This is a for-profit hospital. As such, staffing is pretty thin, especially nursing. The demand placed on nursing staff to handle up to 9-10 patients is completely unfair, and almost irresponsible. Staff turnover has not helped much, as the veterans are also helping to train the newbies on the fly.
The hospital has 2 credentials, a stroke program and a brain injury program. Wow, that sounds great right? Until you actually start asking questions about the level of care a patient will receive. Some of the nurses have experience with neuro patients, others do not. Ask the hospital about the patient re-admission to acute care settings.. Ask the hospital about cleaning protocols when a patient has C-Diff. Ask the hospital about mortality rate of discharged patients. Ask the hospital about handicapped accessibility. There are no power-assisted doors anywhere in the hospital, so a patient (or visitor) using a walker or wheelchair will need someone to prop open a bathroom door so they can manuever themselves to get into a stall. When this question was raised to a senior level manager, the response was "Well no other hospital in the town has that either, we can't just add it now".
The therapy department has many challenges, mainly due to poor management. The demand for one-on-one patient care is alleviated by using unlicensed patient care technicians, as long as a primary licensed therapist has a line of sight to them. Other hospitals use CNAs, but this hospital does not require training or licensing for entry level staff to handle basic patient care in addition to performing therapy exercises with them. The entry level staff handle a lot of the therapy in addition to regular duties like dressing, toileting, transfers, etc. The Therapy Dept management is spread very thin over 3 lines of care, acute, rehab, and outpatient. Management tends to spend far too much time micro-managing things that have little impact on patient care, and tends to ignore major things that should require immediate communication. Management tends to spend a good portion of the week in meetings or in their office, away from patients. It would be nice if they could take the time to be a little more visible to patients and staff. Management tends to demonstrate "paralysis by analysis" when it comes to being decisive. Communication from management is poor, and often unclear and confusing. Make sure you have a cell phone plan with unlimited texts, because management prefers to communicate via text long after work is over.
Another member of senior leadership is disappointing as well. A former physical therapist, this person has a very can-do attitude which makes you think she's an ally for the staff, but that is not the case. At one point the morale in the therapy department was low enough for someone to step forward and compile a list of all the complaints from the frustrated staff. The leader in question stated she didn't want to see the list and instead reprimanded the brave employee, stating it went against the culture of the hospital.
Staff turnover is an enormous issue. There is an alarming trend of staff burnout and job stress, with no viable options for employees to give feedback to management without fear of reprisal. It seems the only option is for good employees to leave. Even then, the HR department may or may not provide you with an opportunity to complete an exit interview. And who knows if anyone will actually read it and makes changes to improve the toxic atmosphere.
