Report: 90% of nurses considering leaving the profession in the next year • Hacker News Board

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

#721

Post by mumblemumble » Wed, Apr 27, 2022, 9:25 PM UTC

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..

The Invisible Hand works generally fine-ish for non-essential and commodity goods. People might be sad their favorite store went away, but, for the most part, life goes on. It seems to even be the least bad way to handle these sorts of things.

It's a bit harder for me to see this as an acceptable approach to health care. Not every segment of the economy needs to be a constant drunkard's walk in search of maximum profitability in the aggregate. Sometimes what the public actually desires is stability and reliability.

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

#722

Post by BeetleB » Wed, Apr 27, 2022, 9:26 PM UTC

ben0x539 wrote: post #687

BeetleB wrote: post #665

Earlier quoted context omitted.

> 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. In case people want an idea of what travel nurses made during COVID... https://khn.org/news/highly-paid-traveling-nurses-fill-staff... > In April, she packed her bags for a two-month contract in then-COVID hot spot New Jersey, as part of what she…

How many working hours are in those weeks?

I haven't found concrete figures, but from what I've read, they do often work more hours during the contract. However, travel nurses in general have far more control over their schedule than regular salaried nurses. A salaried nurse cannot refuse to work, but travel nurses routinely say "No" to contracts if they don't like the pay or the hours.

What happens is they'll accept a few weeks (or 2 months) of long hours, and then take a month off and relax. As you can imagine, if they're getting paid $6000/week, they can easily take a lot of time off and still get paid more annually than their salaried counterparts (while overall working fewer hours per year).

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

#723

Post by t_mann » Wed, Apr 27, 2022, 9:26 PM UTC

If there ever was a contrarian move then it'd be for an 18-year-old to start nurse training now. Probably one of the last professions at all to be hit by automation, practically guaranteed demand for skilled labour and a hefty shortage thereof in the making.

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

#724

Post by majewsky » Wed, Apr 27, 2022, 9:26 PM UTC

thepasswordis wrote: post #681

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…

>Patients in COVID have become downright mean. Maybe, but nurses have also used "because covid" as an excuse to engage in some pretty awful behavior. Fathers have only very recently been allowed in the room during ultrasounds, for instance. NICUs only recently started allowing both parents to visit at the same time.

Is this because of the whims of individual nurses, or because of policies put forth by the hospital administration?

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

#725

Post by johnnyanmac » Wed, Apr 27, 2022, 9:27 PM UTC

KarlKemp wrote: post #642

ayngg wrote: post #577

Earlier quoted context omitted.

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…

This reads too much like a generalization of the standard complaints about management and their stupid meetings, the basic thesis of that web comic that was neither funny nor true, Dilbert. The criminal justice system may be overwhelmed, but its reaction certainly isn't to just let criminals "exit like a revolving door". The US is still incarcerating people at 10x the rate of other wealthy countries. Nurses being ove…

>Nurses being overworked is simply due to there not being enough nurses.

yes but this begs the obvious question of "why?", which either leads to the immediate thoughts of

1. not enough people want to be nurses 2. companies don't want to hire more nurses

I'm assuming #1 is false, so #2 is the go-to conclusion, at least on the high level. I'm sure I'm missing some more nuanced #3/4/5 explanations, but it does seem to ultimately come down to money that isn't being spent (be it maliciously or simply due to not having the budget).

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

#726

Post by BeetleB » Wed, Apr 27, 2022, 9:30 PM UTC

jonlucc wrote: post #716

BeetleB wrote: post #665

Earlier quoted context omitted.

> 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. In case people want an idea of what travel nurses made during COVID... https://khn.org/news/highly-paid-traveling-nurses-fill-staff... > In April, she packed her bags for a two-month contract in then-COVID hot spot New Jersey, as part of what she…

These contracts are likely emergency contracts, which pay outrageously but often require a full week of 12-hour shifts or something similar with the expectation the nurse will only do one week then recover. I've seen this for COVID peaks and when a hospital's entire nursing staff is planning to strike. The $5200/wk rate is more likely 3 or 4 12-hour shifts.

