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Nursing in the Corporate World; Dishonest & Cut Throat; This RN's Experience

Updated on February 15, 2014
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In the corporate home health care environment, I learned that the manager that smiles the widest should be trusted the least!

Having been connected with hospitals in various fields of nursing, both as a staff nurse and manager, I decided to give the corporate world a try. I accepted a marketing position for a well known home health care company. I am sharing my experience to elicit feedback from other nurses or professionals currently or formerly employed with a for profit home health care company at the corporate or middle management levels. Anyone with anything to say about their experience with home health care in general is invited to comment.

My experience as a nurse manager in a for profit home health care agency iniitially seemed to have many more benefits and perks than my experience working in a hospital environment. I was relieved to be free of the pressures that seemed to come from all angles while working as a hospital RN. What I did not anticipate were the hidden pressures and the isolated feeling that comes with the realization that no one can be trusted in a corporate environment. I have always been a rather trusting person so this aspect of life in the corporate world was very difficult for me.

The idea that no one can be trusted is one that becomes instinctual, almost like a sixth sense. The environment wreaks of stealth.By the time that there is an awareness that something does not feel right, it is usually because there has been an invisible assault involving a razor,sharp edge of a shiny blade to the back. The only two people that usually know about it are the victim and the perpetrator, who,often is seen as the shining star of the company.

The pleasantries that exist in a corporate healthcare environment make it seem much more appealing than the environment of a hospital. The fancy lunches, new technological equipment, paid expenses etc provide a false sense of security and value. The company rhetoric, which initially seems sincere lures one in and creates an initial belief that finally the ultimate job has arrived. It is like a new romance in which both partners have the same values and see each other through rose colored glasses. The juices are flowing.

The old saying "if it sounds too good to be true, it probably is" comes to mind at this point in the game. It does not take long before the chinks in the armour are discovered and it is realized that although many of the values are similar, they come at a high price. The goggles come off and are replaced with disappointment and disillusionment.

Some of this, I am aware can be expected, but to what degree? Nothing is perfect. This leaves me asking if my experience in the corporate, for profit home health care world of nursing is standard or did I make an especially bad choice when it comes to choosing a company to work for?.

The cult-like mantra of the company I went to work for, I will call 'Company Ex' is all about service excellence, compassion, quality etc. It is a requirement of 'Company Ex' that all employees view a video which addresses the mission and values of the company. The CEO almost in tears, communicates how important it is that patients come first.. He is so choked up with pride that his wife, who he met in the company, has to speak for him. Cute video.

They talk about how they first met at the company, back in the day. FYI, nepotism is quite common within the company. It only took me a month to recognize that I had been bamboozled with all the phony rhetoric shoved down my throat by executives, managers and other influential admin. You are either in at this company or you are out.

There are a lot of young climbers (all very attractive) in 'Company Ex' that have been given too much power with little experience or understanding of what it means to be a good manager. They are in with the executives and get compensated quite well monetarily for their positions.

They are phony and create an initial false sense of security for the employees they hire. If they don’t like something you say to them, or someone else, OR, if they simply don’t like you, you are out.

Do not consider voicing your thoughts. They are not welcome even if they tell you they are. If you are one of the chosen, you are treated more than well. If not, you are expendable and tossed out without any thought, discussion or opportunity to voice your feelings. The chosen few have the opportunity to laugh and have a good time without worry while everyone else has to live in a paranoid world, for fear that one of the managers will take something the wrong way.

These young managers are given too much power with little credentials. The biggest and most important sin of this company is the fact that the company's success can all be attributed to the field staff (RN's, PT, OT and nurse's aides) The certified nurse’s aides, who, for their sweat producing and back breaking work are paid $9.00/hr. The aides cannot make a living off this salary and most need 2 jobs.

They are worked like slaves by the administrative staff in the office. They do not get benefits and are easily discarded. Once the employee is let go, the aide is further humiliated when the entire company of admins are sent an email with the aide’s employee picture, now mug shot, letting everyone know that the aide has been fired and is not eligible for rehire.

The way that 'Company Ex' takes advantage of their nurse's aides has a sweat shop feel to it. The aides continue to produce quality work at a rate of pay in which they cannot make a living while 'Company Ex' continues to grow as a company through the promotion of the quality field staff and aide services. The executives, managers and admin staff have health insurance, paid time off, sick time, bonuses, gifts (Mini I-Pads for Christmas) and a full, all expenses paid weekend getaway every year to an exotic place where they are rewarded for their outstanding work during the year.

The executives, managers and office admins feed each other's egos and pat themselves on the back for a job well done; a job that, quite frankly, the field staff and nurse’s aides are responsible for.

The executives and managers at 'Company Ex' are happy with themselves for finding new and innovative ways to drive their field staff and aides to work harder through company jargon. The nurse’s aides continue to get nothing more than a paycheck and maybe an occasional tote bag for their efforts. They get no incentives, health insurance etc. They might get an empty thank you.

It is easy to be the CEO filmed on video, expressing the importance of quality, excellence and compassion when you are making big money off of others that are actually meeting those standards everyday.

