5 ms·

There are a few things I've learned from the nurses I know... - Nurses, the primary caregivers in Hospitals, have been treated pretty poorly for a long time. S

by mfer 5y ago

There are a few things I've learned from the nurses I know... - Nurses, the primary caregivers in Hospitals, have been treated pretty poorly for a long time. Some of it is pay, some of it is expectations, some of it is just the way the people around them treat them (e.g., the way surgeons often talk to them). - Some management has gotten down right mean. I know one hospital that has dictated that refusing to work a mandated shift (that's where they keep you longer than your shift to keep working) will cause you to be fired. They've gone through on that already. - ICU nurses have seen the worst. In places that have had peak COVID it's not unusual for 9/10 people with COVID in the ICU to die. That takes a tole on people. - Some hospitals are giving huge bonuses to new hires. And better pay. There's nothing like being a senior nurse in an ICU who has more responsibility and higher expectations while having the new person next to them having just gotten a bonus and making more money. You might as well quit and go work at a different nearby hospital to get a bonus and raise. I wonder what would happen if hospitals starting doing peakon surveys of their people and started working to improve on things.

randycupertino 5y ago
> Some of it is pay, some of it is expectations, some of it is just the way the people around them treat them (e.g., the way surgeons often talk to them). Not to mention the patients! I'm not a nurse but have worked with patients on a few hospital units and I have been groped by old male patients several times. Also patient's families can be incredibly rude, mean and demanding to nurses. They're trained for it and you do kind of get used to it, but it does wear you down after a while.
wayoutthere 5y ago
> (e.g., the way surgeons often talk to them) To be fair, surgeons talk to everyone that way. I haven’t met a surgeon who didn’t talk down to other people. My theory is that you have to have a huge fucking ego to cut someone open and believe you’re going to make them better.
- mfer 5y ago
  Nurses working 12 hour shifts spend more time around surgeons than most other people do. It takes it's toll. You can be very good at what you do and confident in it without talking down to others, being arrogant, or treating others poorly. It's a cultural and character thing.
- smabie 5y ago
  How many surgeons do you know?
- chucksta 5y ago
  Good theory, mine was there is such little tolerance for them to be incorrect, so it's "what I said because I said it"
- senortumnus 5y ago
  Surgeon here, always try to treat nurses with respect and work with them as a team member to accomplish the best care for the patient. Maybe it’s a midwest thing.
  - SquibblesRedux 5y ago
    Independent of the medical profession, there is definitely a midwest thing. I have traveled a fair amount, and the culture in the US midwest is infinitely more polite, respectful, and helpful that that of the east or west coasts.
    - deleted 5y ago
      [deleted]
    - wayoutthere 5y ago
      You don’t fully understand Midwest culture then. You never say anything negative to someone’s face. You say it behind their back. Midwesterners are some of the most passive-aggressive people in the country. They’ll help you out of a sense of obligation then resent you for it. I much prefer the coasts where you know where you stand.
lmilcin 5y ago
I don't have any experience with US healthcare but I know this depends a lot on the country. Large part of this is that much of US healthcare is in the business of earning money or optimizing costs, the care being only side effect. As long as incentives are not right, there exists no practical way to fix the system, only prop it up here and there to eliminate worst offenses. As to salaries, I just can't imagine how it is even legal for nurses to do same job but being paid more because they just joined. I can sort of understand that you can be paid more if you do same job but have more experience. You get paid for loyalty and for the added value of your knowledge/experience that makes your work potentially higher quality. But being paid less is shady af because it exploits the nurses which have high incentive to stay at one place if only to keep the commute to the hospital. If you have family you can't just move to somewhere else every 2-3 years just to keep your salary competitive. As to verbal treatment, I understand that the problem is that if you are a good surgeon, you will be hired no matter how mean you are toward your coworkers. In large companies I have worked for (mainly financial) this is not tolerated (as much). You can be great senior developer or tech lead, but if you are mean to junior developers you are likely going to be reprimanded and then dismissed if you continue.
- mfer 5y ago
  > Large part of this is that much of US healthcare is in the business of earning money or optimizing costs, the care being only side effect. ICUs are not optimized. Hospitals in general are not optimized in the US. A lot of the cost issue is in inefficiency. Many ICU patients cause a hospital to loose money. > As to salaries, I just can't imagine how it is even legal for nurses to do same job but being paid more because they just joined... Salary is what ever a company decides to pay a person. There are all kinds of ups and downs. If you're running financially inefficiently, as most US hospitals are, then you need to limit when you pay people more. When US hospitals have seen a majority of their patients as COVID patients the loss they were talking about lead to bankruptcy speculations. While the predictions weren't right (in terms of timing) there is a lot of good context in https://claytonchristensen.com/books/the-innovators-prescription/ https://claytonchristensen.com/books/the-innovators-prescrip...
TheCapn 5y ago
Canadian speaking, wife is ICU RN. Everything you've said is spot on, but there's always more to add. Nurses get assaulted pretty much daily. It's such a problem, management basically said it's not worth reporting because nothing is going to be done. The largest issue is the chronically understaffed units. The burnout that results from having double the normal patient load makes everyone cranky and the team atmosphere breaks down. In better managed units the nurses are all willing to pitch in, help with workload or take over so you can have a break. In units that are suffering, everyone starts looking out for #1 and that whole system breaks down. People start scheming and creating cliques among themselves so if you're not with the "in" crowd on a shift you can get royally screwed... the animosity just grows. My wife has had coworkers commit suicide. There's been countless nurses straight up quitting, whether to retire or to take up contract work south of the border (the stories of how much they're making filter back through and more nurses start going that direction). Personally, my wife was forced to go on early mat leave because when she told management she will not be able to be primary on COVID patients. Management said goodbye... My assumption is the union would not allow nurses to create such demands (even with proper doctors notes and accommodation) but they would rather lose a nurse entirely than deal with accommodations in an unprecedented time. I've spoken with her multiple times and ultimately I think a lot of their issues stem from being unable to shift their hiring/onboarding practices. As an Engineer, I start as Junior. I get jobs designated for Junior Engineers, and I work alongside the Seniors to pick up skills and craft. As an RN she's fighting with people 25 years her senior for a position. She was out of school working casual shifts for 5 years before getting a temporary position, and longer after to get the permanent job. But even then, she's competing with the senior nurses for the same shifts. They aren't equal in skill, but they're treated that way, and the seniors gobble up everything they can until they run out and crash.
- 908B64B197 5y ago
  > management basically said it's not worth reporting because nothing is going to be done. Just call the police directly. > She was out of school working casual shifts for 5 years before getting a temporary position, and longer after to get the permanent job Sounds like there's too much nurses on the market if that's what the job market looks like.

