HCW staffing crisis

[wathe]

Part rant and part vent, I think.

NYT: Nursing is in Crisis:  Staff Shortages Put Patients at Risk

CBC: Nurses are leaving their jobs  "Roughly two-thirds of emergency room nurses at a hospital in Kamloops have recently left their jobs"

Quebec ER's on the Verge of Breakdown "A growing number of emergency rooms in Quebec are struggling to care for patients as hospitals deal with severe staffing shortages caused by nurses fed up with pandemic working conditions."

CTV: Ontario nursing sector slammed with shortage as many rethink their careers.

This is all over, both US and Canada.  My own ED has lost about 1/4 of its nursing staff, almost all pandemic related.  The staff who  remain are just.so.done.   Exhausted and morally injured. Working short-staffed in an overcrowded department is misery.  It's becoming impossible to put on a "game face" while at work.    I fear that we're into an autocatalytic, vicious cycle.  It's very hard to persuade new hires to work in these conditions.  There has been a tremendous loss of experienced staff, which really will affect patient safety. Seasoned ED staff are invaluable.   It's going to affect every single person needing hospital care for any cause.  For years.  

There have been news pieces all through the pandemic devoted to the HCW experience.  So, not a new issue.  Yet I haven't seen much about actually doing something about it.

(OK, not nothing:  We did have modest "pandemic pay" for certain frontline workers, but that ended over a year ago.   We also have "resiliency training" and various MH support services available, but none of that fixes the actual problem of poor working conditions and being understaffed)  

I can tell you what's not going to help:  Alberta Health Services invokes emergency work rules for nurses as COVID hospitalizations rise " Alberta's nurses may soon be forced to work mandatory overtime and cancel holidays in response to a chronic staffing problem worsened by surging COVID-19 hospitalizations."

 

 

 

 

[wathe]

Continuing on,

My coworkers and I have had lots and lots of thank you's for the care we've provided during the pandemic.  No doubt that they are sincere.  And I appreciate the sentiment greatly.

But... I don't really want to be thanked for providing crummy care in a hallway after a 6 hour wait in a packed waiting room, in an overcrowded, understaffed ED with hassled burnt out staff.  

What I want is to be supported to proved excellent care.  And I just don't see how that's going to happen soon

[prairiewindmomma]

Locally, I hear a lot of people upset that they are getting paid x amount, but traveling nurses on contract, doing the same job, are getting paid 3x-4x. Meanwhile administrators are being “let’s all rally and pull extra shifts” while not allowing for downtime for nurses to see their family, decompress, etc. 

It really sucks for all HCW. 

 

[Murphy101]

I would love to post this directly from you on my FB and IG. 

This is a nightmare long in the making. There’s been a shortage of medical and teaching staff for at least a decade and every year it gets worse while the ability to even access those careers gets harder and harder financially for the poor souls who are glutton enough for punishment to be seeking to enter those fields.

[happi duck]

I'm so sad that this is not seen as reason enough to take drastic action and do the hard things needed to help the situation.

(hugs)

[Murphy101]

I think medical and teaching unions are the worst. They don’t seem to ever do a damn thing for their membership. ETA: to be clear I’m usually very pro union. I don’t think we have near enough of them. But it’s important to hold unions accountable when they repeatedly fail to stand up for their membership. And I do think that’s the case with nurses and teachers. 

Edited August 21, 2021 by Murphy101

[lauraw4321]

A young cousin left nursing to become a truck driver. And that was pre-pandemic. 
 

The pandemic has made me want to go to nursing school. Probably way too late for me and silly for me to do, but it feels like people who joined the military after 9/11. Seems like a patriotic / useful thing to do. It takes years to backfill losses. I don’t have a good answer. 

[mommyoffive]

Is there anything we can do to help?   I mean other than get your shot to stay out of the hospital.  

[fraidycat]

((Hugs)) It's not surprising, but it is very sad that it had to come to this. Reactive measures (if there are any) will never make up for the lack of proactive measures that could have been taken over a year ago. 

[Frances]

23 minutes ago, prairiewindmomma said:

Locally, I hear a lot of people upset that they are getting paid x amount, but traveling nurses on contract, doing the same job, are getting paid 3x-4x. Meanwhile administrators are being “let’s all rally and pull extra shifts” while not allowing for downtime for nurses to see their family, decompress, etc. 

It really sucks for all HCW. 

 

This. Someone else posted an article about the nursing shortage that said some traveling nurses were getting $20k bonuses and $140 per hour. I can’t even imagine how it must feel for a long term loyal employee to see that and not just feel even more defeated.

