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Doctors and Nurses Are Running on Empty

nytimes.com

161–170 of 180 posts

Re: Doctors and Nurses Are Running on Empty

#161

After spending billions of dollars on lobbying to corner the market Physicians and hospital workers are tired. I'm sure they sleep fine in their multi million dollar homes. My best solution is to create a Science based healthcare alternative as competition to current Authority based healthcare system. Regarding COVID, Do we really need someone to spend 14 years to learn to put a ventilator in? Or can we teach this 1…

ventilators are highly specialized, and they're death sentences. A lot of people early on died due to the overuse of vents. Today they're not used until needed and the recovery rates have gone up.

Re: Doctors and Nurses Are Running on Empty

#162

Earlier quoted context omitted.

you're blaming ground-level individual doctors and nurses for administrative and systematic industry failures. In a heavily regulated and specialized industry where mobility is more limited.

No, this guy is actually correct. The supply of medical doctors is kept artificially low in order to keep salaries artificially high. I ran into this firsthand. I was actually a pre-med student in college, but as I really dug into how the whole system works and found out that physicians' groups and lobbies work to prevent new medical schools from being established, to keep spots in existing medical schools scarce, to…

Is this true in other countries? I had a friend who finished med school in Brisbane but then struggled when he came back to the US to find a residency.

Re: Doctors and Nurses Are Running on Empty

#163

I'll do it. Lots of the things they can do can be outsourced to a cheaper less-trained individual. I know because the sleep deprivation means half of them are working at the capacity of a drunk version of me. The number of mistakes surgical assistants make that surgeons have to watch out for is quite something. Veteran surgeons like my parents have top notch surgical teams they've cultivated over time. But most surge…

Thanks. But you are not scalable. You know what is? An entire society taking this thing seriously.

Do you honestly think people aren't 'take this seriously'? People are scared out of their minds, and a lot of the fear has gone way too far. We are well past the point of mass hysteria.

Re: Doctors and Nurses Are Running on Empty

#164

I'm sure some of these folks could really use a break. But we need them! So please remember next time you're in a healthcare setting to treat your providers and nurses with dignity and respect! Then we need to start talking, as a nation, what our goals are for our healthcare industry and what we're willing to set aside to achieve those goals. Clearly we were not prepared for this pandemic, maybe we need to make some…

The same should be said of police officers as well.

Re: Doctors and Nurses Are Running on Empty

#165

Earlier quoted context omitted.

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.

What are you basing that on?

Re: Doctors and Nurses Are Running on Empty

#166

Earlier quoted context omitted.

Sorry, perhaps I digressed. To get back to the point: > If a nurse quits on their job, then their patients die. This is obviously not true, people are not dropping like flies whenever a nurse in America takes a vacation or calls in sick. Are you seriously claiming that there is a national shortage of people who can be trained to empty bedpans, setup IVs, draw blood, and take temperatures? At any price? If wages go up…

> Are you seriously claiming that there is a national shortage of people who can be trained to empty bedpans, setup IVs, draw blood, and take temperatures? At any price? Yes. Because COVID19 is happening right now. Even if you had infinite money, there's no way you can train all of those people to take care of the COVID19 surge that is literally happening right now. The effects of the pandemic are here and are alread…

> COVID19's job is closer to shoving catheters into people while you put them under a ventilator, setting up IV drips, etc. etc.

OK, so how many years of training is required to learn how to insert catheters and IVs and all that? The army demonstrates that anyone can learn these skills in a few days. I'm sorry, but it's just not some kind of unique magical skill set that only special people can learn.

> I'm not sure if you realize how dire the situation is right now.

I'm not sure if you do. There is no crisis, hospitals are not near capacity, there are plenty of empty beds. (Oklahoma, for example, is at 66% capacity, nothing to get hysterical about.) There is no huge difference in hospital bed utilization between today, last week, last month. Remember that giant hospital ship? The one that sat empty in NY harbor and then quietly left without treating a single patient? Excuse me for being desensitized to chicken little's alarming news.

> Nurses who test positive for COVID19 are being kept on the job because there's literally too many patients and not enough nurses.

Nobody is being "kept on the job". Nobody is being forced to work. Those nurses are volunteering to stay on the job.

Re: Doctors and Nurses Are Running on Empty

#167

Earlier quoted context omitted.

> Are you seriously claiming that there is a national shortage of people who can be trained to empty bedpans, setup IVs, draw blood, and take temperatures? At any price? Yes. Because COVID19 is happening right now. Even if you had infinite money, there's no way you can train all of those people to take care of the COVID19 surge that is literally happening right now. The effects of the pandemic are here and are alread…

> COVID19's job is closer to shoving catheters into people while you put them under a ventilator, setting up IV drips, etc. etc. OK, so how many years of training is required to learn how to insert catheters and IVs and all that? The army demonstrates that anyone can learn these skills in a few days. I'm sorry, but it's just not some kind of unique magical skill set that only special people can learn. > I'm not sure…

https://tulsaworld.com/news/local/no-icu-beds-available-in-t...

