Temp firms a magnet for unfit nurses

[n2doc]

With scant regulation and some agencies' poor screening, workers can hopscotch from job to job.

By Tracy Weber and Charles Ornstein
December 6, 2009

Firms that supply temporary nurses to the nation's hospitals are taking perilous shortcuts in their screening and supervision, sometimes putting seriously ill patients in the hands of incompetent or impaired caregivers.

Emboldened by a chronic nursing shortage and scant regulation, the firms vie for their share of a free-wheeling, $4-billion industry. Some have become havens for nurses who hopscotch from place to place to avoid the consequences of their misconduct.

An investigation by the nonprofit newsroom ProPublica and the Los Angeles Times found dozens of instances in which staffing agencies skimped on background checks or ignored warnings from hospitals about sub-par nurses on their payrolls. Some hired nurses sight unseen, without even conducting an interview.

As a result, fill-in nurses with documented histories of poor care have fallen asleep on the job, failed to perform critical tests or stolen drugs intended to ease patients' pain or anxiety.

"A lot of them are really bad nurses," said Sandra Thompson, a nursing supervisor at Northridge Hospital Medical Center and Sherman Oaks Hospital, both in the San Fernando Valley. "Sometimes I see them here and think, 'I wonder how long before I see them over' " at Sherman Oaks?

more:
http://www.latimes.com/news/local/la-me-nurses6-2009dec06,0,1174984.story

[imdjh]

1. I can understand why it's bad. I can also understand why a nurse would want to work through the...

.... service if he can work that way. Day in and day out working in the same confined area and under the same bitchy office politics would be enough to drive a person away. Being able to work essentially as a contractor had its benefits, even if it doesn't have health benefits. So I can see working the minimum number of hours in one place, and then working anywhere else for the rest.

As a standard of care, though, I see this as irresponsible on the hospitals' part. Continuity of care is right up there with quality of care, a seriously ill person should be cared for by as FEW people as possible, so they KNOW the patient and know how he was yesterday, what normal looks like, and can tell when something is changing. This is especially true of patients on heavy medication.

[Warpy]

2. I worked agency for a few years

and there were only two types of nurse there: the truly great nurse who could walk onto any floor in any specialty and manage to do her job, a different specialty every night, and the type of nurse who was one jump ahead of getting her license pulled. I came onto a floor more than once when the previous shift had an agency nurse who had been found passed out in the bathroom with stolen narcotics.

FWIW, I've also seen that with staff nurses, although they generally get caught faster.

Agencies really do try to police themselves, but they're relying on lawsuit wary former employers just like everybody else.

Agency work is the toughest out there. You have to be on top of a dozen different specialties and be willing to do home care one day and critical care the next. My fellow agency nurses were some of the most awesome nurses I've ever worked with.

The problem is that a lot of HR people are loath to report real problems and be honest with employers down the line.