22 ms·

Hospital exec says employees are walking off the job

162 points by belltaco 5y ago

originalvichy 5y ago
It was unexpected but still somehow expected since many of them were already overworked before covid hit. Turns out the healthcare systems didn't get overloaded by just the virus, but also the years or decades old issues bubbling under the surface. Nurses all the way in Finland are voting with their feet as well. Management that isn't up to par, working hours, pay... David Graeber's essays about how caring work is both underpaid and underappreciated rings true.
- Maxburn 5y ago
  Yup, news reports about "hospitals are 90% capacity" or whatever is a business decision by design. They might have a couple more floors available but no staff for them because they aren't scheduled, because patients aren't there. They proactively cut staff wherever possible and then try to react.
  - deleted 5y ago
    [deleted]
  - schaefer 5y ago
    There are not enough nurses, and aren't enough doctors sitting idle right now to hire up in the way that you're suggesting... and if you thought spinning up a chip fab in Texas is taking too long, wait until you try to solve the problem of spinning up more doctors. the residency program that takes up years of their schooling relies on having other doctors mentor them.
    - nradov 5y ago
      At times there have been a lot of idle doctors and nurses. Hospitals cancelled elective procedures to reserve capacity for an expected surge of COVID-19 patients (which in most areas never really arrived). My neighbor is an anesthesiologist and was only working half time for months. Doctors can be retained for other specialties but it's a slow process.
    - RhodesianHunter 5y ago
      There's actually an enormous abundance of nurses in the US. One in 100 people is a registered nurse. The nursing shortages are entirely due to the fact that these nurses have left bedside care due to the BS they have to deal with from understaffing, poor compensation, terrible shifts/hours, to abusive management and patients. The "nursing shortage" is as much a myth as the current labor shortage. There's only a shortage of nurses at current pay rates and working conditions.
      - mumblemumble 5y ago
        And I think that this is very much a result of a market failure. In a lot of metro areas, the health care networks have been consolidating, so that a single company dominates the market. That creates a double problem. It's not just that they don't have to pay a reasonable market rate for staff. It's also that they don't have to maintain a reasonable staffing level, because dissatisfied and poorly-treated patients don't necessarily have anywhere else to go.
        dantheman 5y ago
        Hard to call it a market failure when the government restricts new entrants and highly regulates every aspect of healthcare.
        mumblemumble 5y ago
        At least in the clinic a family member of mine owned, regulation was far from the biggest challenge. It was billing, especially interacting with private health insurance companies. Dealing with their labyrinthine systems costs a lot of money and time. The private insurance companies are a big factor driving the consolidation, too. As the care networks consolidate their negotiating power, it gives them more and more of a competitive advantage over their smaller competitors, who have relatively less ability to negotiate good rates. That, in turn, leads to them having to drop off of the insurers' networks, which then results in patients being directed elsewhere. I certainly don't want to say that government influence has no influence, but the brand of capitalism that sees government as the source of all evil is more about politics than economics. Economically speaking, cartels and informal cartel-like systems can be just as harmful. You don't get a healthy, well-functioning market by indiscriminately yanking any one lever; you get it by carefully tending the garden, and balancing a lot of competing considerations.
    - jaywalk 5y ago
      We should just put new doctors into an emergency six month fast track program.
      - objectivetruth 5y ago
        Dude, I don't even trust the graduate of a six-month boot camp to touch my production code for a niche web app and you want to let one PERFORM HUMAN MEDICINE?!?!
      - preordained 5y ago
        A bootcamp for doctors, that's the ticket!
    - rtkwe 5y ago
      Pandemics in particular stress the system a lot because normally events the push hospitals to their limits are fairly localized and hospitals can borrow workers from elsewhere to fill out the staff. That happened early in 2020 in the US, some nurses made good money going from place to place as areas peaked in the early days of COVID. Private hospitals in particular are never going to be particularly amenable to keeping the kind of slack that would be required to handle a pandemic. They barely keep enough staff for normal operations.
  - readams 5y ago
    Actually regulations limit the number of beds hospitals can have. The theory is that this will cut health care costs to insurers and the government because they assume hospitals will find a way to admit patients until they are full.
    - greedo 5y ago
      Regulations also limit the number of hospitals you can have in a city/county. You have to demonstrate a need for the healthcare facility. Currently 35 states require a CON (Certificate of Need) to open a new healthcare facility.
- matz1 5y ago
  plus now they have to do all kind of new ridiculous covid protocol testing tests all patients being admitted to the hospital no wonder they are overworked
- e40 5y ago
  It's the same with service sector workers. Having months off, many are realizing actually how shitty their jobs were. I highly recommend yesterday's The Daily podcast. They talk with a bunch of small business owners and service sector workers. Very illuminating.
Rd6n6 5y ago
There are discussions of a strike where I live because the province is trying to cut nursing total comp by about 5% https://calgary.ctvnews.ca/mobile/when-is-the-strike-vote-facing-wage-rollbacks-alberta-nurses-consider-job-action-1.5499741 https://calgary.ctvnews.ca/mobile/when-is-the-strike-vote-fa...
- AlexandrB 5y ago
  Ontario is squeezing nurses as well: https://cupe.ca/despite-heroic-sacrifices-ontario-health-care-workers-face-real-wage-cuts https://cupe.ca/despite-heroic-sacrifices-ontario-health-car...
- MattGaiser 5y ago
  Fellow Albertan here. I am out of astonishment for the actions of the UCP at this point.
- cbushko 5y ago
  Manitoba Nurses are on shaky ground too as they haven't had a contract for 4 years.
- syshum 5y ago
  The joy's of Government Healthcare. No one wants to pay more taxes, No one wants healthcare workers get less money, No One wants substandard care.. You can not have All 3, More Care, and More Pay requires more Taxes... Canadian's however do not want to pay more Taxes.
  - mindslight 5y ago
    You can get all 3 improvements if you're starting with an absolutely terrible worst-of-all-worlds system, like the one we have in the US. The main losers of any reform would be administrative paper pushers, but needless fakejobs aren't good for anybody.
    - syshum 5y ago
      I find it highly ironic that you believe the losers "administrative paper pushers" when 90% of the paperwork needed by the medical industry is a result of GOVERNMENT regulations. Medicare is full of all kind of "administrative paper pushers" It is beyond me why people think the solution to a government created problem is more government
MattGaiser 5y ago
Is there any profession out there that shouldn't be job hunting right now?
- JohnJamesRambo 5y ago
  Mortician, Repo Man, Prison Guard. The dystopian Holy Trinity.
goodells 5y ago
I am an EMT and talk to a lot of nurses, PAs, and physicians in various circles. This wave is worse for a few reasons. - Healthcare staff have great animosity towards the unvaccinated patients. They aren't victims here, they did this to themselves. Nobody can muster any more compassion, especially for these people. Patients and people at large, not even just the total-nutjob anti-vaxxers, are tired of restrictions. "Things are opened back up, I deserve to have a good time." - Staffing shortages building over the pandemic are making nurses hate the hospital administrations even more than before. Many were furloughed or laid off 6-12 months ago, and are now asked to work mandatory overtime with ridiculously unsafe nurse:patient ratios. - ... all while traveling contract nurses and providers are being utilized by the hospitals at a pay rate 3-4 times what staff are paid. Many nurses are leaving their jobs that pay $30/hour to take a traveling assignment at $90+/hour. These people are working side by side, there's disdain towards the travelers, but who cares they're making bank. - The "healthcare heroes" messaging is so obviously just a scam and the healthcare staff are now almost 18 months into a kafkaesque, double-speak nightmare. Previously this was reserved for veterans, and of course they were similarly screwed. It's all just been building up since the beginning of the pandemic - issues with skilled staffing are very real and happening across the country.
- MattGaiser 5y ago
  Any corporate culture messaging is a scam really. A company cares with its money (and this can be shown in working you less too, so not just cash comp). No money, they don't care about you.
  - teeray 5y ago
    Not true. A company can pay 50% over market and have a complete trash culture that burns people out in weeks. Not being total assholes is also a form of soft comp that doesn’t get enough recognition. I do realize “pay me more” is a balm that is acceptable to many, but I actually like to enjoy what I do.
    - MattGaiser 5y ago
AlexandrB 5y ago
Good for them. Despite the mantras of "support our frontline workers" many of these employees have been treated like shit by their employers[1], their government who refused to take measures to limit the spread, and their patients - some of whom will continue to actively deny COVID even as they die from it. [1] https://www.nwahomepage.com/knwa/mercy-employees-frustrated-about-not-receiving-covid-19-bonus-pay/ https://www.nwahomepage.com/knwa/mercy-employees-frustrated-...
- MattGaiser 5y ago
  If a company cares about you, it is shown in money. The People and Culture guy is a snake oil salesman meant to scam you.
