Hacker News Re-Imagined

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

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  • 2 months ago

  • @dr_pardee
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Report: 90% of nurses considering leaving the profession in the next year


@phil21 2 months

Replying to @dr_pardee 🎙

While it's anecdote, every single peer in bedside medical care I know without exception has either left the field, or has immediate plans to as soon as student loan debt is repaid. The few older medical professionals in my family are simply sticking out the last few years until they can retire early.

This was generally the case prior to pandemic due to how poor the work environment has become, but the pandemic seems to have broken the few remaining folks who still had hopes and dreams.

How doctors of all professions lost their professional agency to do-nothing administrators within a generation is quite puzzling and a bit terrifying to me.

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@agumonkey 2 months

Replying to @dr_pardee 🎙

I'm surprised how long and deep the medical bleeding has been going. You'd think a vital organ bleeding would cause faster reaction..

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@vonnik 2 months

Replying to @dr_pardee 🎙

I work at a startup* trying to tackle nurse burnout, and two of my family members are nurses. Here are a few things I've learned:

- Nurses were getting burned out before the pandemic, and the US has a nursing shortage that's been going on for about 90 years (it started with an infrastructure buildout in the 1930s).* So it's a secular problem, with chronic as well as acute causal factors.

- There is a ladder of nursing credentials, and the shortage effects them differently. Hiring for roles like CNA and LPN/LVN has exploded because of the shortage of RNs and above. CNAs get trained in 4-12 weeks to do the heavy lifting of care; RNs get ~3 year degrees to perform much more complicated tasks.

- Burnout, and the nursing shortage, are in a positive feedback loop/downward spiral. That is, the more nurses burn out, the more they cause other nurses to burn out. Short-staffed facilities have a very hard time pulling back to normal staffing, because nobody wants to join a skeleton crew. (I know of long-term care facilities where the scheduling nurses (the bosses) are working the graveyard shift because they can't fill it.)

- Many nurses work rigid schedules on 12-14 shifts, and a lot of medical errors happen at the end of those shifts. **

- The hot US job market (Great resignation, great reshuffle) is hitting nursing especially hard; it is very sensitive to external shocks. There are paths to easier work and higher pay.

- Many healthcare facilities and systems don't give nurses flexibility or the possibility of advancement. (One family member will need to quit her current job and come back in a year or two to her current employer if she wants to move up a pay grade -- which is like some tech companies -- but slower moving and lower paying.)

- Many facilities are run entirely on foreign staff (the H2-B visa allows that). And many nurses are imported from the Philippines.

* https://clipboardhealth.com

* https://www.nursing.upenn.edu/nhhc/workforce-issues/where-di...

** https://www.nytimes.com/video/opinion/100000008158650/covid-...

(plug: if you're interested in this problem, we're hiring: https://culture.clipboardhealth.com)

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@xkbarkar 2 months

Replying to @dr_pardee 🎙

Find it a bit amazing that so many here act as if the past two years are the sole reason.

Few people have been as relentlessly toxic and unforgiving on social media as nurses.

As a child of a nurse, that job has sucked for at least the past 40 years. The pay is average. Workplace is a cesspool of gossip and toxic work culture. Management is generally terrible. Also, the pandemic has exposed how many in the profession really are just narcissists.

The amount of facebook posts from indignant nurses spreading the most horrible comments , just to receive likes and be perceived as heroes, these past two years have made my stomach turn.

Its about time we cleaned up in healthcare. Not just aduquate pay, making sure we properly manage healthcare professionals and evolve healthcare management to grow where its needed.

I am 100% positive a flexible healthcare system that expands and shrinks after societal need is possible.

Not this crazy old fashioned fixed set of beds for x or y, that gets cut in some wave when they are needed less. Only to cause havoc in years when they are needed more.

Make sure the good nurses dont burn out and quit leaving the narcissist and ego maniacs behind.

There are amazing nurses out there, but we need to face that many of them are absolute shit at their jobs. And should seek other venues. This exodus may be a good thing in the end.

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@everhard_ 2 months

Replying to @dr_pardee 🎙

This seems like a world-wide pattern, and it was already an issue even before covid.[1] I'm curious about what alternatives they have, may be joining newer tech-enabled companies with nursing services, or going fully independent and work solely by their own terms with some patreon-like app... ?? Or is it the case that they are really sick of nursing and might prefer changing professions or even unemployment?

[1] https://www.icn.ch/system/files/2021-07/ICN%20Policy%20Brief...

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@davesque 2 months

Replying to @dr_pardee 🎙

I see a lot of people mentioning the poor working conditions of healthcare professionals. Things like low pay, long hours, mean patients, etc. These are undoubtedly all problems that largely fall on the shoulders of nurses.

The issue with entitled, mean patients strikes me. While I'm sure a fair bit of this is due to the way in which misinformation about COVID and other health issues spreads on social media, I have a hard time believing this is the primary cause of this grumpiness. It seems more likely that the average person is just fed up being taken to town by a completely inhumane system that really ought to be the most humane of systems. Nurses are the front line representatives of a system that exploits people when they are most vulnerable.

Now, I'm not saying nurses deserve this at all. They're not to blame for the state of things. But the observation might go some ways in explaining the psychology of the phenomenon.

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@andrewclunn 2 months

Replying to @dr_pardee 🎙

Meaningful Use, ICD-10, more and more top down "big data" standards and approaches, that focus on qualitative data entry AS care. I mean this literally: thanks Obama.

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@thenerdhead 2 months

Replying to @dr_pardee 🎙

My sister is a RN training to be a NP. Caring for others has always been in her blood. But I can tell she's not happy over the last few years (even prior to covid).

This survey has such a low number of responses to make any meaningful conclusion from. 200 people surveyed. Non surprising stats like 71% of respondents having 15+ years of experience wanting to quit.

What really should be the lesson here is that capitalism does what capitalism does best:

It cuts costs.

- More patients to nurse ratio (Simply unsafe given most medical professionals already lack sleep)

- Little to no compensation relief on the way. (Huge boom of travel nursing during pandemic)

- Excess job responsibilities (More paperwork/aid duties, less actual nursing)

- New talent / old talent challenges (Larger incentive to switch jobs, hard to properly train)

We better figure out something soon. The medical field feels like it's holding on by a thread. Insurance companies run rampant with no end in sight. Health care continues to increase in costs and fail patients to the point of walking out or even dying to get care.

While I think generally speaking, nurses like my sister just want to feel appreciated like other jobs people are burning out in. You can do that in many different ways:

- Don't overwork them.

- Don't underpay them.

- Don't give them unwanted responsibilities.

- Most importantly, listen to them.

I think you may find that people actually do love the profession as it's one of the most noble professions out there, just that they are being forced out of doing something they love because of greed. Greed is not good.

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@adventured 2 months

Replying to @dr_pardee 🎙

Report: 90% of people want to stop working.

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@uf00lme 2 months

Replying to @dr_pardee 🎙

Poor pay, shift work, bad working conditions and multiple chances of catching all kinds of diseases. Most nurses I know have above average intelligence with an excellent work ethic. Just one bootcamp away from a much better life.

So much sacrifice for the greater good, we the public are not worth it.

Another profession I always think of are math teachers, they are good people.

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@lexwraith 2 months

Replying to @dr_pardee 🎙

My wife was/is both an RN and a DNP in NYC during the entirety of the pandemic. I'm an Iraq infantry veteran. Our experiences are remarkably similar and there are major trends as to why there is unsustainable turnover.

1. Everyone pays lip service. People stand at airports and say thank you for your service the same way they open their windows at 7PM and start clapping and cheering during shift turnover. Sometimes they'll say they know people who are veterans or 'frontline healthcare workers' as a sign of solidarity

2. Nobody actually wants to hear what you went through. Hearing people die or knowing people are about to die in sometimes painful, unfortunate ways is too raw for people to try to seek out and understand, despite the fact that for a significant portion of the population that's how we're going to go out, in a hospital with all sorts of drugs pumped into our system

3. There's a constant barrage of emotional/mental harm. Believe it or not, you don't magically 'harden up' immediately. Absorbing/witnessing drastic outcomes gets easier, but the burden doesn't get lighter. This isn't to mention physical harm. People do all sorts of things out of desperation and frustration.

