HCW staffing crisis

[Junie]

Hugs to you, @wathe.  I can't imagine how hard your job is.  Thank you for your hard work and your caring spirit.

 

 

[Carrie12345]

11 hours ago, Faith-manor said:

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!

That’s very upsetting! Dd has been making more as new EMT. Plus shift differentials, excellent health insurance, and free paramedic school. But, to be fair, she does do some extra shifts at other companies that aren’t quite as great. Still, I’m not aware of any area EMT shifts as low as $15. Maybe close.

Other dd has decided against nursing. I think she’s mostly worried about getting through the program. I don’t know if she’ll change her mind with more confidence, but she’s pretty set on ultimately working on dead people who can’t mistreat her!

[Mrs Tiggywinkle]

1 hour ago, Carrie12345 said:

That’s very upsetting! Dd has been making more as new EMT. Plus shift differentials, excellent health insurance, and free paramedic school. But, to be fair, she does do some extra shifts at other companies that aren’t quite as great. Still, I’m not aware of any area EMT shifts as low as $15. Maybe close.

Other dd has decided against nursing. I think she’s mostly worried about getting through the program. I don’t know if she’ll change her mind with more confidence, but she’s pretty set on ultimately working on dead people who can’t mistreat her!

Our EMT-basics make significantly more than $15 an hour. Granted—I work for a private company that does 911 and transfers and pays the best in about a two hour driving area. But still, I should make close to $65,000 this year working two 24s a week.  My husband will be over six figures(he works a lot more than I do lol).  
We still can’t hire enough people.  It’s definitely not the pay rate.  I complain a lot because I want advancement and there is none here, but they offer unlimited time off with four weeks PTO.  And bend over backwards to get parents Christmas morning and the first day of school off work.  It’s neither working conditions or pay, it’s that people are simply leaving all kinds of healthcare jobs in droves and there aren’t enough coming down the pipeline.

[pinball]

4 minutes ago, Mrs Tiggywinkle said:

Our EMT-basics make significantly more than $15 an hour. Granted—I work for a private company that does 911 and transfers and pays the best in about a two hour driving area. But still, I should make close to $65,000 this year working two 24s a week.  My husband will be over six figures(he works a lot more than I do lol).  
We still can’t hire enough people.  It’s definitely not the pay rate.  I complain a lot because I want advancement and there is none here, but they offer unlimited time off with four weeks PTO.  And bend over backwards to get parents Christmas morning and the first day of school off work.  It’s neither working conditions or pay, it’s that people are simply leaving all kinds of healthcare jobs in droves and there aren’t enough coming down the pipeline.

Considering where you live, that is in the highest bracket of income for your area for a family
 

$165,000 is a crazy amount of money in most places, let alone rural NYS

[Faith-manor]

24 minutes ago, Mrs Tiggywinkle said:

Our EMT-basics make significantly more than $15 an hour. Granted—I work for a private company that does 911 and transfers and pays the best in about a two hour driving area. But still, I should make close to $65,000 this year working two 24s a week.  My husband will be over six figures(he works a lot more than I do lol).  
We still can’t hire enough people.  It’s definitely not the pay rate.  I complain a lot because I want advancement and there is none here, but they offer unlimited time off with four weeks PTO.  And bend over backwards to get parents Christmas morning and the first day of school off work.  It’s neither working conditions or pay, it’s that people are simply leaving all kinds of healthcare jobs in droves and there aren’t enough coming down the pipeline.

Yes. I agree. In my area it is low pay, high cost insurance, totally scrappy work conditions. But dd worked for a private company in New Jersey and it was way better. Still, even if she were there now, she would not be willing to work the job because of how people are acting during this pandemic, the rhetoric politically that puts HCW's at risk, the total lack of care or concern for overwhelming the system, and the fact that this has all exposed how fragile our system is and there is no will among leadership nor the public to make changes. The majority want to bury their heads in the sand, and don't care who they burn in the process. I think the exit will continue if not accelerate until there is a total collapse. We can't keep putting bandaids on this and expecting it to limp along. But I don't think that the powers that be and their followers believe it can collapse and every time anyone brings up the mess that our healthcare system is the battle cry of "socialism", " communism" gets thrown out, people lose their minds, and that is that. 

[TechWife]

17 hours ago, Frances said:

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.

My sister is 58 years old. She’s been a nurse for 38 years, starting as an LPN and then going back to school in her 30’s to get her RN. She has worked for her current employer for 23 years. She turned in her resignation a few weeks ago and is hitting the road for this reason. She plans to travel for a couple of years and then retire early. 

I do think she’s going to have a hard first assignment, it’s a large city hospital and she has been placed on a Covid unit, so her plans may change after a couple of contracts. 

[Fritz]

13 hours ago, athena1277 said:

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?

