Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Worn-out nurses hit the road for better pay, stressing hospital budgets, morale

text.npr.org

Post reply on HN
Print view View original

51–60 of 97 posts

Re: Worn-out nurses hit the road for better pay, stressing hospital budgets, morale

#51

Post by akudha »

mooreds wrote: post #10
Miner49er wrote: post #2

Isn't the solution simple? Pay nurses like 80%-100% of what traveling nurses make, instead of 50% or less.

I don't run a hospital, but know folks who have worked in one. My guess is that paying someone 2x (or many someones) for a short period of time is easier on the long term budget than raising the wages of permanent employees. Feels similar to how every company seems to want senior developer talent, but few will pay for training new senior talent.

I have never been in management, so maybe I am missing something here. Even from a purely economic perspective, wouldn't it make sense to keep your existing employees happy than having to deal with constant turnover, unhappy workers etc? All I see is constant hiring (even in small teams) and people constantly leaving, to the point that some teams become completely new in just 3-4 years because of attrition.

In my previous job, a lonnnnnnnnnnnnng list of items were pending, because they didn't have enough people to work on them. The mobile app hadn't been updated in 3 years, not even the bugs were fixed. And still the company was one of the most boring places I've worked, with meeting after meeting after meeting...

How hard can it be to have individual conversations with employees once a quarter or something, pay them decent, and at least try to help them do their jobs better? All of which will result in more revenue for the company, no?

I had a chat with a recruiter who argued that remote workers should be paid less. Shouldn't they be paid more (or at least the same as in-office workers for the same work) because the company is saving money on office space, electricity, internet and even stupid coffee and toilet paper? If the recruiter opens the conversation that remote workers are worth less, then how do they expect the candidates to take them seriously? This is just one example.

I just don't get it. Maybe I am not management material/

Re: Worn-out nurses hit the road for better pay, stressing hospital budgets, morale

#52

Post by TheCapn »

mfer wrote: post #33

There are a few things I've learned from the nurses I know... - Nurses, the primary caregivers in Hospitals, have been treated pretty poorly for a long time. Some of it is pay, some of it is expectations, some of it is just the way the people around them treat them (e.g., the way surgeons often talk to them). - Some management has gotten down right mean. I know one hospital that has dictated that refusing to work a m…

Canadian speaking, wife is ICU RN. Everything you've said is spot on, but there's always more to add. Nurses get assaulted pretty much daily. It's such a problem, management basically said it's not worth reporting because nothing is going to be done.

The largest issue is the chronically understaffed units. The burnout that results from having double the normal patient load makes everyone cranky and the team atmosphere breaks down. In better managed units the nurses are all willing to pitch in, help with workload or take over so you can have a break. In units that are suffering, everyone starts looking out for #1 and that whole system breaks down. People start scheming and creating cliques among themselves so if you're not with the "in" crowd on a shift you can get royally screwed... the animosity just grows.

My wife has had coworkers commit suicide. There's been countless nurses straight up quitting, whether to retire or to take up contract work south of the border (the stories of how much they're making filter back through and more nurses start going that direction). Personally, my wife was forced to go on early mat leave because when she told management she will not be able to be primary on COVID patients. Management said goodbye... My assumption is the union would not allow nurses to create such demands (even with proper doctors notes and accommodation) but they would rather lose a nurse entirely than deal with accommodations in an unprecedented time.

I've spoken with her multiple times and ultimately I think a lot of their issues stem from being unable to shift their hiring/onboarding practices. As an Engineer, I start as Junior. I get jobs designated for Junior Engineers, and I work alongside the Seniors to pick up skills and craft.

As an RN she's fighting with people 25 years her senior for a position. She was out of school working casual shifts for 5 years before getting a temporary position, and longer after to get the permanent job. But even then, she's competing with the senior nurses for the same shifts. They aren't equal in skill, but they're treated that way, and the seniors gobble up everything they can until they run out and crash.

Re: Worn-out nurses hit the road for better pay, stressing hospital budgets, morale

#53

Post by brezelgoring »

bluedino wrote: post #24
Miner49er wrote: post #2

Isn't the solution simple? Pay nurses like 80%-100% of what traveling nurses make, instead of 50% or less.

Healthcare isn't expensive enough?

Administrative overhead and corporate bonuses account for that far more than any nurse could ever hope to, also the whole insurance system too.

