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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

#411

Post by dan_quixote »

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…

> 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

This is precisely why I think we will never be able to effectively treat healthcare as a "free market" with tools like HSAs, posted price sheet, etc. The end user can never know the true cost of their procedure until it's long over (sometimes years later) and often don't get to choose at all.

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

#412

Post by gedy »

omginternets wrote: post #176
duxup wrote: post #41

Earlier quoted context omitted.

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

I went to an undergraduate school with a fairly large nursing program, and interacted with a fair number of nursing students. One thing I noted was that a large proportion of nursing students were first-generation college students from lower-middle-class and working class backgrounds. I suspect that the meme of nursing being "well paid" stems from the fact that it is a step-up in that context.

This is my antidotal experience as well from extended family and friends. Many (mostly young women) weren't really sure what to do and picked nursing because "it pays well" and had a romanticized/simplistic view of nursing. Didn't seem particularly interested or passionate about it, so I can see how many would lose interest once the reality of the hard work in the midst of a pandemic.

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

#413

Post by giantg2 »

tristor wrote: post #370
artful-hacker wrote: post #363

Earlier quoted context omitted.

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.

We've created so much regulation that no one person can know it all - not the legislators, not the agents/bureaucrats, not the judges, and certainly not the workers or patients who would be most affected by them.

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

#414

Post by tomatowurst »

mikkergp wrote: post #291
chimprich wrote: post #203

My wife is a nurse in the NHS. She actually saves people from cancer, or at least prolongs their lives. Her work is difficult, with huge responsibility. She gets a pay cut this year in real terms. I make slight improvements to computer systems. In most of the jobs I've done, despite my best efforts to work for reasonably ethical companies, I've not been convinced I've made anyone's lives better. Yet my salary is 2-3…

It's an interesting problem, because we currently align economic 'productivity' and pay rather than social value and pay, which is efficient since we don't have to redistribute resources between industries or roles, and resource redistribution is a dirty word, at least in America. My wife is a doctor and I make significantly more than her working as an SRE, when her job is significantly more difficult (particularly e…

Athletes and celebrities are paid because of economic productivity? It definitely seems like social value based on restricted supplies.

If there are lot of participants in a labor pool, naturally wages will be under constant pressure. The barriers to entry also play a role.

For those RN's quitting, they will simply be replaced by foreign workers. It's similar to how certain jobs no longer have locals in it anymore, instead relying on migrant workers. It's the reality in Singapore for instance and naturally creates an implicit caste system.

Now the markets have evolved/evolving where incumbent locals are no longer granted the same privileges they once enjoyed, somebody who does not have the luxury to consider alternatives will be the ones who fill the jobs, and get the blame when the descendants of local incumbents cannot make their way back.

This is sort of the system I am seeing emerging and it explains the anxiety of us vs them. In reality, the government, markets simply do not care for such superficiality. It seeks to accomodate those who are productive, not sit around waiting for higher powers to "fix". And as such, this dynamic ensures wages in certain industries stagnate, and it's especially true in markets with the characteristics I mentioned above: low barrier to entry and abundant supply of labor.

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

#415

Post by momirlan »

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…

just adding a case when a doctor prescribed double the quantity for an infant. i spotted it right away, he panicked, asked to have the prescription back and promptly destroyed it.

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

#416

Post by cogman10 »

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…

The one I think you are missing is that nurses are and have been overworked for a WHILE now. (that's what I get from /r/nursing)

Hospitals have made sure they hire JUST ENOUGH nurses to cover shifts and no more. With covid hitting, this blew out the number of nurses needed resulting in a lot of "I know you've already worked 60 hours, but can you do another 20? we are short!".

Rather than hiring permanent people or upping salary, Hospitals have instead elected to just use travel nurses and an extreme premium so as to avoid any salary increases.

The fix is one that Hospital admins don't want. Pay your nurses more and hire more than the minimum to cover shifts so a nurse being out sick doesn't result in another working a 80 hour week.

So, instead it's been day old pizza with superhero stickers.

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

#417

Post by post-it »

ubermonkey wrote: post #371

A good friend of mine was a nurse practitioner in cancer care here for 17 years, and quit last year to do contract work in interesting places. She's unmarried, no kids, etc., so I think it's a little bit of a "shake things up" thing but also a little bit "make hay while the sun shines." Her most recent gig was in Antarctica. I mean, cool, right?

I would love to spend a winter at the south pole station. The biggest downside of being able to do my job remotely means I'll never get sent to cool places. :(

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

#418

Post by Wistar »

elhudy wrote: post #408
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…

Don't forget that nurses can now legally be thrown under the bus with criminal charges for malpractice while hospitals walk away scotch-free [1]. This is huge in the nursing community right now. [1] https://www.npr.org/sections/health-shots/2022/03/24/1088397...

And, alas, found guilty:

https://www.npr.org/sections/health-shots/2022/03/25/1088902...

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

#419

Post by primedteam »

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…

HITRUST certification is the most demoralizing thing I've done in my life. You need a policy, a procedure and evidence of things like this:

Shared system resources (e.g., registers, main memory, secondary storage) are released back to the system, protected from disclosure to other systems/applications/users, and users cannot intentionally or unintentionally access information remnants.

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

#420

Post by [deleted] »

vlunkr wrote: post #387

I'd like to know what "considering leaving" means in this study. I consider leaving my profession every time a React hook misbehaves and locks up my browser, but I'm not actually going to leave. 90% seems way too high to be people who are actively wanting to leave.

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