5 ms·

You're assuming that hospitals wouldn't rather pay double to have nurses who see themselves as transient cogs in the machine and give few shits about anything b

You're assuming that hospitals wouldn't rather pay double to have nurses who see themselves as transient cogs in the machine and give few shits about anything beyond hitting the KPIs they need to keep getting paid.

randycupertino 5y ago
> You're assuming that hospitals wouldn't rather pay double to have nurses who see themselves as transient cogs in the machine and give few shits about anything beyond hitting the KPIs they need to keep getting paid. This is a really great point! I recently read a pretty good true crime book (cheesy, I know, lol!) about the serial killer nurse Charles Cullen who was a nurse in New Jersey and killed his patients via insulin injections. He killed 40 know and up to 400 patients which makes him one of the most prolific serial killers in history. What I found interesting and ties right into your comment is that before they were onto him and when his patients kept dying, the hospital managers LOVED HIM because he was very efficient, hit all his KPIs and took on a lot of work. He would ask to help out the other nurses and kill their patients so then it wouldn't get on his record that he was killing his own patients. It was a pretty interesting but harrowing read if anyone is looking for book recommendations. The Good Nurse by Charles Graeber: https://www.audible.com/pd/The-Good-Nurse-Audiobook/B00C9SW5CC https://www.audible.com/pd/The-Good-Nurse-Audiobook/B00C9SW5...
- gremIin 5y ago
  I'm starting to think health care should not be run like a business.
MattGaiser 5y ago
Aren't all workers very quickly becoming transient cogs in the machine? I don't know a single friend at this point on a fully staffed team in any field anywhere. Whether it be FAANG, startups, or the government, data analytics in retail or lawyers at law firms, there is massive churn everywhere.
- throwaway0a5e 5y ago
  It's not a binary. Fully staffed or not people who see themselves as long term employees with skin in the game or as providing a service to their community will be resistant to implementing policies that screw the customer and will help customers ask for the things they need to ask for to not get screwed. Employees who see themselves as transient more readily implement whatever management asks without thinking.
  - h2odragon 5y ago
    Very well put
  - MattGaiser 5y ago
    That is interesting take. I would have thought that transients would be less likely to do that as they could more easily take other roles, while embedded people would have more to lose by opposing management. Why companies hire consultants for unpopular changes, as they will be leaving anyway and thus have less to lose. I am not sure which one is the case.
cogman10 5y ago
Yeah, but that's really where this article should be focusing. Hospitals are basically at the "We tried nothing and we are out of ideas!" The solution to a lot of nurse burnout is really pretty simple, increase their wages, hire more than the minimum of travel nurses so they aren't all working overtime.
- adolph 5y ago
  Wages are orthogonal to burnout Burnout is a psychological factor
  - tomrod 5y ago
    Both factors are crucial when retaining people.
  - SamBam 5y ago
    I think you are mostly right about this, but decent pay goes a long way to signaling respect, which is definitely a factor in burnout.
    - adolph 5y ago
      Likely not curative after the fact
  - cogman10 5y ago
    Imagine being a programmer earning 60k. Now imagine that your company has a time crunch, During that time crunch they are expecting you to work 80+ hours a week. Now imagine that because of said crunch they say "Hmm, we need some contractors to speed this up." So they hire just enough to reduce your hours from 80 to 75. Now imagine how you'd feel learning all those contractors are earning $120k and with your skill set, you could to if you left your employer (because there's a high demand for devs everywhere). Not only that, but you have a lot more flexibility in your hours and no longer need to do 80+ hour weeks. What would you do? Wage is a huge factor here and the nurses leaving aren't necessarily leaving nursing but instead turning into travel nurses. This creates the vicious cycle the hospitals are currently experiencing. Hospitals have 2 levers to pull to fix this problem. 1. Increase wages so less nurses feel inclined to leave for more money. 2. Increase the number of travel nurses so current nurses aren't pressured into insane and demanding work hours. The lever they are pulling instead, is "hire just enough travel nurses for minimal compliance (maybe) and buy little caesars pizza... maybe. Then complain to media outlets about how lazy nurses are." The reason hospitals aren't fixing this problem is simple. Once they raise their nurses salaries, they will have a HARD time lowering them again.

