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> The hospital strain point gets made a lot but I have one problem with this. Its been two years: have hospitals or the healthcare industry as a whole made an h

> The hospital strain point gets made a lot but I have one problem with this. Its been two years: have hospitals or the healthcare industry as a whole made an honest effort at upping the capacity in their facilities? It takes 10 years to train a doctor and 6 years to train a nurse. Exactly what exactly is your plan to get more doctors / more nurses? ------- In my state, we've declared an emergency. The national guard has been deployed to hospitals to run non-medical jobs. Student nurses are now allowed to work in hospitals / clinics, and we've even signed cross-state agreements to share our excess nurses in a pool with other states (so that as we get hit with COVID19 emergenies, we can help pass nurses around and better distribute the load as needed). If you got any better ideas, we're all ears. Immigrant visa applications are __heavily__ slanted towards doctors / nurses as well. Its an open secret that if you want USA-citizenship, just train to be a nurse then move here. Our systems are firing 100% on hiring more nurses and we still don't have enough of them. -------- Port-cities (we have a few of them) can make requests to the US Navy for hospital ships. This doesn't work for land-locked states but its an option for us.

RONROC 5y ago
We need more beds and equipment, not doctors. Sure, they’ll be overworked, but hey, when the going gets tough, the tough get going, don’t they? How about an increased emphasis on putting together the right incentives that ameliorate their personal risk tolerance just enough so that they’re OK with double shifts? Everyone has a price. So how about we just get to the part where we get those (who can and want to help) what they need so that we can move on.
- dragontamer 5y ago
  I don't think you've grasped the reality of the situation yet. We've cut out 20% of non-essential surgeries in our state to make room for COVID19 patients. "Non-essential" surgeries include biopsies and other potential-cancer events. ------- We have plenty of hospitals actually, and equipment. USA is very very rich, we can afford anything. Its the nurses / doctors we can't afford right now, cause they're non-existent. We can poach doctors/nurses out of school, maybe grab a few more doctor/nurse immigrants, and finally pool doctors/nurses together to make them more efficiently distributed across state-lines. But that's about it. You can't squeeze blood from a stone. You can't just "magic" doctors into reality by asking them to work twice as many hours. -------- This is no longer a "find student doctors/nurses" situation. We're well into "cancel other surgeries", and triage of care. Yes, here in the USA we've run out of health-care resources.
  - RONROC 5y ago
    The amount of attention from a body (nurse, doctor, janitor) that a person who has a serious case of COVID needs, is, at least a few orders of magnitude less "on-hands" than a surgery, any surgery (non-essential or not; that's a non-stater, and commonly used as fodder to pad your main point). The reality is that there aren't that many interventions that need to take place to help those with a serious case of COVID. It's not open heart surgery nor is it a more garden variety surgical procedure such as cyst removal or non-invasive plastic surgery. Apart from intubation and steroids in some cases, where's the rocket science here? An EMT or an army medic, with the right equipment, will more likely than not guarantee the same quality of healthcare that an MD or nurse will give. Although I hardly think you'll meet me halfway on that, so here's this question: Do you think the situation is/was helped by firing all unvaccinated healthcare professionals at hospitals around the country? If so, why? If not, why?
