Our Hospital is Closing

[Ting Tang]

A shock to the community, the local hospital is closing.  It may be reopened as an emergency rural hospital with an ER only, but not as of right now.  No more OB, inpatient, lab, etc. 

They cited money lost on births, a cyber attack, staffing shortage, and Covid as reasons for their financial decline.  (Remember when we were told they were making money off Covid?! ah ha)  The hospital is about 20-25 minutes away.  Now the closest one will be 45 minutes-ish.  

Our schools are not great here. Our only college is a community college.  And now there is no hospital. 

Is this sort of thing happening all over?  

Edited January 27, 2023 by Ting Tang

[mommyoffive]

Wow, that would terrify me to be so far from a hospital.  We don't have one in our town either and I regret the choice to live in a place without one. 

[Mrs Tiggywinkle Again]

The county I lived in for twenty years had their hospital mostly close a few years ago. I guess more than a few, because I was pregnant with my daughter and she’s almost 11.  They kept the ER as a critical access ER but any admissions have to be transferred to another hospital. They stopped doing births and surgeries; the inpatient rooms got turned into a beautiful rehab/skilled nursing facility  In all honesty the community didn’t really suffer, because it was so small that they only ever admitted the simplest of medical issues and only did very general surgeries like non complicated gall bladders and appys. 
Now people really just use the ER as an urgent care or for life threatning can’t make it to the bigger hospitals emergencies. It’s not even staffed by doctors, but mid levels(who are mostly great; no shame on mid levels, but it does bother some out of town people when they go there expecting an MD). The nearest hospital from there is 35 minutes.

Hospitals outside of large metro areas are moving towards models that involve a lot of transferring patients.  When I became a paramedic it was a big deal to transfer a patient to the large city hospital.  Like they’d give you the company credit card to get dinner and call in an extra crew to take it.  Now on a 24 hour shift it’s not unusual for 7-8 patients to be transferred to the city hospitals 2 hours away.  The smaller hospitals cannot sustain paying for specialists, including pediatricians, so they’ve stopped offering it.  One of my doctor friends told me the reason our local hospital can’t keep surgeons is because the hospital cannot afford the super expensive robotics, so the surgeons leave after their contract is up to go someplace with more up to date equipment.  
 

But yes, it’s happening all over.

https://www.fiercehealthcare.com/providers/unsustainable-losses-are-forcing-hospitals-make-heart-wrenching-cuts-and-closures-leaders

[Pawz4me]

Quite a few rural hospitals have closed in my state over the past few years. My understanding is that there are a number of reasons--those hospitals tend to serve an older and poorer population, more procedures being done at outpatient clinics, and the failure of our state to expand Medicaid. The legislature seems to be reconsidering the latter, and the main reason I've read for that is to slow the closing of so many rural hospitals. I'm very glad we're in close proximity (20 minutes or less) to two major medical centers and four community hospitals, but the closing of more rural hospitals means that all of those are more crowded all the time.

[prairiewindmomma]

Yes, that sort of thing is happening all over. https://www.usnews.com/news/health-news/articles/2023-01-16/hundreds-of-hospitals-could-close-across-rural-america
 

I know of several hospitals closing. The rural area I grew up in has been hollowing out since the 1980s. Schools are generally the last to go, and once healthcare goes it’s generally mostly the elderly left behind….elderly who need care and can’t access it.
 

Hospitals closing means that a lot of good jobs are lost, and the families around those jobs will relo to where those workers can be employed. 
 

I just read the report of a hospital in distress where my extended family lives—for them, it’s been primarily a Medicare/Medicaid issue as well as a high number of patients with no insurance at all. 😞

[saraha]

6 years ago our hospital closed. Luckily, the hospital in the next county over benefit from that and expanded. It does everything but obstetrics, so from my home, the nearest hospital that routinely delivers babies is in KY.

