ICU nurse horrified at illegal practices at private hospitals



One of the issues in the ongoing debate among Fin24 users about the reasons for high private hospital costs  is the staff component.

Hospital costs are often a medical scheme’s single biggest item and could account for over 44% of a scheme’s total annual expenditure on claims.

Over two thirds of the costs of running hospitals could be related to staff and there is a shortage of nurses in SA.

Yet, a number of Fin24 users who work at private hospitals, have written about their problems, including low salaries.

READ: Debate on private hospital costs hots up

Now another Fin24 user writes to warn of certain ICU practices she deems illegal. She claims  these practices cost the medical aids a lot of extra money, because hospitals are illegally cutting corners in terms of staffing costs. She writes: 

I agree that the claim by private hospitals that staffing costs are pushing up their prices is rubbish.

I would go further to claim that private hospitals are breaching legislated staffing requirements by using under-qualified, less expensive staff and intentionally under-staffing their facilities to cut costs.

I am an ICU qualified nurse and it horrifies me that our ICU employs three times more enrolled nurses than registered nurses.

Enrolled nurses are neither trained, nor legally allowed to care for patients on life support systems – yet today this is the norm.

Apart from being illegal, this practice of using unqualified skills to run high-specialty units amounts to medical aid fraud.

A 15-bed ICU, for example, should ideally have a staff complement of 50 to 60 nurses, of whom the majority should be registered and with ICU experience, and at least a third should be ICU-trained.

READ: Behind the scenes in ICU

Only a quarter of our ICU team comprises ICU trained nurses, nine are registered nurses with ICU experience, and about a quarter are enrolled nurses.

We are not enough to run the ICU 24/7, so temporary staff are hired as gap-fillers. These nurses are mostly enrolled, not registered, and come with no history of experience or nursing abilities.

The effects have been devastating.

Firstly, there have been regular avoidable disasters resulting in severely compromised care to patients.

Secondly, the stress levels of permanent staff, and particularly our team leaders, run at unsustainably high levels due to having to supervise inexperienced agency nurses, who have no ICU skills.

And thirdly, because of avoidable set-backs in patient care our patients’ length of stay in ICU is unnecessarily extended.

Our high care unit is even worse, with only a few registered nurses supervising up to 12 enrolled nurses for more than 20 patients.

This was unheard of a decade ago. The result is that doctors refuse to transfer patients to high care, preferring to keep them in ICU for unnecessary extra days.

This obviously costs the medical aids many thousands of extra rands simply because hospitals are illegally cutting corners in terms of staffing costs.

ALSO READ: Two sides to private hospital care

– Fin24

Disclaimer: All articles and letters published on MyFin24 have been independently written by members of the Fin24 community. The views of users published on Fin24 are therefore their own and do not necessarily represent those of Fin24.

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