Cancer patients at Truman Medical Center Hospital Hill in Kansas City, Mo., may receive more than medical care from the safety net hospital during their treatment and recovery-they may also get a new job.
When Truman nurse Bennie Turner noticed that an increasing number of the not-for-profit hospital's low-income patients were losing their jobs before or during cancer treatment, she created a program for the hospital to hire and pay the salaries of female cancer patients. Through its new Pink Collar/Pink Ribbon/Pink Slip initiative, Turner and Truman officials hope to help at least 10 low-income women upgrade their skills and regain steady employment with healthcare benefits by the end of 2004.
"Unemployment can be financially and psychologically devastating, especially in tandem with a cancer diagnosis," Turner says. She estimates that she sees at least 50 patients annually who are unable to work because of debilitating cancer treatments like surgery, radiation or chemotherapy.
"Our patients oftentimes don't have health insurance through their jobs because they work blue-collar jobs," says hospital grant specialist Cynthia Robinson. "Most start without health insurance and then lose their jobs after that. Bennie was also having to persuade patients to get into cancer treatment because they said they couldn't afford to go if it also meant that they would lose their jobs."
The program's first patient, Betty Hampton, began working for Truman earlier this month in the hospital's environmental services department. Hampton, who was diagnosed with colon cancer, lost her previous job when her employer would not allow her return to work after she had surgery during treatment.
"Truman's program was a lifesaver," says Hampton, who has been in remission for a year. "Going through my cancer, I couldn't find help for anything. I called the cancer associations but no one could help. I lost everything because I couldn't work. I had to move out of my apartment and move in with my daughter. This is a program that every hospital should have. It should be called the Pink Angels."
An outlook gap
Trying to get a clear take on hospital financial trends by scanning credit-rating reports? Good luck. In this era of rapid change, even professional analysts sometimes seem to be at loggerheads.
Take this example. On April 5, Moody's Investors Service issued a report announcing a "reversal of improving trend as downgrades increase" for not-for-profit hospitals. Two days later Standard & Poor's issued a first-quarter roundup that it said "demonstrates growing sector stability."
So are hospitals skidding or sailing along smoothly? Outliers asked both companies to set the record straight.
Moody's analyst Bruce Gordon says the company stands by its long-term negative outlook and expects downgrades to continue to outpace upgrades. "We don't comment on the other guy's stuff," he says. "They've got a different database of ratings than we do. They have different conversations and experiences."
S&P analyst Martin Arrick says he doesn't disagree with anything in the Moody's report. "I'm not putting on my positive hat and saying happy days are here again. But for the relatively near term, I'd say the next year, I don't see any major problems," he says.
Chalk up the dichotomy to differences in timing as well as data and interpretation. Moody's based its nine-page report on a multiyear trend that showed it issued more downgrades in 2003 than in previous years. S&P, on the other hand, focused on first-quarter data that showed more balance between its downgrades and upgrades compared with previous quarters.
Of course, all this doesn't mean a thing to individual hospitals, some of which made $100 million or more in profits last year while others continued to lose money. As Arrick puts it, "It's one hand in boiling water, one hand in ice cubes."
Patches of honor
With staffing shortages turning a national spotlight on the role of registered nurses in affecting clinical outcomes, patients and doctors alike might ask how to pick out the RN on duty in a sea of anonymous scrubs.
"A solution to the identity issue," according to an authority on nursing issues, and a registered nurse herself, is affixing "RN" patches on scrubs and lab coats. Currently the square red-and-white insignia can be ordered only in quantities of 5,000 or more through Valley Products Co.
RNs are the "patient surveillance system" says Diana Mason, editor in chief of the American Journal of Nursing, who wrote an editorial about the patch in the magazine's April issue. It's about "people knowing who the RN is and what to expect out of them," she says.
Mason says when she hears stories about "a nurse doing something horrible at the bedside," she knows it wasn't an RN. Although they're just part of a team of caregivers, RNs garner a different level of expectations because they have the assessment skills to monitor patients, she says.
As nursing uniforms have evolved, the issue of what to wear always has fanned some flames, and it's ultimately about nurses getting more control, including how they dress.
A trial run for the patch is set to begin soon at the Hospital of University of Pennsylvania to find out how RNs feel about wearing the RN designation and whether patients take notice.
"Let me describe fairly briefly here how the sausage actually gets made here at Triad Hospitals in estimating bad-debt expense."
-Burke Whitman, chief financial officer and executive vice president of Triad Hospitals, during the company's quarterly earnings conference call, talking about the hot topic of bad-debt expense.