I am seeing this among my coworkers. This is especially true of young nurses, nurses close enough to retirement, and CNAs. They feel like last year they were "heros" and now cattle that need to shut up, line up and get a vaccine they do not want in order to keep the job they have been doing for about 18 months now of pandemic. Be careful what you wish for for those of you demanding mandates. Nurses and other HCW are walking away.

[Mrs Tiggywinkle]

4 hours ago, pinball said:

Considering where you live, that is in the highest bracket of income for your area for a family
 

$165,000 is a crazy amount of money in most places, let alone rural NYS

This company changed from a for profit to a profit sharing structure over the last three years, hiking wages considerably.  If there was advancement potential and a little less misogyny and nepotism, it would be perfect in many ways.  But we’re losing people. Hemorrhaging.  Mostly because the abuse of 911 and the emergency room systems.  Yesterday I had not one but two 911 calls where, when I arrived on the ambulance, found patients with minor(but still Miserable, I admit) Covid symptoms who wanted to go to the ER by ambulance to receive ivermectin(which absolutely no one is doing here because that would be bad medicine).  Mild as in fatigue and chills.  we have urgent care, but people frankly prefer the ER. Partly because they think they see a “real doctor” vs a midlevel provider, some because the ER gets them attention from their families(particularly neglected elderly people), some for pain meds, some just because they don’t know what else to do.  Add in vaccine refusal and people who don’t need to be sick now getting really sick, it’s just absolutely draining.  We lost a paramedic last week to a landscaping job instead. He was probably making very close to six figures. He’s not even close that now, but he was breaking between the busy call volume and the short staffing and the waiting 45-60 minutes in the ER in the middle of the night for a hospital bed to open up to turn our patient over and the late night hospital to hospital transfers 5 hours away because nobody closer has beds or staff.

It’s not the pay or even the hours, but the absolutely draining moral injury. 

Edited August 22, 2021 by Mrs Tiggywinkle

[Mrs Tiggywinkle]

1 hour ago, Fritz said:

I am seeing this among my coworkers. This is especially true of young nurses, nurses close enough to retirement, and CNAs. They feel like last year they were "heros" and now cattle that need to shut up, line up and get a vaccine they do not want in order to keep the job they have been doing for about 18 months now of pandemic. Be careful what you wish for for those of you demanding mandates. Nurses and other HCW are walking away.

If it mandates in my state for EMS, we’ll lose 3 paramedics. We can’t lose 3 paramedics.  The local ER is going to lose 5 nurses.  They don’t want the vaccine. I don’t understand it, but people have choices.  But that’s really a lot of people to lose.

[Murphy101]

Yes I know that unions are not magic wands. But they can and do make demands of employers and they can use their numbers to give power to those demands.  Let’s not pretend unions have zero power either.  If the numbers of union nurses is very low then that says to me that part of the problem is more nurses need to unionize to give themselves bargaining power.

If nurses for example can’t take on training duties bc it will get them written up for slacking in other duties - a union can help negotiate how to resolve that issue.

[KathyBC]

If (vaccinated) family members were once again allowed in hospitals, do you think that level of minimal care would take at least some of the pressure? I'm thinking of making sure patients get safely to and from the bathroom, things like that.

[Fritz]

I just read that medicare and medicaid funding for nursing homes will be tied to vaccine mandates for their HCW. This will likely exacerbate the problem.

As far as allowing vaccinated family members in to help with their loved ones; sometimes family is helpful, somtimes they are more of a hindrance. I don't think it's likely to happen in any case being that the vaccine is proving to not be effective in preventing 100% (or even close to that) of infection.

Edited August 22, 2021 by Fritz

[Frances]

2 hours ago, Fritz said:

I am seeing this among my coworkers. This is especially true of young nurses, nurses close enough to retirement, and CNAs. They feel like last year they were "heros" and now cattle that need to shut up, line up and get a vaccine they do not want in order to keep the job they have been doing for about 18 months now of pandemic. Be careful what you wish for for those of you demanding mandates. Nurses and other HCW are walking away.

At least here, healthcare workers have already quit because they don’t want to work around unvaccinated coworkers. Outside of the covid wards, masks that are taken off when eating and drinking don’t provide the kind of protection they desire. And they find it hard to medically trust coworkers who express “interesting” theories about the vaccines. So they are leaving the hospital setting for jobs they deem safer.

[Frances]

6 hours ago, Mrs Tiggywinkle said:

Our EMT-basics make significantly more than $15 an hour. Granted—I work for a private company that does 911 and transfers and pays the best in about a two hour driving area. But still, I should make close to $65,000 this year working two 24s a week.  My husband will be over six figures(he works a lot more than I do lol).  
We still can’t hire enough people.  It’s definitely not the pay rate.  I complain a lot because I want advancement and there is none here, but they offer unlimited time off with four weeks PTO.  And bend over backwards to get parents Christmas morning and the first day of school off work.  It’s neither working conditions or pay, it’s that people are simply leaving all kinds of healthcare jobs in droves and there aren’t enough coming down the pipeline.

