8 ms·

> Staying when you want to leave indicates there's enough compensation to 'make it worth it' at least versus whatever shitty alternatives you have. Leaving when

> Staying when you want to leave indicates there's enough compensation to 'make it worth it' at least versus whatever shitty alternatives you have. Leaving when you want to stay, to me, would be a much bigger indicator that nurses who want to stay in the profession can't because of wage/benefits/conditions issues. I think the conclusion of this sort of economic thinking is basically: Give your employees just enough money that they can keep they keep their head above the water but not enough to flourish, and just enough pressure/responsibility that they don't have energy to do anything else, but not too much that they have a complete mental breakdown that leaves them with the conclusion that they should leave your industry at any cost. When you spent a lot of time and money into a specialized and demanding career, I imagine it practically very difficult to actually change your career, even if it's killing you. It's probably even worse if you have familial obligations. You likely do not have time or energy to better your situation after hours, and if you quit, you potentially resign yourself (perhaps) to many years of destitution while you accumulate the necessary knowledge to do something else. I would not be surprised if many people just bear bad conditions because the cost to do anything else worth one's time is simply too high.

nradov 4y ago
Employers are going to pay the minimum wages they can in order to retain sufficient workers. They obviously aren't going to voluntarily pay extra just so that employees can flourish. There are a lot of jobs openings available to someone with an RN certificate and some experience. Unemployment in that group is close to zero. They don't all work in direct patient care roles.
- deleted 4y ago
  [deleted]
- scaramanga 4y ago
  It looks like you accidentally "did a communism" by arguing for nationalizing health and putting patient-care considerations above market considerations :)
  - nradov 4y ago
    Communism never has worked and never will work. We should just set legal minimum standards for patient care quality. Hospitals can then do whatever they need to comply with those standards, including setting nurse wages at whatever the market dictates.
    - scaramanga 4y ago
      Thanks Ayn Rand, a more astute reader might see the meme phrase, the scare quotes, the smiley, and see the obvious humorous intention :) But I'll go ahead and explain the joke. There is a long history of the private sector using the spectre of communism (or socialism, or "big government" or "nanny state") as a canard to prevent sensible policies eg. anything that would improve patient care, even if it were at minuscule costs and will use that canard to justify lobbying aggressively to prevent it. And if they cannot obstruct legislative action then they switch to defunding the state bodies which enforce the regulations as an exercise in "cost cutting" because "the state is wasting your hard earned taxes!!" etc. Hope you have a better rest of your day. Edit: I mean, once you have set a regulation, and established a body to police it, you have already interfered with the market, so even what you are suggesting could be described as having "done a communism"
      - notch656a 4y ago
        >Edit: I mean, once you have set a regulation, and established a body to police it, you have already interfered with the market, so even what you are suggesting could be described as having "done a communism" Exactly, remove regulations from health care. I'm dead serious. Regulatory burden on nurses and health care workers are insane. It's completely plausible the net effect would be far more people saved than lost, due to greater access to healthcare and lower burdens to achieving outcomes.
        nradov 4y ago
        Which specific regulations would you propose to remove? Everyone loves the idea of reducing regulatory burden but they always fail to give specifics. For example, hospitals spend a lot of money complying with CMS reporting rules on iatrogenic harm such as bed sores and secondary infections. Should they stop doing that?
Nasrudith 4y ago
That conclusion would be fallacious, although many on both sides believe it. For one it ignores both growth potential and relative costs. High productivity workers can and do utterly dominate in ways which more than make up for it. And miserable employees are mercurial in quality at best relative to happy and motivated ones. I recall hearing about one desert conflict "gratuitous" allocation of several times the prior typical water per day resulted in outsized military performance. I think it may have been the Six Day War. But Silicon Valley is basically the exemplar of that business model as they specifically go with a very high COL area in the world's richest country instead of mass outsourcing. Even assuming that the actor is a heartless and selfish bastard what truly matters first is net profit. It is the same fallacious false economy seen both among slaveowners and the Soviet Union. That the labor is free or already paid for so don't worry about its efficiency.
- scaramanga 4y ago
  The caring professions are quite a special case. The worse things get, the more carers care. They are not like computer programmers who can make an industrial process be 10,000x faster. They cannot magically care 10,000x more, no matter how relaxed and comfortable they are. Furthermore, as they are pushed closer and closer to failure, the collapse in patient care standards does not result in a collapse in profit. People aren't going to not seek medical treatment, it's a basic human need, sometimes a life or death need. So we're back to the question: does that mean they should be exploited and milked of all their caring, at the same time the standard of care collapses, because the economic incentives reward that? And that is fundamentally a moral/humanitarian question in which you have to make an adult moral judgement.
XorNot 4y ago
It also cues your organization up for a failure cascade. You don't have workers who want to stay, you have workers who are forced to stay. As soon as they can leave, you're not going to lose "1 or 2" you're pretty likely to use a substantial plurality since whatever changed probably changed for all of them at the same time. Can your organization survive with 50% of the staff giving 4 weeks notice at the same time?
- LilBytes 4y ago
  What we're seeing play out is essentially the Dead Sea Effect, but in Nursing. https://medium.com/geekculture/the-dead-sea-effect-d71df13724f8 https://medium.com/geekculture/the-dead-sea-effect-d71df1372...
- vkou 4y ago
  > Can your organization survive with 50% of the staff giving 4 weeks notice at the same time? Yes, you hire them back at travel nurse rates, while you lobby for your state legislators to ban your employees from doing any work if they quit.
- throwaway48375 4y ago
  Just sue them to prevent them from being able to quit. https://www.latimes.com/business/story/2022-01-24/wisconsin-hospital-sued-workers-for-quitting-thedacare https://www.latimes.com/business/story/2022-01-24/wisconsin-...
  - MomoXenosaga 4y ago
    Wow that's basically indentured servitude. We are going back a 150 years in time!