Tulsa has run out of ICU beds.

Just because Oklahoma in the aggregate has beds, doesn't necessarily mean that communities have beds anymore (even large ones with comparatively many resources, like Tulsa). And with Thanksgiving around the corner, I'd expect cases to skyrocket right after these celebrations.

> Nobody is being "kept on the job". Nobody is being forced to work. Those nurses are volunteering to stay on the job.

Because they know their patients will die if they don't perform.

> The army demonstrates that anyone can learn these skills in a few days.

Once again with the army comparisons. Its easy to build a training program when you have a $700 Billion/year budget. If you want to make an army-like training program for nurses, then I agree with you. That'd be great for our country.

But I recognize that I have a minority opinion and that most Americans won't accept raising their taxes to pay for such a thing.

Re: Doctors and Nurses Are Running on Empty

#168

Earlier quoted context omitted.

> COVID19's job is closer to shoving catheters into people while you put them under a ventilator, setting up IV drips, etc. etc. OK, so how many years of training is required to learn how to insert catheters and IVs and all that? The army demonstrates that anyone can learn these skills in a few days. I'm sorry, but it's just not some kind of unique magical skill set that only special people can learn. > I'm not sure…

https://tulsaworld.com/news/local/no-icu-beds-available-in-t... Tulsa has run out of ICU beds. Just because Oklahoma in the aggregate has beds, doesn't necessarily mean that communities have beds anymore (even large ones with comparatively many resources, like Tulsa). And with Thanksgiving around the corner, I'd expect cases to skyrocket right after these celebrations. > Nobody is being "kept on the job". Nobody is b…

> Tulsa has run out of ICU beds.

So now we're in agreement. The sky is not falling, and Tulsa may have a local logistical challenge. Nothing to see here.

> Because they know their patients will die if they don't perform.

It's presumptuous to speak to what others know. All I know is that they weighed the alternatives for themselves and chose to willingly go to work instead of doing all the other things that they could have done instead.

> Its easy to build a training program when you have a $700 Billion/year budget.

Are you arguing that only a $700B/yr organization can train people to do the simple tasks that a soldier learns to do? The field manuals and training materials are all available, you can look and see for yourself that there is no secret super 700 billion dollar teaching method being used. As important as they are, these skills are not uniquely difficult to teach nor to learn. (Nevermind the fact that last year the federal government spent over a trillion dollars on healthcare, and the private sector spent even more than that, so if there is some special budgetary threshold that must be passed before workers can be effectively trained, I think we passed it a long time ago.)

> Americans won't accept raising their taxes to pay for such a thing.

Right, because we don't just assume that the solution to every problem must come from the government. There is absolutely nothing preventing hospitals from training new workers to change bedpans and insert catheters via on the job training. Well, nothing except for all the government regulations, but as they say "nobody gets a speeding ticket at the indy 500". They could do it and it would be fine.

Re: Doctors and Nurses Are Running on Empty

#169

Why are degree requirements so high for nurses? What's with this artificially imposed supply shortage?

They aren't! Nursing is one of very few licensed professions you can do with an associates degree. And that 2 years is PACKED with a ton of need-to-know skills. The field requires rather incredible breadth just for an entry level position. It's a very demanding program. These are people dealing with the possibility of life and death mistakes constantly without immediate supervision so a licensure is totally appropria…

There is a skillset required for nursing. But those skills can be taught. They are taught. What's stopping us from teaching them en-masse?

Re: Doctors and Nurses Are Running on Empty

#170

Why are degree requirements so high for nurses? What's with this artificially imposed supply shortage?

They aren't! Nursing is one of very few licensed professions you can do with an associates degree. And that 2 years is PACKED with a ton of need-to-know skills. The field requires rather incredible breadth just for an entry level position. It's a very demanding program. These are people dealing with the possibility of life and death mistakes constantly without immediate supervision so a licensure is totally appropria…

> Nursing is one of very few licensed professions you can do with an associates degree.

There are lots of licensed professions you can do with a associates degree or less. (In California, the list includes Barber, Commercial Fisherman, Cosmetologist, Dental Hygienist, Drinking Water Plant Operator, Electrician, EMT, Funeral Service Director, General Contractor, ...and that's just through the “Gs” of positions covered by the National Occupational Licensing Database. [0]

[0] https://www.ncsl.org/research/labor-and-employment/occupatio...

Nursing is actually a set of separately licensed professions, the lowest couple levels (CNA, LPN/LVN) typically require a non-degree certification, though the latter may also be offered in associates degree form in some institutions. RN requires either an associate's or bachelor's (ADN or BSN), and the levels beyond RN require additional education; NP requires at least a BSN, Nurse midwives and nurse anesthetists require at least a Masters.

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