I'm not sure I follow:

> The $5200/wk rate is more likely 3 or 4 12-hour shifts

3 or 4 12 hour shifts a week is normal for salaried nurses. $5200/wk isn't. It's over double.

> which pay outrageously but often require a full week of 12-hour shifts or something similar with the expectation the nurse will only do one week then recover.

I'm not sure what you're trying to say. Yes, it may be a full week of 12 hour shifts, but it's still a much higher pay. And if you get the next week off, it's a fantastic deal.

For context, pre-pandemic, I knew a nurse who often would do this schedule for her salaried job - she requested it as she liked having a full week off.

What I mentioned elsewhere: Travel nurses have a lot more control over the contracts they take. They can work fewer hours per year and still make significantly more. They may have stretches of long hours in a given contract, but annually they work less.

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

#727

Post by LanceH » Wed, Apr 27, 2022, 9:31 PM UTC

ikiris wrote: post #624

HarryHirsch wrote: post #565

Earlier quoted context omitted.

The solution isn't that Radonda Vought, who killed a patient through a string of crassly negligent actions should walk free - one would like to see the whole chain of command be given serious prison time. It's clear that patient safety at Vanderbilt isn't a priority - training and safety culture reflects that. Strange to see that HN, which is generally suspicious of copaganda, falls for very transparent nursepaganda.

Its the strong libertarian vibe. They think consequences shouldn't exist, and the dead guy can take his money elsewhere.

The strong libertarian vibe of npr saying she's being scapegoated?

When you have millions of drugs being issued, there will be some legitimate mistakes happening -- some will even cause death. If you want people to actual work in healthcare, they shouldn't be fearing for their lives for being less than perfect.

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

#728

Post by sumanmd » Wed, Apr 27, 2022, 9:31 PM UTC

Being a physician, Since IT came, it has alleviated some problems but has unleashed a monster which tend to cause lot more data driven to documentation to burnout. Every physician in United States currently experiences some kind of burn out. Nurses on the other hand experience much worse, 12-14 hrs shifts of constant stress. Overall health system in US is broken just as the insurance system. People will leave jobs when there is no satisfaction and just burn out.

In my opinion nurse should have shorter 8 hrs shifts and 4 per week . In this capitalistic driven health care system, where being a patient and health care provider comes with a cost.

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

#729

Post by avianlyric » Wed, Apr 27, 2022, 9:31 PM UTC

bumby wrote: post #672

triska wrote: post #587

Earlier quoted context omitted.

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 agric…

As somebody with experience at NASA, this made me chortle. I would NOT characterize the average civil servant that I worked with as "devoted to the goals of the organization." That includes the lowest level field organizations. Unfortunately, for the average employee, it eventually gets treated like any other job. It's possible this dichotomy works in theory only. Being generous, it's possible they just disagree abou…

That’s the point. The second group, those who only care about the existence of the organisation, and the power/money it provides to them, have taken over at NASA.

As a result only those who act to increase the power/wealth at the expense of all else, such as the original goals of the organisation, get promoted and hang around. The end result, an organisation that achieves very little, and consumes huge amounts of resources, full of people who really don’t care about the fundamental goals of the organisation.

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

#730

Post by asdff » Wed, Apr 27, 2022, 9:34 PM UTC

tristor wrote: post #719

asdff wrote: post #644

Earlier quoted context omitted.

There is a reason why these things are like this. Someone with influence is making money hand over fist with the current state of affairs, so it says. Regulation are always penned by those in industry they are set to regulate with government connections. Politicians don't do anything unless there is a push for it by lobbyists or donors because that's where the incentives are.

For healthcare the regulations mostly entrench the big players in insurance. It’s regulatory capture 101.

And what sucks about this entire situation is even if you today fixed healthcare, because you havent fixed regulatory capture it will end up screwed up in some other direction as soon as the grifters finish planning out their graft and ringing personal phone numbers in washington DC and state capitols. Fixing regulatory capture is therefore required to solve the big problems we have, like climate change, housing, and healthcare, otherwise no fix will ever be long term and meaningful. The incentive structures with regulatory capture favor personal profit over public good every time.