The hospital where I work has a money issue. That is, our department was more than a thousand hours over budget on staffing. As a result, the ED director was fired last year, and the new director has been swinging the budget axe. She laid off 25 nurses as her first official act a year ago, and we have been running understaff since. They took us from 3:1 patient to nurse ratios to 4:1. They also eliminated most of the nurse assistant positions. As a result, we usually don’t get lunches on our shift, nor do we get off work on time. This results in a 12 hour shift usually stretching out to 13 or 14.
Still, our department saw more than 150,000 patients last year, so we are raking in the money. My recent visit to the emergency room was billed at over $40,000, so do the math. Even if they only collect a quarter of what they are charging, they made billions from the ED alone.
On top of all of this, they don’t let us do required trainings during our shift, we are required to do them on our days off. This training is required by our employer, and is over and above the continuing education that we do on our own to maintain licensure. They tell you that annual NIH stroke scale certification is required, and you are subject to discipline if it isn’t completed, for example. So you do it on your days off.
In the past year, more than a quarter of our nurses have left. They are desperately trying to hire replacements, but the word has gotten out, and the only nurses applying for jobs are brand new ones out of school with no experience, because they are hungry for a job that isn’t med-surg.
Admin then tells you that they will pay for a maximum of 2 hours per week of training. The only problem is that they assign far more than that. This two week pay period alone, I have done 8 hours of mandatory training on my days off: a 3 hour class on NIH stroke scale, a 3 hour class on IV insulin, and a 2 hour class on ESI triage policy.
They are only going to pay for 4 hours of it, if they keep up their policy. In the past year, they have denied paying me for about 100 hours of mandatory training. I’m tired of it. I have screen shots of emails telling me the training is mandatory, screenshots of my online time card, and emails of the policy saying they will only pay for 2 hours per week.
I am turning them in to the state department of labor. I’m going to get my money. If they take any action against me, that is illegal and I will sue their ass. I am tired of being made to work for free because they have a “budget.” Well, I have a budget, too, and I expect to be paid for my work so I can make my budget.
16 Comments
SoCoRuss · July 21, 2025 at 10:55 am
After reading your blog for a while. I’m surprised it took this long. I wouldn’t have lasted that long. Aren’t their labor laws in FLA on being denied meals when on a 12 hr shift also?
Good luck
But since you are a guy, You may want to change your employee info data in the HR system and ID as a Black Lesbian to cover all bases….
Divemedic · July 21, 2025 at 12:02 pm
No laws requiring breaks.
Georgiaboy61 · July 22, 2025 at 12:37 am
Re: “Aren’t their labor laws in FLA on being denied meals when on a 12 hr shift also?”
More theft – many departments require a “lunch break”and deduct it from your pay – but they don’t put it back if you have to work through your break or if you get paged, called by a patient, etc. Straight-up theft. And I feel the author’s pain about training and the costs thereof. Telling someone they have to do something without providing a budget for it is known as an “unfunded mandate,”and they’re supposed to be illegal.
Congrats to you for standing up to the HR bullies. Hope you win your case.
Grumpy51 · July 21, 2025 at 11:05 am
FLSA (Fair Labor Standards Act) back in the 80s dealt with this – its where (IIRC) “40 in a week or 80 in 2 weeks” came about regarding OT.
I’m guessing you’re classified as “hourly” which just opened them up for a lawsuit (federal, IIUC) – caveat, I am NOT a lawyer, just a long term healthcare dude……
Steve S6 · July 21, 2025 at 1:17 pm
Get ’em.
Engineering staff jobs they often get around the OT by making you “salaried” vs hourly. Some would have comp time but at 2:1 (2 hrs non paid OT gets 1 hour comp time off). Needless to say most figured out ways to avoid having to work extra hours – sorry, can’t attend the (stupid, useless time wasting) meeting, have a schedule deadline to make being one way.
@HomeInSC · July 21, 2025 at 2:34 pm
Our whole country is in a state of imbalance. Generations of corruption, influence peddling, and fraudulent regulation have made us disfunctional.
The underlying problems – dishonesty and greed. But clearly we haven’t been raped enough by our fellow citizens to wake up enough of us to put a stop to it.
WallPhone · July 21, 2025 at 2:40 pm
Had to do something similar. Entire company had a bonus promised if we hit certain sales goals. My department director held onto my bonus check due to some other metric I wasn’t meeting at the time.
Mailed a certified letter saying was going to file in court if they continued to flout state labor laws, then they’d be liable for statutory damages in addition to the bonus.
Two days before my deadline, someone never before seen nor since dropped off an envelope, and that director was never seen again too.
