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> If the daily threads at on r/nursing subreddit are even mildly representative, the status quo in nursing is unsustainable Call me a skeptic but every career

> If the daily threads at on r/nursing subreddit are even mildly representative, the status quo in nursing is unsustainable Call me a skeptic but every career subreddit is dominated by the whiniest complainers imaginable (easily lapping even the HN commenters who froth at the mouth at the thought of RTO). Using this as a key point of an article seems flimsy at best. > Personally, I’m betting on two out of the three, but I’m not telling you which two. Also lol at this.

toomuchtodo 2y ago
“US nursing crisis” are the search keywords you will want to use. https://thehill.com/opinion/healthcare/4304685-americas-nurse-staffing-crisis-has-reached-the-breaking-point/ https://thehill.com/opinion/healthcare/4304685-americas-nurs... https://www.axios.com/2024/06/07/health-care-worker-shortages-us-crisis https://www.axios.com/2024/06/07/health-care-worker-shortage... https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2817317 https://jamanetwork.com/journals/jamanetworkopen/fullarticle... https://www.aacnnursing.org/news-data/fact-sheets/nursing-shortage https://www.aacnnursing.org/news-data/fact-sheets/nursing-sh... https://www.aha.org/news/headline/2023-04-13-study-projects-nursing-shortage-crisis-will-continue-without-concerted-action https://www.aha.org/news/headline/2023-04-13-study-projects-... https://www.ncbi.nlm.nih.gov/books/NBK493175/ https://www.ncbi.nlm.nih.gov/books/NBK493175/
vundercind 2y ago
The teaching trend is very, very real. Public schools are in crisis due to the dual shocks of Covid and inflation (which came on top of years of underinvestment and declining quality of the work environment, so the whole thing was already teetering before that shove) and nobody’s even talking about spending what it’ll take to fix them. The low-COL-adjusted-comp areas are worst-hit, but a marked decline in quality is in store for the whole sector, largely due to staff shortages and an associated, unavoidable decline in average quality.
- tmpz22 2y ago
  You post problems in addition to COVID and Inflation but you barely scratch the surface. No Child Left Behind, School vouchers, defunding public colleges, the list goes on and on and on as to how we’ve been chipping away at education.
  - vundercind 2y ago
    Yep, you’re spot-on. The sector’d been taking a pummeling for years and years, that was just the final one-two punch (and a doozy, at that). If there’s a third thing, it’s the renewed and persistent negative political attention on schools from the right over the last eight years.
- slt2021 2y ago
  Could private school vouchers and magnet schools fix it? I feel like a lot of problems with teaching is due to overregulation from department of education and increasing scope bloat of their responsibilities. Just stick to mass daycare with curriculum model and allow free competition from private sector and it should be fine. The best compensated teachers are the ones that achieve results: train champions and elevate students to their highest potential. Its not going to happen at public school
  - jghn 2y ago
    > Could private school vouchers Ask Arizona how it is going [1] [1] https://www.propublica.org/article/arizona-school-vouchers-budget-meltdown https://www.propublica.org/article/arizona-school-vouchers-b...
    - Terr_ 2y ago
      "To open our meeting, good news: This year we managed to direct a ton of public tax dollars towards our favorite private entities and churches, and the budget shortfall gives us an excuse to strangle other safety-net programs we already didn't like!" /s As a note for non-US folks, individual states cannot print currency the same way the federal government can, so budget shortfalls on that level are a lot more immediate and impactful.
    - diddid 2y ago
      It was an interesting read, but it only says how much they spend on school vouchers. I didn’t see a spend for the standard public schools. They said the average voucher was 7k which is almost for sure lower than what public school is charging per student. Maybe they just need to add an income requirement to it and if you make too much no voucher.
      - Jtsummers 2y ago
        https://www.census.gov/newsroom/press-releases/2024/public-school-spending-per-pupil.html https://www.census.gov/newsroom/press-releases/2024/public-s... ~$10k, so yes the voucher is less than what the public school students are getting (directly from their teachers and indirectly through other school services and faculty).
- diddid 2y ago
  I think the lack of quality is not being driven at the individual teacher level and isn’t related to covid at all. Covid made the issues that already existed visible. Removing AP classes and charter schools, graduating kids missing credits, downplaying test results, and failing to properly address poor student behavior are all usually made at the district level. I don’t think increased funding would change any of that and I think a lot of good teachers would still quit.
  - slt2021 2y ago
    the highest per student spend is at the most failing and underperforming school systems: Chicago, DC, Baltimore - and they haven't showed a trend to improve at all and keep demanding more and more resources
    - vundercind 2y ago
      Low-performing inner city schools do sometimes pay quite a bit more than easy suburban schools—but the work environment is so incredibly terrible and the job so difficult that they struggle to retain good teachers anyway. They have to pay extra just to keep anyone at all.
      - slt2021 2y ago
        It is not the money if kids have no capacity to learn.
  - vundercind 2y ago
    There are two main things reducing quality of the schools as this goes on: 1) There’s a really bad staff shortage. The ways schools are trying to compensate without significantly raising pay are making school worse. Three examples are reducing the length of the school week, cutting “specials” (art, music, languages, non-“core” classes), and replacing instruction with crappy computerized solutions (believe me, they’re mostly crappy). 2) Because there’s a shortage of teachers, it’s harder to turn down an applicant or get rid of a bad or mediocre teacher. These also aren’t disproportionately leaving—plenty of good ones are among the ones moving to other sectors, in part because they tend to have the best prospects outside of school, and it’s not like schools can really offer them more to try to keep them. So, the pool of candidates is at least not improving as it shrinks, and it’s tougher to get rid of teachers that otherwise might be let go. Further, the teacher pipeline is drying up and it’s quickly becoming a less-attractive option for students entering school. Result: average teacher quality may be expected to trend down.
- MostlyStable 2y ago
  Honest question: what is the appropriate level of investment? According to the national center for education statistics [0] Spending per pupil went up 13% from 2010 to 2021 after accounting for inflation, so that's a real increase of 13%, not a nominal increase. And 80% of those dollars are going to staff. I'll admit that I'm anything but an expert, but a real increase in spending of 13% across a decade does not sound like years of underinvestment. I'm happy to be educated on this topic, but from an outsider perspective, it just doesn't seem like the issue. [0] https://nces.ed.gov/programs/coe/indicator/cmb https://nces.ed.gov/programs/coe/indicator/cmb
  - vundercind 2y ago
    Teacher wages lots of places probably need a 20% bump, or more, to stop the bleeding. Regardless of the total being spent, not enough’s going to comp for teachers. The whole thing’s worst in states that were already paying sub-par COL-adjusted wages (obviously) so states that weren’t screwing up quite so bad to begin with might not need so drastic a change.
mschuster91 2y ago
> Using this as a key point of your article seems flimsy at best. For nursing... just ask literally any nurse and they'll chew your ear off. I happen to know some via local volunteer emergency service work and they're all on the verge of burning out, only staying in because they don't want to leave their patients and colleagues.
dividefuel 2y ago
There seems to be a broad understanding among those in these fields that these jobs just keep getting worse, and so people are quitting. They may be getting worse for different reasons (worse conditions, less satisfaction, declining pay, more qualifications needed, etc etc), but there's a net sense of dissatisfaction. For people new to the job, there's usually an initial shock that the job is so far removed from its mission that there's no personal satisfaction, and they ultimately leave.