Wow, it’s nothing like that here in a much higher COL area, except for those who work as firefighters/EMTs or paramedics for cities or counties. Private paramedics are paid very poorly. And at least before the pandemic, often had difficulty finding jobs. When my son worked in a nursing home the summer before he started college, many of his coworkers were underemployed paramedics.

[Matryoshka]

20 minutes ago, Frances said:

At least here, healthcare workers have already quit because they don’t want to work around unvaccinated coworkers. Outside of the covid wards, masks that are taken off when eating and drinking don’t provide the kind of protection they desire. And they find it hard to medically trust coworkers who express “interesting” theories about the vaccines. So they are leaving the hospital setting for jobs they deem safer.

Yeah, this kind of thing (mandating vaxes) cuts both ways. Some people will quit if mandated because they don't wanna, but others are already quitting because they are done having to work with those insisting on being Typhoid Marys. I am unclear why many places seem to be prioritizing the feelings of people who won't do their part to protect their community (not to mention themselves) over the actual health of the people who are (and guess what, those people have feelings too). Why are the first group being coddled?? And yeah, mandated vaccines have always been part and parcel of working in healthcare.  This should not be coming as a surprise. 

And if one group or the other is going to walk out, I choose to keep the group that trusts science and best medical practice against the horse dewormer / denial crowd.  Who do you want treating you in a medical setting?

Edited August 22, 2021 by Matryoshka

[whitestavern]

19 hours ago, Faith-manor said:

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!

That's horrible. My 19 yo makes +/- $30/hour as a server assistant. 

[Murphy101]

1 hour ago, Ordinary Shoes said:

No one said that unions don't have any power. 

Do you know how difficult it is to unionize and how much pressure employees face when they try to unionize? That alone indicates that unions are a good thing. 

Analysis: Amazon's win in union fight shows harsh realities facing labor movement

Amazon workers may be voting again because allegedly Amazon used illegal tactics. 

 

Yes I do know it is damned hard to unionize. I think it is absolutely worth it.  I’m not sure why you seem so defensive to me? If your union is awesome - I’m genuinely happy for you. Again. I’m pro union and don’t think we have nearly enough of them and it shows in how workers are paid and treated.

[KathyBC]

1 hour ago, Fritz said:

I just read that medicare and medicaid funding for nursing homes will be tied to vaccine mandates for their HCW. This will likely exacerbate the problem.

As far as allowing vaccinated family members in to help with their loved ones; sometimes family is helpful, somtimes they are more of a hindrance. I don't think it's likely to happen in any case being that the vaccine is proving to not be effective in preventing 100% (or even close to that) of infection.

So if the vaccine proves to be less than 100% effective, how long do we continue to keep families out of hospitals? 

How do we staff testing sites, immunization clinics and hospitals with the same number of employees we had before? It's clear that can't go on indefinitely. Faltering economies can't double staffing, even if we had the trained personnel available; training which presents more funding challenges.

[Mrs Tiggywinkle]

1 hour ago, Frances said:

Wow, it’s nothing like that here in a much higher COL area, except for those who work as firefighters/EMTs or paramedics for cities or counties. Private paramedics are paid very poorly. And at least before the pandemic, often had difficulty finding jobs. When my son worked in a nursing home the summer before he started college, many of his coworkers were underemployed paramedics.

I work at a unicorn.  If you go to the large ambulance companies that are part of a nationwide conglomerate, they pay very poorly because they have a monopoly in most areas and can do so.  I started at one at 7.50 an hour as a brand new paramedic fifteen years ago.   If I left here and went to the nearest local branch of a conglomerate I’d lose 30% in pay.  

But my point is that we pay a high rate for industry standard and still cannot recruit workers, because people are leaving healthcare at all levels.  My local ED is hiring traveling nurses at what’s rumored to be $150 an hour when the housing stipend is considered, because they’ve lost so many nurses over the last year and can’t safely staff for patient volume. 
Because we suck at healthcare and the well-being of our healthcare workers.

[Murphy101]

41 minutes ago, KathyBC said:

So if the vaccine proves to be less than 100% effective, how long do we continue to keep families out of hospitals? 

How do we staff testing sites, immunization clinics and hospitals with the same number of employees we had before? It's clear that can't go on indefinitely. Faltering economies can't double staffing, even if we had the trained personnel available; training which presents more funding challenges.

