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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

#511

Post by lotsofpulp »

aluva wrote: post #238
rel2thr wrote: post #67

Wages need to go up. Also I think there will be a big push to open up immigration to nurses and doctors over the coming decades Kind of weird that the usa prioritizes software developers over healthcare workers in the immigration system .

If have a nursing degree it's easy to immigrate to USA, in fact you will be coming in with a green card unlike tech worker. So to your point, US does prioritize nurses over others. Doctors are different and it's incredibly difficult for a doctor with a foreign degree to practice in US. I know this for a fact since I come a place where almost every other house has a nurse working in Europe/US

https://www.uscis.gov/green-card/green-card-eligibility/gree...

Immigrant doctors have to be willing to live in the least popular parts of the US.

> One reason USCIS may grant the national interest waiver is because a physician agrees to work for a period of time in a designated underserved area.

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

#512

Post by anonporridge »

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...

This kind of thing is going to further disassociate nurses from interacting like a human with their patients. If you risk criminal prosecution and prison time from making a mistake, everyone starts walking on eggshells and become afraid of doing anything beyond box ticking. They'll start turning a blind eye to things they know are wrong, because the system doesn't see them. All work will align towards pure compliance with the law and the hospital system at the expense of intimate connection with patients.

And of course, a lot of nurses are in the job for the human connection, and will consequently be burned out at an increasing rate.

To some degree this might actually be good long term, because it will be that much harder for hospitals to manipulate nurses into working around the limitations of the system to provide real care, which allows the administration to turn a blind eye to their own flaws. There's going to be a surge of malicious compliance that ends up shining a bright spotlight on just how abusive and dysfunctional hospital systems really are.

And patients will ultimately be the ones who suffer.

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

#513

Post by MomoXenosaga »

alostpuppy wrote: post #394
brimble wrote: post #129

Earlier quoted context omitted.

It doesn't help that hospital systems tend to be garbage at customer service, so the person's been told to wait an indefinite (but always very long) period without any indication of how long it'll be, and asked to tediously fill out the same information five different times on five different pieces of paper and iPads, all while feeling terrible, before they finally snap at a poor nurse who isn't to blame for their ho…

You didn’t even mention the anxiety patients are enduring over the billing the entire time.

And now they will be billed even more because nobody wants to do the job anymore!

Healthcare workers are not slaves they can quit after all.

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

#514

Post by wardedVibe »

bsedlm wrote: post #384
hedora wrote: post #235

Earlier quoted context omitted.

We’re facing some massive generational crises at this point, and it feels like the only solution is to wait for the current leadership to die off, and hope the gen x’ers fix it. The WWII generation fixed the ozone hole, but their kids didn’t lift a finger for global warming. Subsequent generations are scrambling to pick up the pieces for our kids, while crap like this, and our rapidly collapsing democracy keep sabota…

> We’re facing some massive generational crises at this point, and it feels like the only solution is to wait for the current leadership to die off, and hope the gen x’ers fix it. oh man, I choose to laugh so I don't start crying hahaha. I want to turn this into an argument of why age-reversal and other longevity research is such a bad idea (personally, I think it's kind of evil; but maybe I've seen too many villanou…

I mean, making sure Putin doesn't live forever seems like a pretty high priority to me.

There's also the fact that science might lock up, since old scientists have more reputation at stake in the old theories (there's an adage "science advances one funeral at a time"). We're not ready as a species for immortality

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

#515

Post by js2 »

Shuang1 wrote: post #451
mikemac wrote: post #306

Earlier quoted context omitted.

Agree with all of this, and just to add one thing: liability. Look at the RaDonda Vaught case or the Michelle Heughins case; terrifying to be looking at jail time for a med error. Many nurses are watching these cases more closely and deciding that since staffing isn't getting any better and they won't be protected, it's not worth the risk.

That case goes far beyond med error and I don't understand why people keep bringing it up as an example. She pulled the wrong med, and then injected it and walked out of the room rather than observing for effects. Also the med she pulled had warnings on all sides of the bottle and on the top saying very clearly that it's fatal to administer without ventilation. This went beyond a mistake to negligence.

Janie Harvey Garner, a St. Louis registered nurse:

“In response to a story like this one, there are two kinds of nurses,” Garner said. “You have the nurses who assume they would never make a mistake like that, and usually it’s because they don’t realize they could. And the second kind are the ones who know this could happen, any day, no matter how careful they are. This could be me. I could be RaDonda.”

https://khn.org/news/article/radonda-vaught-nurse-error-medi...