    - dragontamer 5y ago
      > Do you think the situation is/was helped by firing all unvaccinated healthcare professionals at hospitals around the country? If so, why? If not, why? Yes. 1. A family friend died from getting a nurse pass COVID19 to him. He was age 35. He further passed COVID19 to his father, who also passed away. 2. People come to hospitals to be protected from diseases. At a minimum, doctors/nurses themselves should be protected to minimize the chance of them spreading it to others. 3. The majority of "off" nurses / doctors in my area are due to COVID19 illness, not from firings. Vaccinations would reduce the chance of the workforce getting sick or spreading the sickness around. ------- Since hospitals are going to become the hottest of COVID19 hotspots (not only because of COVID19 patients visiting, but also as other immuno-comrpomised / weaker individuals visiting. Pregnancies, cancer, even "the flu" can be a complicating ailment that weakens your immune system to make COVID19 hurt more), its absolutely essential to minimize the COVID19 spread at hospitals / health care centers. Even if we lose some doctors/nurses over it, minimizing COVID19 spread (and preventing it from getting worse) takes priority. A huge priority. -------- > An EMT or an army medic, with the right equipment, will more likely than not guarantee the same quality of healthcare that an MD or nurse will give. Army Medics are by-and-large doctors. EMT is basic training. Its enough to maybe diagnose / run tests, but we're not talking about serious COVID19 treatment decisions (ex: whether or not a patient has reached the point to need a ventilator). > The reality is that there aren't that many interventions that need to take place to help those with a serious case of COVID. Dexamethasone, monoclonal antibodies, ventillators. These tools save lives but require proper training to deploy. If you stick someone into a ventilator unnecessarily (ie: shove a tube down their throat so that it can breath for them), you're unnecessarily inflicting trauma upon them. Furthermore, that's a procedure that you want a trained nurse to do, to minimize the discomfort. Dexamethasone cuts death rates by 50% under ventilators IIRC. But as a steroid, it weakens the patient's immune system (!!!), potentially making COVID19 worse. Its a cost/benefit analysis that has no solid rubric for proper use. Instead, you rely upon a doctor (someone who has studied the human body's mechanics to a significant degree) to make that call on a case-by-case basis. Monoclonal antibodies cost $2000. Omicron may or may not be stopped by them, that's once again, the decision that a doctor should make that a lesser-trained EMT / Nurse / Physician assistant is likely incapable of. Given the high cost of the treatment, the number of supplies in the hospital, and the expected results... do you give monoclonal antibodies to a particular patient? --------- Even a simple blood-IV goes horribly wrong if an untrained person attempts it. You can literally kill a patient if done incorrectly. You want a trained nurse who is good at it. Each "missed" attempt causes blood vessels to tense up, making your next attempt harder. Even a good nurse can have a bad day and cause a patient to be pricked 4, 5, 6 times. I know cause its happened to me. Having well trained nursing staff do IVs is just common sense (and its a skill that doctors don't really have, physically feeling for the vein and popping the needle in there). You need that sort of thing if you want monoclonal antibodies btw, to get shoved into the system. Doctors are more knowledgeable of more issues / human mechanics. ---------- In any case, you want __nurses__ for this current situation. That's our bottleneck right now.