It has not gone unnoticed by the field staff (RN's, physical therapy, nurse's aides) that 'Company Ex' is riding financially off of the backs of the field staff. It is because of the blood, sweat, tears and quality work of the field staff that this company continues to grow. There is minimal compensation for field staff.

Directors, that make 6 figure incomes and don't come even a quarter of the way close to working as hard as the field or admin office staff, sit in their offices all day (or where-ever they like). One of the Directors likes to sit smack in the middle of the admin staff because it makes her day more fun.

The Director, often behaving like a friendly bully towards the office admin staff, monitors what they do from minute to minute. Many of the tasks that the office admins do, I would expect would be responsibilities of the the Director.

The office admins basically run the office. They do scheduling, recruiting, hiring, payroll and they act as motivators for the field staff. The admin staff get paid approx $45,000/yr to maintain these responsibilities, which, I noticed are never ending because there are always glitches in scheduling.

The Director, gazing over the shoulders of the office admins all day long acts as "cheerleader". The Director, being free to move about the office makes jokes or has things to say with no respect or concern for whether he/she is interrupting the work flow of the office admins.

The Director talks about how important it is to have "pretty" "matching" supplies. It was quite difficult to tell what the Director did. She had meetings from which she gathered info that was already gathered by everyone else who did the actual work. She supposedly was responsible for budget work, but come on, this does not have to be done every day.

Much of the budget work comes from the motivation and drive of the office admins that work to book hours for revenue. Having no health care background herself, she relied on the nurses in the office that supervised the field staff to make determinations about whether to accept patients for care by the field staff..

Other than bossing people around and exuding superiority, why would they need to pay someone a 6 figure income to act as cheerleader and tell people when to come and go out of the office? It was this type of person that was managing me.

I was new to my job and the person that was my boss was transitioning from her job as Branch Director to 'Division Director'. I was not surprised when I was told that she had worked with the Branch Director for 3 years. They seemed like 2 peas in a pod.

The Division Director had no clue what I was to do since my responsibilities involved transitioning patients from hospital to home as well as marketing. I could not understand why she was my boss. She spent all of 2 hours with me the first month that I worked for this company. She gave me little direction and most of the time did not respond to my emails requesting direction and or informing her that I needed to talk to her.

Being a self directed person, I went about doing the things that were necessary to meet the responsibilities of my job. After 1 month when we finally had the opportunity to catch up, I was fired because of a conversation that I had with another employee that was taken out of context.

Had she been available to me, the conversation would not have taken place with my fellow employee. My fellow employee reported to my boss a twisted version of our conversation which made me appear to be complaining and negative. I said nothing wrong and my intentions were pure.

The information that was exchanged was factual. I was simply trying to get the information that I needed to do my job. There were other avenues that I could have taken but I did not for fear that my boss may appear unorganized and not efficient in doing her job. I knew she was learning her new position so I gave her the benefit of the doubt and did the best I could to go with the flow.

I needed some direction and some outlining of expectations which is why I trusted my fellow employee. This employee, I later learned had only been with the company for 3-4 months. Why was she given such credence to a point where my boss felt comfortable firing me for her version of our conversation? She did not ask me anything and wanted to know nothing when I attempted to explain my situation. I was fired and that was that. The only thing I can think of was that it would have been easier to fire me than actually have to try to catch up from the month that was lost while she was trying to learn her job.

Why did this other employee who had only been working with the company for 4 months and was hired to do the same job as myself twist my words around the way she did? I have my theories as to why she did this but that is not relevant.

In looking at all the pieces related to the company structure, I realize that the managers I was dealing with were young, attractive women connected in higher places with male and female executives. The other people that were successful in "Company Ex" were also connected well with the upper management and executive staff because they had been there since the start of the company or they looked down, said nothing and did their job while kissing up at every opportunity to those that were well connected.

The managers I dealt with were given too much authority with what appeared to be little to no management training. They were the most unprofessional managers I have ever dealt with. I observed these women fire people in the blink of an eye with no concern for the livelihood of the people they fired.

These managers were cold, calculated and in my case the cause was unjust. They know that the state in which they are located is an 'at will' state so there is no justification needed. They don't ask questions. They don't waste much time explaining why. The cliche "we don't think you are a "good fit" for this company is used.

Their decision to fire me was made based on generic, unsubstantiated information. I wonder if my picture went out as a mugshot for all to see, informing of my "termination" and "ineligibility for rehire".

Imagine, people that barely work up a sweat in a day having that kind of power to humiliate and affect the entire financial life of the people they manage. When it happened to me I was flabbergasted and did not see it coming. I thought I was doing a good job and all communication with my boss seemed to indicate that.

I now realize that the managers create a false sense of security for their employees and that the employees at 'Company Ex' need to "watch out" because no job is secure. The Branch Directors and Division Managers are unqualified, untrained, unprofessional and fly by the seat of their pants. This was my experience in the state I live in. Maybe other offices function differently. Hopefully so.

I would like to hear from other nurses and medical professionals that have chosen to work in a corporate environment. Was my experience isolated or is this how it works everywhere?

If you are a health care professional that is or has been employed in the corporate world of home health care (not field staff), how would you rate your experie

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Field Staff (RN's, LPN's, Home Health Aides, Physical Therapy, Occupational Therapy, Speech Therapy, Social Worker)

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