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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

#581

Post by eigen »

cogman10 wrote: post #416
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 up…

and now nurses are apparently solely responsible for medical errors and will not be supported by their employer. the cause of which appears to be related to #3 in GP above where overrides are a regular occurrence and quickly loose meaning if you have to do it multiple times per day.

https://khn.org/news/article/radonda-vaught-fatal-drug-error...

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

#582

Post by manuelabeledo »

ironmagma wrote: post #305
manuelabeledo wrote: post #51

Earlier quoted context omitted.

Maximising profit by cutting down wages and personnel is not a MBA specific problem.

It is a problem fostered by that culture though.

Is it, though.

If you have the opportunity to take a look at the content of your typical business administration book, or even the Harvard Business Review magazine, they essentially are collections of success stories. Instead of setting the narrative, they go and say “this or that worked/didn’t work, to get this company out of a slump”.

The issue, I believe, stems from the fact that “bringing in the MBAs” happens when a company doesn’t hit inflated targets, and for that you have to thank the c-suite, which isn’t necessarily a bunch of kids with master degrees.

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

#583

Post by gruez »

js2 wrote: post #515
Shuang1 wrote: post #451

Earlier quoted context omitted.

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.o…

>I agree she was negligent. I don't think she should go to prison for it.

but we literally have a law for "negligent homicide"?

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

#584

Post by ihodes »

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…

I think this is a great summary of some of the main challenges nurses are facing.

I'd add to #1 that travel (temp) nurses are making 4x+ more than staff nurses, I've heard as high as $13-17k per week in high-demand areas. This exacerbates the problem, as staff nurses hear this, and if they can, they leave. Travel nurses can be great, but they won't know the facility and workflows and people as well as staff nurses: staff nurses now pick up more slack, all while getting paid 1/10th what their new colleagues are. This is more than most doctors.

For #3, this problem is made worse by additional compliance burden. Nurses need to document more and more, click more and more, read more and more… with less and less time. And on systems that are unpleasant to use. Among other issues, this leads to problems like these[0], which drive more and more nurses away.

I'm working with a badass team on solving some parts of these problems, particularly relating to technology and workflows. If you're interested (across basically any role, but product designers, engineers, product managers are top of mind right now), let me know (email in bio)!

[0]: https://www.cbsnews.com/news/radonda-vaught-nurse-guilty-dea...

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

#585

Post by tomc1985 »

ARandomerDude wrote: post #558
cogman10 wrote: post #416

Earlier quoted context omitted.

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 up…

> Hospitals have made sure they hire JUST ENOUGH nurses to cover shifts and no more. This is a two-edged sword. If you hire more than you need, the nurses' hours will be cut during normal situations and they won't make enough money. If hospitals don't cut extra hours and instead keep the staff on the clock, a public scandal will erupt surrounding well-paid medical professionals sitting around doing nothing.

At the rate that healthcare charges in the US, hospitals can more than afford to keep X+1 or +2 needed nurses around in three 8-hour shifts. They just don't.

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

#586

Post by wonderwonder »

anonporridge wrote: post #506
aiisjustanif wrote: post #429

Earlier quoted context omitted.

Jfc that is terrible.

Worse, the family of the victim had apparently forgiven the nurse for her mistake and didn't want criminal prosecution. This was driven purely by the state prosecutor.

Do we really want to live in a society where people are not prosecuted because the family of the victim forgave them? So if two people commit the same offence, Person A is not prosecuted because the victim's family forgave him but Person B is because the victims family did not? Was offender B just unlucky on victim selection? The rule and application of law should not be based on the feelings of the victims family. Did the dead person forgive them?

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

#587

Post by triska »

ayngg wrote: post #577
cogman10 wrote: post #416

Earlier quoted context omitted.

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 up…

I actually think that this is just one example of many across a ton of disciplines where people like Nurses basically are forced to deal with costs and responsibilities offloaded onto them from above the responsibility chain. Resources are eaten up at the top of the chain to their benefit and costs are offloaded down the chain until it reaches people like Nurses at the end of the line who have to deal with it because…

I think this is due to Pournelle's Iron Law of Bureaucracy:

https://www.jerrypournelle.com/reports/jerryp/iron.html

"In any bureaucratic organization there will be two kinds of people:

First, there will be those who are devoted to the goals of the organization. Examples are dedicated classroom teachers in an educational bureaucracy, many of the engineers and launch technicians and scientists at NASA, even some agricultural scientists and advisors in the former Soviet Union collective farming administration.

Secondly, there will be those dedicated to the organization itself. Examples are many of the administrators in the education system, many professors of education, many teachers union officials, much of the NASA headquarters staff, etc.

The Iron Law states that in every case the second group will gain and keep control of the organization. It will write the rules, and control promotions within the organization."

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

#588

Post by rectang »

histriosum wrote: post #482
mfer wrote: post #127

Earlier quoted context omitted.

> I think this is looking at the problem wrong. The problem is that implementing positive change in these systems is impossible for reasons far outside the control of any product designer or developer currently on the team. A developer working on something is different from a product designer. For product designer I don't mean a UI/UX developer. I mean someone empowered to design the thing. This is often a leader or…

> This is an opportunity. To build software that is both compliant and has a good UX. There's an opportunity to disrupt all the crap software here. The thing that everyone is overlooking here is that EMR software is not designed with patient outcomes as the top priority. Every single EMR software I've seen in the field has been designed with BILLING as the top priority -- everything is organized around making sure th…

It is true that billing is a priority and there are profit incentives at work. That's exactly why it's worth it for hospitals to improve the data entry user experience!

Better documentation means more revenue. If your doctors and nurses are not filling in the forms because the interface isn't user friendly, you're losing money.

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

#589

Post by dudul »

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…

We do not align productivity and pay, we simply align pay and how difficult it is to find someone to do the job.

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

#590

Post by throwawaygh »

Aperocky wrote: post #392
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…

> they can 10x their profits by only serving elderly clients. I knew of certain defunct malls that decided to get rid of things that doesn't make money and only keep the high profit inventories. Soon people stopped coming and they went under..

>> they can 10x their profits by only serving elderly clients.

> Soon people stopped coming

Ah, yes. Why didn't we think of this before? By increasing the cost of (geriatric) healthcare, we can destroy demand. That's how supply/demand curves work right? In this way the invisible hand delivers unto us a fountain of youth ;)

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