Hospital exec says employees are walking off the job • Hacker News Board

Re: Hospital exec says employees are walking off the job

#331

Post by zsmi » Fri, Aug 06, 2021, 4:12 PM UTC

FireBeyond wrote: post #239

zsmi wrote: post #192

Earlier quoted context omitted.

It depends what one means by "shift". For example my brother-in-law is a firefighter. He spends 3/4 days straight in the firehouse and then comes home for 3/4 days and works something like 12 hours straight when he is on call and gets rest periods when not actually doing firefighter work. This is possible because the firehouse basically has a small dorm in it. When I ask him when he is going to work he says he has a…

As a firefighter, even for firefighters that's beyond the norm. He's picking up extra shifts, there. The typical maximum scheduled is 48 on, 96 off. Around here (west coast) it's typically called a Detroit schedule (so not just west coast, I guess!)... 24 on, 48 off, but even more closely around here we use a Modified Detroit, which is a nine day rotation, where you work a 24 hour shift on days 1, 3 and 5 of the rota…

Thanks for the comment. That is interesting.

I'll be the first to admit I don't understand precisely what is going on or the challenges involved. Still, my understanding is that this scheduling is just for drivers. Overworking drivers is somewhat scary but necessary because their district has a severe shortage of them. It seems they're hard to hire because they need special certifications, training, and additional experience, and local firefighters have struggled to pass the necessary tests. Therefore, the city "asked" the existing drivers to do extra shifts while hiring new drivers.

At least that is what they said about two years ago...

Looking at the numbers a bit more closely. 48on 96off is 1:3 uptime per firefighter. 72on 72off is 1:2, increasing the uptime but also giving at least some amount continuous away time. Probably the odd 4 day shift is because of extract coverage days, like the fourth of July, or something. Or if a driver needs a vacation. Which is one nice thing they did. They did increase the amount of paid vacation the drivers get as a kind of compensation. Not enough to make up the difference of course, as that would defeat the whole point of the long shifts, but something.

Re: Hospital exec says employees are walking off the job

#332

Post by guilhas » Fri, Aug 06, 2021, 4:44 PM UTC

exo-pla-net wrote: post #151

Some grisly perspective from the linked video: "In 18 months, she saw more patients die than most nurses before COVID saw in a career."

That's sounds like BS, unless you are comparing nurses working in different places, then it would always have been true

Know around 10 nurses at a big hospital. First they've always been on the brink of walking out, they earn on average less, in the UK, than starting IT workers, and they have much more responsibilities.

They're shifts have been understaffed since ever. Everyone always talks about leaving

In the beginning of the pandemic most old and sick were discharged to nursing homes, where they died

And the hospitals actually had less people, but also less capacity since they could use only every other bed for distancing. So at least 50% less capacity. And wards where covid tested positive had to be closed for 2 weeks

The excess mortality is not big enough that would be true for nurses in same position

Re: Hospital exec says employees are walking off the job

#333

Post by janeroe » Sun, Aug 08, 2021, 2:12 PM UTC

handrous wrote: post #243

janeroe wrote: post #125

There is a relevant speech by a surgeon who along with other doctors started their own practice [1]. It's called "Why Aren't There More Free Market Surgery Centers and Clinics". > The last two payments I received from Medicare were as follows: $285 for a six-hour cardiac anesthetic and $78 for the anesthesia services required for a knee replacement. These fees had been imposed through a mechanism referred to as the r…

Every other developed country I'm aware of uses price controls for their healthcare system, usually by declaring price lists regardless of payer, by establishing a state-directed monopsony, or by taking direct control of healthcare providers. Clearly it can work since AFAIK everyone is doing it, and it seems to be basically fine. Not perfect, but fine.

