Downsized

It happened yesterday. After being in budget meetings all day on Monday, my manager came in and immediately started toying with the schedule. I commented that she looked as though she were struggling with it, and she sheepishly looked up at me and said, “We need to talk when you have a free minute.”

I have known since I began working in hospice care that our facility is overstaffed. We, the staff, from time to time have bantered about the idea that, if the patient census did not grow and maintain itself a near capacity, some or all of us would eventually be asked to cut back our hours. The entire staff has been asked to take PAL (Paid Annual Leave) when the patient census is low. I have not accrued any leave yet, so I was spared that - until now.

So, I was not surprised when I met with Frances and she asked me to drop one day a week from my schedule. The old “First Hired, First Fired” rule. Only I was not fired, thank God. I was almost relieved, concerned only about my benefits package. She assured me that I would not lose my benefits, and I breathed a sigh. At 63, it would be impossible for me to find affordable health insurance. Scary, very scary.

Interestingly, lately I have been thinking about my job in terms of what it is taking out of me. Just last week, I entertained the idea of talking to Frances about not working three days in a row any more. I am 63, and on my third (12 hour) day in a row, I am not at top form. It is hard on me because I push myself to my physical and mental limits to make sure my patients don’t suffer because I have brain and body drain. The first day after my three shifts is lost to sleep, a little writing and in general, taking care of myself.

Now, allow me to back up for a moment. One of the biggest problems with our facility is lack of public relations. We are a nonprofit subsidiary of one of the largest health care systems in the state, and they have failed to promote our services. Period.

We have been open for six months, and still there are doctors in this town who do not know we exist. There have been no mass mailings to the medical community, no pens with our name on it to give away, no business cards, no refrigerator magnets, no television exposure, not a single billboard. They have TV ads for their physical rehab facilities, their heart center, their emergency room, and they have billboards all over town promoting the hospital, but none for us.

There are three local television stations. Each one of them has a spot on their early morning programs and on their noon programs that is dedicated to community affairs. Our so-called PR person has not taken advantage of this free publicity. We could promote our facility by calling and asking for time on one of those spots, send our Medical Director or one of the upper management team or one of us nurses to be interviewed. That’s so simple, I thought it up all by myself.

I can survive this draconian cut in pay, I think. A pay cut of one-third my salary is significant. It will mean changes in the way I live, but I can do it. What worries me is those on our staff who, like me, do not live in two-income households. They need their jobs to keep food on the table and clothes on their backs and those of their children.

I can barely make it with a pay cut, but most of them cannot. And all the while, we could all have job security if our parent company had just told the world that we are here.