4. The systems that manage you are byzantine if not kafkaesque. You're never sure how the decisions are made, yet you're the one that will be paying the most for it. You know deep down that you're just a number on a spreadsheet, and the only reason that keeps you going is internal motivation to do what you think is right, so you push on

5. The people who can help rarely think about you. Very few politicians will mention your name or your union that is doing its best to get some kind of safe nurse:patient ratios or even get the hospital to pay for your scrubs that they mandate. Very few billionaires have mentioned healthcare workers or veterans at all. As a whole, until someone has an emergency that threatens their physical or financial status, healthcare and security is treated as a black box with unreal expectations and extra sensitivity to deviations from said expectations, despite a complete lack of introspection and information on how those expectations came to be

I don't know what the solution is. In healthcare, every system is so deeply connected to the rest that destroying one or even refactoring takes down everything else, and we need it to stay online. The same applies to the continuation of geopolitics by other means. You can give every IC the best EMR system, the best rifle and radio, the best monitor/laptop/keyboard, but it's all for nothing if the system as a whole is a dumpster fire. Her frustration is palpable every time she finishes a rough shift (probably 2 out of 3), and the best I can do is lend my ear and pour a glass of wine.

That being said, I am grateful that she is continuing on the path. Our shared experiences have brought us closer than ever.

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@springsprint 2 months

Replying to @dr_pardee 🎙

My wife works as a floater pharmacist in retail, can confirm, the situation is quite similar and very dire. She cannot even get a couple of days of UNPAID time-off when needed. The scheduler and the management are quite abusive with the way how they treat their staff. There is no such thing as a work-life balance.

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@Tozen 2 months

Replying to @dr_pardee 🎙

People can say anything or put whatever on a survey, but then there is having to pay rent and buy food, that brings everything back to reality.

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@civilized 2 months

Replying to @dr_pardee 🎙

This is a PR firm plant http://www.paulgraham.com/submarine.html

In fact the entire website is probably a PR plant.

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@pbuzbee 2 months

Replying to @dr_pardee 🎙

Is this a shock?

- Demanding work: 12 hour shifts, irregular schedules, night shifts, physically exhausting, limited breaks (including bathroom/water!)

- High responsibility with unsafe conditions. You're literally responsible for people's lives. Poor staffing ratios stretch you thin and make you more likely to make mistakes. And if you make a mistake, you're at huge risk for litigation... and now criminal consequences too. Responsibilities, resources, and staffing stretched even thinner due to the pandemic.

- Administration that treats you as something to be optimized and does the absolute bare minimum to support you. Instead they tack on additional tasks, expectations, and requirements ("no water at a nurse's station!"). They encourage a culture where nurses provide a concierge service to 'guests' instead of critical care to patients.

- Hostile/entitled patients. I'd guess many/most patients are not an issue, but it only takes a couple of difficult/combative patients to really ruin your conditions.

- Low pay given the responsibility and working conditions for non-travel nurses. https://nurseslabs.com/nurse-salary/#nurse_salaries_by_state Like many others pointed out here, in tech I make way more than a nurse for a job that's less demanding, has far lower stakes, and is of far less value to society.

To me the blame lies mainly in middle/upper management, whose role is to build and empower an effective workforce. If 90% of your workers are considering leaving, you blew it.

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@goodpoint 2 months

Replying to @dr_pardee 🎙

Can we stop posting posting US-related stuff without a clear tag in the title?

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@fumeux_fume 2 months

Replying to @dr_pardee 🎙

Of course the answer to this problem is more optimization and AI. Lol, wtf website is this?

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@johndhi 2 months

Replying to @dr_pardee 🎙

I've worked in healthcare law for a few years and I think the problem boils down to how it's regulated.

It's super, duper complex with lots of paperwork. The complexity is too great to run a small practice, the Medicare/Medicaid fees are too small to make up for it, and it increases the importance of administrators in the hospital system.

If I had a bunch of time I'd love to go through and write up a proposed alternative approach, and congressional bill -- but I have to imagine even if I did that, no one would listen to it.

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@formerkrogemp 2 months

Replying to @dr_pardee 🎙

This isn't just a market failure or some inevitable 'iron law' of bureaucracy taking over management. This is a society wide failure, and we're all complicit. Umpires, cashiers, pilots, referees, doctors, nurses, baristas, accountants, restaurant staff, bank tellers, flight attendants, and teachers are all quitting due to a belligerent, abusive, or violent public, uncaring administration or management, low pay, lacking benefits, unpaid work hours, or reassessed priorities. Little league and high school games don't need parents, players, or the coach smacking or screaming at the ump or ref. Nurses and even doctors don't need one thank-you basket/gift card for one employee per month, empty thank you slogans and parades, lean staffing/six sigma/JIT healthcare staffing bullshit, for-profit, private equity hospitals/clinics, pre-authorization and insurance managing healthcare instead of doctors, pay freezes, legally mandated pay caps, PTSD, or mental trauma from all this steaming pile of nonsense. Violence against medical professionals has gone underreported and grown dramatically over the past few years. Hospitals are allocating significant budget to security. In places where they've never had security. I'm not even going to touch upon all the myriad other issues right now. And, we're/they're not heroes. They're just doing their job, not saving the world as your personal, sacrificial lamb. It's just a job, not a heroic sacrifice. So yeah, we will all quit and play musical chairs with our jobs until things improve.

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@artur_makly 2 months

Replying to @dr_pardee 🎙

I'm sure Elon has a solution for this in 2023.

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@nameless912 2 months

Replying to @dr_pardee 🎙

Anecdotally, many of my partner's coworkers have been on the school setting therapist -> hospital setting therapist -> burnt out craft store employee pipeline over the last couple of years, and my partner is desperate to join them once we have enough savings to allow her to quit her job. This is within the Speech/Language, Physical, and Occupational Therapist realm, so not nurses exactly, but it's similarly bad for a lot of medical-adjacent jobs right now.

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@dopaminop 2 months

Replying to @dr_pardee 🎙

My mom is a nurse and although she doesn't live in the US she also suffers from the same poor conditions. She has to work on the database herself, staff shortage is a big problem (sometimes getting to 4 nurses in her "sector"). She gets underpaid even though she works 12 hours shifts sometimes in consecutive days (she usually gets paid 400 dollars per month if I estimated correctly). It's quite miserable.

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@nfriedly 2 months

Replying to @dr_pardee 🎙

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 local farm/fruit stand. The main things that drove her to retire early was management insisting on 12 hour shifts and not hiring enough staff.

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@geocrasher 2 months

Replying to @dr_pardee 🎙

Nurses have an extremely hard job. Before my wife died, she spent days to weeks at at time in hospitals over and over again. She went out of her way to show them kindness despite her suffering, and they always thanked her for it. Most patients treat them like slaves and are even abusive toward them- at the very least, thankless. COVID only made this worse. It's no wonder they are leaving in droves.

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@jmyeet 2 months

Replying to @dr_pardee 🎙

The number of people in the US who continue to defend the abhorrent health insurance system is absolutely mind-boggling. The level of brainwashing that pervades discourse about single-payer health insurance being some sort of communist plot is testament to some of th emost successful propaganda of all time.

What's worse is it belies an ugly aspect of human nature (particularly pervasive in the US IME) that people absolutely do not give a fuck about anyone else when it comes down to it. As long as someone is fortunate enough to have decent health insurance through their job, people who don't are lazy.

The big picture here is that the wealthy want people dependent on jobs and to be in debt (eg student debt) because it makes them compliant.