[wathe]

5 minutes ago, mommyoffive said:

Is there anything we can do to help?   I mean other than get your shot to stay out of the hospital.  

As individuals?  All the things that many of us are already doing: get vaccinated, wear masks, have patience with healthcare workers, use emergency departments for emergencies, not convenience (that last is more of a Canadian issue, I suspect).

I think this is going to need a bigger, collective solution.  Primary care and other social services need to find a way to see their patients and clients in person and provide pre-pandemic levels of service.  Hospitals and governments need to find a way to fix working conditions and staffing.  I'm afraid it will take a lot of effort and money.

[Frances]

39 minutes ago, Murphy101 said:

I would love to post this directly from you on my FB and IG. 

This is a nightmare long in the making. There’s been a shortage of medical and teaching staff for at least a decade and every year it gets worse while the ability to even access those careers gets harder and harder financially for the poor souls who are glutton enough for punishment to be seeking to enter those fields.

What’s even harder that the financial burden, at least for those interested in medical professions, is nabbing one of the very limited training spots. According to this article, we produce about 170,000 nurses per year in the US, but turn away 80,000 qualified applicants, primarily due to shortage of teaching staff. I know access to practicum locations can also be an issue, although it’s hard for me to understand places complaining about shortages if they won’t help with training.

https://www.msn.com/en-us/news/us/nursing-is-in-crisis-staff-shortages-put-patients-at-risk/ar-AANzpMa?ocid=msedgntp

In my state, it’s ridiculously competitive to get into a nursing or just about any other healthcare training program. Compared to the Midwest where  I grew up, it’s a pretty night and day difference. Yet in articles about it, decision makers here will say they can just rely on recruiting from other states because it is such a desirable place to live. Well what about the young people in our state who want to go into a healthcare field? They are at a huge disadvantage due to the limited number of training spots here.
 

Several of my son’s friends have gone out of state for post-bac BSN programs which cost more in both tuition and living expenses because they can’t stay with family. And he knows several people who got into multiple top medical schools, but were denied a spot in our state medical school. And only very recently did the state even start offering a small public physical therapy program. I was shocked over 20 years when we moved here that they didn’t have one and they still don’t remotely have anything like the long established one in my home state that is substantially larger, despite the state population being significantly smaller.

 

Edited August 21, 2021 by Frances

[Murphy101]

20 minutes ago, Frances said:

What’s even harder that the financial burden, at least for those interested in medical professions, is nabbing one of the very limited training spots.

Oh I’m well aware of the limited education options too.  Iirc the nursing program at our local community college was accepting a whopping 18 candidates to entry to nursing program a YEAR pre covid.    Someone told me they think it’s on purpose to ensure that medical professionals are scarce enough to get good wages and have a job at graduation.  I suppose those *might* have been the reasoning and plentiful entry standards 60 years ago. I doubt it for even then, but it absolutely is not enough now. People have no idea how genuinely terrified they should be that in 3-10 years they may literally not have nurses and doctors in their area even in the city. It’s already true in most rural areas. And who will be available to even train them if we keep on this trajectory. Seriously. 
 

ETA: I went looking out of curiosity and just in the past few months the county passed funding to up the number of allotments! It is now open to 80 students every spring. 

Edited August 21, 2021 by Murphy101

[Mrs Tiggywinkle]

My 88 year old grandmother went to the ER yesterday with sudden onset substernal chest pain radiating down her left arm, nausea and dizziness.  I couldn’t persuade her to go by ambulance.

2.5 hours later in the waiting room, they had still not done a triage EKG.  Now—I know they had two call outs yesterday and all 48 beds were full and people were in the hallways and they had less than 10 nurses working. My grandmother was never seen because she wound up just going home.  She figured she could die at home in more peace than in the waiting room.  The sad part is, my grandmother ran this hospital’s pediatric and maternity units for years as the head nurse. She’s medically sophisticated and is anything but a frequent flyer.  Her treatment was truly awful yesterday and I usually stick up for the staff, but the triage nurse was beyond rude(when my grandmother said nicely, look, I am just going to go home, the triage RN said “Well, I’m not keeping you here.”).  

I tell this story because this afternoon I had a deceased patient who also left the hospital without being seen two days ago. His complaints were sudden thunderclap headache.  He sat 6 hours waiting for a bed to open up, according to his family. He’s dead now.

This is what happens when we don’t have enough staff, when my local ICU of 20 beds has 11 Covid patients leaving other ICU level patients in the ER because there’s no ICU beds, when nurses and techs and paramedics are  quitting in droves because you can make the same money doing something that’s a lot less stress and a lot better run….this. This is what happens.