All vaccines are less than 100% effective. Even a vaccine that is only 30% effective is still a tremendous advancement and worth having. I’d love to keep all 10 people in my house covid free, but I’m sure not going to write off 3 out of 10 bc I can’t get 10 out of 10. 

It doesn’t take much training to properly and safety jab someone. Millions of diabetic children do it to themselves every day. 

[brehon]

7 minutes ago, Mrs Tiggywinkle said:

…because they’ve lost so many nurses over the last year and can’t safely staff for patient volume. 
Because we suck at healthcare and the well-being of our healthcare workers.

QFT 

[kbutton]

2 minutes ago, Mrs Tiggywinkle said:

I work at a unicorn.  If you go to the large ambulance companies that are part of a nationwide conglomerate, they pay very poorly because they have a monopoly in most areas and can do so.  I started at one at 7.50 an hour as a brand new paramedic fifteen years ago.   If I left here and went to the nearest local branch of a conglomerate I’d lose 30% in pay.  

But my point is that we pay a high rate for industry standard and still cannot recruit workers, because people are leaving healthcare at all levels.  My local ED is hiring traveling nurses at what’s rumored to be $150 an hour when the housing stipend is considered, because they’ve lost so many nurses over the last year and can’t safely staff for patient volume. 
Because we suck at healthcare and the well-being of our healthcare workers.

Do you think there is a rural/suburban/urban divide? It seems like we have both a training problem and a how we treat people problem, but rural healthcare has had an egregiously hard time recruiting people for decades. My mom worked in a rural healthcare system (office work), and as soon as they'd get a really good candidate interested, it would come down to, "It's an hour to the mall (or whatever thing they were interested in, which might be even farther than an hour)? We can't do that." You literally need to find people who WANT to work rurally because they birdwatch or like the outdoors (and my hometown isn't that podunk, it's just not on the beaten path). 

Meanwhile, you have big healthcare systems that are both offering access to higher levels of care (for instance, having specialist hours certain days of the week in town) but also adding layers of bureaucracy and inefficiency (as the mergers happen, the office staff have so many specific instances of "We did this a lot better before"). 

Inner cities have some of the same issues, and then suburbia has a hospital on every corner, and they are trying to take each other down (literally happening two miles down the road from me). Insurance companies are also targeting individual hospital systems, holding them over a barrel on reimbursement, and telling those hospitals that they are targeting them because they are low-hanging fruit, and they plan to do this to bigger health systems as they gain momentum.

It's broken in so.many.ways.

[Murphy101]

12 minutes ago, Mrs Tiggywinkle said:

I work at a unicorn.  If you go to the large ambulance companies that are part of a nationwide conglomerate, they pay very poorly because they have a monopoly in most areas and can do so.  I started at one at 7.50 an hour as a brand new paramedic fifteen years ago.   If I left here and went to the nearest local branch of a conglomerate I’d lose 30% in pay.  

But my point is that we pay a high rate for industry standard and still cannot recruit workers, because people are leaving healthcare at all levels.  My local ED is hiring traveling nurses at what’s rumored to be $150 an hour when the housing stipend is considered, because they’ve lost so many nurses over the last year and can’t safely staff for patient volume. 
Because we suck at healthcare and the well-being of our healthcare workers.

This. I kinda feel like people think the ONLY problem is pay. It’s just not. Let me phrase it this way - how much pay do we think is enough to entice people to work in a sweat shop?  Most would say there isn’t enough pay to do that. 
 

ETA: and would we be right to suggest that people are just too lazy and prefer to mooch off the govt or are just “living in fear instead of Christ” for not taking those sweatshop jobs? Even at better pay?  

Edited August 22, 2021 by Murphy101

[Faith-manor]

9 minutes ago, Mrs Tiggywinkle said:

I work at a unicorn.  If you go to the large ambulance companies that are part of a nationwide conglomerate, they pay very poorly because they have a monopoly in most areas and can do so.  I started at one at 7.50 an hour as a brand new paramedic fifteen years ago.   If I left here and went to the nearest local branch of a conglomerate I’d lose 30% in pay.  

But my point is that we pay a high rate for industry standard and still cannot recruit workers, because people are leaving healthcare at all levels.  My local ED is hiring traveling nurses at what’s rumored to be $150 an hour when the housing stipend is considered, because they’ve lost so many nurses over the last year and can’t safely staff for patient volume. 
Because we suck at healthcare and the well-being of our healthcare workers.

This, this, this!!!! We 100% suck at valuing the people who take care of us in our most vulnerable moments, but revere and worship stupid celebrities, and athletic programs. We have a very deeply sick culture in this regard.

[Faith-manor]

1 minute ago, Murphy101 said:

This. I kinda feel like people think the ONLY problem is pay. It’s just not. Let me phrase it this way - how much pay do we think is enough to notice people to work in a sweat shop?  Most would say there isn’t enough pay to do that. 