So I'm not surprised nurses are leaving. Insurance companies make providing healthcare an absolutely miserable business and deliberately killing people ("prior authorizations", "pre-existing conditions", etc) should not be the basis for commercial enterprise. Denying someone life-saving or life-changing care should not be a profit motive.

What's worse is that a lot of the burnout is effectively caused by people who are profoundly selfish and are voluntarily choosing to get sick and die of what is now a highly preventible disease.

It's a hard situation because people depend on nurses so collectively they're torn. Teachers OTOH aren't life-critical (but still obviously important) so I'd actually like to see them make a mass exodus over all the right-wing censorship they're facing in most states.

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@Ericson2314 2 months

Replying to @dr_pardee 🎙

There should be strikes until we get medicare for all. Simple as that.

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@lucidone 2 months

Replying to @dr_pardee 🎙

I have family members who work in health care here in Canada. The fact that their wages are subject to regulation (e.g., they are effectively getting a paycut this year with inflation), they realistically cannot strike to improve their working conditions (people will die), and that their work is very demanding (physical labour, emotional labour, shift work, constantly understaffed) makes this an unsurprising statistic from my anecdotal experience.

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@Footkerchief 2 months

Replying to @dr_pardee 🎙

Is that 90% figure new, or has it been the case in past years?

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@gagan2020 2 months

Replying to @dr_pardee 🎙

Why no one talking about survey size of 200 nurses of particular area only

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@AviationAtom 2 months

Replying to @dr_pardee 🎙

How are more people not sounding alarms about the future of our society with more bleak headlines like this? I fear we have become far too reactive to many problems that should have been anticipated, and planned for.

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@mbrodersen 2 months

Replying to @dr_pardee 🎙

Things will only change if nurses do more than just considering. Management don’t care as long as they have just enough nurses to get things done. Nurses are routinely sacrificed on the alter of higher profits and CEO bonuses. Only real action has any chance of changing the status quo.

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@Zeetah 2 months

Replying to @dr_pardee 🎙

Wonder if this is a US phenomenon or a global phenomenon?

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@bezospen15 2 months

Replying to @dr_pardee 🎙

How do we reduce the cost of health care while simultaneously paying nurses more?

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@jmugan 2 months

Replying to @dr_pardee 🎙

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.

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@shantnutiwari 2 months

Replying to @dr_pardee 🎙

The article seems to focus too much on : How can IT fix this problem?

Ugggh, maybe it can't? As the main problems seem to be political, not tech related?

You might as well ask how IT can be used to fix homelessness or police brutality?

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@ed_balls 2 months

Replying to @dr_pardee 🎙

The average ago of nurses went from 46 to 55 in my country. The current retirement age is 60.

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@detcader 2 months

Replying to @dr_pardee 🎙

because the headline can never be "90% of nurses' employers fail their employees this year"

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@dopaminop 2 months

Replying to @dr_pardee 🎙

My mom is a nurse and although she doesn't live in the US she also suffers from the same poor conditions. She has to work on the databases herself, staff shortage is a big problem (sometimes getting to 4 nurses in her "sector"). She gets underpaid even though she works 8 but usually 12 hours shifts sometimes in consecutive days (she usually gets paid 400 dollars per month if I estimated correctly). It's quite miserable but at least she a number of vacation days which she can choose when to "validate" them.

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@fitba72 2 months

Replying to @dr_pardee 🎙

In my experience, most nurses come in, socialise and cheer you up, take your blood pressure and temperature with automated devices, that one can buy for home use, and give you medicines that a doctor has prescribed (someone can also can do at home if they are feeling up to it). This is a wonderful profession and they should be highly paid but do they really need a bachelor's degree or master's degree to do this job? Some specialised nurses can even draw blood but, again in my experience, many of those were unable to "find a vein" and had to call on someone more experienced or a doctor. Pretty sure some experienced heroin users could do a better job at this. Just my experience.

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@theguyovrthere 2 months

Replying to @dr_pardee 🎙

Nurses leaving the field is only part of the larger problem.

Nursing educators aren't exactly a dime a dozen. The average age of a masters prepared nursing educator in the us ranges between 56-62. Doctorally prepared is higher. The country is facing a nursing shortage, and a nursing educator shortage.

Now my doctor has an interesting theory that some of the pain points for nurses is being created by the hospital systems and industry themselves as an excuse to say we dont have enough nurses and bring in nurses from other countries like the Philippines, as they'll be glad to come to the US and work for less, and will be so grateful for the opportunity that they'll go along with whatever the hospital says they need to do. (This was in the context of vaccines.)

The other thing that has nurses worked up is recently is this case: https://www.cbsnews.com/news/radonda-vaught-nurse-guilty-dea...

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@gentryb 2 months

Replying to @dr_pardee 🎙

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.

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@jrochkind1 2 months

Replying to @dr_pardee 🎙

There's even more in here beyond the headline about nurse satisfaction.

USA healthcare pretty broken, and sliding into catastrophe. Nurse dissatisfaction is just the tip of the iceberg, or the canary in the coalmine.

> Eighty-four percent of emergency room nurses and 96% of intensive care or critical care nurses have a 4:1 ratio, which is double the optimal target of 2:1.

> Thirty-six percent of nurses said they've seen patients with acute health conditions walk out of the ER because of the wait times for an inpatient bed. And 37% said that surgeries had to be rescheduled because of bed shortages.

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@sujitjadhav 2 months

Replying to @dr_pardee 🎙

Time to bring Robots faster.

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@fallingfrog 2 months

Replying to @dr_pardee 🎙

Never seen an industry that needed unions more.

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@susrev 2 months

Replying to @dr_pardee 🎙

They surveyed "more than 200 hospital registered nurses based in the U.S.". Does this small of a sample size truly reflect the feelings of the ~2.4 million (2019) registered RN's in the US?

That is 0.00008 % of all RN's in the US.

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@stakkur 2 months

Replying to @dr_pardee 🎙

I work for a major healthcare provider (thousands of nurses) and while there's a lot of unhappiness, nowhere near '90%' are considering leaving.

And really, this is a red herring; the real problem started long before COVID. This video essay nails it (or so care practitioners at my workplace say, anyway): https://www.nytimes.com/video/opinion/100000008158650/covid-...

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@sllewe 2 months

Replying to @dr_pardee 🎙

Using an anecdotal source - My Wife (ICU RN) this is sounds right.

Outside of the existing issues with Bedside nursing (long days, physically demanding) - the primary issue is staffing. Pre-pandemic the ratios were already bad but now many are leaving for travel contracts which carry significantly better wages. It quickly becomes a loop where employees leave for Travel Contracts, and then can only be backfilled with Travel Contracts. The remaining FT staff nurses are left making much less money, and have to assist "training" with the outside Travel nurses. And while this is nothing against them - The travel RNs also often have a different "vibe" as they are much less focused on long term improvement or problem solving within the Unit.

Also ICU/PCU/ER nursing throughout the pandemic was a terribly depressing place to be. Leaving many of my Wifes colleagues (including herself) with what is essentially PTSD with little or no support from the Hospital System.

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@mansilladev 2 months

Replying to @dr_pardee 🎙

As the son of a retired nurse, I can tell you that this has been true since the dawn of the nursing profession.

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@sonicggg 2 months

Replying to @dr_pardee 🎙

Nurses complain about their work conditions, but I don't understand them. They had this massive leverage during the pandemic to discuss improvements. Some people may say "Oh but it is illegal for nurses to strike in country X", but what will governments and companies realistically do if all nurses decide to stop, arrest everyone and let the health system collapse? Not a reasonable option.

There's just something masochist about their profession.

