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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

#601
post #550

Not to be mean, but 'leave nursing' and then what ? Nursing is a well paying middle-class job without a lot of transferable skills to other professions. Don't say programming. It isn't the solution to everything. Other low-entry-barrier jobs pay much less and have exploitation problems of their own. For a lot of middle class families, dual income is essential to maintain their lifestyle. So SAHM is not an option. Nur…

> 'leave nursing' and then what

When we got married, my wife (Physicians Assistant) made handily more than I did. $140k to my $82k midwest, software development job.

10 years later, she makes $130k (after cutting hours back) and I make $4-500k as a software engineer in the midwest. The two markets crossed drastically

Where are they going?

For us, home.

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

#602
post #583
post #515

Earlier quoted context omitted.

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"?

Yes we do, but we also give DAs discretion over when to enforce it. Given the extenuating circumstances, I don’t think it should have been enforced here.

Her employer, by not creating a culture of safety, set her up for failure.

I just don't see how in the long term this prosecution reduces medical errors and generally disagree with criminalizing mistakes; even ones such as this.

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

#603

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…

Doctors and hospitals control some of the more powerful lobbying groups in the United States making it a bit strange they haven't worked on those issues.

"Doctors and hospitals" are not nurses and do not seem themselves as akin to nurses.

It's like asking why most software devs don't go to bat for technical support people.

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

#604

Earlier quoted context omitted.

> 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.

> Better documentation means more revenue.

This is not actually the way the system works, as currently designed, and so correspondingly this is not how EMR systems are designed. The documentation that matters is capturing the procedure codes and inventory codes for billing -- and EMR systems and the associated hospital workflows and security mechanisms are designed around making sure that those billing codes must be entered in order to do anything else.

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

#605
post #550

Not to be mean, but 'leave nursing' and then what ? Nursing is a well paying middle-class job without a lot of transferable skills to other professions. Don't say programming. It isn't the solution to everything. Other low-entry-barrier jobs pay much less and have exploitation problems of their own. For a lot of middle class families, dual income is essential to maintain their lifestyle. So SAHM is not an option. Nur…

"If supply-demand is in the Nurse's favor, then don't they get more leverage on what QOL and wages they can demand?"

I have a family member who works in public health and is trying to staff nursing positions. She has something like a $400k budget to hire 4 nurses at $100k each (let's say). She is unable to fill the positions because cost of living in her area has gone up so much. She'd rather have 2 nurses at $200k each instead of zero nurses, but she's simply not allowed to do that. She's trying to change policy but it's a massive uphill battle.

Power's concentrated very high up in health care, and it's exercised through the use of rigid policies. It certainly seems like nurses should command higher wages, but the bureaucracy has become very effective at preventing basically anything from changing quickly.

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

#607
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…

The rules nurses have to deal with around things as asinine as taking PTO are AMAZING. They’re required to put in PTO requests months in advance and the hospital can and will say “Sorry, denied. We don’t have enough people…” As they are intentionally creating skeleton crews of nurses to wring every ounce of profit out of the business.

My mom was a nurse, my aunt was a nurse, my sister is a nurse and my best friend’s mom is a nurse. I really can’t believe anyone continues to be a nurse given the insane working conditions these folks have to put up with. Twelve hour shifts, overflowing with patients, watching newcomers earn more than seasoned veterans… When I compare it to my laid back software engineering job it’s like I’m living in an entirely different universe. The hospital industry is a hugely demoralizing place.

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

#608
post #557
post #550

Not to be mean, but 'leave nursing' and then what ? Nursing is a well paying middle-class job without a lot of transferable skills to other professions. Don't say programming. It isn't the solution to everything. Other low-entry-barrier jobs pay much less and have exploitation problems of their own. For a lot of middle class families, dual income is essential to maintain their lifestyle. So SAHM is not an option. Nur…

> Nursing is a well paying Only in a vaccuum. It pays far worse than other jobs at the same rate given the effort and stress the job entails. > don't they get more leverage on what QOL and wages they can demand ? Sure, but it needs to get far worse. The hospitals are only going to budge once walkouts are organized. But that can't happen without strong unions, most nurses just need to pay the bills which is why they c…

> don't they get more leverage on what QOL and wages they can demand ?

Following up on this apart from my reply above, my observation is instead of raising pay they simply let roles languish. It's bizarre.

But then again it feels like that's what happens when nursing/AP care is treated as a cost center. It seems like they aren't concerned with addressing a market as much as keeping cost/income the same as it has always been.

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

#609
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…

Yes and No.

On an individual basis, nurses are overworked because they choose to be and their employers allow for it. The standard work week is 3 12 hour shifts, which is much less than most professionals work. Like a retail or warehouse worker, they are expected to clock out as soon as possible and leave when the shift ends. Those of us with salary jobs knows how difficult that can be in our arrangements and how much "free" work we end up performing. They get paid premiums for everything; night, weekend, etc. And since they're hourly, they typically LIKE the overtime and signup for it as much as possible. They also might work FT at one hospital and pull extra shifts at another hospital on a PRN basis. These things are very common. Just like in a retail environment, people typically LIKE to work holidays so long as it's voluntary because it's 1.5x pay (or more?).

> 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.

This makes no sense. Capacity is the problem, paying more for the same capacity does not solve the problem. Hospitals try very hard to avoid overtime and the travel nurses due to the cost. It's also a very elastic model to balance and a lot of flex (non Full Time) folks are needed to fill the gaps and manage cost somewhat.

> 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.

That is the current system. The problem is usually time. If someone calls in sick, they do it an hour before their shift starts. They usually can solve for this. Either they call from their roster or a supervisor level person with an active RN license steps into the clinical side that day. Staffing at 2x just in case everyone calls in makes no sense. Staffing at 5x just in case a pandemic hits makes no sense.

Hospitals barely make money as it is, I don't see how this is a sustainable solution. Paying more does not create capacity in this industry.

It's also important to note that "nurse" is a very generic term. For example, ICU nurses is a very distinct type of nurse that has been dealing with COVID first hand (caring for vent patients). They are the ones you hear about making $150-200/hour in COVID times. It is difficult to become an ICU nurse. It hasn't been possible for a surgical nurse to pivot to ICU nurse in these times so the labor pool has been rather fixed, or shrinking due to natural churn and inability to onboard new folks. It would be akin to suggesting why does some [insert super specific domain expertise] developer make $1M/year at FAANG when they could hire a PHP coder for $15/hour on a freelance website. There is no immediate/cheap substitute for the experience and knowledge that the expensive developer has, so they cost more. This is happening in nursing where some are thriving while many actually got furloughed early on in the pandemic.

My personal opinion on the matter, is one only has to look at the demographics of an average nurse. It's become quite "old" and like other industries, the boomer's retiring is causing a labor issue. The handful of nurses that made 5-10 years of salary since Q1.2020 are now ready to retire early as well. I don't blame them.

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