as more and more ED higher levels of care are bought out by big medical corporations, EDCare is fighting to stay privately owned by the skin of its teeth.
it's all a game.
How big can the census be without needed to hire more staff? If they census drops how long can we hold on to the amount of staff that we have? How long can we go without hiring to fill an open position? Is retention worth it or can we continue to hire newly graduated staff that have lower salary demands? Should we, as a company, lower ourselves to the national standard of care when provided above the standard of care (family therapy, long PHP days, etc.) was a selling point of our program?
The answer is always "whatever will make or save the company the most amount of money". The burn out level or capacity of the staff is rarely a part of the equation. Therapists and dietitians are given huge caseloads while a position is open and the census is high with the promise that things will even out. Milieu staff are stretched thin in large censuses and running groups that they are not trained for. When milieu staff ask for training to be able to provide the best group possible to patients, they are told there isn't money in the budget and that they should just consult old curriculum. Patients can tell when the staff are unprepared to run the groups they are assigned and they suffer because of it.