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@bsedlm 2 months

Replying to @dr_pardee 🎙

at some point, somehow, medical care stopped revolving about 'healing' and medicine became all about 'treating'.

the health of the patient became subordinate to the economic incentives of the hospitals and the other involved institutions (insurance providers, pharmaceutical corporations, etc...)

and so I have the hypothesis that this happened because people (young adults) going into medicine because of a vocation to help and heal others become disheartened when they find out it's all about institutional profit; only them who get into this becuase "doctors make good money" really make it to the end (which is not terrible, as they usually do learn the methods and techniques of medicine, but that in the long run prioritize money over health).

health care should have never been allowed to become a capitalist marketplace.

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@screye 2 months

Replying to @dr_pardee 🎙

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. Nursing has clearly gone through a rough 2 years, but I suspect that things are going back to normal now. Why leave now ?

> High patient-to-nurse staffing ratios

This bit is confusing me. If supply-demand is in the Nurse's favor, then don't they get more leverage on what QOL and wages they can demand ? It is not like they can fire a senior nurse on low pay, when new nurses are harder to find and demand higher wages. I know that the nurses refusing work and resulting deaths has bad optics, but it doesn't look like hospitals have a lot of leverage right now.

> Administrative burden and manual tasks

Sounds like an opportunity for a startup to disrupt the space. But, the jaded side of me thinks that the startup will fail due to insufficient political leverage with hospitals/insurance/law-makers.

> health IT

Keep calling it health IT and the problems will never be solved. Solving hard problems needs reframing of the resources dedicated to it. When tech workers are seen as assets and not cost-centers, these problems will solve themselves.

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@sebow 2 months

Replying to @dr_pardee 🎙

No surprise at all. A lot of unnecessary stress (yes, more than enough, even for a pandemic) and the top-down approach of the institutions really broke the trust of the public in many healthcare systems worldwide. I think the sentiment would be the same even if wages would be raised (and in many cases they have been).

Considering it was bothersome for both healthcare workers and the public, in my opinion the friction is more between the healthcare workers and management/government entities (& their policies) rather than "some patient bothered me" cases.

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@TYPE_FASTER 2 months

Replying to @dr_pardee 🎙

I'm a software engineer. My wife is a RN. It's been interesting over the past 20+ years to see the parallels in two different markets. Temporary staffing is used to fill vacant reqs. Gradual erosion of employer provided benefits.

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@giantg2 2 months

Replying to @dr_pardee 🎙

"... poor processes, along with inefficient operational workflows and administrative burden are key drivers of frustration and burnout among ..." [insert job here]

This is pretty much universal in my experience. As a dev, it always seems to boil down to these. It's amazing how the business doesn't know their processes, can't document them accurately, or simply don't care to analyze and document them. Garbage requirements become a garbage system.

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@Blackstone4 2 months

Replying to @dr_pardee 🎙

Might be similar for teachers...I know many have cut back hours to part time where they can or are considering leaving. They are having to fill in for staff absenses and are stressed.

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@mattmaroon 2 months

Replying to @dr_pardee 🎙

It’s a lot easier to say you will leave your profession than to actually do it, so I don’t expect anywhere near 90% to be true. But it won’t take that many to leave before it becomes a severe problem. The industry will be forced to reckon with this. We can’t not have nurses and healthcare is basically an infinitely large industry (people will spend all of their money to stay alive) so I’m sure it will be improved.

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@t_mann 2 months

Replying to @dr_pardee 🎙

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.

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@retr0nerd 2 months

Replying to @dr_pardee 🎙

Get ready for another dark age. The destruction of education and medicine in this country means plague doctors will be making a return. Better check with your HMO to make sure your policy covers them.

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@ubermonkey 2 months

Replying to @dr_pardee 🎙

A good friend of mine was a nurse practitioner in cancer care here for 17 years, and quit last year to do contract work in interesting places. She's unmarried, no kids, etc., so I think it's a little bit of a "shake things up" thing but also a little bit "make hay while the sun shines."

Her most recent gig was in Antarctica. I mean, cool, right?

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@jimmar 2 months

Replying to @dr_pardee 🎙

A family member just quit her nursing job because she refused to learn yet another system. She was great with patients but could not stand the computer systems she had to use.

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@throw8383833jj 2 months

Replying to @dr_pardee 🎙

Here's my naive understanding of the situation:

It sounds like they're just being overworked. So, just have the nurses take a 20 minute break every 2 hours, to go out and take a walk. The hospital can require it if it comes to that but why wouldn't they just want to do it? and if the hospital doesn't want to do it, then the nurses should insist on it and walk off the job if not given their breaks. I would imagine the hospital would rather agree to 20 min breaks every 2 hours rather than loosing 90% of their workforce forever: they don't have a choice, they have to agree.

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@airstrike 2 months

Replying to @dr_pardee 🎙

Compared to what % historically? If you don't give me historical trends, I don't know what to make of this one data point.

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@mberning 2 months

Replying to @dr_pardee 🎙

My wife worked bedside at a nationally ranked childrens hospital for 5+ years. She left recently for private practice and loves it. More money, less stress, better management. The list goes on. Bedside nurses are often not paid very well, are treated poorly by patients, and even more poorly by administrators. The hospital’s motto should be “anything for the patient, nothing for our employees”.

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@saos 2 months

Replying to @dr_pardee 🎙

Not surprised. Cost of living is at an all time high whilst wages have stagnated. Atleast thats the problem in the UK.

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@mfer 2 months

Replying to @dr_pardee 🎙

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 trying to stop nurses from talking about pay.

2. Patients in COVID have become downright mean. Add this to the problems nurses have management and doctors (who are often rude and arrogant) and it's a poor culture. The quality of the environment, from a mental health standpoint, is on the decline.

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.

4. Nurses are the catch all for jobs. Not enough aides? Nurses do the work. Food service workers don't want to take food into a patients room... nurses will do it. Not only do they have higher ratios of patients but they fill in the work when other areas have shortages, too. So, the work per patient goes up. Pay doesn't go up, though.

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@hadlock 2 months

Replying to @dr_pardee 🎙

Not only are nurses talking about leaving the industry, in the "newbie programmer" groups I help mentor in, there is an alarming number of people who were considering going in to health care/nursing, who are now seriously reconsidering their options, or changing majors in college mid-way through to move into technology/programming.

I guess my point is, not only is the current healthcare labor market at stake, but hiring/pay/working conditions now are having upstream impacts on the labor pipeline of people coming into the market, or evaluating entering healthcare. Having recently gone to the ER with my toddler, I can tell you this is not an area you want the market going for lowest bidder when you do have to use healthcare services.

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@dukeofdoom 2 months

Replying to @dr_pardee 🎙

I have a nurse friend that was fired because she did not want to take the vaccine. She had covid before, and strongly believes in bodily autonomy. She did not want to be forced to put something in her body against her will. She's started a business cleaning houses now, and says is making same money. Except now she isn't pressured to be rushing from patient to patient like crazy. She's choosing her hours, works during the day at her pace and doesn't bring home the emotional stress of dying people. She worked as a nurse for 7 years and in that time she had thousands of patients. She said in all that time she only discharged 3 patients after chemo therapy. She's kind of convinced both are billion dollar scams by medical industry.

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@LatteLazy 2 months

Replying to @dr_pardee 🎙

You see these numbers come out of nursing and teaching regularly. But they both have very high retention rates. Because in both cases, people stay because they would feel bad if they left. They're not there for the money. This is why they're so badly paid. This is why I didn't go into teaching: you cannot compete with people who will work for emotional rewards instead of cash.

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@pkaye 2 months

Replying to @dr_pardee 🎙

A couple changes I've heard from nurses would be helpful:

1. Safe mandated staffing ratios. California is one that does this and many nurses seem happy with the ratios.

2. Safe harbor laws. If the nurse feels they are pushed into a risky situation, they should have a right to notify management which will take on liability if they do not resolve it. A few states have this but hospitals bully nurses not to invoking it.

3. Better pay for the liability they take. Unlike management, they could go to prison for mistakes they make. There was a recent case nurses were outraged about.

