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

#311

Post by DaltonCoffee » Wed, Apr 27, 2022, 4:56 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.

This inefficiency and it's resulting poor working conditions aren't unique to countries with health insurance and private healthcare tho, see Canada.

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

#312

Post by Spooky23 » Wed, Apr 27, 2022, 4:56 PM UTC

JackFr wrote: post #250

pc86 wrote: post #85

Earlier quoted context omitted.

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…

> * I strongly believe that only physicians should be running hospitals. Certainly not administrators whose only education is an MHA and only experience is working for for-profit health companies. The skills need to run a hospital are quite different than those required to be a doctor. I'm not saying hospitals aren't unique - I believe they are and their adminstration is highly specialized. Doctors should inform the…

Doctor pay is high because supply is constrained.

We’re “fixing” this by flooding the market with less trained nurse practitioners and PE. Doctors are being gobbled up by regional medical cartels and put where they can maximize billing.

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

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Post by LegitShady » Wed, Apr 27, 2022, 4:56 PM UTC

woodruffw wrote: post #48

duxup wrote: post #41

Earlier quoted context omitted.

I was under the impression that nurses were paid pretty well (generally speaking).

Nurses are paid well, relative to the average American salary. I don't think they're paid particularly well relative to the job's lifestyle requirements and latent stress levels, especially during a pandemic. Looking at my area (NYC), I'd have to take over a 50% pay cut from my engineering job to be "paid well" as a nurse. And I suspect my job is a lot less stressful.

While I don't doubt that nurses have very high stress jobs, the reason why you'd take a pay cut to become an nurse is because their job is a lot less technically difficult.

I have some friends from university who became nurses, one of which I was roommates with for two years during school. I helped them study for 'their most difficult math test' and it was a relatively straightforward test on changing units. They would not have passed a first year calculus class. The majority of their academic work was memorization, and then lots of hands on work in hospitals. The reason they get paid well is because the job is important and stressful, not because it requires highly technical people of which there is limited supply.

I don't say that as a slight - I know many nurses who are very intelligent people, its merely a judgement as to the academic rigor involved in getting your nursing credentials.

PS I worked at home depot during busy periods in the summer when the store was understaffed, I've worked as a waiter where I was the only person on shift because the owners/manager were idiots, and I've worked cleaning big chicken barns out in preparation for new chickens and those were all significantly more stressful than my technical work. Stress is not correlated with difficulty or limit of supply.

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

#314

Post by pomian » Wed, Apr 27, 2022, 4:56 PM UTC

hateful wrote: post #72

nittanymount wrote: post #29

Earlier quoted context omitted.

this is more correct, the medical fields have to do a lot of paperwork to follow rules and avoid issues (legal?) almost half of their time are on charting instead of taking care of patients, paperwork is needed, but in most facilities, it takes too much time, and the workflows are not optimized enough as well...

I've always wondered why they don't hire an assistant that JUST does the paperwork/coding for the doctor. They could follow them into room and just take notes (and leave at times when it is appropriate). How much could it cost to pay someone else to do this? Surely less than a doctor makes doing it... It can become its own profession. It's a separate skill - separate from what a doctor should be focusing on. On a sid…

Brilliant suggestion. Some of us still remember the days when we were paid to be creative engineers, solid creative engineers, designing elegant solutions. Didn't know or need to know how to type, design layout of reports, kerning and fonts, didn't keep track of bills and accounts: Just engineering. (Of course report presentation, review and editing were still necessary, not not the actual technical aspects.)

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

#315

Post by hedora » Wed, Apr 27, 2022, 4:56 PM UTC

api wrote: post #187

hedora wrote: post #179

Earlier quoted context omitted.

See also: California’s plan to eliminate algebra 2 and calculus from the highschool curriculum. It is being spearheaded by someone without a math degree, in the name of improving marketability of the kids for data science positions, or something. See also (2): Monty Python’s bicycle repairman sketch.

Yeah that proposal is insane. For a while now it feels like the left and the right are attempting to one-down each other on how stupid they can get. That proposal seems like an example of the left trying to out-stupid Trump and the alt-right. Don't worry I'm sure the right is working on things even dumber than this, and then those will have to be topped, and so on. In 2024 we will have Dr. Oz and Marjorie Taylor Gree…

I think the root problem is that administators without practical skills are running everything.

Since they got by without any practical skills, they don't value such things. Now, they want to eliminate them entirely from the educational system.

The managers are at war with the individual contributors, and they don't understand that someone has to actually do work, or the system will collapse.