I know I’m ranting. It’s Saturday and I am at work until Tuesday with two four hour breaks.  Because we don’t have staff.

[Murphy101]

2 minutes ago, Ordinary Shoes said:

Oddly, it's easier to get into medical school in Oklahoma than in other states like Oregon. That's one of the few things that Oklahoma has done right. Unfortunately it doesn't extend to the other healthcare professions. I'm curious how many grads of the two Oklahoma medical schools leave the state though. 

Clarifying, by easier I don't lower standards. There are more slots available and they give preference in-state residents. 

Idk. I think many do leave for lots of good reasons.  But we have many end up staying too bc it’s harder to move out of LCOL state.

[Murphy101]

3 minutes ago, Mrs Tiggywinkle said:

My 88 year old grandmother went to the ER yesterday with sudden onset substernal chest pain radiating down her left arm, nausea and dizziness.  I couldn’t persuade her to go by ambulance.

2.5 hours later in the waiting room, they had still not done a triage EKG.  Now—I know they had two call outs yesterday and all 48 beds were full and people were in the hallways and they had less than 10 nurses working. My grandmother was never seen because she wound up just going home.  She figured she could die at home in more peace than in the waiting room.  The sad part is, my grandmother ran this hospital’s pediatric and maternity units for years as the head nurse. She’s medically sophisticated and is anything but a frequent flyer.  Her treatment was truly awful yesterday and I usually stick up for the staff, but the triage nurse was beyond rude(when my grandmother said nicely, look, I am just going to go home, the triage RN said “Well, I’m not keeping you here.”).  

I tell this story because this afternoon I had a deceased patient who also left the hospital without being seen two days ago. His complaints were sudden thunderclap headache.  He sat 6 hours waiting for a bed to open up, according to his family. He’s dead now.

This is what happens when we don’t have enough staff, when my local ICU of 20 beds has 11 Covid patients leaving other ICU level patients in the ER because there’s no ICU beds, when nurses and techs and paramedics are  quitting in droves because you can make the same money doing something that’s a lot less stress and a lot better run….this. This is what happens.

I know I’m ranting. It’s Saturday and I am at work until Tuesday with two four hour breaks.  Because we don’t have staff.

Seriously. You should post that on FB so I can share it. 

I do not think you are ranting. I mean you might be. But the major point is while this may be venting or ranting, it’s also simply saying this is your reality. You aren’t asking to be called a hero or to be thanked or saying you hate your career. You are saying straight this is legit happening and we should work together to make it stop happening.

This is worth saying because it’s the truth.  Maybe people won’t care.  Maybe haters will hate.  But they won’t be able to legitimately say they didn’t know they could make a change.  All we can do is speak up.

 

[kbutton]

1 hour ago, wathe said:

I can tell you what's not going to help:  Alberta Health Services invokes emergency work rules for nurses as COVID hospitalizations rise " Alberta's nurses may soon be forced to work mandatory overtime and cancel holidays in response to a chronic staffing problem worsened by surging COVID-19 hospitalizations."

That's way basically saying, "Beatings shall continue until morale improves." 

[kbutton]

52 minutes ago, wathe said:

As individuals?  All the things that many of us are already doing: get vaccinated, wear masks, have patience with healthcare workers, use emergency departments for emergencies, not convenience (that last is more of a Canadian issue, I suspect).

No, using the ER like a doctor's office, urgent care, and school nurse's office (but getting out of work instead of class) are all common. DH had a patient brought in by grandma for a mosquito bite. Grandma wanted an Rx for the $1 tube of itch cream she could've gone to Dollar Tree for and saved taxpayers the @$1000 or so it costs to be seen at an ER. Some of the patients, when they realize they can watch movies while there get the whole family to show up. Many demand a meal while there. It's a full service B and B, lol!!! 

Our local ER has a budget category for "Sending people home in a taxi." There is a medical bus as well, but I think it's has some limitations. 

43 minutes ago, Frances said:

What’s even harder that the financial burden, at least for those interested in medical professions, is nabbing one of the very limited training spots. According to this article, we produce about 170,000 nurses per year in the US, but turn away 80,000 qualified applicants, primarily due to shortage of teaching staff. I know access to practicum locations can also be an issue, although it’s hard for me to understand places complaining about shortages if they won’t help with training.