4. Unions are beneficial. In California the nurses union is pretty strong to negotiate better terms and conditions.

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@xyzzy123 2 months

Replying to @dr_pardee 🎙

Canberra flagged, Tasmania exempted, Sydney and Melbourne upvoted.

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@honkycat 2 months

Replying to @dr_pardee 🎙

Greed is destabilizing society everywhere you look.

1. Hire more nurses to spread the load around

2. Pay existing nurses more

3. Incentivize people to get the technical training required to become a nurse.

"But what about my boss's 4th home?" I know. I am worried about that too. i pay 1500/mo to live there, and the costs will probably trickle down to me. we will have to figure something out.

"But we don't have the money! Who is going to pay for it?" Well. Then I guess the goose is cooked. We no longer have the resources to run a functioning society. I want you to think about that, and maybe think if we could get the funding from somewhere.

We are out of trained workers. The money diet our overlords put us on has officially starved us. Welcome to the 3rd world. Hope you saved up enough money for a ticket to Elysium.

Nobody wants to take out student loan debt anymore. If you are over 30, let me fill you in: cost of college has gotten even more insane than when we were in school.

we are seeing the same thing in our courts. Everyone is mad at the PDX DA for turning people loose all the time, but the secret is: there are not enough public defenders, and we can't hold people indefinitely without cause. There are literally not enough lawyers graduating from law school/graduated in the past to fill these spots.

Our society is falling apart and all anyone can talk about is how lazy the homeless are and obsess over what genitals people are born with.

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@dcchambers 2 months

Replying to @dr_pardee 🎙

The burnout in healthcare is unreal and is a problem we should all be worried about.

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@tedmcory77 2 months

Replying to @dr_pardee 🎙

My partner works in the healthcare industry; the Radonda Vaught ruling and outcomes are going to echo through that industry in a very significant way.

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@qclibre22 2 months

Replying to @dr_pardee 🎙

These "nursing crisis" articles are a semi-annual feature, likely a PR stunt by the hospitals for more subsidies and guest nurses.

The nursing crisis is 57 years old now: https://pubmed.ncbi.nlm.nih.gov/14252064/ (1965)

Similar articles

    WHY THE NURSING SHORTAGE PERSISTS.
    HALE T. N Engl J Med. 1964 May 21;270:1092-7. doi: 10.1056/NEJM196405212702105. PMID: 14121489 No abstract available.
    
    STUDENTS' DISAPPOINTMENTS IN PUBLIC HEALTH NURSING.
    HANSEN AC, THOMAS DB. Nurs Outlook. 1965 May;13:68-72. PMID: 14291737 No abstract available.

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@gjsman-1000 2 months

Replying to @dr_pardee 🎙

A family friend was talking to a doctor who was considering quitting.

The reason why, at least for that doctor, wasn't really the stress from patients. It was all the damned paperwork and the stress that created.

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@crawfordcomeaux 2 months

Replying to @dr_pardee 🎙

I'm so excited about the idea of creating an anarchic healing network of former medical industry workers looking to create a new system oriented toward meeting all the needs, not just some & also not for profit.

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@brent_noorda 2 months

Replying to @dr_pardee 🎙

About 7 years ago I switched to nursing from nearly 35 years as a software engineer. Each 13-hour shift my 6 or 7 patients, if there was a moment to talk, would ask why I did so. I'd make pretty much the same joke every time: "I was looking a job that was much much harder and paid much much less, so I landed on nursing. Unlike in a hospital, when I was in software and there was a crisis, we'd schedule a meeting and order burritos." The jokes stopped being funny, so three weeks ago I quit my last hospital nursing job.

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@next_xibalba 2 months

Replying to @dr_pardee 🎙

Sometimes the only way to recognize and solve problems is to go through a crisis. I hope all of these nurses quit and the rest of us wise up to how important they are.

(I have a nurse in my family)

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@dijonman2 2 months

Replying to @dr_pardee 🎙

Maybe we shouldn’t have fired a bunch of them.

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@kxyvr 2 months

Replying to @dr_pardee 🎙

My wife is an ICU physician, so I've been watching this from the sidelines. I can't emphasize enough on how badly COVID broke the system. There's always been problem with staffing and burnout. However, COVID really brought out the worst in people. The patient population became far more abusive than it had in the past and this was during a period where all healthcare providers were working extremely hard, not seeing their families, and sacrificing their personal health to help people. Then, a large part of society decided that COVID wasn't an issue, refused to mask, and refused to vaccinate. At some point, a large portion of providers decided enough was enough and quit:

https://www.beckershospitalreview.com/workforce/if-1-in-5-he...

Now, the problem is that when people started quitting, there were fewer nurses to take care of the patients and their ratios went up. During normal times, a floor nurse might be 6-8 patients to one nurse, a step down unit might be 4-1, and an ICU might be 1-1 or 1-2. It depends on the level of care required. Now, they're doing more than double this on a regular basis. And, frankly, they can't do it, at least safely. There's a number that a nurse can call if they believe they have an unsafe number of patients in order to get some kind of legal protection, but they still have to see that number of patients. And, frankly, it's incredibly stressful because they really, truly can't take care of that many patients, so they quit. A friend of my wife is a nurse trainer at a large hospital. They're having 80% of new nurses quit during their onboarding process because the ratios are absurd. A good portion of my wife's time is spent figuring out who's the least sick patient to discharge from the ICU because they don't have the staff.

Unfortunately, I don't think we're even close for this to being over either. The constant refrain is that COVID is the new normal and we need to adjust. I would contend that a new normal would imply a stable operating point and I do not believe this to be the case. It's going to take a really long time to restaff appropriately where the patient ratios and stress level manageable. Long time means years because, really, hospitals want and need BSNs and not just associates level training. In the mean time, every time we have a COVID surge, the hospital gets flooded, everyone gets overworked and abused, and more people quit.

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@tomohawk 2 months

Replying to @dr_pardee 🎙

What I've seen: health insurance companies and large medical companies were able to get everything they wanted. The result was Obamacare. It's been down hill from there.

I have family members in medicine, and they see the same thing. There was a really good opportunity at that time to address some glaring issues with healthcare, and we ended up with this thing that did not address those issues and created a lot more issues.

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@Kharvok 2 months

Replying to @dr_pardee 🎙

Hospital consolidation into major for-profit networks is largely to blame

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@mikewarot 2 months

Replying to @dr_pardee 🎙

This is the direct and extremely unalterable consequence of one decision, to base our medical system on profit, instead of results, or capabilities. We've left a matter of national security in the hands of rent seekers.

The tragic insertion of a middle layer, the insurance industry (AKA Death Panels), makes it even more tragic and inefficient.

You can not seek profits in a competitive environment without reducing every cost to the bare minimum. Of course they are going to cut staff costs, and the number of properly staffed beds to the bare minimum, it minimizes costs. If a surge happens, they're happy to pay a little bit of a premium in the cost side for extra staffing. It's more than compensated by the extra billing.

But the recent public health emergency was a seiche, a tsunami, a pulse of unanticipated magnitude. (Unanticipated in the minds of those looking to meet this quarter's numbers, not in the minds of long term strategic thinkers).

The wrong type of people are in charge of health care in the US, and our nation will not be secure until this changes.

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@sumanmd 2 months

Replying to @dr_pardee 🎙

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.

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@causi 2 months

Replying to @dr_pardee 🎙

90% of nurses considering leaving the profession in the next year

This is an orphan statistic. What percentage of nurses considered leaving every year five years ago? Ten? Twenty?

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@indymike 2 months

Replying to @dr_pardee 🎙

As a patient I dread interacting with healthcare... but I can only imagine how horrible it would be to be on the clinical staff where you are wedged between people needing care and 52 bosses trying to minimize risk, maximize billing, and reduce expenses.

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@monkpit 2 months

Replying to @dr_pardee 🎙

The survey sample was 200 RNs in the USA.