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

#316

Post by tyrrvk » Wed, Apr 27, 2022, 4:57 PM UTC

We talk about insurance killing the medical field, but I'd also argue that EMR companies are doing a number on the profession as well. Have you seen the Epic campus? Epic - located in Wisconsin (not the gaming company). The amount of overhead a hospital needs to support/run that behemoth can't be small. And Epic is _swimming_ in cash.

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

#317

Post by lettergram » Wed, Apr 27, 2022, 4:58 PM UTC

lefstathiou wrote: post #251

lettergram wrote: post #215

Earlier quoted context omitted.

No one wants to hear the truth. There’s near-infinite demand for healthcare and a constrained (mostly artificially) supply. Insurance, people and government can’t solve the problem of the supply and demand by throwing money on it. You either expand supply or remove demand. Given removing demand is... not desirable. The only alternative to fix the issue is remove regulation and expand supply. That’s it. Insurance make…

I think there needs to be some new approach to how medical services are being paid for. My 70yo father fell off a ladder and drove himself to the hospital in Calhoun Georgia (2 hours north of Atlanta, a small town) with a bruised eye and a broken wrist. He got in late afternoon, left the next day, and the bill to insurance (which of course they won't pay) was $69,000... more than per capita income in the US. The syst…

> left the next day, and the bill to insurance (which of course they won't pay) was $69,000

I agree with you and the quote above is because of insurance. Medicare will pay 10% of that total and your father would be charged 2-5%. If he has private insurance you’ll see something different, maybe 15% and your father would be charged 3-6%. If he’s going out of network could be 100%. Hospitals / practices charge insane bills because people pay just a small fraction typically. It really impacts those without insurance or private insurance the worst. It is insane.

This is why I have suggested deregulation, particularly around licensing. It drives down the cost. Insurance may cover doctor X, but if nurse Y can do it for 5% the price... well use the nurse. All doctors would have to reduce prices and insurance would have to raise the coverage amount to compete. It’s what is done elsewhere in the world.

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

#318

Post by UnpossibleJim » Wed, Apr 27, 2022, 5:00 PM UTC

bkjelden wrote: post #242

UnpossibleJim wrote: post #189

Earlier quoted context omitted.

This is totally anecdotal, so take it for what it's worth, but in addition to nurses leaving the profession I've seen quite a few doctors in my area leaving the profession as well. Relatively young men and women retiring the profession completely post pandemic, though I haven't had an opportunity, nor would I, to ask them why they left the position. I have no idea if it has anything to do with the pandemic or the adm…

I have no doubt that MDs are leaving as well - but, at least from my perspective, in any large healthcare system, there is a drastic difference between the way middle management treats MDs and the way they treat everyone else. The latter is completely expendable, whereas the MDs do have a fair amount of negotiating leverage around their working conditions.

Oh, don't get me wrong. The way nurses are treated is horrible. I wasn't arguing that and I hope it didn't come across that way.

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

#319

Post by mfer » Wed, Apr 27, 2022, 5:00 PM UTC

jwagenet wrote: post #201

mfer wrote: post #160

Earlier quoted context omitted.

The travel nurse market is growing due to supply and demand problems. The demand for nurses is increasing as people are leaving and there are more from the boomer generation hitting an age where they need more care. The supply has stayed the same. Schools local to me have not increased output for various reasons (lack of instructors, lack of space in local hospitals where nurses train, etc). The supply is too low. So…

No, the solution is to pay nurses better. There are already tons of high quality nurses who don’t want to do it anymore because of poor pay in the face of demanding hospitals and patients.

Pay is a problem. I don't disagree with that.

But, before COVID there was already a supply problem. The supply problem has been slowly getting worse for years and then COVID accelerated it. If every nurse came back to working as a nurse who wanted to work there would still be a supply problem.

Supply has not been growing to meet the demand growth for years.

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

#320

Post by TOMDM » Wed, Apr 27, 2022, 5:01 PM UTC

sonicggg wrote: post #281

Ensorceled wrote: post #78

Earlier quoted context omitted.

It's more a lack of psychopathy in the profession. If nurses in Ontario had gone on strike two months ago, a lot of extra people would have died.

I know Ontario all too well. The same people that depend on nurses won't do more than needlessly beat pots and pans for their "heros". They do not even support them with their votes, which put in power the nefarious Conservative party. Who exactly are the nurses standing for? People that won't have their back.

I think there's some middle ground between "Hey, we need some more support, our conditions suck" and "Fuck it, we'll let the sick die I guess"