Just wait until you have surgery and your 'cutie' has 18 post-op patients on her hands. Do you really think you're going to get the care you need? The first few days after surgery require skilled nursing care - not just for pain medication but for other nursing activities that will keep you out of big trouble.
I've seen 80 year old patients, unable to see, eating cold sandwiches for supper because they didn't fill out their food menu and no one was available to help them. I've seen those same patients not walked - when they should be - because there was no one to do it. The cardiac arrest down the hall took priority.
I'm not a nurse and I am not a union supporter, but hospitals will cut corners whenever they can and we'll suffer for it.
But you can blame a lot of this on governmental regulation and Medicare to start with. A hospital has to watch its bottom line. Most are not huge money makers; a lot struggle to even stay open. I'm not up on the latest info, but the last time I worked inpatient as a physical therapist they were in the process of bringing in DRGs, or diagnostic related groups, basically meaning that Medicare paid the same for any patient admitted for a cholecystectomy unless there were complications and you could add another diagnosis code to his list.
Of course, the Medicare payout wasn't near enough to include the additional nursing staff required for the assorted other health professionals that had been cut.
Bottom line- mandate the number of nurses and the hospital's either going to close, make cuts elsewhere (housekeeping?), or soak the insurance patients even more.
Therefore, if the patient needed a physical therapist's skill to get him out of bed and walk, the hospital got the same amount of money as if they didn't. Since most of the patients we were walking could be just as easily walked by a nurse, PTs were phased out for most problems other than orthopedic ones, thus adding to the nursing workload.
I know about nursing. It's not an easy job. I know someone who just flew 15 hours here to take the NCLEX exam. And she is a "cutie" because she sees death and keeps it within her like I saw death in the military. It is managed, the best way possible.