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@bitcurious 2 months

Replying to @dr_pardee 🎙

A lot of the work nurses and doctors have had to do over the past few years has been truly soul crushing. Imagine getting a patient you know is likely to die and telling them that no, they can’t die at home. No, they can’t see their family. No, they can’t opt out of the then. For certain groups of patients, the work of nurses has turned into death row prison wardens, because there is a 10% chance they might be saved, and for a while there was no way to opt out of that.

Second hand impression from a doctor friend.

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@badtoro 2 months

Replying to @dr_pardee 🎙

I am sure that the policy that forced nurses with natural immunity to be vaccinated or lose their job has nothing to do with.

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@eksx 2 months

Replying to @dr_pardee 🎙

I work in tech with no college degree and about 9 years of programming experience. I make mid 100,000's per year. My S/O has 6 years of Emergency Department experience and a bachelors degree and she made about 65k at our local hospital. I think pay is an enormous factor in this. Her local hospital has nurses with less than 1 year of experience being preceptors to new grads.

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@germinalphrase 2 months

Replying to @dr_pardee 🎙

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 to death over here.

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@bkjelden 2 months

Replying to @dr_pardee 🎙

Not surprising. My partner is a DNP and has pretty strongly considered leaving the entire profession.

From my perspective, the entire healthcare industry is set up to treat any frontline worker without an MD after their name as completely expendable, nothing more than a row in a spreadsheet that can be optimized for middle management to hit next quarter's bonus targets.

You can meet all metrics management sets out for you, have amazing patient satisfaction scores, etc, and every 6 months some spreadsheet wielding online MBA graduate is going to show up to turn the screws and tell you you need to work harder for the same pay, and to just be happy you aren't getting laid off.

At some point in time, the workers realize the joke is on them and find another profession.

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@jgalecki 2 months

Replying to @dr_pardee 🎙

This is a topic that I'm pretty close to. After programming for four years in the Bay Area, I decided to become a nurse. I spent three and a half years bedside nursing before returning to coding: two and a half at the Cleveland Clinic (a respected hospital) and another year doing 13-week travel contracts across the US. My goal was to find problems affecting nurses that might be solvable through programming. After my time on the floor, I've come to see that the deeper issues are more structural and organizational in nature.

One fundamental force in nursing is that a nursing shift is unpredictable. Some shifts go very smoothly, some are absolute trainwrecks. Patients are, definitionally, sick enough to be in a hospital, and they can start declining very quickly. This means that whatever you are doing at any given moment is often interrupted by a new priority that must be handled RIGHT NOW. It means that your 'plan of attack' for the day (which patients get [meds | baths | food | mobility | turns | dressing changes] when) is often delayed, sometimes by several hours. Any number of things could push the schedule back - incontinence care, a doctor stopping by to discuss a patient with you, a patient fall, a medical emergency, a lonely patient. A few curveballs can put you way into the weeds.

Consequently, the culture on a floor is key to how good your shift is gonna be. If you help others out when you have some slack and they help you out in turn when you are behind, it really smooths out those rough days. If other nurses let you drown, you drown.

The biggest thing that a hospital can do to help nurses is to adequately staff their floors. If everyone is drowning because the floor is understaffed, no one has time to help each other. If you're caring for six patients instead of four (on a med-surge floor), there are days where there literally isn't enough time to do all the nursing care everyone deserves. Documentation can be, and often is, done after passing off your patients in report. After you've already "dropped" documentation from your during-shift schedule, patient mobility - getting people up and walking, or even just sitting up in a chair for meals - is the usually the next thing go. After that, hygiene. Nobody dies if they don't get a bath, but another patient certainly could die if you don't do X. Next up comes pain medication requests and incontinence care. For me, it was enormously stressful not being able to provide the quality of care that the patients deserve.

This can be a huge factor in burnout. The pandemic made things worse in a bunch of different ways. Besides the stress of caring for patients with a deadly virus, you also now have to add on several minutes to every patient interaction for donning and doffing PPE. That's even less time to do the nursing part of the job while you're dealing with a more critical patient population (who will need more care). Burnout rates increase and nurses leave, either leaving the profession or taking contracts that, even if the conditions are no better or much worse), at least pay a premium. Hospitals that were well-staffed face staffing shortages, and hospitals that were already short on staff are now in a staffing crisis. The hospitals have to spring for travel contracts, and the nurses that did stay are angrier that other nurses are making multiples of their pay for doing the same work.

Given that this thread has some 900+ comments already, this comment will start off pretty far down the list. But I see some people mentioning that you are working on trying to make things better for nurses - I'm guessing that those people will read the thread more thoroughly. I would love to chat with you about whatever it is that your startup / company / weekend hackathon project is doing in this space. I've dedicated five years of my life to the problem space and would happily share my thoughts and experiences.

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@dollyworld 2 months

Replying to @dr_pardee 🎙

>> "The survey of more than 200 hospital registered nurses based in the U.S."

small sample size but agree on most points

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@xeornet 2 months

Replying to @dr_pardee 🎙

Many people in many professions have the same considerations about leaving. But then they realise they have a mortgage to pay, responsibilities (debts) they have signed up for, and never leave. Such is the system.

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@rdtwo 2 months

Replying to @dr_pardee 🎙

Another wage shortages (for the quality of work conditions) that will be reported as a worker shortage

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@poorbutdebtfree 2 months

Replying to @dr_pardee 🎙

People should stop giving them such a hard time for dancing every once in a while.

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@cptaj 2 months

Replying to @dr_pardee 🎙

The entire medical profession is insane and intentionally geared towards inefficiency and difficulty.

They pride themselves in it being so hard instead of realizing that this is glaring problem that needs to be solved instead of nurtured.

This begins from medschool being prohibitively hard, to a lack of global licensing process, to doctors being on duty for 36+hrs when you cant legally drive a truck without stopping after 8hrs.

Its all wrong at every level.

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@oliverafajardo 2 months

Replying to @dr_pardee 🎙

My experience: I'm an icu nurse in the sf bay area. I make a good salary. However, you can make this and more with a job with less physical and emotional stress/abuse. Even the "best" hospitals like kaiser/stanford/ucsf are always short staffed. I considered another area of nursing/hc but it's really all the same BS of being short staffed, constantly being denied vacations, etc.

I feel like a waitress, custodian, social worker, therapist, punching bag and other stuff - It's never ending. This has effected my mental health so much that I am slowly doing my career switch to SWE. While I know every job has it's own difficulties bs/stress/politics, the one's i deal with as a nurse now I can no longer deal with. I don't regret this career path because it has taught me a lot, and their is something better for me out there.

Career: I did consider other areas of nursing, but they didn't satisfy me, ICU is relatively the most enjoyable for me. On a regular hospital floor/intermediate floor, a nurse will be given 4-5 patients and let me tell you its a ZOO! In ICU i only have 2, and those keep you busy the whole shift. They're both different kinds of crazy.

I will say, being a nurse in California is 5x better than anywhere else simply because their are laws that allow us to have uninterrupted breaks!

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@rsanek 2 months

Replying to @dr_pardee 🎙

Looks like this is just the second time they ran this survey since 2018 [0]; there's no information in that one on how many were considering leaving (maybe 2021 was the first year they asked the question?) It always frustrates me when these stats are given without any context, how do we know if this is even high when we have no relative basis to compare? I think "considering leaving" is particularly difficult because if you were to ask me how many of my co-workers have told me they're considering leaving over the last year, my response would be near 100%. Yet here we are with only a few actually having left.

And why is it so hard to find the raw data from the actual survey? I'm surprised this is scoring so well on HN.

[0] https://www.hospiq.com/about-us/press-releases/new-hospital-...

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@gsatic 2 months

Replying to @dr_pardee 🎙

Depressing. It's like we are losing control of different subsystems of Jurassic Park every single day :(

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@faangiq 2 months

Replying to @dr_pardee 🎙

Peak Murica.

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@failuser 2 months

Replying to @dr_pardee 🎙

Quit and what's next? Take another loan to switch carriers?