[alisoncooks]

Yep. The hospital near where I grew up closed a few years ago. It was a huge Thing; protests and grassroots campaigns and politics and brother vs brother.  It eventually closed and now the closest hospital for my parents is 1 hr away. The closest “good” hospital is 1.5 hrs. That’s scary. 

[TexasProud]

Yes, very common.  Our hospital closed...ten years ago or more.  Same thing, it is now an ER for the hospital in the next town (25 minutes away).

Even in the neighboring town there is an issue.  Stand alone ER's are a big, big problem. (Not talking about the satellite ones like the one in my town that are affiliated with the hospital.) So there you have little wait, a massage, something to drink, etc. People with insurance adore it. So they go there. That leaves all of the people that do not have insurance going to the hospital. So now very few paying patients go to the hospital ER. Therefore, no one makes up  the difference for the ones who cannot pay.  And many times Medicare and/or Medicaid do not cover the expenses and hospitals and doctors actually lose money on those patients.  Right now the public hospital is hemorrhaging money. 

[kbutton]

It's happening all over. Some hospitals are teaming up with bigger hospitals and becoming hubs for outpatient care--for instance, different specialties will host a clinic in the facility every x number of days or weeks so that patients don't have to travel for their routine care. It really depends on what is close by, relatively close by, the current demographics, etc.

It's sad to me. A lot of semi-rural areas, especially with farming, are facing death by a thousand cuts. Meanwhile the factory farms in areas where there is not enough falling water to replenish itself steamroll right on. The hospital situation will just hasten and intensify those sorts of things.

[Faith-manor]

It is happening in our area in Michigan. But they aren't closing all the outpost hospitals, they are just retooling them. We have two in our county. One was bought by a larger, urban hospital and turned into a more robust urgent care with a good lab. This helps the larger hospital not become overwhelmed with more easily treatable patients since they are pretty landlocked in the city and have nowhere to expand. The other hospital was bought out by a big, very good medical establishment in the city about an hour away. It as a stitch and ditch ER, so it doesn't see a lot of action, but what it has that is wonderful is a rehab now so families do not have to travel an hour one way when their relatives are in rehab care after being released from the large hospital. It also has specialists in cardiology, and a couple of other areas who come out once a week and see patients, and there is a very robust out patient physical and occupational therapy clinic run on site. This is very helpful given the high percentage of 60+ residents. They have a sports therapist there who works with school kids who have been injured playing sports. Patients used to have to travel 90 minutes one way to see a sports medicine therapist. So it isn't all bad.

That said. As long as we have for-profit, insurance dictated medicine, healthcare practices in many rural areas will go under, and many times, nothing will replace them.

For big issues, our preferred hospital is a two hour drive away. The care there is so top notch, and the staff upper echelon,  so we make it work. The level of expertise, the care, the compassion, is just amazing. They are super well funded because several very wealthy corporations and individuals in the area give copious amounts of money to the hospital. Since they don't worry about money, they do not run understaffed, and for every nurse position they have open, they take about a thousand applicants. When they do a doctor search to fill a post, it is startling how many apply. Everyone wants to work there because they are so tippy top. But the sad thing is, all Americans should have access to this level of care. It shouldn't be only X people get that because they are lucky enough to live near rich people endowing medical care or like us, able to manage the ridiculous commute and often hotels in the city. 

My sister lives in France, and the level of care she receives for even minor issues just makes me cry when I think of it in comparison to here. They spend a lot less to provide that care too. Our whole system is nothing but a disaster.

[mom2scouts]

Yes, it's happening all over. I live in a county that has two small cities and the rest of the county is rural. Our one county hospital closed its OB unit and now many women have to travel 45 minutes or more on rural roads in winter to deliver their babies. The city I grew up in had two hospitals. Both of them have closed completely, and again, one of them was the primary hospital for a large rural area.

The other thing that is happening is that big name hospitals are buying up all the independent and charity hospitals and making them part of their network, except people with marketplace plans or Medicaid are only allowed to use certain designated hospitals and not any in the network. The nearest city to me has three large hospitals, but I have to bypass the first two to get to the one that will take my insurance. They're also building those stand alone urgent care/ER centers all over the place, with pools and fitness centers and all kinds of amenities for people with excellent, employer paid insurance but nobody else can afford to use them.

