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

#961

Post by js2 » Thu, Apr 28, 2022, 3:30 PM UTC

JshWright wrote: post #953

js2 wrote: 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 am not a nurse, but I can easily imagine how someone could make the errors she did in an overworked and high-stress environment. There are so, so many differences between the two meds, I don't see how confusing them would be possible short of gross negligence (for context, I am a paramedic, and often administer medications (including both of the meds involved here) in a high stress environment). Vecuronium (the p…

I appreciate your perspective as a medic. The PDF I linked enumerates the mistakes she made and the differences between the two medicines, and I have read all that. From non-professional perspective, it seems like it was inattentional blindness.

But let me allow for a second that this is a case of gross negligence, despite the fact that CMS investigated Vanderbilt and found many other issues in the workplace:

https://www.documentcloud.org/documents/6535181-Vanderbilt-C...

It's not clear to me how criminalizing her mistake helps prevent future medical errors. Do you think criminally prosecuting her was the right decision?

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

#962

Post by MockObject » Thu, Apr 28, 2022, 4:37 PM UTC

scaramanga wrote: post #831

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…

Anyone who has visited planet earth and spent time here is well aware of that. The task is to prevent these people from taking and holding power. Note that the strict formulation of this law (ie. "in _every_ case..") is profoundly anti-democratic in that it assumes no democracy can ever exist or function. Of course, I hope your household provides a good counter example (if not, then you should seek outside support).…

> in order to prevent them from being taken over by sociopaths.

Every institution has already been taken over by sociopaths. That's why it's called an "iron law", and not a mere concern.

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

#963

Post by michaelcampbell » Thu, Apr 28, 2022, 5:43 PM UTC

TomSwirly wrote: post #777

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…

I had no idea that Pournelle was claiming credit for that! He nicked it from Robert Michels, who wrote about the Iron Law of Oligarchies in 1911: https://en.wikipedia.org/wiki/Iron_law_of_oligarchy I was reading some old Analog magazines the other day, and man, Pournelle was one deranged man in his "non-fiction".

Leo Laporte would have him on a variety of his TWIT podcasts from time to time. I considered once coming up with a drinking game where you'd drink every time Jerry would have a sentence that included, "..when I wrote about...", but I realized you'd kill yourself.

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

#964

Post by gentryb » Thu, Apr 28, 2022, 6:05 PM UTC

Funny enough, not a nurse, but took over a 2 year "sabbatical" to do COVID testing and Vaccination. As someone who is used to making design decisions on an EHR in previous consulting engagements, it was beyond enlightening to see how things are where the rubber meets the road. Was only a Clinical Health Tech and a Medical Assistant, but frankly burned out enough to move back to software work.

Saddest thing is that I really felt I was helping, but have to admit I've become burnt out in the healthcare field - Just have $500 or so in scrubs invested...

Taking the time has hurt my career in many ways, I do believe. I have a ton of respect for many nurses, but many travelers are worse than you might imagine. Over-extended, far over-paid for their work. And really don't care about the facility they are working with (or throwing others under the bus to cover up their own mistakes)...

It was a valuable thing to experience, and I do believe I helped many people, but it's a very different thing to be at the bottom rung than the one designing and implementing various systems. God forbid someone can see a workflow issue, propose multiple solutions, and have travelers ignore it because the workflow issue makes them more money.

Not a rant against nurses at all - As someone with over 20 years in various roles of engineering, it was quite an eye opener to me.

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

#965

Post by bitsnbytes » Thu, Apr 28, 2022, 6:14 PM UTC

heavyset_go wrote: post #740

johnnyanmac wrote: post #713

Earlier quoted context omitted.

> There is no shortage of people wanting to be nurses (in some places it is extremely competitive), and there is a huge demand for nurses based on shortages everywhere, but somehow we are in a situation where nurses are overworked because they are short staffed. why is this such a common story across pretty much every single industry? There's more people in the country than 10, 20, 30 years ago. More customers, more…

Owners and operators have learned that they can keep the lights on by running their businesses with skeleton crews and, at the same time, reap the rewards of lower costs as profits.