  - lallysingh 5y ago
    There are certainly shops that treat you like garbage but pay very well. It's an abusive form of golden handcuffs.
    - rdtwo 5y ago
      Amazon
  - pavel_lishin 5y ago
    I think you're underplaying non-financial incentives. I would rather have a job that pays $X but offers flexible work hours and vacation time that allows me to be a better parent, than a job that pays $1.5X but won't let me take a day or afternoon off to (e.g.) take my kid to the doctor, etc. Granted, that probably applies more to WFH desk jobs than front-line nurses.
    - kevinmchugh 5y ago
      There's probably some floor for X below which 1.5x is more valuable than the non-monetary incentives
layoutIfNeeded 5y ago
But we were clapping! :/
bmeski 5y ago
The political class in North America is going to tank the continent. And if you try to stop them or say something about it you’ll likely just end up “committing suicide”.
linuxftw 5y ago
All the lockdowns started because we didn't want to overwhelm the hospital system. In the US, the hospital system, at least the ERs were already running on fumes. Our politicians have decided it's better to play world police and kill people overseas than invest in community hospitals. All the billions handed out to the vaccine companies and the propaganda machines, but no investment in increasing hospital capacity. These mega corporations that run the hospitals, they prey on people's caring capacity. Nurses haven't already left the field because nothing else pays a living wage and they have 60k in student debt to pay off. Let's just blame the unvaccinated though. That ensures Pfizer keeps buying ads on CNN.
- aantix 5y ago
  > In the US, the hospital system, at least the ERs were already running on fumes >but no investment in increasing hospital capacity Agree, where did all the billions go? The most expensive healthcare on the planet and we can't find the money to scale and expand a year and a half later.
  - twox2 5y ago
    I mean, every hospital director needs at least three vacation homes and two boats right?
    - mikeyouse 5y ago
      We have this whole additional trillion-dollar industry that other countries don't .. nearly every dollar of our healthcare spending flows through insurance companies who add zero value to actual health care but have hundreds of thousands of employees and hundreds of billions in salary to pay. Health insurers know their time in the crosshairs is coming which is why they're buying up pharmacy groups and providers, to give their offerings a sheen of actual care.
      - lotsofpulp 5y ago
        Health insurers (better called managed care organizations) are politically locked in. Politicians get to use them as scapegoats, and there is no way voters in the US accept taxpayer funded healthcare. Someone has to be the bad guy and allocate the limited amount of healthcare resources available, and I see no reason why the existing relationship of government makes the rules allocating the care, but MCO implements them and takes the heat would change. Traders also seem to think the same given the gains in MCO market caps. Also, all the MCOs have profit margins of 5% or less, so this game of punting responsibility costs relatively little in the grand scheme of things. At the root of it all is a demand for healthcare that far outstrips supply, and so these obfuscations are useful in making sure certain socioeconomic classes are able to attain a greater share of it than others.
papito 5y ago
The garbage fire of 2020 was almost worth it, it seems. First, the reconfiguration for hybrid remote work, but also - helping the "essential employee" class realize they have been taken for suckers. I can imagine it's hard to go back to pulling overtime around ungrateful anti-vaxxers, while the office TV is showing billionaires take off into space in personal rocket penises.
- jcpham2 5y ago
  I feel like this might be a highly underrated commentary on the socio-economic status of America.
- vagrantJin 5y ago
  > while the office TV is showing billionaires take off into space in personal rocket penises. Stripped of the emotional phraseology, I 100% agree with your point. There is something pointedly psychotic about flying rockets just because when your employees are not paid or treated fairly. But that's just psuedo "capitalism".
  - muaytimbo 5y ago
    I assume we're talking about Bezos here, Amazon pays above the prevailing wage in most markets and if workers don't feel they are being treated fairly they have the choice to work elsewhere. Bezos is flying to space not "just because", he's flying to space in order to build another company we all might benefit from, like AWS or Prime. He's flying to space because he's earned it, by improving a lot of developers and consumers lives. The timing was just unfortunate and a "gotcha" moment for those who complain about anyone with more than $100 in their bank accounts.
    - papito 5y ago
      This fetishizing of the rich is exactly the problem. How dare these socialists take this wealth and give it to the unthankful moochers! No one is talking about "punishing" the ultra-rich, but I would like to see them pay around my percentage tax rate, which is 28% - that's just Federal. I challenge you to find a wealthy person paying anywhere near that. The top tax rate in the US, decades ago, was 90%. It effectively capped the wealth, preventing entities from becoming more powerful than the government (good luck with that anti-trust action), which had the added benefit of forcing them to reinvest the money into the business and wages. What are the incentives now? The IRS is gutted. White collar crime, outright fraud. Profit, ruin a company, walk away with untaxed riches. No one is looking.
mistersquid 5y ago
The look on the interviewed Director’s face and the tremor in his voice speaks volumes about the stress he and his colleagues are enduring. The explanation Phan gives that healthcare workers expected this point in time to be easier because of warm weather and vaccinations is heartbreaking.
citilife 5y ago
I dont know how you can take CNN seriously, they've repeatedly been show to suppress real information and promote single cases to support a narrative. They've even been caught bragging about this. Regarding capacity, hospitals are designed to run at 90% capacity -- the state literally limits the number of hospitals in regions to ensure this is the case (i.e. hospitals stay profitable). ICU capacity is often at 100% and if you know anyone working in ICUs (I have multiple family members) this isn't new. That being said, they will increase turn-over by reducing their current care level, etc. Also should note, I can't help but feel this focus on Florida, Texas, Arkansas, etc is because they have banned masks and vaccine mandates. If you look at actual hospitalizations and more importantly death rates you see something different: https://www.statista.com/statistics/1109011/coronavirus-covid19-death-rates-us-by-state/ https://www.statista.com/statistics/1109011/coronavirus-covi...
- Dumblydorr 5y ago
  I'd say CNN is fine here, the narrative of overworked healthcare workers is common throughout NPR, NYT, etc. Wouldn't you be fed up if you got no extra monetary comp for putting your life on the line early-on while others stayed home with generous unemployment? Anyway, the link you posted shows NY, NJ, MA, and RI had the worst deaths per 100k. We already knew they got hit hard with the more fatal variant early on, when we didn't know about dexamethasone or turning patients on their front side, nevermind using vaccines to greatly halt severe cases. Furthermore, these are dense and urbanized areas, demographically more susceptible. So your call to check this site isn't that helpful in the current fourth delta wave. Now we're seeing 98% of deaths in the unvaccinated, according to NPRs recent article. This is a fourth wave, and it is categorically different than the other three because it's mostly hitting the unvaccinated. This is obviously a self-induced injury that our culture has inflicted.
- naturalauction 5y ago
  >Also should note, I can't help but feel this focus on Florida, Texas, Arkansas, etc is because they have banned masks and vaccine mandates. If you look at actual hospitalizations and more importantly death rates you see something different. But this is in the past (or cumulative over the whole pandemic), the news article is talking about now. If you look at current numbers, you can see where hospitalizations are now. See https://www.nytimes.com/interactive/2021/us/covid-cases.html https://www.nytimes.com/interactive/2021/us/covid-cases.html FL and AR seem to be hotspots to me
armchairhacker 5y ago
I've never worked as a nurse or doctor but it's hard to imagine what they go through. Every day they deal with people in serious pain, people with traumatic injuries, rude people, rude people with traumatic injuries, screaming children and babies. Apparently nurses in particular are also routinely disrespected by higher-ups, put in danger by higher-ups, and don't get paid much. In college I heard insane stories from the nursing majors. Apparently going on shifts working 72+ hours non-stop is the norm. Imagine spending 72 hours in that hell: delivering this guy's meds, then checking this guy's blood pressure while he berates you, then typing in some paperwork, then giving this baby lab work while he's screaming, then doing more paperwork, etc. for 72 hours straight. I can't imagine it, I can barely imagine spending more than 3 hours. Anecdotally, the few times I've been to doctors' offices and hospitals, I always notice the stress on doctors. Doctors and nurses are rushing everywhere, and they try to act nice but are simultaneously drained of emotion from disrespectful patients and general fatigue. Ironically sometimes they don't look that healthy, with all due respect, probably because of the immense stress and that it's hard to fit in exercise when you work 12-hour overnight shifts. Also, I live in Massachusetts where hospitals haven't been near capacity for some time now. Everything I described is just regular operation, pre-Covid.
- MattGaiser 5y ago
  I find it absurd that we allow medical staff to work 24 hour shifts. We don't let pilots do that. We don't let truckers do that.
  - someguydave 5y ago
