Vanderbilt University Medical Center's latest budget moves mean nurses will be responsible for a lot more than patient care.
The Channel 4 I-Team has learned some Vanderbilt nurses will now be in charge of cleaning patients' rooms, even bathrooms.
Sanitized environments in hospitals are critical to a patient's health, but the new cost cutting measure has at least one nurse concerned.
"Cleaning the room after the case, including pulling your trash and mopping the floor, are all infection-prevention strategies. And it's all nursing, and it's all surgical tech. You may not believe that, but even Florence Nightingale knew that was true," said a hospital administrator to staff in a video obtained by the Channel 4 I-Team.
The new cleaning changes were also detailed in an email sent to staff of the Vanderbilt Medical Center East team, which - according to a hospital employee - works in surgery areas and patient rooms.
A manager writes in the email, "We have undergone some major budgetary changes ... this means we will need to pull together like never before."
The email says nurses will now have to pull their own trash and linens, sweep up and spot mop. Nurses, care partners and nursing assistants will be responsible for all patient care areas.
"The priority will be what the patient sees," the email states.
Also, in bold highlighted text, the email says, "Be sure to wear the appropriate [personal protective equipment] when doing any disinfecting - that includes, a cover up gown, gloves, mask and even an eye shield when necessary."
Nurses were also told to "refrain from speaking negatively about this in an open forum where our customer can hear. If you need to vent come see me."
The hospital employee did not want to be identified for fear of losing her job but wanted the public to be aware of the changes.
"This is our new reality. The work still must be done. We must still care for patients, and we must do so in an efficient manner," the hospital administrator told staff in the video obtained by the Channel 4 I-Team.
The nurse to whom we spoke says before these changes, the hospital's environmental services department was in charge of cleaning those patient areas and that staff does not have interaction with patients.
The nurse is concerned that doing both cleaning and patient care could lead to cross contamination.
The email obtained by the Channel 4 I-Team does say environmental services will still be handling some cleaning.
In a statement, Assistant Vice Chancellor John Howser, said:
"The safety of our patients is always of foremost concern. All decisions about operational process redesign at the Medical Center are being made in a patient-centric manner and will not affect the safety of patient care."
The Tennessee Department of Health says it does not specify how a hospital chooses to clean, as long as the employees are appropriately trained and follow CDC guidelines.
If they do that, the state says there should not be any increased risk of infection.
We checked with Lipscomb's nursing staff. The executive associate dean of nursing, who has been a nurse for 25 years, says she hasn't heard of a hospital doing this before.
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