[WildflowerMom]

It hasn’t happened here and honestly, I’m surprised by that.  All these small towns in my region have hospitals.  I’m happy about that, but I do wonder how it’s sustainable.   
I’m sorry, btw.   It really is an awful hit to a small community.  

[Murphy101]

Yes. It’s become common everywhere and it’s going to get a lot worse before it has a chance to get better.

Staffing being the biggest problem.

We have got to change our education system.

[Harriet Vane]

The medical landscape in this country is horrifying. We are like the proverbial frog in boiling water--it's getting worse and no one seems to be doing anything about it.

I pray our legislators wake up, stop playing stupid power games with each other, and DO something about this.

More staffing. Reasonable schedules and patient loads for staff so that they can actually get enough sleep and a work-life balance. Education for trained medical staff that doesn't put them in lifelong, overwhelming debt. Affordable prescriptions. Accessible and affordable healthcare for every single person. And no executive profiteering from the health and well-being of people. 

[kbutton]

47 minutes ago, mom2scouts said:

The other thing that is happening is that big name hospitals are buying up all the independent and charity hospitals and making them part of their network, except people with marketplace plans or Medicaid are only allowed to use certain designated hospitals and not any in the network. The nearest city to me has three large hospitals, but I have to bypass the first two to get to the one that will take my insurance.

That's tragic and a self-fulfilling prophecy. Yuck!

Quote

They're also building those stand alone urgent care/ER centers all over the place, with pools and fitness centers and all kinds of amenities for people with excellent, employer paid insurance but nobody else can afford to use them.

That's kind of a problem even in non-rural areas. There are some nice things about the standalones, but if you a patient that really needs more robust care (or are a complicated patient), ambulances are often obligated to dump you at one of these because they are closer. It's very frustrating.

Also, I forgot to mention that the urban poor are getting the rural treatment as well--they close hospitals in worse parts of town and then open three in the suburbs. If the hospital system has any compassion, they will sometimes turn the old hospital into a standalone ED. If they do, those places are hoppin' usually (DH often has shifts at one of those). But so many things have to be transferred to be admitted, sigh. At least it's not a long transport, and you're usually in the same system with a lot of overlap when it happens.

34 minutes ago, Murphy101 said:

Staffing being the biggest problem.

We need some kind of balance between doing right by patients and burnout. We really need to screen people not just for their abilities and willingness to jump through hoops but for whether they are the types to do the right thing or pass the problem on to someone else. The people who are willing to do the right thing are often being burned out by those who are shirking for various reasons (DH literally worked for someone in leadership who was a doctor specifically to fund expensive hobbies--while he was a competent doctor, he was not easy to work with because he didn't want to be at work), etc. Or people who insist that their work-life balance trumps your right to, you know, live at all, while simultaneously turning a blind eye to how they could help better the system or push back on stupid stuff in the system to get that work-life balance in an appropriate way.

I should get off my soapbox now, but DH and I just had some enlightening conversations that are a direct result of his latest shift where multiple people were staying extra, one going unpaid for that time because it would affect RVUs (and therefore reflect badly on his productivity), to make sure patients didn't get passed onto "that doctor" (x2 doctors in two different specialties!).

It makes me want to light my hair on fire sometimes.

[Katy]

Yes. NPR did a story on this recently too. And then this week there was one about how many primary care providers are switching to a concierge medical model where they have 25% of the patients but you have their cell phone number and spend an hour with them instead of 10 minutes. It costs thousands upfront though, isn’t covered by insurance, and will make the primary care provider shortage much worse. 

[Granny_Weatherwax]

One of our two hospitals closed last January.  The loss of jobs, flooded housing market, and other social and financial ramifications are ongoing. 