When you get followed closely on productivity at work, you don't have time to train people. "Train people so you can lose your job" is not a popular slogan. In some jobs, like for mid-levels, their productivity is closely monitored, but they are expected to take increasingly higher level patients all the time, and the scope of practice for most NPs and PAs has expanded astronomically in the last few years. More responsibility, no time to even pee or eat, and crazy hours is not conducive to, "Sure, I'll take a student." And, to be honest, if you are in something like emergency med, lots of people in that field have ADHD, and thrive there, BUT it's hard for them to divide attention between patients, workflow, and students. Two of three is fine. All three is too much (and even then patients=a room full of family too; workflow=nagging specialists who are paid to be on call to actually come to the ED or for a doc to admit, etc.). 

Regarding the productivity...the expectations just keep amping up, and as older practitioners literally do slow down and are expected to take on more than when they are hired, they are also at a disadvantage relative to peers that knew what they were signing up for and probably learned a LOT more about productivity in their clinicals (and learned the technology shortcuts during clinicals vs. after being on the job for a decade or more). At the same time, some of the best people to be mentoring students are those people experienced enough to have been on the job for 10-15 years, but not out so long that they are calcified in their practices and knowledge base. 

Add all of this up, and it's a lot to ask. 

Oh, and locally, we have a lot of nurses because we have a lot of places that train them locally. Unfortunately, that means that while other areas have shortages, we have nurses here that can get away with playing on Facebook during work hours, and then the people that depend on them have to do more than just their job because the nurses will get mad for being asked to work (obviously not all of them, but this has been more the norm than not in my DH's longest lasting job). 

[TechWife]

1 hour ago, wathe said:

Seasoned ED staff are invaluable.   It's going to affect every single person needing hospital care for any cause.  For years.  

This is what public health officials have been warning about all along - that if hospitals are overwhelmed with pandemic patients, there will be a resulting lack of care available to all. Care isn't just about beds and supplies. It's about personnel as well. Nurses have been underappreciated for a very long time and they have now hit their limit.

To our great loss, many will never return to health care in any capacity. Schools can only turn out RN's so fast - training takes time and seats in ASN, BSN and NP programs are limited. In our area there have been applicants who are turned down to all of these programs for years now, making them more competitive and even harder to get into even at the community college level.

Many people talk about how they want things to get back to "normal." I think that ship has sailed.

[Frances]

31 minutes ago, Ordinary Shoes said:

Oddly, it's easier to get into medical school in Oklahoma than in other states like Oregon. That's one of the few things that Oklahoma has done right. Unfortunately it doesn't extend to the other healthcare professions. I'm curious how many grads of the two Oklahoma medical schools leave the state though. 

Clarifying, by easier I don't lower standards. There are more slots available and they give preference in-state residents. 

Yes. Your state of residence definitely makes a difference in your odds of getting into medical school, as for most students their best chance is at their state medical school. And the number of spots per capita varies drastically from state to state. Perversely, my state actually increases the odds for acceptance for out of state students who graduated from any college in our state. As for admission purposes only, they are treated like residents. So for admissions, they can be treated like residents of both our state and their home state. They also allow other special categories to be considered state residents for admission purposes only. And it doesn’t even matter that they have to pay out of state tuition if they ultimately attend because it’s barely more than the ridiculously high in state tuition which is more similar to private medical school tuition than other publics.

[Mrs Tiggywinkle]

42 minutes ago, Murphy101 said:

Seriously. You should post that on FB so I can share it. 

I do not think you are ranting. I mean you might be. But the major point is while this may be venting or ranting, it’s also simply saying this is your reality. You aren’t asking to be called a hero or to be thanked or saying you hate your career. You are saying straight this is legit happening and we should work together to make it stop happening.

This is worth saying because it’s the truth.  Maybe people won’t care.  Maybe haters will hate.  But they won’t be able to legitimately say they didn’t know they could make a change.  All we can do is speak up.

 

I would, but DH is doing his RN clinical at that hospital and I don’t know if it would cause him problems if I’m posting derogatory things about their nurses(I like and am good friends with most of the ED nurses, it’s not personal, but that triage nurse is a traveler that I don’t know and was so rude to my very old, very sweet grandmother).

I am salty, I guess.  It’s been a looming problem for a long time.  Doctors, nurses, techs, EMS.  The pandemic has just publicly lit up the cracks that were already there.  Misuse of the ED is a huge, huge issue—but other than refusing care, which can’t be done—I don’t know what the answer is there.  My colleagues in countries with universal healthcare see the same thing, so I’m not sure it’s tied to insurance or not being able to afford a primary doctor.  But along with Covid and understaffing, it leads to burnout.

