This one made me chuckle.  I worked at a hospital for 18 years, and I swear there were at least three faucets that never didn't leak the entire time I was there.  Seriously.  It was almost like it was a badge of pride for maintenance, at no point was any effort made to fix them (despite multiple work orders).

Is she getting things the agency would provide? Like Health Insurance, 403b and life insurance?

This one’s going on supposedly in my town to save money. They were hemorrhaging millions on continuously returning uninsured people using the ER as a primary care. The administration formed a shell charity that the ER would have the indigent patient sign up for. The hospital makes donations to this charity and writes it off on their taxes. The donations finance the charity signing up and paying for the patients to be on Obama care. The hospital can now bill the government and had a dramatic decrease in expenses. That should win you the gift card.

productive time vs overhead.  

Treat the productive staff like overhead and now you have the shitshow we’re in.

End government administration costs.

union?

if so, you know what needs to be done.

Tell people who come to the E.D. with a yellow booger to GTFO.

Led lights. I am sitting in a hospital right now. It is new and nice and full of fluorescent lights .

The solution is to withhold medical care from people that have no intention of paying for it.  Let me give you an example of just how big the problem with freeloading is.  Something like 90% of the births at one of the hospitals I worked for were indigent illegal aliens.  90 fucking percent.  What if you ran a company where only 1 in 10 customers paid?  That was just one department.

Yeah, she's eligible for full benefits.  She actually never did get benefits with the traditional travel agencies, as they made it so that you were only eligible after 90 days, which is basically the end of the contract.  She always looked for the best contracts over loyalty to one agency.  I've always kept her on my health insurance plan to avoid potentially resetting her deductible with each new contract.  The tradeoff is basically (for example) making $3k a week in salary vs $2000 a week in salary plus $1000 a week in tax free stipends.  So your taxes are higher, but with the stipend you're required to maintain a separate household and the in-house agency will hire local nurses.

Someone is a real problem solver, guys.  This is the way.

That's pretty good actually.

Close the ER.  Make it "urgent care" and if you do it right, you can refuse those without insurance.

Have vending machines that sell cigarettes, candy bars, and sodas. Good chance some of the people that are there are used to buying that stuff.

Get rid of travel nurses and pay normal nurses more money to stay. (Travel nurses make bank to travel to a hospital)
Fight lawsuits instead of rolling over and giving a big payoff every time
Don't fire people for refusing a clot shot. Just make them wear a mask and that is it

Fire 10% of executive and administrative staff (by cost, not volume) until patient care quality decreases, then add back 4%.

Mmm...stop paying equipment manufacturers and pharma companies insane premiums because they're "healthcare?"

Seriously there is no industry in the entire world that's more f'd up than American healthcare. We're literally the only country in the world with this issue. Like, literally no other country out of 7+ billion people. We've let it spin totally out of control here.

I was in a Southern European country and slipped on some wet/frozen bricks and split my head open pretty bad. They gave me a full MRI, IV, and 20ish stitches, overnight stay in the hospital. The bill was about $290 dollars without any insurance.

Americans without perspective don't realize how truly f'd over they are.

The problem with raising wages for nursing is that nursing services is viewed as a “cost” by the bean counters.

Prior to the 1930s, hospitals were more for the poor/indigent and was often staffed by volunteers or religious orders. Nurses also often billed families directly for their care. Scientific advancements opened the door to hospitals becoming businesses in the ‘30s. Hospitals struggled with how to pay nurses so they looked to the hotel industry for ideas. The charge for nursing services was included in the daily room charge as a cost control measure in the ‘30s. This has had the effect of depressing nursing salaries for decades by excluding them from supply/demand market forces. This is part of why travel nursing took off during covid. The market pressure became so great for resources it side stepped the cost controls for nurse salaries and travel nursing exploded.

https://www.beckershospitalreview.com/want-to-fix-the-nursing-shortage-change-this-100-year-old-policy.html

There’s also an issue with a flawed budget process in use by many hospitals that produces a 2-6% shortfall in expected FTEs needed to met their budget assumptions for patient care, time off, and education. One of the largest health systems in the US is using this flawed budget process and, due to the math error, they need over 2,000 more nurses than they realize. The bad budget process is actually being taught to nurse managers and other nursing leaders by 4 high-profile healthcare professional organizations and charging attendees $400-$600 per person. I’m retaking one of these workshops this week to see if they’re still teaching the wrong way after I brought it to their attention last fall. I’ve tracked the error across 30+ sources spanning the past 39 years including journal articles, textbooks, conference presentations, white papers, and consulting materials.  There are a lot of “experts” that have made a LOT of $ and established their reputations on teaching this flawed method to healthcare leaders. The first author/expert I contacted regarding finding the error in a couple of their articles responded that they had “always done it that way” and that they had worked with 3 large consulting firms and they did it that way too. So this issue is likely widespread and the nursing shortage is likely even worse than we realize.

There’s also a whole mess around how many healthcare leaders simply don’t understand how to operationalize nursing budgets… but I could give a whole day seminar on all those issues.

We’ve been shooting ourselves in the foot for decades and it’s come time to pay the piper.

One of our hospitals in Madison had their entire Orthopedic Dept walk out en masse a couple of weeks ago.
With 400 surgeries scheduled now turned away.
They are currently looking for a new home.

COVID completely skewed this number.  Everyone swears travel nurses are all Tik-Tok dancing millionaires, but it wasn't like this before 2020...and now numbers are returning back to normal.  Plus, I don't think people realize how close salaries really are, especially when you factor in insurance, vacation time, travel costs, training, etc.  I was paying $1k/month for a 1 BR apartment (that's almost a mortgage payment here), and $1200/month for insurance...with no vacation time.  Plus, my contract could be canceled at any time.  

Were there some very lucrative contracts?  Sure, but those numbers have dropped significantly.  Regardless, travel RN pay isn't what's making or breaking a hospital budget.

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Our condo complex switched from annual flowers to perennials to save the cost of planting flats every year for a couple thousand bucks.

We also installed every other back porch light and a bunch of other lights with motion sensors to cut electricity in half.

Slash the administrative staff in half. Guarantee it won't change a damn thing.

My tiny department has 3 educators, a director, a manager, 2 assistant managers, and at least two other people with managerial power who I'm not quite sure what they even do.

Retain staff better. They constantly onboard new grads only for them to quit within a year and constantly hemorrhage seasoned staff only to pay travelers 2-4x as much. They could raise the core staff's salaries by 25% and it'd still save them money.