by mfer 5y ago

randycupertino 5y ago

> Some of it is pay, some of it is expectations, some of it is just the way the people around them treat them (e.g., the way surgeons often talk to them). Not to mention the patients! I'm not a nurse but have worked with patients on a few hospital units and I have been groped by old male patients several times. Also patient's families can be incredibly rude, mean and demanding to nurses. They're trained for it and you do kind of get used to it, but it does wear you down after a while.

wayoutthere 5y ago

> (e.g., the way surgeons often talk to them) To be fair, surgeons talk to everyone that way. I haven’t met a surgeon who didn’t talk down to other people. My theory is that you have to have a huge fucking ego to cut someone open and believe you’re going to make them better.

mfer 5y ago
Nurses working 12 hour shifts spend more time around surgeons than most other people do. It takes it's toll. You can be very good at what you do and confident in it without talking down to others, being arrogant, or treating others poorly. It's a cultural and character thing.
smabie 5y ago
How many surgeons do you know?
chucksta 5y ago
Good theory, mine was there is such little tolerance for them to be incorrect, so it's "what I said because I said it"
senortumnus 5y ago
Surgeon here, always try to treat nurses with respect and work with them as a team member to accomplish the best care for the patient. Maybe it’s a midwest thing.
- SquibblesRedux 5y ago
  Independent of the medical profession, there is definitely a midwest thing. I have traveled a fair amount, and the culture in the US midwest is infinitely more polite, respectful, and helpful that that of the east or west coasts.
  - deleted 5y ago
    [deleted]
  - wayoutthere 5y ago
    You don’t fully understand Midwest culture then. You never say anything negative to someone’s face. You say it behind their back. Midwesterners are some of the most passive-aggressive people in the country. They’ll help you out of a sense of obligation then resent you for it. I much prefer the coasts where you know where you stand.