    There seems to be a strong hazing culture in the medical industry.
  - nradov 5y ago
    It's a complicated problem. Tired healthcare providers make more errors. But the majority of harmful errors happen in handing over patient care from one provider to another. Shorter shifts mean more care transitions. A patient in the ICU isn't like a truck that you can park and leave alone for 8 hours.
traveler01 5y ago
It's not only in the US. It's everywhere. And no, Covid-19 wasn't entirely at fault. This virus its just showing the cracks the entire western world's health system.
ilamont 5y ago
Spouse worked at a hospital until last fall. As @originalvichy noted, there were years of old, unresolved issues bubbling under the surface. COVID just lay everything bare. She let them know exactly what the problems were for her and for the department at large. They wouldn't budge on anything, and as last summer's surge was dwindling, were planning on returning to the status quo. She walked.
dageshi 5y ago
All the people who hate the masks and hate the vaccines never really have any answer to this, what happens when the hospitals fill to capacity or the staff give up from exhaustion. No answers.
- switch007 5y ago
  If I had to talk a wild guess, they give answers but you don’t listen or like the response. Hospitals are designed to run near capacity. It’s reported every winter in the UK that they’re near or over capacity. And outside of winter they’re just as busy. 12 hour shifts, asking ungodly things of staff is nothing new. Where was your haughty indignation during the last bad flu season? We have vaccines and had/have mask mandates, yet still staff are giving up. What’s your answer to that?
  - dageshi 5y ago
    Well I read the article and watched the video and the point is, many of the people coming into the hospitals now are unvaccinated by choice. They're quitting because the rate of admissions should be slowing and they should be getting a break after dealing with it for 12+ months, but they're not.
    - TheFreim 5y ago
      I think hospitals should treat people who are there because of their own fault. Smokers with lung issues, overweight people with diabetes/heart issues, etc should all be treated. I don't see how this is any different. I understand being frustrated but dealing with people's problems causes themselves is part of the job.
  - greedo 5y ago
    The last bad flu season didn't kill over 600K Americans...
    - switch007 5y ago
      What’s that got to do with my post? The flu season places extra pressure on the hospitals - I’m not comparing the two viruses. Don’t get so triggered.
idownvoted 5y ago
It has of course nothing to do with ever mounting pressure on Health Care workers to vaccinate…
antioxidant 5y ago
Some quit because they didn’t want to be forced to get the vaccine. Some quit because they’re forced to wear masks all day. Some quit because inflation is here, yet their wages are not going up. And they’re getting stimulus checks. EDIT: Why the downvotes?
yobbo 5y ago
The Federal reserve has been purchasing (among other things) mortgage backed securities to about $40 billion per month since July 2020 [0]. That would be $160.000 USD per nurse in the USA in one year. Total asset purchases count in tens of thousands per US citizen, and this is plainly visible in asset prices. If it was a priority, subsidizing nurses and "front-line workers" would be a non-issue. (The "housing market" is more a plan economy and "hope to god the wealth effect/trickle down finally works this time".) [0] Google.
ortusdux 5y ago
Some of the first person accounts on reddit sound harrowing. https://www.reddit.com/r/Coronavirus/comments/oxzmdc/florida_hospitals_fighting_to_get_oxygen_with/h7pul2x/ https://www.reddit.com/r/Coronavirus/comments/oxzmdc/florida...
flerchin 5y ago
I don't understand the regional disparities in nurse pay. I know nurses in CA and TX that make close to $200k.
- axaxs 5y ago
  Is there a big one? Or is it that there are what, like 10 types of things called nurse now? I'm asking earnestly, not making an accusation. Ten years ago in a LCOL area, I knew an RN making about that, and they were treated like queens. Was able to work 3 12's, be paid for 40 hrs, and given hotel stay for free, among other things...usually including optional unlimited overtime at double pay. Then I knew some CNAs or LPN(can't remember which) who made much, much less.
  - ectopod 5y ago
    "Nurse" covers a huge round of competencies in the UK. The standard full-time pay scale goes from £18K to £105K. https://www.nurses.co.uk/careers-hub/nursing-pay-guide/ https://www.nurses.co.uk/careers-hub/nursing-pay-guide/
    - user5994461 5y ago
      From the link, qualified nurses start on band 5 that is £24,907 guaranteed nationwide out of university. Then it increases automatically to £30,615 after 7 years of experience (and more by then because it's also adjusted up automatically for inflation). Honestly it's decent out of university... if the hours and the patients aren't too bad. Bear in mind it's a guaranteed MINIMUM (outside of London). edit: was wondering how difficult it is to promote to the next band that starts above that. other articles say it's doable in two years. nurses read just like the typical HN discussion where companies have to progress developers quickly or they all jump ship a year after graduation. ahah
voidfunc 5y ago
I know someone who works in hospital / physician group admin that said doctors are straight up quitting right now unless the hospital bends to their demands to only work 3 days a week. They can't hire doctors either and they have no way to accept new patients at the moment.
- Miner49er 5y ago
  Seems reasonable, depending on shift length. Some doctors work 24 hour shifts, three 24 hour shifts a week would be brutal. Even three 12 hour shifts would be 36 hours, not much less than a standard 40 hour week.
  - rdtwo 5y ago
    3 12 hour shifts is often a full work week in places where that’s normal
varelse 5y ago
I suspect one could go a long way towards solving this by announcing that unvaccinated covid cases will get zero health insurance coverage. Make exceptions for those that truly cannot be vaccinated but to hell with everyone else. Going further, make society difficult to navigate for people unwilling to be vaccinated or wear masks and our frontline workers will have much better lives. Why are we compromising our quality of life, national security, and economic well-being to cater to these sorts? Just the economic damage alone from an indefinite pandemic seems like more than enough of a free market incentive to eliminate their negative impact on everything around them.
- adolph 5y ago
  Also smokers? Also drunk drivers who wreck? Also people who abuse drugs? Also people without documentation? Also those who don't accept blood letting? Also people who make bad decisions?
  - varelse 5y ago
    Your freedom stops at others immune systems. Think of this as a choose your own adventure. And if you don't wish to be vaccinated or wear a mask you are opting into the road less traveled. What's with all this negativity? But smoke all you want, they already factor that into health insurance costs. Drive drunk all you want, but don't whine if you get caught and they throw you in jail and take away your car and license. WTF undocumented sorts? You're all over the map IMO.
    - adolph 5y ago
      > Drive drunk all you want, but don't whine if you get caught and they throw you in jail and take away your car and license. Do you think a person who sustained an injury while they were intoxicated and needs medical treatment "get zero health insurance coverage?" Would it matter if they were at fault? Do you think a person who made a poor life decision "get zero health insurance coverage?" > What's with all this negativity? My questions aren't negative or positive. Their purpose is to think through the idea you proffered. If you didn't wish for people to think through this, why would one enter a comment?
hourislate 5y ago
Does this mean if they all walk off the job there won't be anymore TikTok videos of all the dancing nurses? If that's the case we have to vaccinate the unvaccinated because a vaccinated person might get sick from the virus they were vaccinated against because of those who refuse to be vaccinated.
janeroe 5y ago
There is a relevant speech by a surgeon who along with other doctors started their own practice [1]. It's called "Why Aren't There More Free Market Surgery Centers and Clinics". > The last two payments I received from Medicare were as follows: $285 for a six-hour cardiac anesthetic and $78 for the anesthesia services required for a knee replacement. These fees had been imposed through a mechanism referred to as the resource-based relative value scale, more appropriately called the Rosemary’s baby of healthcare. According to the folks at Harvard who gave birth to this creature, every physician service had a price and they knew what those prices were. > Prices are signals, after all, and Medicare was sending me a signal regarding what they thought the service I provided was worth, or they meant to intentionally cull the ranks. I felt obligated to respond with a rational signal of my own and as I’ve mentioned, I quit participating in their scheme. > To further bolster this bankrupt-hospital narrative, physicians and surgeons were told there was no money to buy the equipment and supplies they needed. It was becoming increasingly obvious that it was time to get out. I had no desire to be controlled by the rising administrator class. Next he discusses how under the guise of protection of customers and care about the citizens, government (lobbied by hospitals) tried to close their practice up because they charged 1/10th of what "not-for-profit" hospitals did. https://mises.org/wire/why-arent-there-more-free-market-surgery-centers-and-clinics https://mises.org/wire/why-arent-there-more-free-market-surg...
- handrous 5y ago
  Every other developed country I'm aware of uses price controls for their healthcare system, usually by declaring price lists regardless of payer, by establishing a state-directed monopsony, or by taking direct control of healthcare providers. Clearly it can work since AFAIK everyone is doing it, and it seems to be basically fine. Not perfect, but fine.
  - janeroe 5y ago