To receive 'good' quality care, we have to drive 45 min away to one of the larger cities. The remaining hospital is good for more common illnesses but I would never want to have surgery here. 

[rebcoola]

IYes rural hospitals closing is happening in the outlying areas.   Locally  specialists aren't being replaced when they retire and they are having  mid level providers take over and using virtual consulting with specialists in big cities.

[Sneezyone]

3 hours ago, Ting Tang said:

A shock to the community, the local hospital is closing.  It may be reopened as an emergency rural hospital with an ER only, but not as of right now.  No more OB, inpatient, lab, etc. 

They cited money lost on births, a cyber attack, staffing shortage, and Covid as reasons for their financial decline.  (Remember when we were told they were making money off Covid?! ah ha)  The hospital is about 20-25 minutes away.  Now the closest one will be 45 minutes-ish.  

Our schools are not great here. Our only college is a community college.  And now there is no hospital. 

Is this sort of thing happening all over?  

In rural areas and/or states that failed to expand Medicaid, yes. Medical providers can't afford to make a living in those areas and don't, for the most part, want to establish and raise families there.

Edited January 27, 2023 by Sneezyone

[TexasProud]

There is also the same type of shortage that is happening with other industries as far as lifestyle.  When my husband went through med school and residency, the hours were completeely insane.  Completely insane.  They did pass legislation so that residents cannot work those kind of hours anymore.  Problem is to some extent long hours are still required.  Doctors just coming out of training are refusing to work that way.  They don't want to take call or take much, much less.  They want to see less patients. The younger docs don't want to put up with all the crap and somewhat reasonably so.  However, that means it takes 2 doctors to replace the one.  And right now, we can't even replace the one to one ratio.  

We have 5 family practice docs in our town. Three of them in their mid 60's, two are in their mid fifties.  They will be retiring close to the same time.  They have started bringing in more nurse practitioners to fill the gap I have noticed.  But in 15 years, you won't be able to get any basic care in this town.  Those 5 all started when the hospital was still here in town.  Obviously, all the OB and surgical specialties left for the other town.  Well, actually most were like my husband and they had an office here and also in the other town as our town couldn't support them by itself.

[Serenade]

2 hours ago, Murphy101 said:

 

We have got to change our education system.

Yes!  Universities are the gatekeepers for many jobs, and universities aren't admitting enough students in critical jobs.

My son is in the mechanical engineering program at UNC Charlotte. Mechanical engineering is the second most competitive program at this university.  Do you know what the number one program is?  Nursing!  It is so hard to get into the nursing program, and the University takes way more pre-nursing students than they will ever have room for in their program.  If a pre-nursing student makes one B, he or she will probably not make it into the BS in nursing program.  Now, obviously we want the best to be on our medical team, but a B, or two, doesn't make someone a poor candidate for nursing school.  There are just not enough spots in the program. Students who make a B or two are told to find another career!   And that's the same with most Bachelor of Science in Nursing programs in our state.  And yet we don't have enough nurses!!  You would think they would expand the programs to allow enough students in to meet the needs of the state. 

[QueenCat]

2 hours ago, mom2scouts said:

They're also building those stand alone urgent care/ER centers all over the place, with pools and fitness centers and all kinds of amenities for people with excellent, employer paid insurance but nobody else can afford to use them.

We have the free-standing ER centers, which are great, but they do not have pools and fitness centers!

[Mrs Tiggywinkle Again]

1 hour ago, Serenade said:

Yes!  Universities are the gatekeepers for many jobs, and universities aren't admitting enough students in critical jobs.

My son is in the mechanical engineering program at UNC Charlotte. Mechanical engineering is the second most competitive program at this university.  Do you know what the number one program is?  Nursing!  It is so hard to get into the nursing program, and the University takes way more pre-nursing students than they will ever have room for in their program.  If a pre-nursing student makes one B, he or she will probably not make it into the BS in nursing program.  Now, obviously we want the best to be on our medical team, but a B, or two, doesn't make someone a poor candidate for nursing school.  There are just not enough spots in the program. Students who make a B or two are told to find another career!   And that's the same with most Bachelor of Science in Nursing programs in our state.  And yet we don't have enough nurses!!  You would think they would expand the programs to allow enough students in to meet the needs of the state. 