lmilcin 5y ago

I don't have any experience with US healthcare but I know this depends a lot on the country. Large part of this is that much of US healthcare is in the business of earning money or optimizing costs, the care being only side effect. As long as incentives are not right, there exists no practical way to fix the system, only prop it up here and there to eliminate worst offenses. As to salaries, I just can't imagine how it is even legal for nurses to do same job but being paid more because they just joined. I can sort of understand that you can be paid more if you do same job but have more experience. You get paid for loyalty and for the added value of your knowledge/experience that makes your work potentially higher quality. But being paid less is shady af because it exploits the nurses which have high incentive to stay at one place if only to keep the commute to the hospital. If you have family you can't just move to somewhere else every 2-3 years just to keep your salary competitive. As to verbal treatment, I understand that the problem is that if you are a good surgeon, you will be hired no matter how mean you are toward your coworkers. In large companies I have worked for (mainly financial) this is not tolerated (as much). You can be great senior developer or tech lead, but if you are mean to junior developers you are likely going to be reprimanded and then dismissed if you continue.

mfer 5y ago
> Large part of this is that much of US healthcare is in the business of earning money or optimizing costs, the care being only side effect. ICUs are not optimized. Hospitals in general are not optimized in the US. A lot of the cost issue is in inefficiency. Many ICU patients cause a hospital to loose money. > As to salaries, I just can't imagine how it is even legal for nurses to do same job but being paid more because they just joined... Salary is what ever a company decides to pay a person. There are all kinds of ups and downs. If you're running financially inefficiently, as most US hospitals are, then you need to limit when you pay people more. When US hospitals have seen a majority of their patients as COVID patients the loss they were talking about lead to bankruptcy speculations. While the predictions weren't right (in terms of timing) there is a lot of good context in https://claytonchristensen.com/books/the-innovators-prescription/ https://claytonchristensen.com/books/the-innovators-prescrip...

TheCapn 5y ago

Canadian speaking, wife is ICU RN. Everything you've said is spot on, but there's always more to add. Nurses get assaulted pretty much daily. It's such a problem, management basically said it's not worth reporting because nothing is going to be done. The largest issue is the chronically understaffed units. The burnout that results from having double the normal patient load makes everyone cranky and the team atmosphere breaks down. In better managed units the nurses are all willing to pitch in, help with workload or take over so you can have a break. In units that are suffering, everyone starts looking out for #1 and that whole system breaks down. People start scheming and creating cliques among themselves so if you're not with the "in" crowd on a shift you can get royally screwed... the animosity just grows. My wife has had coworkers commit suicide. There's been countless nurses straight up quitting, whether to retire or to take up contract work south of the border (the stories of how much they're making filter back through and more nurses start going that direction). Personally, my wife was forced to go on early mat leave because when she told management she will not be able to be primary on COVID patients. Management said goodbye... My assumption is the union would not allow nurses to create such demands (even with proper doctors notes and accommodation) but they would rather lose a nurse entirely than deal with accommodations in an unprecedented time. I've spoken with her multiple times and ultimately I think a lot of their issues stem from being unable to shift their hiring/onboarding practices. As an Engineer, I start as Junior. I get jobs designated for Junior Engineers, and I work alongside the Seniors to pick up skills and craft. As an RN she's fighting with people 25 years her senior for a position. She was out of school working casual shifts for 5 years before getting a temporary position, and longer after to get the permanent job. But even then, she's competing with the senior nurses for the same shifts. They aren't equal in skill, but they're treated that way, and the seniors gobble up everything they can until they run out and crash.

908B64B197 5y ago
> management basically said it's not worth reporting because nothing is going to be done. Just call the police directly. > She was out of school working casual shifts for 5 years before getting a temporary position, and longer after to get the permanent job Sounds like there's too much nurses on the market if that's what the job market looks like.