 

Well—and this attitude from hospital administration—

Edited August 21, 2021 by Mrs Tiggywinkle

[Murphy101]

25 minutes ago, TechWife said:

Many people talk about how they want things to get back to "normal." I think that ship has sailed.

Proof that we should be careful what we ask for bc precovid “normal” was plenty 🦇💩 and is a major reason why we are in this hand basket now. 

[Carrie12345]

2 hours ago, Murphy101 said:

I think medical and teaching unions are the worst. They don’t seem to ever do a damn thing for their membership. ETA: to be clear I’m usually very pro union. I don’t think we have near enough of them. But it’s important to hold unions accountable when they repeatedly fail to stand up for their membership. And I do think that’s the case with nurses and teachers. 

You scared me for a minute! 
I agree.

[Ottakee]

For the ER crisis I think we need more public health clinics ....maybe even in or next to the hospital that are open 24/7.   I remember being in peds ER with dd with O2 stats of 74 while there were whole extended families there at 2am with a child who was teething.

We need many more and more accessible primary care offices so that ER can be used for emergencies.

Our area just opened a psych ER which is great for relieving some of the burden on the regular ER.

[sassenach]

4 hours ago, Murphy101 said:

I think medical and teaching unions are the worst. They don’t seem to ever do a damn thing for their membership. ETA: to be clear I’m usually very pro union. I don’t think we have near enough of them. But it’s important to hold unions accountable when they repeatedly fail to stand up for their membership. And I do think that’s the case with nurses and teachers. 

IDK have you had many conversations with nurses about their unions? The nurses around here LOVE their union. SEIU (a HCW union, not nurse) procured its own PPE for its members at the beginning of the pandemic.

As an almost nurse, I very much hope to get a job at a hospital with a strong union.

[sassenach]

I was listening to This American Life's episode titled "Essential." They didn't profile nurses but rather positions like restaurant servers, child care, and public transit employees but the themes absolutely applied. This idea that these workers put up with a baseline level of crap and now are realizing just how not worth it it is. Especially with upper management who add all this pressure without getting in the trenches. I think everyone is now really clear about how disposable they are. I live in an area where nurses are paid really well but I'm kind of shocked by how low paid they are in most of the country. Who would put themselves through all that for $30/hr?

 

[Faith-manor]

5 minutes ago, sassenach said:

I was listening to This American Life's episode titled "Essential." They didn't profile nurses but rather positions like restaurant servers, child care, and public transit employees but the themes absolutely applied. This idea that these workers put up with a baseline level of crap and now are realizing just how not worth it it is. Especially with upper management who add all this pressure without getting in the trenches. I think everyone is now really clear about how disposable they are. I live in an area where nurses are paid really well but I'm kind of shocked by how low paid they are in most of the country. Who would put themselves through all that for $30/hr?

 

Paramedics in my area only get $15 an hour. They do it because they love trauma field medicine, but the reality is it is unsustainable to work that kind of job stress and those hours for such crappy pay. Thus, lots of new medics work a few years, and then move on to something else because the pay raises are never going to come. Everyone here wants EMS, but no one wants to pay a damn thing for it. It is dysfunctional and stupid!

[Murphy101]

30 minutes ago, sassenach said:

IDK have you had many conversations with nurses about their unions? The nurses around here LOVE their union. SEIU (a HCW union, not nurse) procured its own PPE for its members at the beginning of the pandemic.

As an almost nurse, I very much hope to get a job at a hospital with a strong union.

Did you read my entire post? Let’s be clear. I’m generally very pro union. But overall? I’m not seeing nurses and teachers being served at all by theirs.  I mean I’m glad that your’s got you PPE.  But what they should have done was fought for your employer to provide it.  I wouldn’t be very happy that dues went for something the employers should and usually do provide.

idk. I’m glad you are happy with yours I suppose. But over all? I don’t know why anyone other than union bigwigs making serious money would be happy with these 2 unions.

[Murphy101]

17 minutes ago, sassenach said:

I was listening to This American Life's episode titled "Essential." They didn't profile nurses but rather positions like restaurant servers, child care, and public transit employees but the themes absolutely applied. This idea that these workers put up with a baseline level of crap and now are realizing just how not worth it it is. Especially with upper management who add all this pressure without getting in the trenches. I think everyone is now really clear about how disposable they are. I live in an area where nurses are paid really well but I'm kind of shocked by how low paid they are in most of the country. Who would put themselves through all that for $30/hr?