There’s a dearth of nursing instructors.  Most are adjunct and the pay is horrible. Most professor pay is terrible anyway.  People aren’t going to do that when they can make huge money travel nursing or even just start at $91,000, which is what a friend of mine was just offered. She won’t even graduate until May, but has a job secured already.

[Sneezyone]

12 minutes ago, Mrs Tiggywinkle Again said:

There’s a dearth of nursing instructors.  Most are adjunct and the pay is horrible. Most professor pay is terrible anyway.  People aren’t going to do that when they can make huge money travel nursing or even just start at $91,000, which is what a friend of mine was just offered. She won’t even graduate until May, but has a job secured already.

Was gonna say this. My cousin and a friend went from BSN to MSN to PA as single moms. Rough road but the money was waaaayyyy better in private practice/hospitals than teaching and govt (which is what one of them did, the other worked for a school ISD).

[Faith-manor]

28 minutes ago, Mrs Tiggywinkle Again said:

There’s a dearth of nursing instructors.  Most are adjunct and the pay is horrible. Most professor pay is terrible anyway.  People aren’t going to do that when they can make huge money travel nursing or even just start at $91,000, which is what a friend of mine was just offered. She won’t even graduate until May, but has a job secured already.

I believe this is a huge issue potentially the number one issue when it comes to nursing schools. Universities pay nothing for professors, and everything for sports coaches and administrators. 😠

At the college my mother in law taught nursing school, the current pay for an instructor is the same as it was 25 years ago! That should be illegal. And ya, why would a nurse take a position teaching for pittance when he/she can get such better pay elsewhere.

I also think the number of positions available for medical school should be doubled. I know numerous high MCAT scoring, 4.0 science bachelor degree folks who cannot get in anywhere. That is absolutely nuts when we need more doctors. And if we had double the number we have now, docs would not need to work such insane hours or we wouldn't struggle to cover the patients and the hours so doctors can have a life.

[Katy]

Another factor is the American Medical Association limiting the number of physician training slots in schools. I can’t remember exactly how many years it’s been since they expanded it, but maybe 10 years back I read a book that said it hadn’t been expanded in decades even as our population went up by more than 400%. Their purpose was to increase physician salaries, but it’s resulted in tuition going way up, admission becoming almost impossible, and a severe shortage of primary care providers with medical degrees. And while I’d argue that a nurse practitioner is probably better for quality of life and general complaints anyway, NP’s can’t even operate independently in every state. I believe the book called for congressional intervention. To my knowledge it’s never been addressed. 

[bolt.]

(As a non-American) do local or other government authorities have any means of ensuring hospital coverage? I mean is there a methodology or a structure at all where a government can dictate to a hospital ownership that they "have to" continue providing care at this-or-that level within such-and-such a radius?

Or do they just rely on supply and demand to suggest that if there are enough people, there's enough demand, and profit will motivate someone to provide the services? 

Or something in between? How does it work?

Edited January 27, 2023 by bolt.

[Sneezyone]

Those folks who want to become nurses tho should be a little more flexible about where they go. Some states have more slots/availability than others and admissions requirements vary widely.

[Faith-manor]

2 hours ago, bolt. said:

(As a non-American) do local or other government authorities have any means of ensuring hospital coverage? I mean is there a methodology or a structure at all where a government can dictate to a hospital ownership that they "have to" continue providing care at this-or-that level within such-and-such a radius?

Or do they just rely on supply and demand to suggest that if there are enough people, there's enough demand, and profit will motivate someone to provide the services? 

Or something in between? How does it work?

Supply and demand. Capitalism rules everything here including healthcare.