And that's why author's practice survived despite the hostility of the US government. They started treating Canadian patients:

> The first patients to arrive after we posted prices were Canadians. This was instructive, as these patients had so-called insurance coverage. There was no access, however, to the care that many of them required. The most common story then as now for the Canadians was a patient waiting two years to see a gynecologist for a hysterectomy to stop their bleeding, bleeding usually so severe that intermittent transfusions were required. For $8,000, which covers the facility, surgeon, anesthesia, pathology, and an overnight stay at the surgery center, Canadians can end their nightmare. The first question a Canadian asks when they call us is how long they’ll have to wait. Our answer that there is no waiting time is met with disbelief. A Canadian friend of mine has told me the old joke that no Canadian is truly content unless standing in line.

All thanks to the success of a "state-directed monopsony" of a "developed country".

Re: Hospital exec says employees are walking off the job

#334

Post by fumar » Sun, Aug 08, 2021, 6:12 PM UTC

rangoon626 wrote: post #317

fumar wrote: post #54

Earlier quoted context omitted.

What about the parent's statement provides critical thinking? Would you invest billions in building out ER facilities now? I am curious what is the less-wrong solution to help citizens. Is to increase care for the sick or decrease the likelihood of sickness?

The less-wrong solution to help citizens is to encourage a healthy diet including weight loss, stop spreading FUD, and to implement the MATH+ protocol for those who do fall seriously ill instead of chiding and coercing a clearly hesitant public into taking an experimental therapeutic treatment (that seems to do less than originally promised as the days tick by) and harsh lockdowns. Instead we see the opposite, which…

You believe that encouraging Americans to be healthy will work? Has it worked before? In my experience from years in hospitals, the majority of people want less mental and physical health requirements. They want a heart pill or diabetes pill instead of a nutrition-based approach. What would you do in this scenario: as a physician, your patient is at high risk for heart disease, over weight, and above 45 years old. Do you recommend they drastically change their life style and increase routine lab work until improvements are made. Your patient could do nothing and be at risk for a stroke. Your other option is to have them ingest two pills daily to control their symptoms but not the root cause - their lifestyle.

A life is in your hands. I’ve witnessed and lived through both scenarios. The majority of the time people want the pills.

I am curious how you would solve for modern human ailments. Would you impose a government sanctioned food protocol? Would you let people die who refuse to increase their quality food intake and exercise?

Re: Hospital exec says employees are walking off the job

#335

Post by rangoon626 » Fri, Aug 13, 2021, 3:02 AM UTC

fumar wrote: post #334

rangoon626 wrote: post #317

Earlier quoted context omitted.

The less-wrong solution to help citizens is to encourage a healthy diet including weight loss, stop spreading FUD, and to implement the MATH+ protocol for those who do fall seriously ill instead of chiding and coercing a clearly hesitant public into taking an experimental therapeutic treatment (that seems to do less than originally promised as the days tick by) and harsh lockdowns. Instead we see the opposite, which…

You believe that encouraging Americans to be healthy will work? Has it worked before? In my experience from years in hospitals, the majority of people want less mental and physical health requirements. They want a heart pill or diabetes pill instead of a nutrition-based approach. What would you do in this scenario: as a physician, your patient is at high risk for heart disease, over weight, and above 45 years old. Do…

> You believe that encouraging Americans to be healthy will work?

Yes, however it starts with improving the food preparation options and raising food quality. There is horrible stuff in our food - stuff that is outlawed in Europe because it is a known toxin.

Something has clearly gone wrong in the US and it’s a pretty patronizing position you have taken to put the blame entirely on the public. The government institutions supposed to be watching out for this stuff have failed, and are likely corrupt.

> Would you impose a government sanctioned food protocol?

Nah, not needed. This is fixed by a PR campaign and some cultural adjustments.

For example, for some reason the media has been promoting “body positivity” in recent years and encouraging unhealthy lifestyles. Those people who actually bought into that idea were set up in a worse position when this kicked off.

Probably not promoting bad ideas like that would be a good place to start. The commies will whine that it’s “fascist” or not “big hearted” whatever, though.

—-

In the end, I guess only people who can see through the lies will survive, and that’s just the game we’re playing now. That doesn’t mean that we should accept living a society where this is normal.