toomuchtodo 2y ago

“US nursing crisis” are the search keywords you will want to use. https://thehill.com/opinion/healthcare/4304685-americas-nurse-staffing-crisis-has-reached-the-breaking-point/ https://thehill.com/opinion/healthcare/4304685-americas-nurs... https://www.axios.com/2024/06/07/health-care-worker-shortages-us-crisis https://www.axios.com/2024/06/07/health-care-worker-shortage... https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2817317 https://jamanetwork.com/journals/jamanetworkopen/fullarticle... https://www.aacnnursing.org/news-data/fact-sheets/nursing-shortage https://www.aacnnursing.org/news-data/fact-sheets/nursing-sh... https://www.aha.org/news/headline/2023-04-13-study-projects-nursing-shortage-crisis-will-continue-without-concerted-action https://www.aha.org/news/headline/2023-04-13-study-projects-... https://www.ncbi.nlm.nih.gov/books/NBK493175/ https://www.ncbi.nlm.nih.gov/books/NBK493175/

vundercind 2y ago

The teaching trend is very, very real. Public schools are in crisis due to the dual shocks of Covid and inflation (which came on top of years of underinvestment and declining quality of the work environment, so the whole thing was already teetering before that shove) and nobody’s even talking about spending what it’ll take to fix them. The low-COL-adjusted-comp areas are worst-hit, but a marked decline in quality is in store for the whole sector, largely due to staff shortages and an associated, unavoidable decline in average quality.