[prairiewindmomma]

3 hours ago, bolt. said:

(As a non-American) do local or other government authorities have any means of ensuring hospital coverage? I mean is there a methodology or a structure at all where a government can dictate to a hospital ownership that they "have to" continue providing care at this-or-that level within such-and-such a radius?

Or do they just rely on supply and demand to suggest that if there are enough people, there's enough demand, and profit will motivate someone to provide the services? 

Or something in between? How does it work?

My state has standards, but these can be waived during emergencies. The hospital I would normally be seen at has had a waiver in place several times in the last three years. Here’s the emergency order letter that allowed the emergency deployment of extra staff… https://drive.google.com/file/d/1iWQIqvYQsSWOeIcXF-n6xISfP_-zLKU9/view

an example of when National guard were deployed in local hospitals: https://www.army.mil/article/253345/oregon_national_guard_surging_to_support_hospitals_again

But, really, I have zero desire to be receiving care during staffing emergencies. The stories I hear from my HCW friends (like the ICU nurse on the COVID floor, or peds nurses) are not encouraging. 
 

We need to be creating larger cohorts of nursing students, and we need to expand Medicare and Medicaid. Until we solve BOTH of these, we have no hope of long term relief.

 

[Katy]

3 hours ago, bolt. said:

(As a non-American) do local or other government authorities have any means of ensuring hospital coverage? I mean is there a methodology or a structure at all where a government can dictate to a hospital ownership that they "have to" continue providing care at this-or-that level within such-and-such a radius?

Or do they just rely on supply and demand to suggest that if there are enough people, there's enough demand, and profit will motivate someone to provide the services? 

Or something in between? How does it work?

There are regulations as to amounts of coverage, but I think that has more to do with nursing rules than physicians.  I know there are designations of levels of care for hospitals that have to do with both staffing and equipment, and if a hospital gets downgraded because they don't have required physician coverage they can lose a lot of money.  This means that if you're in a smaller city they cannot get proper staffing, the doctors can be paid INORDINATE AMOUNTS for their salaries.  Like, 20 years ago I was visiting a town in Iowa and they were advertising for a neurosurgeon and the salary alone was over 1 million dollars per year, but it also had all kinds of benefits including a travel allowance in the event that the doctor's family preferred to live elsewhere.  They would pay for the doctor to fly home on their days off.  I have no idea what those kinds of benefits would cost, but I cannot imagine it wasn't double the salary.

Edited January 28, 2023 by Katy

[knitgrl]

Haven't read all the replies...Ours closed in the early 90's. A whole bunch of them in the surrounding area serving small populations have closed within the past ten years, largely due to mismanagement. For two of them they hired some guy as CEO who previously tanked several other hospitals. It's almost like they *wanted* these hospitals to die. After several years, the buildings have been slurped up as satellites for a large hospital based in the nearest city. So there's at least urgent care or ER now, where there was nothing for years after the local hospital went belly up. We still have another local hospital that hasn't been shut down yet, but I don't know how they are still in business. We took dd to the ER years ago, and it took them two years to start billing anybody.

[Ting Tang]

I’m sorry, everyone. It’s sad to read this is such a common thing. I think we as a country could be doing so much better. We have a $2700/ month health insurance premium, though, which we barely use. 😢

[Farrar]

6 hours ago, Sneezyone said:

Those folks who want to become nurses tho should be a little more flexible about where they go. Some states have more slots/availability than others and admissions requirements vary widely.

Some. But... it's not as good as you'd think For some majors like mechanical engineering, be flexible and there are options, even options that will take any student with half decent grades and if you can stick it out through the program, then you can finish. But much harder with nursing even if you're willing to go to a "flyover" state in a less prestigious university. Even then it can be tough to get in or tough to get something semi-affordable.

[Faith-manor]

8 hours ago, Farrar said:

Some. But... it's not as good as you'd think For some majors like mechanical engineering, be flexible and there are options, even options that will take any student with half decent grades and if you can stick it out through the program, then you can finish. But much harder with nursing even if you're willing to go to a "flyover" state in a less prestigious university. Even then it can be tough to get in or tough to get something semi-affordable.

