Professional fees for nursing services - its time to level the playing field
Professional fees, physicians charge them, respiratory therapy, occupational therapy, physical therapy, and a host of other disciplines in medicine charge for their services above the basic costs associated with being in a hospital. Departmental charges may also be present on a hospital bill – lab, emergency department, x-ray etc. The charge for nursing gets rolled up in the room rate. Why hasn’t nursing promoted itself and made advances to be able to bill for their own time and services?
The vast majority of care provided in any healthcare organization is provided by nurses. Twenty-four hours a day three hundred and sixty-five days a year nurses are in the forefront coordinating and providing care to the ill and injured. Nurses coordinate interdepartmental activities, act as liaisons between family members and medical staff, keep physician providers apprised of a patient’s current status, and a multitude of other actions.
Nursing has always been the grassroots of healthcare. We see the patient more than any other discipline in medicine. Every other segment of medicine – primary care provider, consultant, ancillary services, administration, etc. – seeks out nursing to find out what is going on with a patient. Nursing is the “go to guy / girl” when others want to be up to date.
In concert with other healthcare providers nursing sacrifices family time, holidays, endless nights of lost sleep, and endure the stresses of healthcare – which there are several – some of which are quite dangerous. The responsibility is enormous and the potential liability – well, let’s just say most of us in healthcare are not thinking about the liability we incur all the time, but it definitely drives some of the decision making.
Other disciplines rely heavily on nursing to provide accurate and current data about patients to enable them to make care decisions. Typically this is when physician providers come onto the scene. Now, I don’t want to diminish or trivialize the contributions that physicians and other providers bring to the care table, far from it. My point here is that many medical decisions that other providers make are based on the data that nursing obtains through their assessments.
An admitted patient in an intensive care unit develops complications. Nursing is the entity that makes on going medical assessments, identifies the changes in a patient’s status, and initiates the appropriate interventions to manage the patient to restore them to an optimal status. The attending physician is not there for that process. The physician provider relies on the data obtained through the nurse’s assessment to make their own care decisions. Nursing quite frequently provides otherwise lost perspectives on patients that are crucial in developing a plan of care.
The contributions that nursing makes in the care of any patient regularly directs the course of action that other providers take in managing the care of the patient. Nursing should be compensated for their time and professional input. Establishing a room charge which incorporates the care that nurses provide is insulting and demonstrates a lack of value by hospitals.
Breaking out the cost of services provided by nursing can establish more financial flexibility for nurses by enabling nurses to charge patients directly as other providers do. Again it is time to level out the playing field. Nursing plays a key role in the healthcare arena, is a unique and distinctive part of medicine, and should be recognized in the same manner as other healthcare providers.
About the Author
Mike Pringle is the creator of Mike’s ViewPoint, where he provides his perspective on various Healthcare issues. He has over 20 years of nursing experience working both domestically and internationally. Mike has a Bachelor’s Degree in Nursing and a Masters Degree in Public Administration with a healthcare emphasis. He specializes in both Emergency and Critical Care Nursing. Mike has held positions ranging from department staff and Nurse Manager to Executive positions.
Jane responds:
Posted: March 1st, 2008 at 12:59 pm →
Do you know of a website that outlines how much revenue is created by a nurse per year for a hospital?
Mike Pringle responds:
Posted: March 1st, 2008 at 11:22 pm →
Good question Jane, unfortunately I don’t. The charge for nursing services typically is rolled into the room charge for a hospital. I suspect that different charges are levied for different areas of a hospital – ICU would charge more for nursing time than say a med/surg floor.
If you do find a website that gives this type of information I would be interested. The hard way would be to ask your local area hospitals for an example of an itemized hospital bill.