Covid was also used to exploited the issue further and as an excuse for horrible service and skeleton crews.

During covid Business owners saw that the consumer was willing to take it so they will continue to run on skeleton crews as long as the consumer takes it.

Sure the consumer will complain but they are still using their money to buy from skeleton run places.Partly because most industries nowadays are Oligarch control and what one does the other does as well and the consumer has lost their control of the marketplace.

We are living in a world where the big guys have the majority control of the market place and the market want's skeleton crews.

This is seen across the board in all big business run industries. However with nursing, especially in the ER and the ICU that are now running a skeleton crew the consequence is your health and even your life. Until the big healthcare providers,insurance industry, hospitals, doctors , etc start to get sued over low staffing as the cause of death nothing will change and they know how to document to prevent such a case.

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

#966

Post by xyzzy21 » Thu, Apr 28, 2022, 7:06 PM UTC

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…

A lot of the problem starts with the fact that most hospitals in the USA were taken over and are now owned by "Private Equity".

If you know ANYTHING about finance, that should send shivers up your back and also make you realize why this happening with nursing.

Private Equity is where you go to get money if:

• Your business is floundering and no one will loan to you

• Your industry is in the ebbing phase and not growing

• You are ignorant or naive about getting money for business

• You haven't done your due diligence

• Your company is in play for a hostile take-over

Having Private Equity getting involved is always a major Red Flag if not Black Flag.

In general, Private Equity knows nothing about your business norms or markets - they don't care. They are a one-size-fits-all investor and that primarily means "Cut Costs on Everything".

It's very akin to having a lawyer become your CEO (e.g. Sears/Kmart) - it's a omen of VERY BAD things being imminent.

A case in point: the COVID bounties from Medicare for testing, admissions, treatment AND DEATH BY COVID are exactly something that Private Equity would love maximally, dream up and probably try to enact with lobbyists.

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

#967

Post by conductr » Thu, Apr 28, 2022, 7:32 PM UTC

markdown wrote: post #894

conductr wrote: post #609

Earlier quoted context omitted.

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 muc…

> Hospitals barely make money as it is They aren't supposed to.

Yeah. That's just like, your opinion, man.

It doesn't match up to the reality of the US's "system"

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

#968

Post by klyrs » Thu, Apr 28, 2022, 7:51 PM UTC

duxup wrote: post #373

klyrs wrote: post #158

Earlier quoted context omitted.

They're paid alright (generally speaking), but most devs wouldn't even consider a job at that rate. And the bar for entry is way higher: years of competitive and expensive schooling. And that's ignoring the other factors that GP mentioned. I don't get assaulted on a daily/weekly basis. I'm not getting coughed on by COVID-infected patients who want to kill me because they don't believe that COVID is real. I don't endu…

>but most devs wouldn't even consider a job at that rate Lots of people ... most people work jobs that fall into that category. I'm not sure that means much. I don't know how many folks who go into nursing are likely to just chose to be a developer or if it is that simple for them.

I know a few folks who went to university planning to continue on to med school, but ended up as devs for various reasons. Also, a vast majority of the audience for this site are devs.

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

#969

Post by FireBeyond » Thu, Apr 28, 2022, 8:21 PM UTC

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…

> and see undergraduate classes are taught by grad students who make ~30k a year

Hah, wasn't it UCLA who recently got excoriated for advertising for grad students to teach undergraduate classes with this stellar line:

"This is an uncompensated position"?

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

#970

Post by mywittyname » Thu, Apr 28, 2022, 8:28 PM UTC

ryanSrich wrote: post #538

To the surprise of absolutely no one who understands healthcare. I have many friends and relatives that are nurses, MDs, and therapists. Compensation is about as backwards as you can get. Seniority has no impact on your pay. Once you hit the ceiling you’ll never make more money. This is especially true for Nurses and therapists. Even if you switch jobs. The market rate is what you’re going to get paid (within 10%). M…

> Benefits are also beyond comical.

Self-insurance seems pretty common anymore. Which amounts to - you can receive treatment in the hospital you work in. You'd at least think it would at least be free, but nope.