Re: Worn-out nurses hit the road for better pay, stressing hospital budgets, morale

#55

Post by mfer »

lmilcin wrote: post #49
mfer wrote: post #33

There are a few things I've learned from the nurses I know... - Nurses, the primary caregivers in Hospitals, have been treated pretty poorly for a long time. Some of it is pay, some of it is expectations, some of it is just the way the people around them treat them (e.g., the way surgeons often talk to them). - Some management has gotten down right mean. I know one hospital that has dictated that refusing to work a m…

I don't have any experience with US healthcare but I know this depends a lot on the country. Large part of this is that much of US healthcare is in the business of earning money or optimizing costs, the care being only side effect. As long as incentives are not right, there exists no practical way to fix the system, only prop it up here and there to eliminate worst offenses. As to salaries, I just can't imagine how i…

> Large part of this is that much of US healthcare is in the business of earning money or optimizing costs, the care being only side effect.

ICUs are not optimized. Hospitals in general are not optimized in the US. A lot of the cost issue is in inefficiency. Many ICU patients cause a hospital to loose money.

> As to salaries, I just can't imagine how it is even legal for nurses to do same job but being paid more because they just joined...

Salary is what ever a company decides to pay a person. There are all kinds of ups and downs. If you're running financially inefficiently, as most US hospitals are, then you need to limit when you pay people more.

When US hospitals have seen a majority of their patients as COVID patients the loss they were talking about lead to bankruptcy speculations.

While the predictions weren't right (in terms of timing) there is a lot of good context in https://claytonchristensen.com/books/the-innovators-prescrip...

Re: Worn-out nurses hit the road for better pay, stressing hospital budgets, morale

#56

Post by ceejayoz »

NoblePublius wrote: post #54

Sounds like a great time to fire healthcare workers who won’t get vaccinated.

There's likely a net positive to forcing out workers who put themselves, their coworkers, and their patients at risk based on misinformation, yes.

Re: Worn-out nurses hit the road for better pay, stressing hospital budgets, morale

#57

Post by nathanaldensr »

akudha wrote: post #51
mooreds wrote: post #10

Earlier quoted context omitted.

I don't run a hospital, but know folks who have worked in one. My guess is that paying someone 2x (or many someones) for a short period of time is easier on the long term budget than raising the wages of permanent employees. Feels similar to how every company seems to want senior developer talent, but few will pay for training new senior talent.

I have never been in management, so maybe I am missing something here. Even from a purely economic perspective, wouldn't it make sense to keep your existing employees happy than having to deal with constant turnover, unhappy workers etc? All I see is constant hiring (even in small teams) and people constantly leaving, to the point that some teams become completely new in just 3-4 years because of attrition. In my pre…

How hard can it be to have individual conversations with employees

It can be very difficult when the management and executive classes tend to self-select for sociopathic traits.

Re: Worn-out nurses hit the road for better pay, stressing hospital budgets, morale

#58

Post by adolph »

ceejayoz wrote: post #11
josh_today wrote: post #4

Could this also be a result of forced vaccinations on healthcare workers (who were on the front lines for us early in the pandemic) who then move to states without mandates.

The mandate is Federal - any facility that takes Medicaid or Medicare is subject to it. That's pretty much everything except a few small private practices. Traveling nurses will almost always be required to be vaccinated.

Apparently the mandate is in progress and doesn’t yet exist:

A CMS spokesperson told Fierce Healthcare that the agency is currently in the active rule-making process and cannot comment on any specifics of the pending healthcare provider regulations but did note that there will be a 60-day comment period immediately following its publication in the Federal Register.

https://www.fiercehealthcare.com/hospitals/conflicting-feder...

Re: Worn-out nurses hit the road for better pay, stressing hospital budgets, morale

#59

Post by david38 »

Miner49er wrote: post #2

Isn't the solution simple? Pay nurses like 80%-100% of what traveling nurses make, instead of 50% or less.

Just like that? All that money just burning a hole in the hospital’s pocket?

Tell me, at the hospital you manage, how’s that policy working out?

Re: Worn-out nurses hit the road for better pay, stressing hospital budgets, morale

#60

Post by adolph »

SamBam wrote: post #47
adolph wrote: post #19

Earlier quoted context omitted.

Wages are orthogonal to burnout Burnout is a psychological factor

I think you are mostly right about this, but decent pay goes a long way to signaling respect, which is definitely a factor in burnout.

Likely not curative after the fact
Post reply on HN