Grumpy51 · July 21, 2025 at 3:37 pm
Above led me to look it up — https://workforce.com/news/a-snack-sized-guide-to-lunch-break-laws
Interesting….
Chris · July 21, 2025 at 7:18 pm
I read somewhere not long ago that 60% + of medical costs/profits go to the administrative apparatus that’s essentially ruining the whole of medicine. Is that an accurate number?
Chris(CIII)
Georgiaboy61 · July 22, 2025 at 12:43 am
As I am sure the author knows, there is always downward pressure on acute care nursing services because they are a cost center for the hospital, and not a profit center. Everyone in management says that they want the best patient care possible in order to get those coveted certifications and Joint Commission approvals, but no one wants to actually pay to hire sufficient staff.
How does the old saying go? You can have any two of the three – fast, high-quality, or cheap.
If you want it fast and good, you’d better be prepared to pay for it. Cheap and fast will get you low quality. If you want high-quality without paying a lot, then be prepared for progress to be slow.
Phrased differently, you can’t squeeze blood from a stone.
Aesop · July 22, 2025 at 3:24 am
I worked at a hospital that tried to pretend that federal and state labor laws were “like the Pirate’s Code: just guidelines, really”. The state labor board’s sense of humor on that point was right around zero.
That little self-dick-slam cost them $25M in a class action, on top of fines from the state, and my payout was right around $10K.
Suddenly, the day after the judgement, they had staffed an additional nurse on every shift in every department whose job was to do nothing but give breaks and lunches, and you got written up if you didn’t take your breaks and lunches.
Snapping a bear trap around their privates seems to be the only way hospital manglement (not a typo) learns that you can’t short-sheet staffing, but they have to be bitch-slapped about it every few years to keep the memory fresh.
Best wishes.
Milton · July 22, 2025 at 10:45 am
In the engineering world, overtime of 15-20 hours per week was normal. As an hourly employee I was always fine with this.
As a salaried employee the rules were awllll different. My loosely held rule was when I leave (punch-out) my commitment to the company ends. No homework.
Some managers treated workers as professionals and accepted a fourty-something hour workweek from their salaried team. With managers that had some misunderstanding about my rules, well, they might have achieved stealing more hours from me, but those hours had a very low correlation to actual output.
This hampered career growth with assholes as managers.
This reduced stress from the workplace, and my own satisfaction. Don’t be asshole. Don’t work (long) for assholes. Go easy on yourself.
I applaud you for using the authorities to recoup the costs of your labor. Good luck. Don’t “give” them anything of your free time in the near future, unless and until you are on the team of good management that appreciates and rewards you accordingly.
Dan · July 22, 2025 at 3:16 pm
If your facility is collecting 25% of ER billing they are doing real well. Most large hospitals don’t. Most hospitals stay open based on the revenue from outpatient procedures done in Radiology and the Lab…plus for some Surgery Center profits. ER is and has always been a LOSS center. If you aren’t happy with the way your hospital treats you then quit. There is no shortage of jobs for healthcare workers who can and will. You might have to move but there will always be a job.
And yes…healthcare management is evil. It sucks up what little profits are made and spends much of it in the form of overinflated salaries for admins plus their evil “bonus schemes”. Again, nothing to be done but find a job that fits you better. The system is collapsing. Between the massive increase in OLD decrepit patients sucking up HUGE amounts of care just to prolong the inevitable and the vast numbers of indigents and illegals who use the ER as their private free “doctors office” the current system is simply doomed. It must collapse and eventually will.
Divemedic · July 22, 2025 at 8:42 pm
I dont have time for a long answer, but here are some quick points:
1 If the ED is a money loser, why are there so many freestanding emergency rooms, and so few hospitals without an ED?
2 I expect employer to follow the law and pay me what they owe me. I am not walking away like a little bitch.
Aesop · July 23, 2025 at 5:18 am
Actually, most ERs are revenue generators, as they drive hospital admissions (80% or so), which is where the money comes from to have a hospital in the first place.
LargeMarge · July 29, 2025 at 1:28 pm
2013.
Eugene Oregon.
A building collapsed on me.
.
Eight days in Riverbend Hospital was about us$60,000.
Other than trying to pass-off soy-burgers as real meat, they treated me like royalty!
.
A couple months later after I could get around, I visited the Eighth Floor to thank the staff, then went to Billing to verify insurance paid for my time in-house.
.
The clerk informed me insurance negotiated their due down to about us$6,000, a significant down-grade from the hospital’s cost.
me : “Do I owe the difference?”
them : “No, this happens all the time, we just eat the loss.”
.
I suppose they make it up in volume…