    And that's why author's practice survived despite the hostility of the US government. They started treating Canadian patients: > The first patients to arrive after we posted prices were Canadians. This was instructive, as these patients had so-called insurance coverage. There was no access, however, to the care that many of them required. The most common story then as now for the Canadians was a patient waiting two years to see a gynecologist for a hysterectomy to stop their bleeding, bleeding usually so severe that intermittent transfusions were required. For $8,000, which covers the facility, surgeon, anesthesia, pathology, and an overnight stay at the surgery center, Canadians can end their nightmare. The first question a Canadian asks when they call us is how long they’ll have to wait. Our answer that there is no waiting time is met with disbelief. A Canadian friend of mine has told me the old joke that no Canadian is truly content unless standing in line. All thanks to the success of a "state-directed monopsony" of a "developed country".
citizenpaul 5y ago
Hospital workers are like education workers in that they are spoiled. (not all of course but a huge percent) Education workers already get over 4 months of leave every single year built into the job, they are almost unfireable for any infractions. Yet they want higher salaries even though in national stats they already make over the median salary by quite a bit. (yes there are bad pay areas) Hospital workers are making a killing right now on par with crazy dotcom boom tech salaries. Due to the already in place massive bonus systems they have. Yet they are walking off for extra bonuses? Sounds spoiled to me. Bracing for what will likely be the most downvoted thing I have ever written.
- exo-pla-net 5y ago
  > "they are walking off for extra bonuses" What a bizarre characterization. They're walking off because they're working in hellish conditions, watching people die with no resources left to help them.
- jeffrallen 5y ago
  Maybe it would not get down voted so much if it was factual.
EricRiese 5y ago
The graph shown when talking about daily cases exploding was a graph of cumulative hospitalizations with the y-axis not starting at 0, to make an increase from 360k to 380k look like a tripling. Do better CNN.
- davak 5y ago
  I hate chart hacking. However, cases are up over 130% in the last two weeks. Hospitalizations up 80%. (1) The surge is unfortunately real. (1) https://www.nytimes.com/interactive/2021/us/covid-cases.html https://www.nytimes.com/interactive/2021/us/covid-cases.html
exo-pla-net 5y ago
Some grisly perspective from the linked video: "In 18 months, she saw more patients die than most nurses before COVID saw in a career."
- guilhas 5y ago
  That's sounds like BS, unless you are comparing nurses working in different places, then it would always have been true Know around 10 nurses at a big hospital. First they've always been on the brink of walking out, they earn on average less, in the UK, than starting IT workers, and they have much more responsibilities. They're shifts have been understaffed since ever. Everyone always talks about leaving In the beginning of the pandemic most old and sick were discharged to nursing homes, where they died And the hospitals actually had less people, but also less capacity since they could use only every other bed for distancing. So at least 50% less capacity. And wards where covid tested positive had to be closed for 2 weeks The excess mortality is not big enough that would be true for nurses in same position
MarkLowenstein 5y ago
Did they walk off the job in December and January, when they had higher than the current numbers of infection for 2 months straight? CNN is highlighting this non-unique situation to dump on a hated "red" state. Will they be there in a week, when "blue" Oregon, Washington, and Hawaii all have bigger numbers than they've ever seen? Those states all social-distanced themselves into ripe fruit, ready for picking by the more contagious Delta variant.
- joshgrib 5y ago
  Does social distancing somehow increase the risk of getting the Delta? I did some searching and couldn't find anything to back that up, if a certain state was better at social distancing the first time it seems like they probably would be for the next one too
  - MarkLowenstein 5y ago
    I meant to point out that if a region has kept COVID conflagrations from happening, via social distancing efforts, they will have accumulated less natural immunity, thus they are riper for conflagrations in the future. The way I predict "who's next" in the U.S. is to look at which states are at the bottom in terms of infections per capita. Those are the ripest. The technique has worked very well for me thus far.
    - greedo 5y ago
      Calling this entire argument out as non-factual. Oregon, Washington and Hawaii all are leading the nation in vaccination rate per capita. The idea of natural immunity is unfounded. You might have immunity BECAUSE you already had COVID. The idea that "infections per capita" trumps vaccination rate when determining future infections rates is just ridiculous. And claiming this is a hit job on a red state is just as foolish. Arkansas is one of the laggards in vaccinations, and the Delta variant is showing why they're paying the price.
      - MarkLowenstein 5y ago
mensetmanusman 5y ago
I wonder if it makes sense to de-prioritize the unvaccinated.
- djohnston 5y ago
  Definitely, assuming there is no legitimate underlying inability to be vaccinated.
- guilhas 5y ago
  Yes, lets also de-prioritize people with STDs, paedophiles, violent criminals, etc...
kxyvr 5y ago
Since most of this community is outside of healthcare, I figure I might as well share some of what this experience has been like for my wife, who's an ICU physician. In short, it's not good. Normal times for her community are always a bit stressful and burnout is real. Prior to COVID, a typical community, non-academic job, consists of 12 hour shifts and and at least 15 shifts a month. Some of those shifts will be weekends. Expect at least 3-4 nights. Realistically, the shifts end up being longer because of charting and billing. Alternatively, if someone codes (dies) at the end of the shift, you're there longer to see that the patient is stabilized and to give a proper sign out to the next physician. When COVID started, the number of shifts per month went up. Simply, there are more sick patients and more people dying, so the work requirements were higher. Practically, that means double the number of worked weekends and nights. More days a month. Really, they end up with only a handful of days off a month. Beyond that, a couple of things started to really wear on the community over time. One, physicians like to see their patients get better. For COVID, once they hit the ICU, they're probably going to die. And, it's not just they show up and die right away. Medical technology is really good. Mostly, they stay on the vent for weeks at a time in a very fragile state and then they die. Emotionally, it's very difficult to see someone that you care for intimately die like that, repeatedly. Two, grieving families are rarely easy to deal with, but COVID has made them incredibly abusive and hostile. It's pretty common now for the families to either in person or on the phone to scream, berate, and degrade the physicians and the care they provide. They accuse them of trying to kill their family or to providing inadequate, incompetent care. They Google the treatment of the week and demand that it be used. When they don't get what they want, they threaten lawsuits or demand transfer to another hospital. These transfers are not possible since moving the patient will kill them and the other hospitals are already full. Now, most physicians don't require someone to kiss their ass (some do), but given the amount of time, energy, and tears that they put into taking care of someone, it's deflating and demoralizing to be treated like this. No one wants to. There's always been abusive families, but I'll contend that the situation has gotten much worse. Three, many hospitals have put restrictions on the personal lives of their staff, which has diminished their ability to cope and recharge. A common refrain is that they're "all hands on deck," which translates to a ban on out of state travel or approved vacation. Now, while it's important that the medical community set a good example and keep their patients safe, they're also people and need to decompress. So, things like going one state over to a national park while staying in a remote cabin are now fireable if you get caught. Certainly, this is not the case everyone, but not so uncommon. But, really, the primary stressor now is that, from a medical point of view, the whole situation is rests on stupidity and it's incredibly frustrating and stressful. All of the cases my wife sees now are unvaccinated. It's not to say there aren't breakthrough cases, but she's not getting them. Now, eventually, someone gets close to dying and the family gets called in. They'll ask ahead of time, "Are you vaccinated?" Universally, the answer is no. They push a little, "Soooo, your mother/child/husband/wife is sitting here dying of COVID, you may want to think about a vaccination." They'll answer, "No, I'm good and I want to come in." Then, they'll say, "Alright, fine, but this person is on BiPap and you may want to wear an N-95 before you enter the room." Then, they'll complain about masks. After that, two weeks later, they get the mother/child/husband/wife in the ICU. It's horrific. What can be done? In my opinion, money's not the driving factor. Get the vaccine. Just do it. It saves lives. It works. Just get the vaccine. The medical community really is burning out and I can assure you that when you eventually hit the hospital for something related to COVID or not you're going to want them on their A-game. They're not going to be with the amount of time this has gone on. Get the vaccine.
prirun 5y ago
Last time I was in the hospital, I asked my nurse if she liked her job. We got to talking and she mentioned she previously worked as a barkeep. I said, "Well, at least you're making better money now." She said, "Actually, I made more money as a barkeep." I was completely shocked. Does this mean we need to increase health care costs? Of course not. We need to get rid of the waste, same as with university tuition and adjunct professors not making much.