Thing is they are finding out they are not quite as disposable as they were told they were. Turns out when a large number of people refuse to work for those wages/conditions - union or not in this case - employers find they are screwed for lack of ability to run their businesses.  And when those employers whine about it, usually by implying everyone is just too lazy to work for them?  The former employees in just kinda smirk and repeat back what they have heard for a very long time: too bad so sad, have those companies tried to maybe cut back on their avocado toast and $6 lattes to save money?  What happened to their 6 months of savings?

idk. My husband just found out very discouraging information about his former employer and most of the time we are fairly cheerful but there’s brief moments when it’s hard not to be angry. 

[sassenach]

19 minutes ago, Murphy101 said:

Did you read my entire post? Let’s be clear. I’m generally very pro union. But overall? I’m not seeing nurses and teachers being served at all by theirs.  I mean I’m glad that your’s got you PPE.  But what they should have done was fought for your employer to provide it.  I wouldn’t be very happy that dues went for something the employers should and usually do provide.

idk. I’m glad you are happy with yours I suppose. But over all? I don’t know why anyone other than union bigwigs making serious money would be happy with these 2 unions.

I did read your post. The union hospitals around here are just much, much better to their nurses and that is because of the contracts negotiated by the unions. Union hospitals have better pay, better benefits, better legal protection. Unions do a lot and are highly valued. That's all I can tell you. Maybe California unions are better than other places. IDK. All I know is that I haven't met a nurse out here who is upset with their union. They're damn pissed with their management, state, JCAHO, CDC, etc. 

[Murphy101]

32 minutes ago, sassenach said:

I did read your post. The union hospitals around here are just much, much better to their nurses and that is because of the contracts negotiated by the unions. Union hospitals have better pay, better benefits, better legal protection. Unions do a lot and are highly valued. That's all I can tell you. Maybe California unions are better than other places. IDK. All I know is that I haven't met a nurse out here who is upset with their union. They're damn pissed with their management, state, JCAHO, CDC, etc. 

I guess that’s great. But more often than not what I see is teachers/nurses who are pissed at everyone except their union when it’s literally the job of their union to mitigate those other factors to be more favorable to the nurses/teachers.

[sassenach]

26 minutes ago, Murphy101 said:

I guess that’s great. But more often than not what I see is teachers/nurses who are pissed at everyone except their union when it’s literally the job of their union to mitigate those other factors to be more favorable to the nurses/teachers.

Hmm, I think the nurses and teachers are probably in the best position to know who is responsible for their working conditions. Shrug. 

Edited August 22, 2021 by sassenach

[Murphy101]

12 minutes ago, sassenach said:

Hmm, I think the nurses and teachers are probably in the best position to know who is responsible for their working conditions. Shrug. 

Okay.  I don’t think that’s always true.  Sure blame employers and administrations for not just doing more without union threats.  That’s valid to be unhappy that people don’t just do the right thing to begin with. But if anyone thought that was ever likely, they wouldn’t have formed a union.  If the union isn’t willing to use its bargaining power to demand more, then personally I don’t think it’s meeting it’s purpose. More often than not workers accept far less than they should IMO.  Of course it’s a free country and anyone can disagree with me.

[athena1277]

I was reading the comments on a local news article about the current hospital problems.  One commenter made an interesting point.  He said that part of the problem was that the hospitals now mandate the COVID vaccine, so some people are quitting or being fired, when last year they did the same work, but unvaccinated.  While I totally understand the benefits of all hospital staff being vaccinated, wouldn’t this be a good time to be more lenient about it, in order to have enough staff to care for all of those in need?

[Katy]

Hours ago I typed this out, then decided not to post.  Since many of you have touched on the same issues, here it is….

The pandemic is only the final straw. There are systemic issues in nursing careers, and when you couple that with restrictions in the number of people who can get through school because of waiting lists, often requiring 5 years of school for a bachelor’s degree because of the waiting lists, then during non-pandemic times going on to treat nurses like glorified waitresses to maintain survey ratings, or being spoken down to every year by a new batch of interns who think practicing medicine is like Grays Anatomy (where hospitals are devoid of nurses except as convenient plot devices), being physically assaulted by people, not to mention patients who would be better cared for at home but are admitted because they lack  insurance… plus difficult physical conditions and periodic layoffs… it’s little wonder that many people can find a less stressful way to make money.  

You can make just as much in insurance claims, with bankers hours and holidays and never have the stress of life or death on your shoulders, and never need to worry about a survey result again. You can go to grad school and make more than twice as much money. A fair amount of my coworkers moved into travel nursing, saved money and paid off debt to become stay at home moms. Others retired when Covid hit.

