Report: 90% of nurses considering leaving the profession in the next year • Hacker News Board

Re: Report: 90% of nurses considering leaving the profession in the next year

#121

Post by gbear605 » Wed, Apr 27, 2022, 3:43 PM UTC

treeman79 wrote: post #76

christophilus wrote: post #18

Earlier quoted context omitted.

I've known a few nurses, doctors, and PTs who expressed exactly this sentiment. It's such a stupid problem, too. There's no reason they should have such an onerous burden, and yet they all do. One of the PTs I know spent at least as much time filling out paperwork as he did with patients. This was partly due to the volume of paperwork required by govt / insurance / lawyers / whatever, and partly due to absolutely awf…

I got badly injured. Everyone refused to do paperwork. Every doctor said it was every others job. I had great disability coverage. (In theory) Result. Spent 2 years trying to work when I couldn’t get out of bed and was mostly blind. All because doctors didn’t want to spend 20 minutes filling out forms. Plus Disability companies lie constantly until various deadlines pass.

Obviously the doctors should have done the paperwork and you shouldn’t have had to deal with that. But it seems like the root cause isn’t that doctors don’t want to do paperwork, it’s that the insurance is introducing too much paperwork.

Re: Report: 90% of nurses considering leaving the profession in the next year

#122

Post by belval » Wed, Apr 27, 2022, 3:43 PM UTC

sonicggg wrote: post #34

Nurses complain about their work conditions, but I don't understand them. They had this massive leverage during the pandemic to discuss improvements. Some people may say "Oh but it is illegal for nurses to strike in country X", but what will governments and companies realistically do if all nurses decide to stop, arrest everyone and let the health system collapse? Not a reasonable option. There's just something masoc…

It's unfortunate to see this downvoted because I've heard this sentiment echo'ed a lot and I think it's worth explaining.

It's not about the illegality, it's really just about people dying. Yes you can go on a strike but your patient that's in critical condition won't survive on principle. You could say "just don't care about the patient and strike anyway", but that's extremely hard to do.

Striking when it hurts some millionaire owner is one thing, you wouldn't feel bad about yourself. Striking when it hurts someone post-op who did nothing wrong aside from being sick isn't noble, you get to live with the fact that as an individual you could have saved them, yet you didn't because you wanted money.

Re: Report: 90% of nurses considering leaving the profession in the next year

#123

Post by cwbrandsma » Wed, Apr 27, 2022, 3:43 PM UTC

brightball wrote: post #39

phil21 wrote: post #17

While it's anecdote, every single peer in bedside medical care I know without exception has either left the field, or has immediate plans to as soon as student loan debt is repaid. The few older medical professionals in my family are simply sticking out the last few years until they can retire early. This was generally the case prior to pandemic due to how poor the work environment has become, but the pandemic seems…

Insurance companies. Everything is controlled by insurance companies. You can’t do anything unless it’s exactly how insurance wants and only for what insurance will pay. It limits everything, including how every profession can be compensated simply because you can’t easily hire somebody for more than what insurance will pay for their services. You can, but the funds have to come from somewhere.

The hospitals themselves are also to blame. There are a couple court cases where the hospital threw the nurse under the bus to cover up for their own issues (short staffing, bad safety procedures, covering up for a doctor, etc), and nurses are justifiably pissed off right now.

There was a time when hospitals could have helped the nurses with the stress and workload, but the admins bungled it at every possible turn, and now it seems they missed their window.

Re: Report: 90% of nurses considering leaving the profession in the next year

#124

Post by alexashka » Wed, Apr 27, 2022, 3:43 PM UTC

belval wrote: post #52

brightball wrote: post #39

Earlier quoted context omitted.

Insurance companies. Everything is controlled by insurance companies. You can’t do anything unless it’s exactly how insurance wants and only for what insurance will pay. It limits everything, including how every profession can be compensated simply because you can’t easily hire somebody for more than what insurance will pay for their services. You can, but the funds have to come from somewhere.

I doubt that it's as simple as that. Nurses are also leaving in Canada and we don't have insurance breathing down their neck.

Are they? Leaving to do what, exactly?

For every story of 'X leaves to do Y', there are a thousand people claiming they'll leave, that never do.

Re: Report: 90% of nurses considering leaving the profession in the next year

#125

Post by phkahler » Wed, Apr 27, 2022, 3:44 PM UTC

pc86 wrote: post #94

birdmanjeremy wrote: post #84

Earlier quoted context omitted.

I'm friends with quite a few nurses, primarily travel nurses, and not a single one is considering a change in career that I am aware of. Simply an anecdotal counterpoint and nothing more.

Travel nurses are compensated quite a bit more in my understanding. And the travel aspect means they can leave the more toxic locations more easily.

They're paid a shit ton more. And because of that, more nurses are quitting to do the travel thing, which worsens the shortage and increases demand for travel nurses ;-) never seen an industry fuck itself over so bad. That's really the issue - healthcare has become an industry, not a profession.

Re: Report: 90% of nurses considering leaving the profession in the next year

#126

Post by SomeCallMeTim » Wed, Apr 27, 2022, 3:44 PM UTC

uf00lme wrote: post #22

Poor pay, shift work, bad working conditions and multiple chances of catching all kinds of diseases. Most nurses I know have above average intelligence with an excellent work ethic. Just one bootcamp away from a much better life. So much sacrifice for the greater good, we the public are not worth it. Another profession I always think of are math teachers, they are good people.

A bootcamp doesn't guarantee anything; without the right aptitude and temperament the tech industry is just as miserable, with a side of failure if you can't keep your jobs.