162 points by belltaco 5y ago

It was unexpected but still somehow expected since many of them were already overworked before covid hit. Turns out the healthcare systems didn't get overloaded by just the virus, but also the years or decades old issues bubbling under the surface. Nurses all the way in Finland are voting with their feet as well. Management that isn't up to par, working hours, pay... David Graeber's essays about how caring work is both underpaid and underappreciated rings true.

Maxburn 5y ago
Yup, news reports about "hospitals are 90% capacity" or whatever is a business decision by design. They might have a couple more floors available but no staff for them because they aren't scheduled, because patients aren't there. They proactively cut staff wherever possible and then try to react.
- deleted 5y ago
  [deleted]
- schaefer 5y ago
  There are not enough nurses, and aren't enough doctors sitting idle right now to hire up in the way that you're suggesting... and if you thought spinning up a chip fab in Texas is taking too long, wait until you try to solve the problem of spinning up more doctors. the residency program that takes up years of their schooling relies on having other doctors mentor them.
  - nradov 5y ago
    At times there have been a lot of idle doctors and nurses. Hospitals cancelled elective procedures to reserve capacity for an expected surge of COVID-19 patients (which in most areas never really arrived). My neighbor is an anesthesiologist and was only working half time for months. Doctors can be retained for other specialties but it's a slow process.
  - RhodesianHunter 5y ago
    There's actually an enormous abundance of nurses in the US. One in 100 people is a registered nurse. The nursing shortages are entirely due to the fact that these nurses have left bedside care due to the BS they have to deal with from understaffing, poor compensation, terrible shifts/hours, to abusive management and patients. The "nursing shortage" is as much a myth as the current labor shortage. There's only a shortage of nurses at current pay rates and working conditions.
    - mumblemumble 5y ago
      And I think that this is very much a result of a market failure. In a lot of metro areas, the health care networks have been consolidating, so that a single company dominates the market. That creates a double problem. It's not just that they don't have to pay a reasonable market rate for staff. It's also that they don't have to maintain a reasonable staffing level, because dissatisfied and poorly-treated patients don't necessarily have anywhere else to go.
      - dantheman 5y ago
        Hard to call it a market failure when the government restricts new entrants and highly regulates every aspect of healthcare.
        mumblemumble 5y ago
        At least in the clinic a family member of mine owned, regulation was far from the biggest challenge. It was billing, especially interacting with private health insurance companies. Dealing with their labyrinthine systems costs a lot of money and time. The private insurance companies are a big factor driving the consolidation, too. As the care networks consolidate their negotiating power, it gives them more and more of a competitive advantage over their smaller competitors, who have relatively less ability to negotiate good rates. That, in turn, leads to them having to drop off of the insurers' networks, which then results in patients being directed elsewhere. I certainly don't want to say that government influence has no influence, but the brand of capitalism that sees government as the source of all evil is more about politics than economics. Economically speaking, cartels and informal cartel-like systems can be just as harmful. You don't get a healthy, well-functioning market by indiscriminately yanking any one lever; you get it by carefully tending the garden, and balancing a lot of competing considerations.
  - jaywalk 5y ago
    We should just put new doctors into an emergency six month fast track program.
    - objectivetruth 5y ago
      Dude, I don't even trust the graduate of a six-month boot camp to touch my production code for a niche web app and you want to let one PERFORM HUMAN MEDICINE?!?!
    - preordained 5y ago
      A bootcamp for doctors, that's the ticket!
  - rtkwe 5y ago
    Pandemics in particular stress the system a lot because normally events the push hospitals to their limits are fairly localized and hospitals can borrow workers from elsewhere to fill out the staff. That happened early in 2020 in the US, some nurses made good money going from place to place as areas peaked in the early days of COVID. Private hospitals in particular are never going to be particularly amenable to keeping the kind of slack that would be required to handle a pandemic. They barely keep enough staff for normal operations.
- readams 5y ago
  Actually regulations limit the number of beds hospitals can have. The theory is that this will cut health care costs to insurers and the government because they assume hospitals will find a way to admit patients until they are full.
  - greedo 5y ago
    Regulations also limit the number of hospitals you can have in a city/county. You have to demonstrate a need for the healthcare facility. Currently 35 states require a CON (Certificate of Need) to open a new healthcare facility.
matz1 5y ago
plus now they have to do all kind of new ridiculous covid protocol testing tests all patients being admitted to the hospital no wonder they are overworked
e40 5y ago
It's the same with service sector workers. Having months off, many are realizing actually how shitty their jobs were. I highly recommend yesterday's The Daily podcast. They talk with a bunch of small business owners and service sector workers. Very illuminating.

Rd6n6 5y ago

There are discussions of a strike where I live because the province is trying to cut nursing total comp by about 5% https://calgary.ctvnews.ca/mobile/when-is-the-strike-vote-facing-wage-rollbacks-alberta-nurses-consider-job-action-1.5499741 https://calgary.ctvnews.ca/mobile/when-is-the-strike-vote-fa...

AlexandrB 5y ago
Ontario is squeezing nurses as well: https://cupe.ca/despite-heroic-sacrifices-ontario-health-care-workers-face-real-wage-cuts https://cupe.ca/despite-heroic-sacrifices-ontario-health-car...
MattGaiser 5y ago
Fellow Albertan here. I am out of astonishment for the actions of the UCP at this point.
cbushko 5y ago
Manitoba Nurses are on shaky ground too as they haven't had a contract for 4 years.
syshum 5y ago
The joy's of Government Healthcare. No one wants to pay more taxes, No one wants healthcare workers get less money, No One wants substandard care.. You can not have All 3, More Care, and More Pay requires more Taxes... Canadian's however do not want to pay more Taxes.
- mindslight 5y ago
  You can get all 3 improvements if you're starting with an absolutely terrible worst-of-all-worlds system, like the one we have in the US. The main losers of any reform would be administrative paper pushers, but needless fakejobs aren't good for anybody.
  - syshum 5y ago
    I find it highly ironic that you believe the losers "administrative paper pushers" when 90% of the paperwork needed by the medical industry is a result of GOVERNMENT regulations. Medicare is full of all kind of "administrative paper pushers" It is beyond me why people think the solution to a government created problem is more government

MattGaiser 5y ago

Is there any profession out there that shouldn't be job hunting right now?

JohnJamesRambo 5y ago
Mortician, Repo Man, Prison Guard. The dystopian Holy Trinity.

goodells 5y ago

I am an EMT and talk to a lot of nurses, PAs, and physicians in various circles. This wave is worse for a few reasons. - Healthcare staff have great animosity towards the unvaccinated patients. They aren't victims here, they did this to themselves. Nobody can muster any more compassion, especially for these people. Patients and people at large, not even just the total-nutjob anti-vaxxers, are tired of restrictions. "Things are opened back up, I deserve to have a good time." - Staffing shortages building over the pandemic are making nurses hate the hospital administrations even more than before. Many were furloughed or laid off 6-12 months ago, and are now asked to work mandatory overtime with ridiculously unsafe nurse:patient ratios. - ... all while traveling contract nurses and providers are being utilized by the hospitals at a pay rate 3-4 times what staff are paid. Many nurses are leaving their jobs that pay $30/hour to take a traveling assignment at $90+/hour. These people are working side by side, there's disdain towards the travelers, but who cares they're making bank. - The "healthcare heroes" messaging is so obviously just a scam and the healthcare staff are now almost 18 months into a kafkaesque, double-speak nightmare. Previously this was reserved for veterans, and of course they were similarly screwed. It's all just been building up since the beginning of the pandemic - issues with skilled staffing are very real and happening across the country.

MattGaiser 5y ago
Any corporate culture messaging is a scam really. A company cares with its money (and this can be shown in working you less too, so not just cash comp). No money, they don't care about you.
- teeray 5y ago
  Not true. A company can pay 50% over market and have a complete trash culture that burns people out in weeks. Not being total assholes is also a form of soft comp that doesn’t get enough recognition. I do realize “pay me more” is a balm that is acceptable to many, but I actually like to enjoy what I do.
  - MattGaiser 5y ago

AlexandrB 5y ago

Good for them. Despite the mantras of "support our frontline workers" many of these employees have been treated like shit by their employers[1], their government who refused to take measures to limit the spread, and their patients - some of whom will continue to actively deny COVID even as they die from it. [1] https://www.nwahomepage.com/knwa/mercy-employees-frustrated-about-not-receiving-covid-19-bonus-pay/ https://www.nwahomepage.com/knwa/mercy-employees-frustrated-...