Not wrong. I mean at this point due to the 100% wicked brokenness of the educational system, there really isn't a price tag that would woo me back into the fold. There would have to be a radical change in how schools operate and how faculty are treated to make me take up the mantle again. Yes, a good and decent pay in relation to the level of responsibility and training is a must, but that is NOT the only hurdle. The other hurdles at this time are so high it is difficult to imagine ever getting over them.

[Murphy101]

4 minutes ago, Faith-manor said:

Not wrong. I mean at this point due to the 100% wicked brokenness of the educational system, there really isn't a price tag that would woo me back into the fold. There would have to be a radical change in how schools operate and how faculty are treated to make me take up the mantle again. Yes, a good and decent pay in relation to the level of responsibility and training is a must, but that is NOT the only hurdle. The other hurdles at this time are so high it is difficult to imagine ever getting over them.

It is difficult to imagine but historically we know that we can. There’s a reason unions started in this country. A damn good reason. And they did make amazing changes for the better.  Tenement housing  or factories with elementary children losing limbs or many other things that were once normal really not very long ago at all are very much not normal now. Sometimes I think people are like well it’s not like it was in 1920 so it’s good enough. No. It isn’t. There’s still so much better we can and should do. 

[TechWife]

1 hour ago, Murphy101 said:

It is difficult to imagine but historically we know that we can. There’s a reason unions started in this country. A damn good reason. And they did make amazing changes for the better.  Tenement housing  or factories with elementary children losing limbs or many other things that were once normal really not very long ago at all are very much not normal now. Sometimes I think people are like well it’s not like it was in 1920 so it’s good enough. No. It isn’t. There’s still so much better we can and should do. 

I am not sure how unions would improve this situation. They will not lower the number of patients nor will they increase the number of HCW. The situation is that there is no relief in sight. No sign of covid letting up so the stress and long hours and people leaving the field will continue. A union is not going to be able to affect much going into a new place of employment at this point. Negotiate a lower RN:pt ratio? Great, but that means needing more RN’s and where are they going to come from? A union isn’t going to fix the educational pipeline, either.  Increased wages wouldn’t relieve the stress or long hours, nor would it make up for time missed with family. I don’t see how discussing unions at this point would fix anything. 

[Ausmumof3]

21 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. 

This is like 21 hours a day? It can’t be safe doing paramedic work on three hours sleep day in day out.  I hope the situation improves somehow.

[Katy]

2 minutes ago, Ausmumof3 said:

This is like 21 hours a day? It can’t be safe doing paramedic work on three hours sleep day in day out.  I hope the situation improves somehow.

Like doctors on a 24 hour shift, that’s 5 days on.  You get to sleep in between calls if you can. 

[brehon]

18 minutes ago, Ausmumof3 said:

This is like 21 hours a day? It can’t be safe doing paramedic work on three hours sleep day in day out.  I hope the situation improves somehow.

I work a putative 24 hr on - 48 hr off schedule. Right now due to an extreme staffing shortage I and most of colleagues work 48-24 shifts or 96 hr shifts. You’re right; it’s not safe. Not at all. 

14 minutes ago, Katy said:

Like doctors on a 24 hour shift, that’s 5 days on.  You get to sleep in between calls if you can. 

Yup. 

[Ausmumof3]

30 minutes ago, Katy said:

Like doctors on a 24 hour shift, that’s 5 days on.  You get to sleep in between calls if you can. 

But presumably when there’s significant overwhelm you probably don’t get many chances to sleep on shift? I’m pretty sure we don’t have 24 hour shifts here at all the max is 15 or something due to safety.  I may have that wrong though.

Edited August 23, 2021 by Ausmumof3

[TechWife]

23 hours ago, athena1277 said:

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?

This assumes none of the unvaccinated staff will get ill. I think requiring vaccines has many purposes. It protects individuals, families and communities. It also protects the person’s co-workers and reduces both the number and length of call-outs. By doing that, the hospital is actually protecting the cohesiveness of their work force, which in turn, enables them to provide care for their patients. In addition, vaccination reduces the likelihood of a staff member transmitting the virus to a patient who is hospitalized for other reasons.  People who work in hospitals are not strangers to vaccine requirements- accrediting agencies require this and as do some payers. It is to everyone’s benefit to have a vaccinated workforce. 
 

ETA - more than 3K HCW have died from Covid in the US. Worldwide the number is over 110K. These numbers are old - pre delta variant. 

https://www.nursingtimes.net/news/coronavirus/who-says-at-least-115000-health-workers-have-now-died-from-covid-19-27-05-2021/

https://abcnews.go.com/Health/3600-us-health-workers-died-covids-1st-year/story?id=76944085

 

Edited August 23, 2021 by TechWife

[Mrs Tiggywinkle]

37 minutes ago, brehon said:

I work a putative 24 hr on - 48 hr off schedule. Right now due to an extreme staffing shortage I and most of colleagues work 48-24 shifts or 96 hr shifts. You’re right; it’s not safe. Not at all. 