RONROC 5y ago

We need more beds and equipment, not doctors. Sure, they’ll be overworked, but hey, when the going gets tough, the tough get going, don’t they? How about an increased emphasis on putting together the right incentives that ameliorate their personal risk tolerance just enough so that they’re OK with double shifts? Everyone has a price. So how about we just get to the part where we get those (who can and want to help) what they need so that we can move on.

dragontamer 5y ago
I don't think you've grasped the reality of the situation yet. We've cut out 20% of non-essential surgeries in our state to make room for COVID19 patients. "Non-essential" surgeries include biopsies and other potential-cancer events. ------- We have plenty of hospitals actually, and equipment. USA is very very rich, we can afford anything. Its the nurses / doctors we can't afford right now, cause they're non-existent. We can poach doctors/nurses out of school, maybe grab a few more doctor/nurse immigrants, and finally pool doctors/nurses together to make them more efficiently distributed across state-lines. But that's about it. You can't squeeze blood from a stone. You can't just "magic" doctors into reality by asking them to work twice as many hours. -------- This is no longer a "find student doctors/nurses" situation. We're well into "cancel other surgeries", and triage of care. Yes, here in the USA we've run out of health-care resources.
- RONROC 5y ago
  The amount of attention from a body (nurse, doctor, janitor) that a person who has a serious case of COVID needs, is, at least a few orders of magnitude less "on-hands" than a surgery, any surgery (non-essential or not; that's a non-stater, and commonly used as fodder to pad your main point). The reality is that there aren't that many interventions that need to take place to help those with a serious case of COVID. It's not open heart surgery nor is it a more garden variety surgical procedure such as cyst removal or non-invasive plastic surgery. Apart from intubation and steroids in some cases, where's the rocket science here? An EMT or an army medic, with the right equipment, will more likely than not guarantee the same quality of healthcare that an MD or nurse will give. Although I hardly think you'll meet me halfway on that, so here's this question: Do you think the situation is/was helped by firing all unvaccinated healthcare professionals at hospitals around the country? If so, why? If not, why?
  - dragontamer 5y ago
    > Do you think the situation is/was helped by firing all unvaccinated healthcare professionals at hospitals around the country? If so, why? If not, why? Yes. 1. A family friend died from getting a nurse pass COVID19 to him. He was age 35. He further passed COVID19 to his father, who also passed away. 2. People come to hospitals to be protected from diseases. At a minimum, doctors/nurses themselves should be protected to minimize the chance of them spreading it to others. 3. The majority of "off" nurses / doctors in my area are due to COVID19 illness, not from firings. Vaccinations would reduce the chance of the workforce getting sick or spreading the sickness around. ------- Since hospitals are going to become the hottest of COVID19 hotspots (not only because of COVID19 patients visiting, but also as other immuno-comrpomised / weaker individuals visiting. Pregnancies, cancer, even "the flu" can be a complicating ailment that weakens your immune system to make COVID19 hurt more), its absolutely essential to minimize the COVID19 spread at hospitals / health care centers. Even if we lose some doctors/nurses over it, minimizing COVID19 spread (and preventing it from getting worse) takes priority. A huge priority. -------- > An EMT or an army medic, with the right equipment, will more likely than not guarantee the same quality of healthcare that an MD or nurse will give. Army Medics are by-and-large doctors. EMT is basic training. Its enough to maybe diagnose / run tests, but we're not talking about serious COVID19 treatment decisions (ex: whether or not a patient has reached the point to need a ventilator). > The reality is that there aren't that many interventions that need to take place to help those with a serious case of COVID. Dexamethasone, monoclonal antibodies, ventillators. These tools save lives but require proper training to deploy. If you stick someone into a ventilator unnecessarily (ie: shove a tube down their throat so that it can breath for them), you're unnecessarily inflicting trauma upon them. Furthermore, that's a procedure that you want a trained nurse to do, to minimize the discomfort. Dexamethasone cuts death rates by 50% under ventilators IIRC. But as a steroid, it weakens the patient's immune system (!!!), potentially making COVID19 worse. Its a cost/benefit analysis that has no solid rubric for proper use. Instead, you rely upon a doctor (someone who has studied the human body's mechanics to a significant degree) to make that call on a case-by-case basis. Monoclonal antibodies cost $2000. Omicron may or may not be stopped by them, that's once again, the decision that a doctor should make that a lesser-trained EMT / Nurse / Physician assistant is likely incapable of. Given the high cost of the treatment, the number of supplies in the hospital, and the expected results... do you give monoclonal antibodies to a particular patient? --------- Even a simple blood-IV goes horribly wrong if an untrained person attempts it. You can literally kill a patient if done incorrectly. You want a trained nurse who is good at it. Each "missed" attempt causes blood vessels to tense up, making your next attempt harder. Even a good nurse can have a bad day and cause a patient to be pricked 4, 5, 6 times. I know cause its happened to me. Having well trained nursing staff do IVs is just common sense (and its a skill that doctors don't really have, physically feeling for the vein and popping the needle in there). You need that sort of thing if you want monoclonal antibodies btw, to get shoved into the system. Doctors are more knowledgeable of more issues / human mechanics. ---------- In any case, you want __nurses__ for this current situation. That's our bottleneck right now.