OTOH, the rapid turnover is definitely increasing opportunities for new grads.  My niece just got her RN/BSN & is going straight to a covid ICU. Her only work experience is as a CNA/tech. Another friend just went back to school because her husband got disabled. She went to one of those overpriced rapid RN programs that graduate you in a year, had a job offer before she graduated let alone passed boards, and started the day after her board results were back. It’s been good for her family. She was hired for gen med/surge but in Florida was immediately moved to a Covid ward. 

[mom31257]

Dd is a nurse on a cardiac floor, and her hospital was offering $750 extra to take a shift last weekend. So it would be that on top of overtime pay. Dd would have liked the money but was already working  three days in a row and had plans for this entire weekend. She knew she would be exhausted. 

They are starting to have high patient number ratios on the floor due to staffing issues. If they go in and have unsafe numbers, she and some of her coworkers have talked about refusing to take report and clock in until they can get more help there. A group already did it downtown, and an administrator had to step in and work. 

She just graduated in December 2019 and started in Feb of 2020. It's hard to think about her whole first year being during Covid. She really had it rough from Thanksgiving through January. She is often the most experienced nurse on the floor now (works night shift) and is charge nurse at least two times a week. 

I don't know how long she will last before she is burned out. 

 

[TexasProud]

2 minutes ago, mom31257 said:

Dd is a nurse on a cardiac floor, and her hospital was offering $750 extra to take a shift last weekend. So it would be that on top of overtime pay. Dd would have liked the money but was already working  three days in a row and had plans for this entire weekend. She knew she would be exhausted. 

They are starting to have high patient number ratios on the floor due to staffing issues. If they go in and have unsafe numbers, she and some of her coworkers have talked about refusing to take report and clock in until they can get more help there. A group already did it downtown, and an administrator had to step in and work. 

She just graduated in December 2019 and started in Feb of 2020. It's hard to think about her whole first year being during Covid. She really had it rough from Thanksgiving through January. She is often the most experienced nurse on the floor now (works night shift) and is charge nurse at least two times a week. 

I don't know how long she will last before she is burned out. 

 

Yes.  It is about to get bad. The last time our hospital had this many patients, the state sent a hundred nurses.  This time tgey sent none. They are begging. 

[Frances]

Here administrators are pushing for more flexibility in patient/nurse ratios as part of the solution during this Delta surge. But the nurses are saying absolutely not, as they already feel like they are short changing patients. The absolutely lean as possible staffing model so many hospitals use to save money is coming back to bite them big time during the pandemic.

[brehon]

6 hours ago, Mrs Tiggywinkle said:

I know I’m ranting. It’s Saturday and I am at work until Tuesday with two four hour breaks.  Because we don’t have staff.

Word. I’ll have worked nearly 150 hours by the end of the current pay week — NOT pay period. That’s, what, 54 hours over the maximum weekly hours worked. I’m certainly not unusual or special. 

[BeachGal]

37 minutes ago, Frances said:

Here administrators are pushing for more flexibility in patient/nurse ratios as part of the solution during this Delta surge. But the nurses are saying absolutely not, as they already feel like they are short changing patients. The absolutely lean as possible staffing model so many hospitals use to save money is coming back to bite them big time during the pandemic.

I am reading the same. The ratio of nurses to patients is alarming.

I am also reading about the fatigue that is setting in — nurses, MDs, etc. Long hours, multiple shifts, crappy pay for some, abominable treatment by some patients and their families. I feel very sorry for many of them.

[ktgrok]

52 minutes ago, Frances said:

Here administrators are pushing for more flexibility in patient/nurse ratios as part of the solution during this Delta surge. But the nurses are saying absolutely not, as they already feel like they are short changing patients. The absolutely lean as possible staffing model so many hospitals use to save money is coming back to bite them big time during the pandemic.

Yup. My mom comes from a long line of nurses, and shifted out as they started cutting staff and changing ratios. She was having nightmares about her patients, and physically was beat up. She made me promise not to be a nurse, it was that stressful. She just felt she couldn't give patients what they really needed, time wise. 

6 minutes ago, BeachGal said:

I am reading the same. The ratio of nurses to patients is alarming.

I am also reading about the fatigue that is setting in — nurses, MDs, etc. Long hours, multiple shifts, crappy pay for some, abominable treatment by some patients and their families. I feel very sorry for many of them.

Mental health is a real factor, and probably all medical workers, but especially nurses, should get free regular mental health counseling. 

[BeachGal]

Truthfully, I am mostly angry with those hospital administrators who disrespect their staff of HCWs who are working with patients. I read about it on a different forum and it just makes me very angry.