Yup. 

We technically cap people at 39 hours straight and they try not to schedule people usually for more than a 24 here.

Right now that’s all out the window.  We can technically sleep between calls(or read, watch TV, get into trouble, whatever) but anymore it’s so busy that it’s impossible. Last night we had 40 calls between 10pm and 8am.  We had only five crews and one dispatcher on, and all but one paramedic was at the end of a 24 hour shift.

Historically, even being halfway rural, we haven’t had trouble getting workers and neither has the local hospital.  But healthcare here is hemorrhaging workers, especially the experienced ones that are invaluable. And the patient acuity as well as the number of patients continues to increase.

Honestly, I think it would have happened without Covid for many reasons. But Covid hastened it and has made the problems public.

Edited August 23, 2021 by Mrs Tiggywinkle

[kbutton]

29 minutes ago, TechWife said:

This assumes none of the unvaccinated staff will get ill.

QFT. Covid has run through entire sets of staff in places that either had higher exposure/less PPE or who were just plain not as careful (often careful at work, but didn't believe in it at home, but sometimes because of being not careful at work). 

This has had an effect on my DH's current job--it created a staffing problem before he was hired (lack of care on the job), and now it's led to having to come up with a better system for sick days, call offs, etc. because of how many people were sick earlier in the pandemic. As dumb as it sounds, many healthcare jobs are basically designed without any thought of the workforce becoming ill. And oftentimes, after someone has worked in healthcare for a year or two, they are unlikely to catch anything because they are immune. But it's not always that way, and it sure doesn't work that way during a pandemic.

[brehon]

50 minutes ago, Ausmumof3 said:

But presumably when there’s significant overwhelm you probably don’t get many chances to sleep on shift? I’m pretty sure we don’t have 24 hour shifts here at all the max is 15 or something due to safety.  I may have that wrong though.

We theoretically are capped at 48 hours straight and 96 hours in a pay week. Those maximums haven’t been adhered to since mid-May 2020. It’s called “emergency staffing rules” or “e-rules” for short in my system. But if every day has emergency staffing in effect then it’s just the new normal. 

28 minutes ago, Mrs Tiggywinkle said:

We technically cap people at 39 hours straight and they try not to schedule people usually for more than a 24 here.

Right now that’s all out the window.  We can technically sleep between calls(or read, watch TV, get into trouble, whatever) but anymore it’s so busy that it’s impossible. Last night we had 40 calls between 10pm and 8am.  We had only five crews and one dispatcher on, and all but one paramedic was at the end of a 24 hour shift.

Historically, even being halfway rural, we haven’t had trouble getting workers and neither has the local hospital.  But healthcare here is hemorrhaging workers, especially the experienced ones that are invaluable. And the patient acuity as well as the number of patients continues to increase.

Honestly, I think it would have happened without Covid for many reasons. But Covid hastened it and has made the problems public.

Right. If we’re not on a call, restocking, completing run reports, and/or any number of other tasks, we can rest. But our call volume is only increasing as is the number of high acuity patients.

I completely agree with your final paragraph. The pandemic didn’t cause these problems, though it certainly exacerbated them; it merely exposed the deep fault lines in health care and EM/EMS in particular. 

[HeartString]

9 hours ago, KathyBC said:

If (vaccinated) family members were once again allowed in hospitals, do you think that level of minimal care would take at least some of the pressure? I'm thinking of making sure patients get safely to and from the bathroom, things like that.

Not an expert, but I have to think that it would.  During hospital stays that my family has had, I’ve done all of that kind of work.   It’s easier to ask mom/wife to help to the bathroom,etc.  We wouldn’t want to bother nurses with that sort of stuff.  

[Mrs Tiggywinkle]

11 minutes ago, brehon said:

We theoretically are capped at 48 hours straight and 96 hours in a pay week. Those maximums haven’t been adhered to since mid-May 2020. It’s called “emergency staffing rules” or “e-rules” for short in my system. But if every day has emergency staffing in effect then it’s just the new normal. 

Right. If we’re not on a call, restocking, completing run reports, and/or any number of other tasks, we can rest. But our call volume is only increasing as is the number of high acuity patients.

I completely agree with your final paragraph. The pandemic didn’t cause these problems, though it certainly exacerbated them; it merely exposed the deep fault lines in health care and EM/EMS in particular. 