MattGaiser 5y ago
If a company cares about you, it is shown in money. The People and Culture guy is a snake oil salesman meant to scam you.
- lallysingh 5y ago
  There are certainly shops that treat you like garbage but pay very well. It's an abusive form of golden handcuffs.
  - rdtwo 5y ago
    Amazon
- pavel_lishin 5y ago
  I think you're underplaying non-financial incentives. I would rather have a job that pays $X but offers flexible work hours and vacation time that allows me to be a better parent, than a job that pays $1.5X but won't let me take a day or afternoon off to (e.g.) take my kid to the doctor, etc. Granted, that probably applies more to WFH desk jobs than front-line nurses.
  - kevinmchugh 5y ago
    There's probably some floor for X below which 1.5x is more valuable than the non-monetary incentives

layoutIfNeeded 5y ago

But we were clapping! :/

bmeski 5y ago

The political class in North America is going to tank the continent. And if you try to stop them or say something about it you’ll likely just end up “committing suicide”.

linuxftw 5y ago

All the lockdowns started because we didn't want to overwhelm the hospital system. In the US, the hospital system, at least the ERs were already running on fumes. Our politicians have decided it's better to play world police and kill people overseas than invest in community hospitals. All the billions handed out to the vaccine companies and the propaganda machines, but no investment in increasing hospital capacity. These mega corporations that run the hospitals, they prey on people's caring capacity. Nurses haven't already left the field because nothing else pays a living wage and they have 60k in student debt to pay off. Let's just blame the unvaccinated though. That ensures Pfizer keeps buying ads on CNN.

aantix 5y ago
> In the US, the hospital system, at least the ERs were already running on fumes >but no investment in increasing hospital capacity Agree, where did all the billions go? The most expensive healthcare on the planet and we can't find the money to scale and expand a year and a half later.
- twox2 5y ago
  I mean, every hospital director needs at least three vacation homes and two boats right?
  - mikeyouse 5y ago
    We have this whole additional trillion-dollar industry that other countries don't .. nearly every dollar of our healthcare spending flows through insurance companies who add zero value to actual health care but have hundreds of thousands of employees and hundreds of billions in salary to pay. Health insurers know their time in the crosshairs is coming which is why they're buying up pharmacy groups and providers, to give their offerings a sheen of actual care.
    - lotsofpulp 5y ago
      Health insurers (better called managed care organizations) are politically locked in. Politicians get to use them as scapegoats, and there is no way voters in the US accept taxpayer funded healthcare. Someone has to be the bad guy and allocate the limited amount of healthcare resources available, and I see no reason why the existing relationship of government makes the rules allocating the care, but MCO implements them and takes the heat would change. Traders also seem to think the same given the gains in MCO market caps. Also, all the MCOs have profit margins of 5% or less, so this game of punting responsibility costs relatively little in the grand scheme of things. At the root of it all is a demand for healthcare that far outstrips supply, and so these obfuscations are useful in making sure certain socioeconomic classes are able to attain a greater share of it than others.

papito 5y ago

The garbage fire of 2020 was almost worth it, it seems. First, the reconfiguration for hybrid remote work, but also - helping the "essential employee" class realize they have been taken for suckers. I can imagine it's hard to go back to pulling overtime around ungrateful anti-vaxxers, while the office TV is showing billionaires take off into space in personal rocket penises.

jcpham2 5y ago
I feel like this might be a highly underrated commentary on the socio-economic status of America.
vagrantJin 5y ago
> while the office TV is showing billionaires take off into space in personal rocket penises. Stripped of the emotional phraseology, I 100% agree with your point. There is something pointedly psychotic about flying rockets just because when your employees are not paid or treated fairly. But that's just psuedo "capitalism".
- muaytimbo 5y ago
  I assume we're talking about Bezos here, Amazon pays above the prevailing wage in most markets and if workers don't feel they are being treated fairly they have the choice to work elsewhere. Bezos is flying to space not "just because", he's flying to space in order to build another company we all might benefit from, like AWS or Prime. He's flying to space because he's earned it, by improving a lot of developers and consumers lives. The timing was just unfortunate and a "gotcha" moment for those who complain about anyone with more than $100 in their bank accounts.
  - papito 5y ago
    This fetishizing of the rich is exactly the problem. How dare these socialists take this wealth and give it to the unthankful moochers! No one is talking about "punishing" the ultra-rich, but I would like to see them pay around my percentage tax rate, which is 28% - that's just Federal. I challenge you to find a wealthy person paying anywhere near that. The top tax rate in the US, decades ago, was 90%. It effectively capped the wealth, preventing entities from becoming more powerful than the government (good luck with that anti-trust action), which had the added benefit of forcing them to reinvest the money into the business and wages. What are the incentives now? The IRS is gutted. White collar crime, outright fraud. Profit, ruin a company, walk away with untaxed riches. No one is looking.

mistersquid 5y ago

The look on the interviewed Director’s face and the tremor in his voice speaks volumes about the stress he and his colleagues are enduring. The explanation Phan gives that healthcare workers expected this point in time to be easier because of warm weather and vaccinations is heartbreaking.

citilife 5y ago

I dont know how you can take CNN seriously, they've repeatedly been show to suppress real information and promote single cases to support a narrative. They've even been caught bragging about this. Regarding capacity, hospitals are designed to run at 90% capacity -- the state literally limits the number of hospitals in regions to ensure this is the case (i.e. hospitals stay profitable). ICU capacity is often at 100% and if you know anyone working in ICUs (I have multiple family members) this isn't new. That being said, they will increase turn-over by reducing their current care level, etc. Also should note, I can't help but feel this focus on Florida, Texas, Arkansas, etc is because they have banned masks and vaccine mandates. If you look at actual hospitalizations and more importantly death rates you see something different: https://www.statista.com/statistics/1109011/coronavirus-covid19-death-rates-us-by-state/ https://www.statista.com/statistics/1109011/coronavirus-covi...

Dumblydorr 5y ago
I'd say CNN is fine here, the narrative of overworked healthcare workers is common throughout NPR, NYT, etc. Wouldn't you be fed up if you got no extra monetary comp for putting your life on the line early-on while others stayed home with generous unemployment? Anyway, the link you posted shows NY, NJ, MA, and RI had the worst deaths per 100k. We already knew they got hit hard with the more fatal variant early on, when we didn't know about dexamethasone or turning patients on their front side, nevermind using vaccines to greatly halt severe cases. Furthermore, these are dense and urbanized areas, demographically more susceptible. So your call to check this site isn't that helpful in the current fourth delta wave. Now we're seeing 98% of deaths in the unvaccinated, according to NPRs recent article. This is a fourth wave, and it is categorically different than the other three because it's mostly hitting the unvaccinated. This is obviously a self-induced injury that our culture has inflicted.
naturalauction 5y ago
>Also should note, I can't help but feel this focus on Florida, Texas, Arkansas, etc is because they have banned masks and vaccine mandates. If you look at actual hospitalizations and more importantly death rates you see something different. But this is in the past (or cumulative over the whole pandemic), the news article is talking about now. If you look at current numbers, you can see where hospitalizations are now. See https://www.nytimes.com/interactive/2021/us/covid-cases.html https://www.nytimes.com/interactive/2021/us/covid-cases.html FL and AR seem to be hotspots to me

armchairhacker 5y ago

I've never worked as a nurse or doctor but it's hard to imagine what they go through. Every day they deal with people in serious pain, people with traumatic injuries, rude people, rude people with traumatic injuries, screaming children and babies. Apparently nurses in particular are also routinely disrespected by higher-ups, put in danger by higher-ups, and don't get paid much. In college I heard insane stories from the nursing majors. Apparently going on shifts working 72+ hours non-stop is the norm. Imagine spending 72 hours in that hell: delivering this guy's meds, then checking this guy's blood pressure while he berates you, then typing in some paperwork, then giving this baby lab work while he's screaming, then doing more paperwork, etc. for 72 hours straight. I can't imagine it, I can barely imagine spending more than 3 hours. Anecdotally, the few times I've been to doctors' offices and hospitals, I always notice the stress on doctors. Doctors and nurses are rushing everywhere, and they try to act nice but are simultaneously drained of emotion from disrespectful patients and general fatigue. Ironically sometimes they don't look that healthy, with all due respect, probably because of the immense stress and that it's hard to fit in exercise when you work 12-hour overnight shifts. Also, I live in Massachusetts where hospitals haven't been near capacity for some time now. Everything I described is just regular operation, pre-Covid.

