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Doctors and Nurses Are Running on Empty

nytimes.com

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Re: Doctors and Nurses Are Running on Empty

#121

Post by mikeyouse »

gwright wrote: post #114
mikeyouse wrote: post #36

Earlier quoted context omitted.

I've got a nurse friend with significant autoimmune issues who can't quit her job because she needs the health insurance - she works in the ER of a rural hospital in the Midwest making ~$45k/year. She's absolutely inundated with Covid patients right now and is risking her life every minute that she spends there. Some random traveling medical professionals making good money in no way absolves the rest of the country's…

Nothing to do with nursing per-se, but de-coupling employment from health insurance would be a good thing. I realize that there are lots of other complicated issues with regard to health care and health insurance but I can't think of any other service that is so tightly coupled to your employer. Some reading: https://www.ncbi.nlm.nih.gov/books/NBK235989/

Yep, 100% agree.

If you've ever worked in a small organization (~50 employees), it's amazing how much money, time and energy is spend on health insurance. Every single HR person in the country needs to be an expert on these esoteric insurance edges or you get taken for a ride and your employees and balance sheet suffer.

Re: Doctors and Nurses Are Running on Empty

#122

Post by bleepblorp »

n0us wrote: post #42

Man, this thread really bringing out the worst of Hackernews and its so disappointing but unfortunately not surprising to see the complete lack of capacity for empathy from some of the other heavily downvoted commenters. Almost everyone who participates on this site is well educated and fortunate enough to understand that people have been putting their lives on the line for months on end to help people through this c…

> Man, this thread really bringing out the worst of Hackernews and its so disappointing but unfortunately not surprising to see the complete lack of capacity for empathy from some of the other heavily downvoted commenters.

That's an improvement over the usual HN COVID-19 threads, where 'it's just a hoax-flu, bro, stop spreading fear' usually gets upvoted and posts pointing out the dangers of SARS-CoV-2--and of SARS-CoV-2 disinformation--are downvoted, flagged, or removed.

The most generous interpretation is that HN has a severe Dunning-Kruger problem. The more likely explanation is that HN is host to a lot of people who are completely incapable of empathy and are unable to protect themselves from disinformation in areas outside of their own expertise.

This doesn't say much for HN or the tech sector in general.

. .

A contagious biological virus is not conceptually different from the Morris Worm. If there was a neo-Morris Worm loose on the Internet, those of us on the sysadmin-side of the IT house would take all reasonable measures to protect our systems from it. Indeed, failing to do so would be negligent.

Failing to take protective measures (social distancing, masks, WFH) against SARS-CoV-2 is no different from putting unpatched systems directly on the internet while a worm is active. It's so clearly negligent that no one whatsoever should advocate for it.

Re: Doctors and Nurses Are Running on Empty

#123

Post by fxtentacle »

hollerith wrote: post #67
cycomanic wrote: post #37

Earlier quoted context omitted.

Is that why the US healthcare system which has less regulations than most other western health systems is also significantly more expensive?

How do you know it has less regulations?

Because US hospitals treat their employees in a way that would be illegal in pretty much the rest of the developed world.

Re: Doctors and Nurses Are Running on Empty

#124

Post by jtbayly »

dragontamer wrote: post #43

Tomorrow is Thanksgiving. And with 2020 shaking up to be one of the "worst years" in history, it is important to remember what we can truly be thankful for. Tomorrow, give a moment to thank the hard working nurses and doctors who have done what they can to save as many lives as possible in this year. That's what Thanksgiving is all about: even in the worst of times, we need to give thanks to the people who made this…

>with 2020 shaking up to be one of the "worst years" in history...

Really?

No. Not even one of the worst in living memory.

Re: Doctors and Nurses Are Running on Empty

#125

Post by segmondy »

n0us wrote: post #42

Man, this thread really bringing out the worst of Hackernews and its so disappointing but unfortunately not surprising to see the complete lack of capacity for empathy from some of the other heavily downvoted commenters. Almost everyone who participates on this site is well educated and fortunate enough to understand that people have been putting their lives on the line for months on end to help people through this c…

Well said, especially sad to see this from the same folks that burnout because they are dealing with a code base with no unit test and told not to rewrite.

Re: Doctors and Nurses Are Running on Empty

#126

Post by michaniskin »

dragontamer wrote: post #119
michaniskin wrote: post #116

Earlier quoted context omitted.

We don't have the power to toss anyone anywhere. They have the freedom to work or not work, or to change jobs, or any number of alternatives to working somewhere where they don't want to work. If a lot of workers quit then the wages (and prices) rise, and workers move from other jobs to do the higher paid ones. There is only a shortage of labor when there are wage or price controls imposed on the businesses by legisl…

There's a shortage of labor because COVID19 grows exponentially, and there's no possible way we can grow our nursing / doctors labor pool exponentially in a few short months.

The type of work required to monitor covid patients can be done by semi-skilled workers for the most part. The army does this, it works.