nradov 4y ago

Employers are going to pay the minimum wages they can in order to retain sufficient workers. They obviously aren't going to voluntarily pay extra just so that employees can flourish. There are a lot of jobs openings available to someone with an RN certificate and some experience. Unemployment in that group is close to zero. They don't all work in direct patient care roles.

deleted 4y ago
[deleted]
scaramanga 4y ago
It looks like you accidentally "did a communism" by arguing for nationalizing health and putting patient-care considerations above market considerations :)
- nradov 4y ago
  Communism never has worked and never will work. We should just set legal minimum standards for patient care quality. Hospitals can then do whatever they need to comply with those standards, including setting nurse wages at whatever the market dictates.
  - scaramanga 4y ago
    Thanks Ayn Rand, a more astute reader might see the meme phrase, the scare quotes, the smiley, and see the obvious humorous intention :) But I'll go ahead and explain the joke. There is a long history of the private sector using the spectre of communism (or socialism, or "big government" or "nanny state") as a canard to prevent sensible policies eg. anything that would improve patient care, even if it were at minuscule costs and will use that canard to justify lobbying aggressively to prevent it. And if they cannot obstruct legislative action then they switch to defunding the state bodies which enforce the regulations as an exercise in "cost cutting" because "the state is wasting your hard earned taxes!!" etc. Hope you have a better rest of your day. Edit: I mean, once you have set a regulation, and established a body to police it, you have already interfered with the market, so even what you are suggesting could be described as having "done a communism"
    - notch656a 4y ago
      >Edit: I mean, once you have set a regulation, and established a body to police it, you have already interfered with the market, so even what you are suggesting could be described as having "done a communism" Exactly, remove regulations from health care. I'm dead serious. Regulatory burden on nurses and health care workers are insane. It's completely plausible the net effect would be far more people saved than lost, due to greater access to healthcare and lower burdens to achieving outcomes.
      - nradov 4y ago
        Which specific regulations would you propose to remove? Everyone loves the idea of reducing regulatory burden but they always fail to give specifics. For example, hospitals spend a lot of money complying with CMS reporting rules on iatrogenic harm such as bed sores and secondary infections. Should they stop doing that?

Nasrudith 4y ago

That conclusion would be fallacious, although many on both sides believe it. For one it ignores both growth potential and relative costs. High productivity workers can and do utterly dominate in ways which more than make up for it. And miserable employees are mercurial in quality at best relative to happy and motivated ones. I recall hearing about one desert conflict "gratuitous" allocation of several times the prior typical water per day resulted in outsized military performance. I think it may have been the Six Day War. But Silicon Valley is basically the exemplar of that business model as they specifically go with a very high COL area in the world's richest country instead of mass outsourcing. Even assuming that the actor is a heartless and selfish bastard what truly matters first is net profit. It is the same fallacious false economy seen both among slaveowners and the Soviet Union. That the labor is free or already paid for so don't worry about its efficiency.

scaramanga 4y ago
The caring professions are quite a special case. The worse things get, the more carers care. They are not like computer programmers who can make an industrial process be 10,000x faster. They cannot magically care 10,000x more, no matter how relaxed and comfortable they are. Furthermore, as they are pushed closer and closer to failure, the collapse in patient care standards does not result in a collapse in profit. People aren't going to not seek medical treatment, it's a basic human need, sometimes a life or death need. So we're back to the question: does that mean they should be exploited and milked of all their caring, at the same time the standard of care collapses, because the economic incentives reward that? And that is fundamentally a moral/humanitarian question in which you have to make an adult moral judgement.

XorNot 4y ago

It also cues your organization up for a failure cascade. You don't have workers who want to stay, you have workers who are forced to stay. As soon as they can leave, you're not going to lose "1 or 2" you're pretty likely to use a substantial plurality since whatever changed probably changed for all of them at the same time. Can your organization survive with 50% of the staff giving 4 weeks notice at the same time?

LilBytes 4y ago
What we're seeing play out is essentially the Dead Sea Effect, but in Nursing. https://medium.com/geekculture/the-dead-sea-effect-d71df13724f8 https://medium.com/geekculture/the-dead-sea-effect-d71df1372...
vkou 4y ago
> Can your organization survive with 50% of the staff giving 4 weeks notice at the same time? Yes, you hire them back at travel nurse rates, while you lobby for your state legislators to ban your employees from doing any work if they quit.
throwaway48375 4y ago
Just sue them to prevent them from being able to quit. https://www.latimes.com/business/story/2022-01-24/wisconsin-hospital-sued-workers-for-quitting-thedacare https://www.latimes.com/business/story/2022-01-24/wisconsin-...
- MomoXenosaga 4y ago
  Wow that's basically indentured servitude. We are going back a 150 years in time!