MattGaiser 5y ago
I find it absurd that we allow medical staff to work 24 hour shifts. We don't let pilots do that. We don't let truckers do that.
- someguydave 5y ago
  There seems to be a strong hazing culture in the medical industry.
- nradov 5y ago
  It's a complicated problem. Tired healthcare providers make more errors. But the majority of harmful errors happen in handing over patient care from one provider to another. Shorter shifts mean more care transitions. A patient in the ICU isn't like a truck that you can park and leave alone for 8 hours.

traveler01 5y ago

It's not only in the US. It's everywhere. And no, Covid-19 wasn't entirely at fault. This virus its just showing the cracks the entire western world's health system.

ilamont 5y ago

Spouse worked at a hospital until last fall. As @originalvichy noted, there were years of old, unresolved issues bubbling under the surface. COVID just lay everything bare. She let them know exactly what the problems were for her and for the department at large. They wouldn't budge on anything, and as last summer's surge was dwindling, were planning on returning to the status quo. She walked.

dageshi 5y ago

All the people who hate the masks and hate the vaccines never really have any answer to this, what happens when the hospitals fill to capacity or the staff give up from exhaustion. No answers.

switch007 5y ago
If I had to talk a wild guess, they give answers but you don’t listen or like the response. Hospitals are designed to run near capacity. It’s reported every winter in the UK that they’re near or over capacity. And outside of winter they’re just as busy. 12 hour shifts, asking ungodly things of staff is nothing new. Where was your haughty indignation during the last bad flu season? We have vaccines and had/have mask mandates, yet still staff are giving up. What’s your answer to that?
- dageshi 5y ago
  Well I read the article and watched the video and the point is, many of the people coming into the hospitals now are unvaccinated by choice. They're quitting because the rate of admissions should be slowing and they should be getting a break after dealing with it for 12+ months, but they're not.
  - TheFreim 5y ago
    I think hospitals should treat people who are there because of their own fault. Smokers with lung issues, overweight people with diabetes/heart issues, etc should all be treated. I don't see how this is any different. I understand being frustrated but dealing with people's problems causes themselves is part of the job.
- greedo 5y ago
  The last bad flu season didn't kill over 600K Americans...
  - switch007 5y ago
    What’s that got to do with my post? The flu season places extra pressure on the hospitals - I’m not comparing the two viruses. Don’t get so triggered.

idownvoted 5y ago

It has of course nothing to do with ever mounting pressure on Health Care workers to vaccinate…

antioxidant 5y ago

Some quit because they didn’t want to be forced to get the vaccine. Some quit because they’re forced to wear masks all day. Some quit because inflation is here, yet their wages are not going up. And they’re getting stimulus checks. EDIT: Why the downvotes?

yobbo 5y ago

The Federal reserve has been purchasing (among other things) mortgage backed securities to about $40 billion per month since July 2020 [0]. That would be $160.000 USD per nurse in the USA in one year. Total asset purchases count in tens of thousands per US citizen, and this is plainly visible in asset prices. If it was a priority, subsidizing nurses and "front-line workers" would be a non-issue. (The "housing market" is more a plan economy and "hope to god the wealth effect/trickle down finally works this time".) [0] Google.

ortusdux 5y ago

Some of the first person accounts on reddit sound harrowing. https://www.reddit.com/r/Coronavirus/comments/oxzmdc/florida_hospitals_fighting_to_get_oxygen_with/h7pul2x/ https://www.reddit.com/r/Coronavirus/comments/oxzmdc/florida...

flerchin 5y ago

I don't understand the regional disparities in nurse pay. I know nurses in CA and TX that make close to $200k.

axaxs 5y ago
Is there a big one? Or is it that there are what, like 10 types of things called nurse now? I'm asking earnestly, not making an accusation. Ten years ago in a LCOL area, I knew an RN making about that, and they were treated like queens. Was able to work 3 12's, be paid for 40 hrs, and given hotel stay for free, among other things...usually including optional unlimited overtime at double pay. Then I knew some CNAs or LPN(can't remember which) who made much, much less.
- ectopod 5y ago
  "Nurse" covers a huge round of competencies in the UK. The standard full-time pay scale goes from £18K to £105K. https://www.nurses.co.uk/careers-hub/nursing-pay-guide/ https://www.nurses.co.uk/careers-hub/nursing-pay-guide/
  - user5994461 5y ago
    From the link, qualified nurses start on band 5 that is £24,907 guaranteed nationwide out of university. Then it increases automatically to £30,615 after 7 years of experience (and more by then because it's also adjusted up automatically for inflation). Honestly it's decent out of university... if the hours and the patients aren't too bad. Bear in mind it's a guaranteed MINIMUM (outside of London). edit: was wondering how difficult it is to promote to the next band that starts above that. other articles say it's doable in two years. nurses read just like the typical HN discussion where companies have to progress developers quickly or they all jump ship a year after graduation. ahah

voidfunc 5y ago

I know someone who works in hospital / physician group admin that said doctors are straight up quitting right now unless the hospital bends to their demands to only work 3 days a week. They can't hire doctors either and they have no way to accept new patients at the moment.

Miner49er 5y ago
Seems reasonable, depending on shift length. Some doctors work 24 hour shifts, three 24 hour shifts a week would be brutal. Even three 12 hour shifts would be 36 hours, not much less than a standard 40 hour week.
- rdtwo 5y ago
  3 12 hour shifts is often a full work week in places where that’s normal

varelse 5y ago

I suspect one could go a long way towards solving this by announcing that unvaccinated covid cases will get zero health insurance coverage. Make exceptions for those that truly cannot be vaccinated but to hell with everyone else. Going further, make society difficult to navigate for people unwilling to be vaccinated or wear masks and our frontline workers will have much better lives. Why are we compromising our quality of life, national security, and economic well-being to cater to these sorts? Just the economic damage alone from an indefinite pandemic seems like more than enough of a free market incentive to eliminate their negative impact on everything around them.

adolph 5y ago
Also smokers? Also drunk drivers who wreck? Also people who abuse drugs? Also people without documentation? Also those who don't accept blood letting? Also people who make bad decisions?
- varelse 5y ago
  Your freedom stops at others immune systems. Think of this as a choose your own adventure. And if you don't wish to be vaccinated or wear a mask you are opting into the road less traveled. What's with all this negativity? But smoke all you want, they already factor that into health insurance costs. Drive drunk all you want, but don't whine if you get caught and they throw you in jail and take away your car and license. WTF undocumented sorts? You're all over the map IMO.
  - adolph 5y ago
    > Drive drunk all you want, but don't whine if you get caught and they throw you in jail and take away your car and license. Do you think a person who sustained an injury while they were intoxicated and needs medical treatment "get zero health insurance coverage?" Would it matter if they were at fault? Do you think a person who made a poor life decision "get zero health insurance coverage?" > What's with all this negativity? My questions aren't negative or positive. Their purpose is to think through the idea you proffered. If you didn't wish for people to think through this, why would one enter a comment?

hourislate 5y ago

Does this mean if they all walk off the job there won't be anymore TikTok videos of all the dancing nurses? If that's the case we have to vaccinate the unvaccinated because a vaccinated person might get sick from the virus they were vaccinated against because of those who refuse to be vaccinated.

janeroe 5y ago

There is a relevant speech by a surgeon who along with other doctors started their own practice [1]. It's called "Why Aren't There More Free Market Surgery Centers and Clinics". > The last two payments I received from Medicare were as follows: $285 for a six-hour cardiac anesthetic and $78 for the anesthesia services required for a knee replacement. These fees had been imposed through a mechanism referred to as the resource-based relative value scale, more appropriately called the Rosemary’s baby of healthcare. According to the folks at Harvard who gave birth to this creature, every physician service had a price and they knew what those prices were. > Prices are signals, after all, and Medicare was sending me a signal regarding what they thought the service I provided was worth, or they meant to intentionally cull the ranks. I felt obligated to respond with a rational signal of my own and as I’ve mentioned, I quit participating in their scheme. > To further bolster this bankrupt-hospital narrative, physicians and surgeons were told there was no money to buy the equipment and supplies they needed. It was becoming increasingly obvious that it was time to get out. I had no desire to be controlled by the rising administrator class. Next he discusses how under the guise of protection of customers and care about the citizens, government (lobbied by hospitals) tried to close their practice up because they charged 1/10th of what "not-for-profit" hospitals did. https://mises.org/wire/why-arent-there-more-free-market-surgery-centers-and-clinics https://mises.org/wire/why-arent-there-more-free-market-surg...

