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

I still think it’s better than the other extreme of just showing up and trusting the professionals. That should work in theory, but my experience for myself and those around me is it’s incredibly ineffective. If what you’re dealing with requires the least bit of thought, odds are you’re getting brushed off to the extent you allow.

The real model of US healthcare is essentially apprentice/master, with the patient as apprentice. Apprentice does a lot of the work, not all, some needs to be approved by the master and the apprentice better know how to learn from the master, when to push back, and how to make it seem like it was their idea all along. You can imagine how this falls apart for mental health.

I suppose you could just pay people more money to make it worth it but the long hours take a toll in other ways as well and contribute to burnout no matter how much you get paid.

1. Everyone pays lip service. People stand at airports and say thank you for your service the same way they open their windows at 7PM and start clapping and cheering during shift turnover. Sometimes they'll say they know people who are veterans or 'frontline healthcare workers' as a sign of solidarity

2. Nobody actually wants to hear what you went through. Hearing people die or knowing people are about to die in sometimes painful, unfortunate ways is too raw for people to try to seek out and understand, despite the fact that for a significant portion of the population that's how we're going to go out, in a hospital with all sorts of drugs pumped into our system

3. There's a constant barrage of emotional/mental harm. Believe it or not, you don't magically 'harden up' immediately. Absorbing/witnessing drastic outcomes gets easier, but the burden doesn't get lighter. This isn't to mention physical harm. People do all sorts of things out of desperation and frustration.

4. The systems that manage you are byzantine if not kafkaesque. You're never sure how the decisions are made, yet you're the one that will be paying the most for it. You know deep down that you're just a number on a spreadsheet, and the only reason that keeps you going is internal motivation to do what you think is right, so you push on

5. The people who can help rarely think about you. Very few politicians will mention your name or your union that is doing its best to get some kind of safe nurse:patient ratios or even get the hospital to pay for your scrubs that they mandate. Very few billionaires have mentioned healthcare workers or veterans at all. As a whole, until someone has an emergency that threatens their physical or financial status, healthcare and security is treated as a black box with unreal expectations and extra sensitivity to deviations from said expectations, despite a complete lack of introspection and information on how those expectations came to be

I don't know what the solution is. In healthcare, every system is so deeply connected to the rest that destroying one or even refactoring takes down everything else, and we need it to stay online. The same applies to the continuation of geopolitics by other means. You can give every IC the best EMR system, the best rifle and radio, the best monitor/laptop/keyboard, but it's all for nothing if the system as a whole is a dumpster fire. Her frustration is palpable every time she finishes a rough shift (probably 2 out of 3), and the best I can do is lend my ear and pour a glass of wine.

That being said, I am grateful that she is continuing on the path. Our shared experiences have brought us closer than ever.

What's worse is it belies an ugly aspect of human nature (particularly pervasive in the US IME) that people absolutely do not give a fuck about anyone else when it comes down to it. As long as someone is fortunate enough to have decent health insurance through their job, people who don't are lazy.

The big picture here is that the wealthy want people dependent on jobs and to be in debt (eg student debt) because it makes them compliant.

So I'm not surprised nurses are leaving. Insurance companies make providing healthcare an absolutely miserable business and deliberately killing people ("prior authorizations", "pre-existing conditions", etc) should not be the basis for commercial enterprise. Denying someone life-saving or life-changing care should not be a profit motive.

What's worse is that a lot of the burnout is effectively caused by people who are profoundly selfish and are voluntarily choosing to get sick and die of what is now a highly preventible disease.

It's a hard situation because people depend on nurses so collectively they're torn. Teachers OTOH aren't life-critical (but still obviously important) so I'd actually like to see them make a mass exodus over all the right-wing censorship they're facing in most states.

There’s a lot of white collar work that only requires a nonspecific college degree, but I’m not aware of such a high demand for for HR staff or accounts payable specialists.