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

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

#361

Post by ryan93 »

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…

There are like 4 million nurses. Where are they going to go for even remotely similar wages?

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

#362

Post by frgtpsswrdlame »

LewisVerstappen wrote: post #249
yhoneycomb wrote: post #234

Earlier quoted context omitted.

Actually, that’s exactly how unfettered “free market” capitalism operates. The end game is big companies end up controlling everything, including the regulations in order to tip the scales in their favor.

Regulatory capture is the issue that needs to be solved. Not free markets. Free markets are the most efficient way for information to be transferred throughout the system. Stricter campaign finance laws, ending revolving-door politics, etc. But putting the blame on free markets seems like a mistake.

Feels a lot like 'Real free markets have never been tried!' which we all know from its standard form on the left. If, at this point in history, real free markets have been unable to sustain themselves in the areas of the economy that people depend on the most (healthcare as a major example) then perhaps we ought to consider whether they're able to sustain themselves at all. I believe free markets and meritocracy are two systems commonly pointed to today that may be 'ideal' in one sense or another but which in practice cannot help but sow the seeds of their own destruction.

Markets exist by virtue of laws created by governments - property law being the primary example - expecting actors in a free market who aggregate enough wealth to affect those governments not to just strikes me as unrealistic. It reminds me a bit of gaming. Everyone agrees that in a competitive game the most fun part is early on before a 'meta' can be established. But of course that meta will always end up established and it's basically dumb to be mad at people for metagaming or to otherwise expect them not to.

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

#363

Post by artful-hacker »

tristor wrote: post #219
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. You're right that there are definitely opportunities for improvement here. As a Product person that has worked in EMR/Healthcare IT systems, I can tell you the biggest challenge is most of the decisions are driven by legally-required compliance. In many cases, you literally cannot make it better because the brokenness is /by design/ to comply with the law. Nearly across the bo…

I'm in this business too, and it's not just the direct features supporting the law, its the law driving out time and talent trying to make things better. We don't have time to improve systems because we are all too concerned with meeting the latest regulatory pipe dream of interoperable systems.

Systems that nobody has ever asked us to use. Entire APIs with full access to key data, that nobody uses.

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

#364

Post by johndhi »

I've worked in healthcare law for a few years and I think the problem boils down to how it's regulated.

It's super, duper complex with lots of paperwork. The complexity is too great to run a small practice, the Medicare/Medicaid fees are too small to make up for it, and it increases the importance of administrators in the hospital system.

If I had a bunch of time I'd love to go through and write up a proposed alternative approach, and congressional bill -- but I have to imagine even if I did that, no one would listen to it.

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

#365

Post by FredPret »

katbyte wrote: post #53
JaimeThompson wrote: post #9

Perhaps allowing modern MBAs to cost optimize most every single thing we do isn't the best way to assure mid and long term security and profitability.

Cost optimization usually have huge gaps in things that are hard to measure like onboarding cost/time or morale or benefits of experience. Who cares about any of that when you can make the shareholders another million a the expense of literally everyone else?

The thing is though this is good for shareholders only in the very short term. In the decades-plus term, doing the right thing is best for the owners.

And this is why we need savvy shareholders who vote in AGMs.

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

#366

Post by 93po »

black_puppydog wrote: post #325
germinalphrase wrote: post #55

I have a close relation that works for one of the oldest pediatric hospitals in the country. It was recently revealed that they will be shuttering almost all pediatric services in the next year because they can 10x their profits by only serving elderly clients. The entire purpose of this organization was to provide pediatric healthcare, and it wasn’t losing money… Sometimes, it feels like we’re min-maxing ourselves t…

Yeah if they're only after profits, why not become a hedge fund?

Many are owned by hedge funds:

https://www.nbcnews.com/health/health-care/private-equity-fi...

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

#367

Post by 77pt77 »

93po wrote: post #339
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…

> people thinking being able to Google and read WebMD qualifies them to argue with their doctor about treatment plans In my experience, I have had: 1. Doctors that know nothing about a really basic ailment and not have any meaningful guidance or treatment to suggest 2. Doctors that Google something literally in front of me, things that I have already Googled myself, and draw the wrong conclusion because they're looki…

You forgot one.

Doctors that blatantly lie to your face because they want to push some procedure.

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

#368

Post by Eric_WVGG »

birdmanjeremy wrote: post #84
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…

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.

Funny you should mention that… reading all of this, I was thinking of a podcast interview with a nurse who was retiring from hospital work. His primary reason for leaving was being tired of fighting with hospital ownership and administration, and was planning on switching to travel nursing which appears to be more of a "gig" space.

He did consider that a career change, I think in the same sort of way that a computer programmer like (presumably) most of us would consider quitting Google to work on an indie app or videogame development would be a career change.

The larger point is, medical professionals are bailing from the hospital system, which looks pretty busted.

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

#369

Post by bsedlm »

at some point, somehow, medical care stopped revolving about 'healing' and medicine became all about 'treating'.

the health of the patient became subordinate to the economic incentives of the hospitals and the other involved institutions (insurance providers, pharmaceutical corporations, etc...)

and so I have the hypothesis that this happened because people (young adults) going into medicine because of a vocation to help and heal others become disheartened when they find out it's all about institutional profit; only them who get into this becuase "doctors make good money" really make it to the end (which is not terrible, as they usually do learn the methods and techniques of medicine, but that in the long run prioritize money over health).

health care should have never been allowed to become a capitalist marketplace.

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

#370

Post by tristor »

artful-hacker wrote: post #363
tristor wrote: post #219

Earlier quoted context omitted.

> This one is big for product designers. You're right that there are definitely opportunities for improvement here. As a Product person that has worked in EMR/Healthcare IT systems, I can tell you the biggest challenge is most of the decisions are driven by legally-required compliance. In many cases, you literally cannot make it better because the brokenness is /by design/ to comply with the law. Nearly across the bo…

I'm in this business too, and it's not just the direct features supporting the law, its the law driving out time and talent trying to make things better. We don't have time to improve systems because we are all too concerned with meeting the latest regulatory pipe dream of interoperable systems. Systems that nobody has ever asked us to use. Entire APIs with full access to key data, that nobody uses.

Yes, this is probably the bigger impact, to be honest. Teams have limited resources and more and more of it is cannibalized by regulatory compliance work.
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