handrous 5y ago
Every other developed country I'm aware of uses price controls for their healthcare system, usually by declaring price lists regardless of payer, by establishing a state-directed monopsony, or by taking direct control of healthcare providers. Clearly it can work since AFAIK everyone is doing it, and it seems to be basically fine. Not perfect, but fine.
- janeroe 5y ago
  And that's why author's practice survived despite the hostility of the US government. They started treating Canadian patients: > The first patients to arrive after we posted prices were Canadians. This was instructive, as these patients had so-called insurance coverage. There was no access, however, to the care that many of them required. The most common story then as now for the Canadians was a patient waiting two years to see a gynecologist for a hysterectomy to stop their bleeding, bleeding usually so severe that intermittent transfusions were required. For $8,000, which covers the facility, surgeon, anesthesia, pathology, and an overnight stay at the surgery center, Canadians can end their nightmare. The first question a Canadian asks when they call us is how long they’ll have to wait. Our answer that there is no waiting time is met with disbelief. A Canadian friend of mine has told me the old joke that no Canadian is truly content unless standing in line. All thanks to the success of a "state-directed monopsony" of a "developed country".

citizenpaul 5y ago

Hospital workers are like education workers in that they are spoiled. (not all of course but a huge percent) Education workers already get over 4 months of leave every single year built into the job, they are almost unfireable for any infractions. Yet they want higher salaries even though in national stats they already make over the median salary by quite a bit. (yes there are bad pay areas) Hospital workers are making a killing right now on par with crazy dotcom boom tech salaries. Due to the already in place massive bonus systems they have. Yet they are walking off for extra bonuses? Sounds spoiled to me. Bracing for what will likely be the most downvoted thing I have ever written.

exo-pla-net 5y ago
> "they are walking off for extra bonuses" What a bizarre characterization. They're walking off because they're working in hellish conditions, watching people die with no resources left to help them.
jeffrallen 5y ago
Maybe it would not get down voted so much if it was factual.

EricRiese 5y ago

The graph shown when talking about daily cases exploding was a graph of cumulative hospitalizations with the y-axis not starting at 0, to make an increase from 360k to 380k look like a tripling. Do better CNN.

davak 5y ago
I hate chart hacking. However, cases are up over 130% in the last two weeks. Hospitalizations up 80%. (1) The surge is unfortunately real. (1) https://www.nytimes.com/interactive/2021/us/covid-cases.html https://www.nytimes.com/interactive/2021/us/covid-cases.html

exo-pla-net 5y ago

Some grisly perspective from the linked video: "In 18 months, she saw more patients die than most nurses before COVID saw in a career."

guilhas 5y ago
That's sounds like BS, unless you are comparing nurses working in different places, then it would always have been true Know around 10 nurses at a big hospital. First they've always been on the brink of walking out, they earn on average less, in the UK, than starting IT workers, and they have much more responsibilities. They're shifts have been understaffed since ever. Everyone always talks about leaving In the beginning of the pandemic most old and sick were discharged to nursing homes, where they died And the hospitals actually had less people, but also less capacity since they could use only every other bed for distancing. So at least 50% less capacity. And wards where covid tested positive had to be closed for 2 weeks The excess mortality is not big enough that would be true for nurses in same position

MarkLowenstein 5y ago

Did they walk off the job in December and January, when they had higher than the current numbers of infection for 2 months straight? CNN is highlighting this non-unique situation to dump on a hated "red" state. Will they be there in a week, when "blue" Oregon, Washington, and Hawaii all have bigger numbers than they've ever seen? Those states all social-distanced themselves into ripe fruit, ready for picking by the more contagious Delta variant.

joshgrib 5y ago
Does social distancing somehow increase the risk of getting the Delta? I did some searching and couldn't find anything to back that up, if a certain state was better at social distancing the first time it seems like they probably would be for the next one too
- MarkLowenstein 5y ago
  I meant to point out that if a region has kept COVID conflagrations from happening, via social distancing efforts, they will have accumulated less natural immunity, thus they are riper for conflagrations in the future. The way I predict "who's next" in the U.S. is to look at which states are at the bottom in terms of infections per capita. Those are the ripest. The technique has worked very well for me thus far.
  - greedo 5y ago
    Calling this entire argument out as non-factual. Oregon, Washington and Hawaii all are leading the nation in vaccination rate per capita. The idea of natural immunity is unfounded. You might have immunity BECAUSE you already had COVID. The idea that "infections per capita" trumps vaccination rate when determining future infections rates is just ridiculous. And claiming this is a hit job on a red state is just as foolish. Arkansas is one of the laggards in vaccinations, and the Delta variant is showing why they're paying the price.
    - MarkLowenstein 5y ago

mensetmanusman 5y ago

I wonder if it makes sense to de-prioritize the unvaccinated.

djohnston 5y ago
Definitely, assuming there is no legitimate underlying inability to be vaccinated.
guilhas 5y ago
Yes, lets also de-prioritize people with STDs, paedophiles, violent criminals, etc...

kxyvr 5y ago

Since most of this community is outside of healthcare, I figure I might as well share some of what this experience has been like for my wife, who's an ICU physician. In short, it's not good. Normal times for her community are always a bit stressful and burnout is real. Prior to COVID, a typical community, non-academic job, consists of 12 hour shifts and and at least 15 shifts a month. Some of those shifts will be weekends. Expect at least 3-4 nights. Realistically, the shifts end up being longer because of charting and billing. Alternatively, if someone codes (dies) at the end of the shift, you're there longer to see that the patient is stabilized and to give a proper sign out to the next physician. When COVID started, the number of shifts per month went up. Simply, there are more sick patients and more people dying, so the work requirements were higher. Practically, that means double the number of worked weekends and nights. More days a month. Really, they end up with only a handful of days off a month. Beyond that, a couple of things started to really wear on the community over time. One, physicians like to see their patients get better. For COVID, once they hit the ICU, they're probably going to die. And, it's not just they show up and die right away. Medical technology is really good. Mostly, they stay on the vent for weeks at a time in a very fragile state and then they die. Emotionally, it's very difficult to see someone that you care for intimately die like that, repeatedly. Two, grieving families are rarely easy to deal with, but COVID has made them incredibly abusive and hostile. It's pretty common now for the families to either in person or on the phone to scream, berate, and degrade the physicians and the care they provide. They accuse them of trying to kill their family or to providing inadequate, incompetent care. They Google the treatment of the week and demand that it be used. When they don't get what they want, they threaten lawsuits or demand transfer to another hospital. These transfers are not possible since moving the patient will kill them and the other hospitals are already full. Now, most physicians don't require someone to kiss their ass (some do), but given the amount of time, energy, and tears that they put into taking care of someone, it's deflating and demoralizing to be treated like this. No one wants to. There's always been abusive families, but I'll contend that the situation has gotten much worse. Three, many hospitals have put restrictions on the personal lives of their staff, which has diminished their ability to cope and recharge. A common refrain is that they're "all hands on deck," which translates to a ban on out of state travel or approved vacation. Now, while it's important that the medical community set a good example and keep their patients safe, they're also people and need to decompress. So, things like going one state over to a national park while staying in a remote cabin are now fireable if you get caught. Certainly, this is not the case everyone, but not so uncommon. But, really, the primary stressor now is that, from a medical point of view, the whole situation is rests on stupidity and it's incredibly frustrating and stressful. All of the cases my wife sees now are unvaccinated. It's not to say there aren't breakthrough cases, but she's not getting them. Now, eventually, someone gets close to dying and the family gets called in. They'll ask ahead of time, "Are you vaccinated?" Universally, the answer is no. They push a little, "Soooo, your mother/child/husband/wife is sitting here dying of COVID, you may want to think about a vaccination." They'll answer, "No, I'm good and I want to come in." Then, they'll say, "Alright, fine, but this person is on BiPap and you may want to wear an N-95 before you enter the room." Then, they'll complain about masks. After that, two weeks later, they get the mother/child/husband/wife in the ICU. It's horrific. What can be done? In my opinion, money's not the driving factor. Get the vaccine. Just do it. It saves lives. It works. Just get the vaccine. The medical community really is burning out and I can assure you that when you eventually hit the hospital for something related to COVID or not you're going to want them on their A-game. They're not going to be with the amount of time this has gone on. Get the vaccine.

prirun 5y ago

Last time I was in the hospital, I asked my nurse if she liked her job. We got to talking and she mentioned she previously worked as a barkeep. I said, "Well, at least you're making better money now." She said, "Actually, I made more money as a barkeep." I was completely shocked. Does this mean we need to increase health care costs? Of course not. We need to get rid of the waste, same as with university tuition and adjunct professors not making much.