I am so tired. All I ever wanted to be was a paramedic.  From the time I was 4 or 5.  My dad and my grandpas were EMTs. My mom and grandma were nurses.  My next door neighbor was a paramedic.  I knew exactly what I was getting into when I took my EMT-basic class, but the world of 2002 was very, very different than the world of now.
And now I am just so tired. 
 

We always knew the population overall was aging. We always knew that there would be a shortage, that people were living longer and living sicker.  That’s the worst part, I feel. Everyone knew it was coming.  Covid has just made it worse.

[Tree Frog]

55 minutes ago, HeartString said:

Not an expert, but I have to think that it would.  During hospital stays that my family has had, I’ve done all of that kind of work.   It’s easier to ask mom/wife to help to the bathroom,etc.  We wouldn’t want to bother nurses with that sort of stuff.  

I think it would be a risk. Many people would be helpful, but I think there would be people who would be too demanding and cause further stress on the nurses rather than relieving some of their burden. I think it could be dangerous.

[Murphy101]

1 hour ago, HeartString said:

Not an expert, but I have to think that it would.  During hospital stays that my family has had, I’ve done all of that kind of work.   It’s easier to ask mom/wife to help to the bathroom,etc.  We wouldn’t want to bother nurses with that sort of stuff.  

For every family member like that - there’s 3 that will constantly press the button for the patient and themselves. Can we have more water please? He needs help to the bathroom.  It’s cold in here. It’s hot in here. His pills are 10 minutes late. We looked up this online and it says these other treatments are an option why aren’t you doing them?

I say that as a firm and adamant believer that having a loving 3rd party with the patient saves lives. The nagging is annoying but it truth is having someone completely invested in that one patient makes a difference. They’ve had more sleep and catch things. They bring up questions the patient hasn’t thought of or forgot. But yeah. It’s not because they make things easier for the staff. 

[brehon]

1 hour ago, Mrs Tiggywinkle said:

I am so tired. All I ever wanted to be was a paramedic.  From the time I was 4 or 5.  My dad and my grandpas were EMTs. My mom and grandma were nurses.  My next door neighbor was a paramedic.  I knew exactly what I was getting into when I took my EMT-basic class, but the world of 2002 was very, very different than the world of now.
And now I am just so tired. 
 

We always knew the population overall was aging. We always knew that there would be a shortage, that people were living longer and living sicker.  That’s the worst part, I feel. Everyone knew it was coming.  Covid has just made it worse.

Yeah. Me, too. Utterly bone tired. I started in late 1996. Completely different world back then. My first eligible retirement date is next July. I honestly never thought I would punch out then. I mean, yes, it’ll be 25 years which is a good run for anyone but especially a field medic. I always planned on retiring at 30 years as that will max out all my retirement benefits — which in my system are incredible. 

I’m not sure I can do this another 5 1/2 - 6 years. Not physically, mentally, emotionally, or spiritually. I still love my job of taking care of patients and I’m damn good at it. But all the other crap I have to deal with? Not so much.

 I just don’t know. 

[wathe]

12 hours ago, KathyBC said:

If (vaccinated) family members were once again allowed in hospitals, do you think that level of minimal care would take at least some of the pressure? I'm thinking of making sure patients get safely to and from the bathroom, things like that.

I would so love to have families back in emergency departments again.  Not so much for providing care, but more for getting the history and advocating for the patient.  It's really, really valuable to have family at the bedside when assessing frail elderly, dementia, chronic illness, and really anything that makes it difficult for the patient to be clear and objective about their history.  Having to track down the right family member by phone is seriously time-consuming and not nearly as valuable as having someone who knows the patient at the bedside.  I am very, very  assertive about declaring a family member an essential visitor to make it happen (I'm quite sure that I annoy admin on this issue) - the quality of care is soooo much better when family can see what's going on, fill in gaps in history and advocate in real time, in person.

Edited August 23, 2021 by wathe

[wathe]

1 hour ago, wilrunner said:

I think it would be a risk. Many people would be helpful, but I think there would be people who would be too demanding and cause further stress on the nurses rather than relieving some of their burden. I think it could be dangerous.

We're pretty good at managing people.  Nobody (patients or their families) in the emergency dept is having their best day....  Managing demanding and anxious people is bread and butter for us.  Truly disruptive visitors get kicked out.

ETA: we aren't asking families to provide medical care.  But the sort of care that they might otherwise be doing at home anyway (fetching drinks/blankets/sandwiches, helping with feeding etc) is not a problem and can be very helpful.  For patients with dementia, having a familiar face at the bedside is often very calming and prevents much agitation and behaviours that otherwise would take up much nursing time.