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@namecheapTA 2 months

Replying to @dr_pardee 🎙

Doesn't basically everyone consider or day dream leaving their medium level job pretty often? What options are there people to make nurse level money in a regular town?

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@slifin 2 months

Replying to @dr_pardee 🎙

Nurse assistants who often do more work than nurses get paid 18k in the UK

Then if they work for years they might increase in pay band from like 2 to 4 which takes them up to like 20k-22k

Absolute joke for the hard work they do

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@gigel82 2 months

Replying to @dr_pardee 🎙

We've read similar reports about the "great resignation" with software engineers. Attrition is actually lower now than it was before the pandemic, so...

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@bob_neumann 2 months

Replying to @dr_pardee 🎙

Vaccine. Mandate.

It cost something like 15% of the nursing workforce, people who were already Covid immune, since they had worked the Covid front lines from day one.

But we pretended the vaccine helped stop the spread of Covid. It doesn't. And we pretended the vaccine had no meaningful risks. It does. And we pretended that natural (recovery) immunity didn't exist. It not only exists, but it's far stronger than anything a vaccine can do.

And yet we pretended anyway. And now we're paying the price. Pretending makes for bad public policy.

There are a lot of things we need to stop pretending about.

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@rel2thr 2 months

Replying to @dr_pardee 🎙

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 .

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@maerF0x0 2 months

Replying to @dr_pardee 🎙

Cynicism and complaint is our zeitgeist. Answer me how many actually left in year prior if you want my attention.

Lots of considering leaving a profession, also considering losing fat on Jan 1, and saving for retirement.

When people are surveyed there is a big difference between why they say and why they actually are doing the action. For example "Yeah, covid has been tough... and those insurance companies though... And doctors really dont respect my profession... Oh my [pregnancy/parental leave/dream of being a DJ]? yeah that has nothing to do with it."

These kinds of opinion surveys are just barely "science" .

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@tmcw 2 months

Replying to @dr_pardee 🎙

Similarly via a quick Google search:

- "Almost HALF Of San Francisco Residents Considering Leaving City" (according to survey of 500)

- "One in three New Yorkers Considering Leaving The State"

- "Over Half Of Young Lawyers Considering Quitting by 2027, IBA Report."

Look for X people considering Y, and you'll find them. Considering is cheap.

The awful experience of nurses, absolutely, true. But this, like so many others, is a silly poll that doesn't say anything.

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@hereme888 2 months

Replying to @dr_pardee 🎙

Clickbait title. It's NOT true that 90% of nurses want to leave within a year. Big difference with the fine print of the article.

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@chimprich 2 months

Replying to @dr_pardee 🎙

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 times hers.

I find it hard to believe there can't be a better way to arrange this kind of stuff.

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@FesterCluck 2 months

Replying to @dr_pardee 🎙

I am a systems engineer and software developer, and I have worked on multiple healthcare related systems including one for a major hospital system.

I wish I had more access to nurses during the process. I was always told they were too busy. I just wanted to observe, as I do with any client I write systems for, and was denied. I can say that at least 2 other groups were working on the exact same project as I in the hospital system, and we "won". We all worked in isolation from one another, I discovered the others by accident.

The top of major healthcare systems is wasteful and full of "little kingdoms". The ideas that "AI is going to help" and "nurses need to feel heard" are basically incompatible. Throwing money at artificial brains is always to substitute real ones, and the concept itself is contradictory to employee development. Why train a bunch of nurses endlessly on a subject when you can train an AI once?

We're supposed to be improving & developing people's lives here, not improving a box. For centuries we've found new ways of thinking that have made us better at science and medicine. Computers could do that, but we're not using them to teach each other. We're using them to replace one another.

It may sound silly, but I've reached the point that the theory Dune puts forth seems right.

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@r3trohack3r 2 months

Replying to @dr_pardee 🎙

Anecdotally - I have an acquaintance exiting the field of pediatric nursing. They worked in the ICU and with chronic conditions (cancer, heart disease, etc.).

The deaths were always hard when working with little kids - and there were a couple a month. But towards the end of COVID they were losing 4 kids PER WEEK (anecdote - I have no data other than listening to them vent) that this nurse firmly believed were avoidable had they received appropriate care.

What caused them to exit was how the hospital handled COVID: they postponed all elective surgeries. For these children, an elective surgery was anything where they "wouldn't die tomorrow" if the surgery wasn't done (somewhat of an oversimplification - but ballpark correct).

During that time hearts got worse, cancer progressed, bodies shut down until electives became emergencies... Success rates of surgeries dropped. And once restrictions started lifting the staff was underwater, they had a huge backlog of "electives" piled up on top of the normal ingress - kids were dying from waiting.

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@pessimizer 2 months

Replying to @dr_pardee 🎙

They'll leave with the teachers. Female-coded professions being derided for political capital as often as "inner-city crime" might tempt one to wonder which came first, the female-coding or the disrespect.

Just kidding. Teachers used to almost all be male until public schooling and the resultant budgeting turned them female (to pay them less.) It's like reverse computer-programming where the profession turned male when they started paying more.

Pay them and they won't leave. Pay them a lot, and dudes will start writing essays about how the reason women aren't being hired and are leaving the profession is because they naturally have less of an interest and aptitude for nursing than males.

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@nickstewart 2 months

Replying to @dr_pardee 🎙

My wife is a NICU nurse at a major NICU... she has worked there four years and is almost at her maximum pay, outside of COL increases, so right now she makes around $64k a year before tax/etc..

The travel nurses make significantly more and now that she has basically hit her cap (after just four years) I've been trying to convince her to move to a different unit or get a different job

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@Victerius 2 months

Replying to @dr_pardee 🎙

U.S. nursing salaries relative to average U.S. wages are above the OECD average: https://www.oecd-ilibrary.org/sites/health_glance-2017-58-en...

So pay isn't the problem.

The U.S. is also above the OECD average for the number of nurses per 1000 population: https://www.researchgate.net/publication/334515420/figure/fi...

So staffing isn't the problem either.

The U.S. is below the OECD average for the number of doctors per 1000 population: https://www.nurses.co.uk/Images/Blog/media/ddad9fa9-b06d-43d...

If nurses could work a regular 40 hours a week and be paid more, as they would like, the additional money and staffing need to come from somewhere. In the United States, we've decided that private hospitals could have the right to exist. Most nurses are thus beholden to a free market. So the question is why other hospitals aren't trying to poach nurses with better wages and schedules. The reason may be that the supply of nurses remains large enough that hospitals don't feel pressured to make these concessions. The business model of hospitals is also drastically different from that of, e.g., tech companies. Tech companies can afford to pay their employees outrageous salaries because it is possible for one software engineer to create a product that will generate $100M in revenue. A nurse's labor has a cap on how much economic value it can generate. Hence why nursing salaries are constrained.

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@nine_zeros 2 months

Replying to @dr_pardee 🎙

From my friends anecdotal experience, burnout in medical industry is partly due to too much administrative work.

It is also partly because the number of patients is increasing disproportionately, mostly because people are getting older. An individual at the age of 50 needed fewer medical appointments than an individual at the age of 70. That's literally from 2002 to today.

There just aren't enough nurses and doctors to tend to such a large old population.

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@FactualActuals 2 months

Replying to @dr_pardee 🎙

High stress environment, stagnant wages unless you're a travel nurse, underappreciated during the pandemic, and having friends turn on you because they associate you with some crazy conspiracy theory. These are all reasons I've heard of career nurses quitting and going into other industries.

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@ryanmarsh 2 months

Replying to @dr_pardee 🎙

I’m going to offer a counter point, anecdotally of course. My daughter is in university right now. She’s a in pre-nursing. She says most of the people in her major this year switched to nursing from other majors during the pandemic because they saw it as the most economically viable major compared to their previous major. In a nutshell the pandemic scared people into being pragmatic about their degree plan.