HN readers can look at this case filing:

https://www.documentcloud.org/documents/6785652-RaDonda-Vaug...

> Also the med she pulled had warnings on all sides of the bottle and on the top saying very clearly that it's fatal to administer without ventilation.

The linked PDF includes images of medicine in question. There's a single warning on top that reads "WARNING: PARALYZING AGENT" and a red cap. I don't see any warnings on the side. The vial appears to be tiny, smaller than my thumb.

But yes, she made a series of mistakes, listed on the last two pages of the PDF.

I am not a nurse, but I can easily imagine how someone could make the errors she did in an overworked and high-stress environment. It's a cascading series of errors that starts with overriding the medicine cabinet when she can't find the medicine she's looking for. But according to her defense, overriding the cabinet had become almost standard operating procedure at Vanderbilt at that timeframe. Once she starts down this path, she's operating on automatic and almost blind to what she's doing.

I agree she was negligent. I don't think she should go to prison for it. In the bigger picture, this is causing more nurses to quit, likely leading to more medical errors and deaths, not fewer.

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

#516

Post by InitialLastName »

alostpuppy wrote: post #409
durrden wrote: post #178

Earlier quoted context omitted.

My wife (ER/Trauma RN) feels the same way. They will need to double the pay of non-travel nurses to get through this.

The existence of travel nurses should really be indicative of a problem.

Should it? The market for medical care has a base rate (and appears to be clearly under-staffed for that rate), but (especially in a pandemic) it's rather peaky and the basic skills appear to be VERY transferable from location to location. If there are people with the skills that are willing to travel, it seems that a system that maintained maximum capacity in all locations would be a very wasteful one.

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

#517

Post by rectang »

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…

> 3. IT systems that they have to use were designed by people who have not talked with the workers who use them. They may have been designed with laws and compliance in mind. Nurses aren't the people who choose or pay for these systems. But, they use them a lot (maybe the most) and it's obvious they weren't taken into account when designing the UX. It's maddening for them.

> This one is big for product designers. Often we listen to the people who pay for it and miss out on the people who actually have to use it.

This resonates with me strongly for two reasons. First my mother is a retired RN, and the electronic record keeping was her biggest frustration. It is hilarious to me how much my mother hates computers, while I make a living in software.

Second, I'm now working for a startup, Smarter Dx (we're hiring: https://angel.co/company/smarterdx/jobs ) that works with these records and tries to make better use of them. To the extent that we're successful, incentives are created for the hospital to improve them, conceivably including improving the UX that nurses see. I don't mean to underestimate the difficulty of the problem, but I think it's possible to at least push in the right direction.

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

#518

Post by ciphol »

jmugan wrote: post #397

A lot of us are saying we need to increase the pay of nurses, but we also believe that medical care is too expensive. So, where is all that money going? There are a lot of flippant answers but they never seem to lead anywhere actionable.

It goes to treating crises (expensive) rather than preventing them (cheap)

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

#519

Post by tssva »

nfriedly wrote: post #462

My mom was a RN (Registered Nurse) for 30+ years. She quit doing what most people think of as "being a nurse" about 10-15 years ago and switched to related work (home checkups, teaching, medical billing, etc.) because of how stressful and demanding working the floor in a hospital was. Last year she retired from the profession entirely, a few years ahead of "normal retirement age", and now she works part-time at a loc…

12 hour shifts have long been the standard for nurses in a hospital setting. A full-time hospital nurse usually works 3 12 hour shifts in a week.

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

#520

Post by TrispusAttucks »

etchalon wrote: post #327
TrispusAttucks wrote: post #174

Earlier quoted context omitted.

You're spot on. This pattern is emerging across many structures. Efficiency is inverse correlated with resiliency. JIT systems have spread over the globe but they don't handle shocks in the pipeline very well.

"Efficiency is inverse correlated with resiliency.". Well, I'm jotting that down in a notebook.

You may enjoy the paper "Examining the balance between efficiency and resilience in closed-loop supply chains" [1] from August 2021.

EDIT: Also interesting relationship with sustainability [2].

[1] https://link.springer.com/article/10.1007/s10100-021-00766-1

[2] https://www.researchgate.net/figure/Sustainability-curve-map...

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