots of it because the EVS at our hospital is contracted and they do not clean blood or body fluid spills… So, I spend lots of time wiping up vomit and mopping urine/feces from the floor!
    This policy at Vandy is only going to further compromise patient safety and good nursing care. What I want to know is, what does the ANA and Tennessee State Board of Nursing say about this???? (And we wonder why there’s a nursing shortage..)

    • Tracy, I don’t believe there is a nursing shortage. There is a shortage of nurse who are willing to work like this.

  46. Sharon Pokorney

    Oliva:Have your read Obama Care, I have the zillions pages of it on the webb, You must be young enough to think that will solve many things and will change medicine ( which does need reform) but just like sending a man to the moon, you do not send him alone and without preparation … Hospitals will prosper from this by getting a subsidy.. that is the deal, Period

    • Sharon, you still haven’t answered my question. If hospitals are “getting a subsidy” from the ACA (and please tell me which page of the “zillions” told you such a thing, so I can look it up), then that should make hospitals MORE prosperous, not less.
      No, I’m not young. I’m just observant enough to realize that this isn’t about lack of “preparation.” Insufficient “preparation” has been used as an excuse for clinging to bad policies throughout history, including state sanctioned slavery and Jim Crow laws.

  47. How often do the administrators come out of their offices to clean the toilets? If they aren’t willing to clean that tells me everything I need to know: top heavy organizations making cuts on the wrong departments.

  48. It’s definitely not about being above anything, it’s about the quality of care patients will be receiving now. Come and work on the actual floor for one day instead of an OR and then comment on “being above”. Nurses have a ton of responsibility on the floor, not saying that OR nurses don’t either, but we also have several patient’s that we’re taking care of at once. There are many times where I have had to be the RN, tech, and unit clerk on my floor; being just the RN is hard enough, so I can’t imagine adding having to clean the patients room on top of everything else. Just saying, I can see this leading to several problems and possible lawsuits for the hospital.

  49. If the people in administration thinks this idea is so revolutionary then come out of those offices and help the nurses on the floor As for comparing a private surgical center to some of the already understaffed floors within a hospital shows either that a person has never worked on these type of floors or did work, could not handle the situation and got out when the opportunity presented itself YES we as nurses are responsible for the patient care and I have cleaned rooms while my patients were in the room HOWEVER once patients are discharged IT is the responsibility of the hospitals to maintain and effectively clean its property NOW I have an idea why some patients enter or re-enter hospitals with infections from outpatient procedures from some surgical centers and hospitals….making staff multitask beyond what is in the best interest of the patients in order to ensure a higher profit line

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