So hospital administration will have a fresh crop of graduates, new to the system, to abuse. The cycle will continue unabated.

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@mugivarra69 2 months

Replying to @dr_pardee 🎙

ya governments are gonna probably bring more immegrants to backfill vs raising their wages and giving them decent life.

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@smm11 2 months

Replying to @dr_pardee 🎙

It's the bare-minimum staffing that's done in nursing, in addition to the bizarro pay scale.

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@nomoreusernames 2 months

Replying to @dr_pardee 🎙

think about this statement, good nurses are taking care of the people you love the most in their most helpless hours. how fucking cruel are we as a society for taking this type of love for granted? its just wrong to use people like that. nurses biggest psychological problem is that they ignore themselves and love others and take care of them better. i think its really shitty. like veterans of defensive wars.

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@Copenjin 2 months

Replying to @dr_pardee 🎙

It's the same in Europe, but I don't know if they are extremely underpaid in the same way. Money could fix part of the problem.

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@vmception 2 months

Replying to @dr_pardee 🎙

Skimmed the article, what is that number like in other years?

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@kingkawn 2 months

Replying to @dr_pardee 🎙

Lots of blame being placed onto the business managerial class that has turned hospitals and the practice of medicine into a nightmare a la Kafka, but I think that the casual brutality of the healthcare educational model deserves a ton of the blame for this burnout. The reaction to all emotional trauma is to bury it and place all the energy into negotiating for higher pay. Money cannot endlessly sit in the place of enduring suffering, and the professions (medicine, nursing, PA, etc) will continue to degrade in quality as long as this barbaric understanding of emotional health is encouraged in the educational institutions.

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@hypertele-Xii 2 months

Replying to @dr_pardee 🎙

In Finland healthcare workers are striking right now, and instead of giving them the few percent raise they are asking for, the government is preparing a law to make it illegal for them to strike.

What a shitshow.

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@yalogin 2 months

Replying to @dr_pardee 🎙

Nurses is a tough profession. They are required to work for longer hours and not paid that much. With Covid, dealing with anti-science patients must have been very draining mentally. On top of changing the working conditions and increasing pay, may be we should make the nurses training free to make the field more attractive.

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@ryanSrich 2 months

Replying to @dr_pardee 🎙

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%).

My wife is a PT and made 3x more traveling as a contract therapist than she did as a full time employee. Three times. That’s absolutely absurd.

Benefits are also beyond comical. Healthcare insurance costs for healthcare workers are higher and the benefits are worse than if you just bought Obamacare directly.

Beyond horrible pay with no upward mobility, you’ll also have to deal with completely disconnected management that has never done any clinical work in their lives. They’ll bitch and moan about saving money, and often enforce policies that put clinicians at risk of malpractice. All to save money.

So yeah. If I were to give any young people advice, it would be to stay as far away from healthcare as you can.

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@giarc 2 months

Replying to @dr_pardee 🎙

I work in healthcare but not as a nurse. I'm in a somewhat obscure field that became pretty important during the pandemic (infection control). No one outside the hospital knew we existed before the pandemic. Then the pandemic hit, conspiracies' started to float around and we had to take our contact list off the public website as colleagues were receiving death threats.

I can't even imagine what nurses have gone through being front line staff interacting with patients (and their families) all day. We need a zero-tolerance policy for families that verbally abuse front line staff, but instead they are often let off due to "stress of a family member in hospital" or the need for "family centered care".

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@JaimeThompson 2 months

Replying to @dr_pardee 🎙

Perhaps allowing modern MBAs to cost optimize most every single thing we do isn't the best way to assure mid and long term security and profitability.

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@bawana 2 months

Replying to @dr_pardee 🎙

As a physician, I can see that the 'corporatization' of healthcare has been a bad thing for patients. Unlike most other services whose use is discretionary, people do not choose to get sick. Healthcare is more like a police, fire or a disaster service. To allow a profit driven structure to use competition among providers to deliver this service will only harm the sick.

In the same way that national defense has been driven into a profit making venture (and encouraging the support for proxy wars), health care has become a beast beyond monopolistic power, able to drive demand for its own supply. The net result has been to give responsibility without authority to the providers. Nurses are subject to mandatory overtime. Physicians are required to take unreimbursed call. These services were once the hallmark of a devoted provider. Now they are exploited by a corporate profit seeking behemoth.

Patients now have such large deductibles that they prefer to pay me in cash for a negotiated lower price. No longer is health insurance actually insurance. It has become more of a coupon or in the language of today's generation, a groupon.

Even retirees who with Medicare only had to pay 20% of unreimbursed allowable expenses, have increasing burdens. The premium for part B (yes you have to pay for the part of Medicare that does not cover the hospital) has increased 15% this year and the government stated this is largely the result of a single dementia therapy - a pill that costs $56,000.

I think we could fix the problem if we required our lawmakers to actually pay for their healthcare. They get it for free. In addition, each gets a multimillion dollar stipend to run their office, separate and apart from their generous salary. For doing what? pushing emails. And they are so afraid of offending any part of their constituency that they spend most of their time arguing about non-issues. Their ridiculous behavior is creating a fertile environment for the next tyrant who will prromise salvation and deliver true misery.

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@say_it_as_it_is 2 months

Replying to @dr_pardee 🎙

This isn't a problem that can be solved by an IT solution. Nurses have more patients assigned to them than what they can manage. They don't need another system of forms and workflows to fill out in addition to their overloaded plate. If anything, the solution is the opposite of an IT solution in that hospitals must hire more nurses and stop following the recommended lean-management staffing numbers provided by software.

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@acchow 2 months

Replying to @dr_pardee 🎙

As nurses quit, nurse compensation will increase and the number considering leaving will start to fall

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@tyrrvk 2 months

Replying to @dr_pardee 🎙

We talk about insurance killing the medical field, but I'd also argue that EMR companies are doing a number on the profession as well. Have you seen the Epic campus? Epic - located in Wisconsin (not the gaming company). The amount of overhead a hospital needs to support/run that behemoth can't be small. And Epic is _swimming_ in cash.

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@vlunkr 2 months

Replying to @dr_pardee 🎙

I'd like to know what "considering leaving" means in this study. I consider leaving my profession every time a React hook misbehaves and locks up my browser, but I'm not actually going to leave. 90% seems way too high to be people who are actively wanting to leave.

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@mulmen 2 months

Replying to @dr_pardee 🎙

I did IT support in a hospital for a year. Nurses do everything. Their job is both hard and thankless. I do not doubt satisfaction is low.

But this sounds like the employee satisfaction corollary to Sturgeon’s Law [1].

“90% of employed people are considering leaving their profession in the next year.”

This survey would be more compelling if it compared nurses responses with the general employed population over time. I only skimmed so maybe it does and I missed it.

[1]: https://en.m.wikipedia.org/wiki/Sturgeon's_law

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@slantedview 2 months

Replying to @dr_pardee 🎙

It would be interesting to see data on this by state. Nursing, unfortunately, is much more difficult in states without unions. In California, the strong nurses union has ensured somewhat better staffing ratios and much better pay than in other states.

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@sytelus 2 months

Replying to @dr_pardee 🎙

Report: Anything saying 90% of something is probably a fake report.

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@weatherlite 2 months

Replying to @dr_pardee 🎙

Hard profession but one of the last things to be automated imo, guaranteed income for next 30-40 years. Don't think you can say the same about certain types of doctors for instance.

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@quxbar 2 months

Replying to @dr_pardee 🎙

The market will surely adjust, by killing off people who can no longer afford nursing.

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@ashitlerferad 2 months

Replying to @dr_pardee 🎙

Salaries about to go through the roof. Time to be a nurse more than ever.

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@petermcneeley 2 months

Replying to @dr_pardee 🎙

Most people work for money so I would take all this with a grain of salt. If you are a RN what are you going to do if not nursing? The same applies to all fields including Physicians.

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