tmpz22 2y ago
You post problems in addition to COVID and Inflation but you barely scratch the surface. No Child Left Behind, School vouchers, defunding public colleges, the list goes on and on and on as to how we’ve been chipping away at education.
- vundercind 2y ago
  Yep, you’re spot-on. The sector’d been taking a pummeling for years and years, that was just the final one-two punch (and a doozy, at that). If there’s a third thing, it’s the renewed and persistent negative political attention on schools from the right over the last eight years.
slt2021 2y ago
Could private school vouchers and magnet schools fix it? I feel like a lot of problems with teaching is due to overregulation from department of education and increasing scope bloat of their responsibilities. Just stick to mass daycare with curriculum model and allow free competition from private sector and it should be fine. The best compensated teachers are the ones that achieve results: train champions and elevate students to their highest potential. Its not going to happen at public school
- jghn 2y ago
  > Could private school vouchers Ask Arizona how it is going [1] [1] https://www.propublica.org/article/arizona-school-vouchers-budget-meltdown https://www.propublica.org/article/arizona-school-vouchers-b...
  - Terr_ 2y ago
    "To open our meeting, good news: This year we managed to direct a ton of public tax dollars towards our favorite private entities and churches, and the budget shortfall gives us an excuse to strangle other safety-net programs we already didn't like!" /s As a note for non-US folks, individual states cannot print currency the same way the federal government can, so budget shortfalls on that level are a lot more immediate and impactful.
  - diddid 2y ago
    It was an interesting read, but it only says how much they spend on school vouchers. I didn’t see a spend for the standard public schools. They said the average voucher was 7k which is almost for sure lower than what public school is charging per student. Maybe they just need to add an income requirement to it and if you make too much no voucher.
    - Jtsummers 2y ago
      https://www.census.gov/newsroom/press-releases/2024/public-school-spending-per-pupil.html https://www.census.gov/newsroom/press-releases/2024/public-s... ~$10k, so yes the voucher is less than what the public school students are getting (directly from their teachers and indirectly through other school services and faculty).
diddid 2y ago
I think the lack of quality is not being driven at the individual teacher level and isn’t related to covid at all. Covid made the issues that already existed visible. Removing AP classes and charter schools, graduating kids missing credits, downplaying test results, and failing to properly address poor student behavior are all usually made at the district level. I don’t think increased funding would change any of that and I think a lot of good teachers would still quit.
- slt2021 2y ago
  the highest per student spend is at the most failing and underperforming school systems: Chicago, DC, Baltimore - and they haven't showed a trend to improve at all and keep demanding more and more resources
  - vundercind 2y ago
    Low-performing inner city schools do sometimes pay quite a bit more than easy suburban schools—but the work environment is so incredibly terrible and the job so difficult that they struggle to retain good teachers anyway. They have to pay extra just to keep anyone at all.
    - slt2021 2y ago
      It is not the money if kids have no capacity to learn.
- vundercind 2y ago
  There are two main things reducing quality of the schools as this goes on: 1) There’s a really bad staff shortage. The ways schools are trying to compensate without significantly raising pay are making school worse. Three examples are reducing the length of the school week, cutting “specials” (art, music, languages, non-“core” classes), and replacing instruction with crappy computerized solutions (believe me, they’re mostly crappy). 2) Because there’s a shortage of teachers, it’s harder to turn down an applicant or get rid of a bad or mediocre teacher. These also aren’t disproportionately leaving—plenty of good ones are among the ones moving to other sectors, in part because they tend to have the best prospects outside of school, and it’s not like schools can really offer them more to try to keep them. So, the pool of candidates is at least not improving as it shrinks, and it’s tougher to get rid of teachers that otherwise might be let go. Further, the teacher pipeline is drying up and it’s quickly becoming a less-attractive option for students entering school. Result: average teacher quality may be expected to trend down.
MostlyStable 2y ago
Honest question: what is the appropriate level of investment? According to the national center for education statistics [0] Spending per pupil went up 13% from 2010 to 2021 after accounting for inflation, so that's a real increase of 13%, not a nominal increase. And 80% of those dollars are going to staff. I'll admit that I'm anything but an expert, but a real increase in spending of 13% across a decade does not sound like years of underinvestment. I'm happy to be educated on this topic, but from an outsider perspective, it just doesn't seem like the issue. [0] https://nces.ed.gov/programs/coe/indicator/cmb https://nces.ed.gov/programs/coe/indicator/cmb
- vundercind 2y ago
  Teacher wages lots of places probably need a 20% bump, or more, to stop the bleeding. Regardless of the total being spent, not enough’s going to comp for teachers. The whole thing’s worst in states that were already paying sub-par COL-adjusted wages (obviously) so states that weren’t screwing up quite so bad to begin with might not need so drastic a change.

mschuster91 2y ago

> Using this as a key point of your article seems flimsy at best. For nursing... just ask literally any nurse and they'll chew your ear off. I happen to know some via local volunteer emergency service work and they're all on the verge of burning out, only staying in because they don't want to leave their patients and colleagues.

dividefuel 2y ago

There seems to be a broad understanding among those in these fields that these jobs just keep getting worse, and so people are quitting. They may be getting worse for different reasons (worse conditions, less satisfaction, declining pay, more qualifications needed, etc etc), but there's a net sense of dissatisfaction. For people new to the job, there's usually an initial shock that the job is so far removed from its mission that there's no personal satisfaction, and they ultimately leave.