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Doctors and Nurses Are Running on Empty

nytimes.com

171–180 of 180 posts

Re: Doctors and Nurses Are Running on Empty

#171

Earlier quoted context omitted.

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?

The skills required to be a nuclear physicist can be taught, but that doesn't mean that they can be taught to anyone, regardless of aptitude. And nursing, in practice, requires more than just a specific set of trainable intellectual skills, it also requires physical and social skills and aptitudes,for which proficiency is less correlated with those for intellectual skills than it is across intellectual skills.

And nursing (viewed broadly) skills are taught in mass, the nursing series of professions employs a huge number of people. RNs alone account for more than 1% of the entire US population, adding CNAs and LPN/LVNs, that goes up to a little under 2%.

Re: Doctors and Nurses Are Running on Empty

#172
post #158

Earlier quoted context omitted.

You mean like in Team America? /jk No seriously, how does it work?

https://work.chron.com/army-required-knowledge-e2-e3-promoti... Various benchmarks: time-in-grade (ex: 6-months as an E1 makes you eligible for a promotion to E2). For E4, there are two paths: Corporal (Non-commissioned officer, a leadership role) or Specialist (non-leadership, but a more specialized set of skills). More importantly: these promotion requirements are well regulated, checked-and-double-checked for cons…

Interesting, thanks for the info.

Re: Doctors and Nurses Are Running on Empty

#173

Earlier quoted context omitted.

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…

> Are you arguing that only a $700B/yr organization can train people to do the simple tasks that a soldier learns to do?

Not only train the soldier: but also to check on their progress, ensure they are following the proper military culture, growing into their role, and promoting those who are worthy.

The entire life of a soldier is well defined thanks to the work of the generals and leaders of the military. Group organization and cohesion is no accident: its a purposefully built goal. And yes, money has a lot to do with it.

Propaganda and recruitment is a big one: there are literally soldiers going out into the country, and individually recruiting kids out of high school to become a soldier. This increases the talent pool, and effectively lowers the wages you need to offer soldiers (supply and demand after all).

No one is going out there recruiting people into nursing fields.

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

And a record death rate. Are you trying to imply that COVID19 deaths aren't happening or something?

Deaths skyrocket with caseload. Yes, there are treatments that help prevent death, but only if the nurses / doctors have enough time to do their job. If they become overwhelmed, then their ability to process life-saving treatment is mitigated.

Re: Doctors and Nurses Are Running on Empty

#174
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…

Some of the worst MAGAs I ever met were computer programmers.

Re: Doctors and Nurses Are Running on Empty

#175

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.

Employee rights !== medical regulations

E.g. truckers still get screwed a dozen ways to Sunday before end of Monday every week, but they get their urine tested regularly and get a good nights sleep.

Re: Doctors and Nurses Are Running on Empty

#176

Earlier quoted context omitted.

There are far more nurses and other health care workers who don't make mega-money than there are MDs making millions.

There are way more MDs making much less than you'd think. Some specializations especially are also feeling the pain of tech disruption, like optometry (most optometry offices rely on glasses and contact sales, which are drying up thanks to online stores) or radiology (thanks to ML image processing).

That's a good thing imo. Products should get cheaper as patents expire, economies of scale are realized, and processes are streamlined. Maybe we don't need as many optometrists today as we did a decade ago. This is where UBI would help a lot. Instead we see the protracted milking of customers that don't know better, highly trained people desperately trying to hang onto their job and lifestyle, and no ones happy except the three people bleeding the value chain dry.

Re: Doctors and Nurses Are Running on Empty

#177
post #102

Earlier quoted context omitted.

The opioid epidemic was caused the the corrupting influence of money in the medical profession. And your solution is to remove the only countervailing force - regulation - and turn the whole thing over to money-driven incentives? I'm sure you're right, and without regulation doctors would be paid less. They'd make it up in direct sponsorships from pharmaceutical companies though.

Arguably, regulatory forces created the environment in which money could be used to so effectively manipulate doctors at the cost of patient outcomes. If doctors stood to lose business when they lost patients -- instead of fearing only for their license being revoked -- perhaps they'd be incentivized more to treat patients well than to engage in opioid schemes.

Crazy thought:

Sometimes well intentioned regulation gets it wrong. Sometimes it's perverted in Congress. Sometimes it's designed to fail. It is congresses responsibility to police themselves as much as it is the people's. When regulation fails fix the regulation. That's hard when Republicans are dying on the hill of Government Bad.

Re: Doctors and Nurses Are Running on Empty

#178
post #102

Earlier quoted context omitted.

Arguably, regulatory forces created the environment in which money could be used to so effectively manipulate doctors at the cost of patient outcomes. If doctors stood to lose business when they lost patients -- instead of fearing only for their license being revoked -- perhaps they'd be incentivized more to treat patients well than to engage in opioid schemes.

Crazy thought: Sometimes well intentioned regulation gets it wrong. Sometimes it's perverted in Congress. Sometimes it's designed to fail. It is congresses responsibility to police themselves as much as it is the people's. When regulation fails fix the regulation. That's hard when Republicans are dying on the hill of Government Bad.

It's not a crazy thought at all. Many Americans see government in this light. Others do not:

"No one will really understand politics until they understand that politicians are not trying to solve our problems. They are trying to solve their own problems -- of which getting elected and re-elected are No. 1 and No. 2. Whatever is No. 3 is far behind".

Thomas Sowell

Re: Doctors and Nurses Are Running on Empty

#179

Earlier quoted context omitted.

There are way more MDs making much less than you'd think. Some specializations especially are also feeling the pain of tech disruption, like optometry (most optometry offices rely on glasses and contact sales, which are drying up thanks to online stores) or radiology (thanks to ML image processing).

That's a good thing imo. Products should get cheaper as patents expire, economies of scale are realized, and processes are streamlined. Maybe we don't need as many optometrists today as we did a decade ago. This is where UBI would help a lot. Instead we see the protracted milking of customers that don't know better, highly trained people desperately trying to hang onto their job and lifestyle, and no ones happy excep…

I don't think it's a good thing at all when optometrists who paid for and went to school for 8+ years have to start driving ubers and those 3 bloodsuckers get to reap the rewards of destroying an entire field of medical practice... just so people can pay $30 less for ill-fitting glasses. Not to mention the result of detaching glasses from optometry care likely being fewer eye conditions caught while they are still treatable.

Re: Doctors and Nurses Are Running on Empty

#180

Earlier quoted context omitted.

That's a good thing imo. Products should get cheaper as patents expire, economies of scale are realized, and processes are streamlined. Maybe we don't need as many optometrists today as we did a decade ago. This is where UBI would help a lot. Instead we see the protracted milking of customers that don't know better, highly trained people desperately trying to hang onto their job and lifestyle, and no ones happy excep…

I don't think it's a good thing at all when optometrists who paid for and went to school for 8+ years have to start driving ubers and those 3 bloodsuckers get to reap the rewards of destroying an entire field of medical practice... just so people can pay $30 less for ill-fitting glasses. Not to mention the result of detaching glasses from optometry care likely being fewer eye conditions caught while they are still tr…

The three people profiting should be regulated out of existence. Prescriptions are still needed for glasses and contacts literally everywhere I've looked so I don't think your argument about less ocular conditions being found for for stated reason holds any water.

If you want to suggest that less conditions are found because people neglect their eyes because of cost then I'll agree and offer myself as an anecdote.

Really, eye doctors are failing to compete on price and if that takes some skeletons out of the force then so be it. That's one part of capitalism I appreciate. Adapt or perish.

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