 

Edited August 23, 2021 by wathe

[TechWife]

39 minutes ago, wathe said:

I would so love to have families back in emergency departments again.  Not so much for providing care, but more for gating the history and advocating for the patient.  It's really, really valuable to have family at the bedside when assessing frail elderly, dementia, chronic illness, and really anything that makes it difficult for the patient to be clear and objective about their history.  Having to track down the right family member by phone is seriously time-consuming and not nearly as valuable as having someone who knows the patient at the bedside.  I am very, very  assertive about declaring a family member an essential visitor to make it happen (I'm quite sure that I annoy admin on this issue) - the quality of care is soooo much better when family can see what's going on, fill in gaps in history and advocate in real time, in person.

I really appreciate this. My dad had dementia & was for the most part blind and I can’t imagine what it would have been like for him to have been in the ED alone. He would have been so frightened and might have bolted. It would have been very dangerous. 

[TechWife]

13 hours ago, Murphy101 said:

Yes I know that unions are not magic wands. But they can and do make demands of employers and they can use their numbers to give power to those demands.  Let’s not pretend unions have zero power either.  If the numbers of union nurses is very low then that says to me that part of the problem is more nurses need to unionize to give themselves bargaining power.

If nurses for example can’t take on training duties bc it will get them written up for slacking in other duties - a union can help negotiate how to resolve that issue.

Nurses and many other professionals resolve situations like this frequently. Communication up and down the chain of command doesn’t need a union. It’s just part of the job and a professional develops the skills to do it. Frankly, if I had a problems I could solve by talking to people, I’d rather do it myself than add another person to the mix or following the guidelines for the other organization instead of just taking care of things and moving on to the next thing to be done. Unions aren’t the solution to our present crisis. They are helpful in many settings, but not at this time in this place with such limited resources. 

[Pawz4me]

My local morning news just now aired a story about the crisis in health care, particularly EMS. They say it's taking four times as long to check patients in, people are calling 911 thinking the EMS crew can test them for Covid or take them to the hospital and they'll get fast tracked. "We're in a perfect storm of health care hell right now" is exactly what one of the EMTs/paramedics said. And then the usual advice to only call 911 for true emergencies, go to urgent care instead of the ER when possible, etc.

[Carrie12345]

8 hours ago, Mrs Tiggywinkle said:

We always knew the population overall was aging. We always knew that there would be a shortage, that people were living longer and living sicker.  That’s the worst part, I feel. Everyone knew it was coming.  Covid has just made it worse.

This can be applied to quite a few issues right now.  
And yet, even with Covid putting it right up in all our faces, we’re still just gonna pretend it’ll all work itself out.  Sigh.

[HeartString]

8 hours ago, wilrunner said:

I think it would be a risk. Many people would be helpful, but I think there would be people who would be too demanding and cause further stress on the nurses rather than relieving some of their burden. I think it could be dangerous.

You’re probably right.  I just can’t imagine being like that myself, so I didn’t think about it.  I always feel like nurses are busy, I can pour water and fiddle with the thermostat.  

[Murphy101]

7 hours ago, TechWife said:

Nurses and many other professionals resolve situations like this frequently. Communication up and down the chain of command doesn’t need a union. It’s just part of the job and a professional develops the skills to do it. Frankly, if I had a problems I could solve by talking to people, I’d rather do it myself than add another person to the mix or following the guidelines for the other organization instead of just taking care of things and moving on to the next thing to be done. Unions aren’t the solution to our present crisis. They are helpful in many settings, but not at this time in this place with such limited resources. 

I think a good union could have fought to avoid some of the current issues years ago. I think a good union would take the load off staff on making those communications. I think if nursing staff were able to argue it themselves as individuals up and down the command - many of these things might have been avoided.

There is never ever a good time for a union to form. Especially in nursing and teaching. There’s always another crisis. There’s always a shortage of staff. There’s always sick people and kids.

But at some point, people have to say enough and demand better for themselves and future workers. I agree now isn’t that time. But it should happen soon. I highly recommend the next lull between covid variations.

Because I have kids who would love to go into medicine if it wasn’t such a nightmare job.  Because I have loved ones and myself that I want to get care from someone who has slept in the last 3 days. Because this is flat out untenable and individuals speaking up for just themselves doesn’t seem to be doing the trick to change things the last 10 years so I don’t understand why that strategy would work for the next 10.

[Stacia]

https://theweek.com/coronavirus/1004043/group-of-south-florida-doctors-stage-walkout-in-protest-of-unvaccinated-covid

 

 

Edited August 23, 2021 by Stacia

[fraidycat]

33 minutes ago, Stacia said:

https://theweek.com/coronavirus/1004043/group-of-south-florida-doctors-stage-walkout-in-protest-of-unvaccinated-covid

 

 

I don't blame them one little bit. Is this what it needs to come to to get the anti-mask, anti-vax crowd to wake up and quit being so damn entitled?

Edited August 23, 2021 by fraidycat