randycupertino 5y ago

> You're assuming that hospitals wouldn't rather pay double to have nurses who see themselves as transient cogs in the machine and give few shits about anything beyond hitting the KPIs they need to keep getting paid. This is a really great point! I recently read a pretty good true crime book (cheesy, I know, lol!) about the serial killer nurse Charles Cullen who was a nurse in New Jersey and killed his patients via insulin injections. He killed 40 know and up to 400 patients which makes him one of the most prolific serial killers in history. What I found interesting and ties right into your comment is that before they were onto him and when his patients kept dying, the hospital managers LOVED HIM because he was very efficient, hit all his KPIs and took on a lot of work. He would ask to help out the other nurses and kill their patients so then it wouldn't get on his record that he was killing his own patients. It was a pretty interesting but harrowing read if anyone is looking for book recommendations. The Good Nurse by Charles Graeber: https://www.audible.com/pd/The-Good-Nurse-Audiobook/B00C9SW5CC https://www.audible.com/pd/The-Good-Nurse-Audiobook/B00C9SW5...

gremIin 5y ago
I'm starting to think health care should not be run like a business.

MattGaiser 5y ago

Aren't all workers very quickly becoming transient cogs in the machine? I don't know a single friend at this point on a fully staffed team in any field anywhere. Whether it be FAANG, startups, or the government, data analytics in retail or lawyers at law firms, there is massive churn everywhere.

throwaway0a5e 5y ago
It's not a binary. Fully staffed or not people who see themselves as long term employees with skin in the game or as providing a service to their community will be resistant to implementing policies that screw the customer and will help customers ask for the things they need to ask for to not get screwed. Employees who see themselves as transient more readily implement whatever management asks without thinking.
- h2odragon 5y ago
  Very well put
- MattGaiser 5y ago
  That is interesting take. I would have thought that transients would be less likely to do that as they could more easily take other roles, while embedded people would have more to lose by opposing management. Why companies hire consultants for unpopular changes, as they will be leaving anyway and thus have less to lose. I am not sure which one is the case.

cogman10 5y ago

Yeah, but that's really where this article should be focusing. Hospitals are basically at the "We tried nothing and we are out of ideas!" The solution to a lot of nurse burnout is really pretty simple, increase their wages, hire more than the minimum of travel nurses so they aren't all working overtime.

adolph 5y ago
Wages are orthogonal to burnout Burnout is a psychological factor
- tomrod 5y ago
  Both factors are crucial when retaining people.
- SamBam 5y ago
  I think you are mostly right about this, but decent pay goes a long way to signaling respect, which is definitely a factor in burnout.
  - adolph 5y ago
    Likely not curative after the fact
- cogman10 5y ago
  Imagine being a programmer earning 60k. Now imagine that your company has a time crunch, During that time crunch they are expecting you to work 80+ hours a week. Now imagine that because of said crunch they say "Hmm, we need some contractors to speed this up." So they hire just enough to reduce your hours from 80 to 75. Now imagine how you'd feel learning all those contractors are earning $120k and with your skill set, you could to if you left your employer (because there's a high demand for devs everywhere). Not only that, but you have a lot more flexibility in your hours and no longer need to do 80+ hour weeks. What would you do? Wage is a huge factor here and the nurses leaving aren't necessarily leaving nursing but instead turning into travel nurses. This creates the vicious cycle the hospitals are currently experiencing. Hospitals have 2 levers to pull to fix this problem. 1. Increase wages so less nurses feel inclined to leave for more money. 2. Increase the number of travel nurses so current nurses aren't pressured into insane and demanding work hours. The lever they are pulling instead, is "hire just enough travel nurses for minimal compliance (maybe) and buy little caesars pizza... maybe. Then complain to media outlets about how lazy nurses are." The reason hospitals aren't fixing this problem is simple. Once they raise their nurses salaries, they will have a HARD time lowering them again.