[PaxEtLux]

14 minutes ago, Ordinary Shoes said:

You've lumping together two very kinds of unions. Teacher's unions are public unions and healthcare unions like SEIU are not public. Members of SIEU are generally pretty happy. 

I totally agree. I don't see how one can equate these two unions.  First off, less than 20% of all nurses are unionized in the US, and the horrible working conditions for nurses (and HCW in general) are equally bad in unionized vs non-unionized hospitals.  Second, what can the nurses' union really do to address overcrowded ICUs?  Strike until the state passes mandatory vaccination laws?  Refuse to treat un-vaccinated covid patients?

And I will say this in favor of the national teacher's union, the AFT -- they did endorse mandatory vaccinations for all teachers.  I don't see many districts requiring vaccinations, though some are.

[Murphy101]

56 minutes ago, Ordinary Shoes said:

You've lumping together two very kinds of unions. Teacher's unions are public unions and healthcare unions like SEIU are not public. Members of SIEU are generally pretty happy. 

How do you know that the union didn't fight for the employer to provide PPE? 

How much do you know about nursing unions? 

 

 I know people complain they aren’t getting a fair shake at work (bc they aren’t) and unions are supposed to help make that happen.  I never said those unions are the same kinds of unions.   I know that every year teachers and nurses here complain about their work conditions and it seems like every year it gets worse instead of better.  If they are relatively happy with their employers bc their unions have demanded better? That’s awesome sauce.  Sincerely.  But here? That’s not what anyone I know locally is seeing or hearing.

[Murphy101]

33 minutes ago, PaxEtLux said:

I totally agree. I don't see how one can equate these two unions.  First off, less than 20% of all nurses are unionized in the US, and the horrible working conditions for nurses (and HCW in general) are equally bad in unionized vs non-unionized hospitals.  Second, what can the nurses' union really do to address overcrowded ICUs?  Strike until the state passes mandatory vaccination laws?  Refuse to treat un-vaccinated covid patients?

And I will say this in favor of the national teacher's union, the AFT -- they did endorse mandatory vaccinations for all teachers.  I don't see many districts requiring vaccinations, though some are.

To be fair - this thread has evolved to more than the pandemic. In many places the nursing and teaching problems have been getting pretty bad long before covid arrived.  It sounds like I’m right that unions aren’t helping nurses - because there aren’t enough nurses unionizing?  Maybe if more nurses unionized, they could fight for better?  No it won’t happen this week. But it seems to me that it should happen. And sooner rather than later. 

again. To be clear. I’m very pro union. I think when unions work, it’s better for everyone, not just their members. 

[Frances]

1 hour ago, Ordinary Shoes said:

You've lumping together two very kinds of unions. Teacher's unions are public unions and healthcare unions like SEIU are not public. Members of SIEU are generally pretty happy. 

Interestingly, SEIU represents the majority of state workers here.

[PaxEtLux]

11 minutes ago, Murphy101 said:

 It sounds like I’m right that unions aren’t helping nurses - because there aren’t enough nurses unionizing?  Maybe if more nurses unionized, they could fight for better?

Maybe I lack imagination, but I'm having a hard time thinking about what action a nurse's union could do to help this situation?

[Murphy101]

1 minute ago, PaxEtLux said:

Maybe I lack imagination, but I'm having a hard time thinking about what action a nurse's union could do to help this situation?

Again. What do you mean by this situation?  I noted my comment in the conversation was not covid specific.

A nursing union can demand that more training options be made available and maximum scheduling limits and fight back on other unreasonable demands at hospitals. An EMS worker and several nurses mentioned how bad some of their conditions are and how it shouldn’t be that way.  And it doesn’t have to stay that way.

Can unions fix the current covid HCW problem?  No. Never said it could.

But it might have helped reduce the problem and could help in the future.  That’s all I’m saying. 

[Mrs Tiggywinkle]

2 hours ago, brehon said:

Word. I’ll have worked nearly 150 hours by the end of the current pay week — NOT pay period. That’s, what, 54 hours over the maximum weekly hours worked. I’m certainly not unusual or special. 

I covered a concert tonight, then we sent a couple long distance transfers, and after that I decided just to find an empty bed to sleep in since I live 45 minutes away still and have to be back at 0800.  Then I’m working till 8 am Tuesday morning. 
And we are still short two complete crews this weekend with an overfilled hospital that’s trying to find empty beds within a six hour radius. 
And it’s not unusual….but I think Covid is shining a spotlight on what a mess the healthcare system has been for a long time.

Fortunately most of my patients today were of the stubbed toe variety.

[wathe]

I'm just back home from work.  Reading the responses in this thread has been quite therapeutic  Thanks all.