And no, "excellent work ethic" isn't enough.

Re: Report: 90% of nurses considering leaving the profession in the next year

#127

Post by mfer » Wed, Apr 27, 2022, 3:45 PM UTC

tmp_anon_22 wrote: post #68

mfer wrote: post #46

I've spent a fair amount of time talking with nurses about the problems. I'm related to a bunch of people who are nurses across disciplines (ER, ICU, med/surg, etc). It's been enlightening hearing them talk about the problems... 1. Many new nurses make the same or more and long time nurses. It's frustrating when the nurse in charge with the most experience is making less than new nurses. Some hospitals are even tryin…

> This one is big for product designers. I think this is looking at the problem wrong. The problem is that implementing positive change in these systems is impossible for reasons far outside the control of any product designer or developer currently on the team. This software is old, has byzantine requirements, probably cut costs all over the place, and conceived in a board room without the benefit of an adequate dev…

> I think this is looking at the problem wrong. The problem is that implementing positive change in these systems is impossible for reasons far outside the control of any product designer or developer currently on the team.

A developer working on something is different from a product designer. For product designer I don't mean a UI/UX developer. I mean someone empowered to design the thing. This is often a leader or product manager.

Product design isn't something taught well in most schools. It's often out of sight and mind. An engineer who was good at building hardware or writing code didn't learn the skills needed for product design through that. Product design requires looking at the whole system differently.

> It probably takes 3 months to move a button around, and instead of moving that button executives are having them push a feature that earns a few more million, or a feature that the customers want more then a UX improvement.

A better UX would reduce the amount of time nurses spend using these systems. That productivity could be used to do more other work (like taking on more patients). I don't like this argument but it's easy to make in terms of cost effectiveness.

I don't think the cost effective conversations are happening. I expect there isn't that level of depth to these. It's hard to do when a purchasing organization (like a hospital) only have a few options and they are all bad.

This is an opportunity. To build software that is both compliant and has a good UX. There's an opportunity to disrupt all the crap software here.

Re: Report: 90% of nurses considering leaving the profession in the next year

#128

Post by polskibus » Wed, Apr 27, 2022, 3:45 PM UTC

brightball wrote: post #39

phil21 wrote: post #17

While it's anecdote, every single peer in bedside medical care I know without exception has either left the field, or has immediate plans to as soon as student loan debt is repaid. The few older medical professionals in my family are simply sticking out the last few years until they can retire early. This was generally the case prior to pandemic due to how poor the work environment has become, but the pandemic seems…

Insurance companies. Everything is controlled by insurance companies. You can’t do anything unless it’s exactly how insurance wants and only for what insurance will pay. It limits everything, including how every profession can be compensated simply because you can’t easily hire somebody for more than what insurance will pay for their services. You can, but the funds have to come from somewhere.

It’s like that in many countries, also in EU. Average age of a nurse is rising, richer countries rescue themselves by importing workforce, because they can’t find workers for the rates they have budgeted at home.

It’s is like that in other professions too if it’s only the tech that gets compensated well. There is a shortage of skilled labour.

Re: Report: 90% of nurses considering leaving the profession in the next year

#129

Post by brimble » Wed, Apr 27, 2022, 3:46 PM UTC

germinalphrase wrote: post #82

xyzzyz wrote: post #64

Earlier quoted context omitted.

> 2. Patients in COVID have become downright mean. Add this to the problems nurses have management and doctors (who are often rude and arrogant) and it's a poor culture. The quality of the environment, from a mental health standpoint, is on the decline. Mean customers, and rude coworkers? I sympathize, but this is a reality in a lot of industries. I have no reason to believe that healthcare here is worse than average…

People who are sick, in pain, or possibly dying might be slightly less emotionally regulated than your typical customer.

It doesn't help that hospital systems tend to be garbage at customer service, so the person's been told to wait an indefinite (but always very long) period without any indication of how long it'll be, and asked to tediously fill out the same information five different times on five different pieces of paper and iPads, all while feeling terrible, before they finally snap at a poor nurse who isn't to blame for their hospital being an uncaring money-making machine with little regard for humanity.

Re: Report: 90% of nurses considering leaving the profession in the next year

#130

Post by wolf550e » Wed, Apr 27, 2022, 3:46 PM UTC

pc86 wrote: post #85

brightball wrote: post #39

Earlier quoted context omitted.

Insurance companies. Everything is controlled by insurance companies. You can’t do anything unless it’s exactly how insurance wants and only for what insurance will pay. It limits everything, including how every profession can be compensated simply because you can’t easily hire somebody for more than what insurance will pay for their services. You can, but the funds have to come from somewhere.

Insurance is the only industry where they agree to pay for something (in this case, "medical care"), but then after service has been rendered can decide to pay less, or not pay at all, or stop paying that provider altogether, etc. This combined with hospitals being run by non-physicians*, and people thinking being able to Google and read WebMD qualifies them to argue with their doctor about treatment plans**, healthc…

re: "Medical decisions need to be made outside of cost considerations."

In the end, labor hours of professionals are finite. Even if you don't need to pay doctors, you only have so many, they can only work so many hours, you will need to prioritize who to help in what way, which procedures to do. Same with all the other personnel, the consumable stuff, the devices/scanners/equipment, etc. So someone is going to have to prioritize. It can be just "how much quality of life can we save using the resources we have", regardless of the patient's ability to pay/insurance/citizenship, but some prioritization will need to happen. The policy of the death panels can be changed, but their existence is inevitable.