Re: Doctors and Nurses Are Running on Empty

#127

Post by m0llusk »

This might be an opportunity to trigger rethinking of how we handle some of our labor pools. Stress is extreme with the medical sector now, but there are signs of similar related stresses in other sectors also. Construction, Education, and Software Engineering all site high labor costs and low labor availability. At the same time the number of adults of prime working age looking for work and not finding it is at record highs as is the number of frustrated working age people that have left the labor pool.

If we had more onramps into these generally lauded labor markets then there might be greater flexibility and humanity in responses to stress, especially really serious stresses such as we see now. Make it possible to get limited training for some kind of assistant position and people can gain experience and potentially move up the ladder or simply serve as useful fodder that insulate better trained and more experienced workers from the worst stresses. Instead potential workers are eliminated early on by requirements that are often old and limited in proven relevance.

And apart from all that there are cultural limitations. It isn't some weird mistake or detailed physical evaluation that keeps female participation in construction at extreme lows and male participation in education of the young similarly low. There are serious social barriers involved. Up till now we have had the luxury of setting up expensive many years long training gateways and arbitrary cultural barriers with these fields, but this isn't necessarily rational and forces limitations which are contributing to dangerous overload.

Re: Doctors and Nurses Are Running on Empty

#128

Post by athriren »

michaniskin wrote: post #120
dragontamer wrote: post #108

Earlier quoted context omitted.

How much money do I have to pay you to get a nursing degree, quit your current job, and start helping out the pandemic? Serious question. Now that you have an idea of how much money that actually costs, do you understand why things don't scale the way you think they do? Even then, it will take you years to get the skills needed to be a nurse (and in ~1 year, thanks to the vaccine, the surge in nurses won't be needed…

Nursing is not that complex. The bulk of the work can be offloaded on semi-skilled labor with on the job training. This is what the army does, it works fine. This is not rocket science here.

nursing is “not that complex” in the same sense that programming is “typing characters into a file”.

my sister is doing critical care work as a nurse in a covid crisis zone earning less than 60K a year. this is with a decade of experience in some of the top hospitals in the country. i think HN has a very California/New York view of nurse’s compensation and status.

her previous hospital responded to covid by firing a lot of nursing staff (grandma’s couldn’t get knee replacements, but covid wasn’t super bad here yet so hospitals just shed resources only to need them again in two months).

hospital administrations responded to the crisis by cutting staff, cutting pay, and increasing their own salaries, while taking months to procure PPE for their workers. at the height of the iraq war, it was a big news story that soldiers had not been receiving adequate protection and that some of the vehicle and personnel armor they had received was defective. if we want to make a war analogy, this is blackwater contractors getting paid millions to play at war games geared to the tits and barely ever leaving the green zone while the soldiers doing the real grunt work are getting shredded by mandatory redeployments with no leave and issued substandard gear.

on top of that, covid has been functionally live clinical experimentation at mass scale. a lot of medicine has been made rote, so i think jaded people think it is just a big book of instructions. this pandemic was figuring things out live at runtime.

the compassionate response to a massive crisis in healthcare worker morale brought on by burnout due to extremely fast paced, high risk, high stress, highly specified work conditions during a global pandemic is something like “i hope this can be managed so that care can continue to be delivered” and not “they should get a new job”.

Re: Doctors and Nurses Are Running on Empty

#129

Post by dragontamer »

michaniskin wrote: post #120
dragontamer wrote: post #108

Earlier quoted context omitted.

How much money do I have to pay you to get a nursing degree, quit your current job, and start helping out the pandemic? Serious question. Now that you have an idea of how much money that actually costs, do you understand why things don't scale the way you think they do? Even then, it will take you years to get the skills needed to be a nurse (and in ~1 year, thanks to the vaccine, the surge in nurses won't be needed…

Nursing is not that complex. The bulk of the work can be offloaded on semi-skilled labor with on the job training. This is what the army does, it works fine. This is not rocket science here.

https://en.m.wikipedia.org/wiki/Military_budget_of_the_Unite...

Yes. It is easy to solve problems with a budget of $700,000,000,000 a year.

With enough money, you can develop training programs to make total dumbasses perform skilled work. But unless you plan on spending $7 trillion over the next 10 years on improving the healthcare system of this country, I don't think your comparisons to the military are very apt.

Re: Doctors and Nurses Are Running on Empty

#130

Post by michaniskin »

athriren wrote: post #128
michaniskin wrote: post #120

Earlier quoted context omitted.

Nursing is not that complex. The bulk of the work can be offloaded on semi-skilled labor with on the job training. This is what the army does, it works fine. This is not rocket science here.

nursing is “not that complex” in the same sense that programming is “typing characters into a file”. my sister is doing critical care work as a nurse in a covid crisis zone earning less than 60K a year. this is with a decade of experience in some of the top hospitals in the country. i think HN has a very California/New York view of nurse’s compensation and status. her previous hospital responded to covid by firing a…

That's a terrible analogy because thousands of newly minted programmers come out of abbreviated code bootcamp type programs all the time, and go right to work.

Anyway, the army actually does this. Even the special forces 18D medic training (the most elite and rigorous medical training they provide) is only a year long, and they can do everything a nurse can do plus, for example, perform surgery on goats.

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