Yes. This. Out of state tuition is unaffordable for most folks, and in our state, admissions gives priority first to in-state prospective nursing students because they are more likely to remain in-state to practice. It isn't feasible to suggest that "fly over states" is an option for most students. 

[Katy]

4 hours ago, Faith-manor said:

Yes. This. Out of state tuition is unaffordable for most folks, and in our state, admissions gives priority first to in-state prospective nursing students because they are more likely to remain in-state to practice. It isn't feasible to suggest that "fly over states" is an option for most students. 

There are either wait lists or highly selective admissions in those cheaper flyover states too. I do know someone who went to one of those for-profit 1 year RN programs that isn’t accredited but does qualify for the RN licensing exam in Florida. It was very expensive but she passed and less than a year later was working enough overtime to make about 100K. But not everyone can finance that. 

[Mrs Tiggywinkle Again]

And right now there’s a huge issue with Florida scam nursing schools.  2200 people apparently did pass the NCLEX, but it was a diploma for money scheme that targeted immigrants and first gen college students who believed they were getting an appropriate education.  The diploma mills apparently provided false transcripts and documents to allow the students to take the NCLEX.
So there is now a call for much more stringent oversight of education programs by nursing boards, which my RN friends really disagree with. 
 

I have a relative who was the head of a BSN program.  She always talked a lot about how difficult it was to find students who not only qualified for admissions(specific hard sciences in high school for example) but were adequately prepared for the academic rigors of the program.  She began her career very against homeschooling but by the time she retired in 2019, she couldn’t praise her homeschooled students enough.  

Edited January 28, 2023 by Mrs Tiggywinkle Again

[Murphy101]

7 minutes ago, Mrs Tiggywinkle Again said:

And right now there’s a huge issue with Florida scam nursing schools.  2200 people apparently did pass the NCLEX, but it was a diploma for money scheme that targeted immigrants and first gen college students who believed they were getting an appropriate education.  The diploma mills apparently provided false transcripts and documents to allow the students to take the NCLEX.
So there is now a call for much more stringent oversight of education programs by nursing boards, which my RN friends really disagree with. 

Wait! How hard is the NCLEX?! Is it so easy that people who otherwise wouldn’t qualify can just breeze through it?  If it is, then the exam seems like a water hoop jump. If it isn’t, then …. what? 

What I’m finding is 7600 people got the diplomas, how many passed the test? Just 2200?  Okay. So. Idk about where you are. But I’m pretty sure out nation, much less a state, can’t handle cutting 2200 nurses from their jobs.

I’m not okay with degree mills either but if we are going to mandate an exam for licensing, then I’m at least 50/50 on passing the exam being good enough. Because that’s literally how bad our medical staff shortage is about to become.

[Mrs Tiggywinkle Again]

1 minute ago, Murphy101 said:

Wait! How hard is the NCLEX?! Is it so easy that people who otherwise wouldn’t qualify can just breeze through it?  If it is, then the exam seems like a water hoop jump. If it isn’t, then …. what? 

What I’m finding is 7600 people got the diplomas, how many passed the test? Just 2200?  Okay. So. Idk about where you are. But I’m pretty sure out nation, much less a state, can’t handle cutting 2200 nurses from their jobs.

I’m not okay with degree mills either but if we are going to mandate an exam for licensing, then I’m at least 50/50 on passing the exam being good enough. Because that’s literally how bad our medical staff shortage is about to become.

The NCLEX is hard(according to my RN friends) but there are a lot of good prep programs.  I have no idea but it sounds like some of these people were LPNs already or had been a nurse in another country where their licensure didn’t transfer to the US.  I’d also suspect a lot did prep programs. 
https://www.usatoday.com/story/news/nation/2023/01/26/florida-nursing-schools-sold-thousands-fake-diplomas-100-million/11126832002/

I really wish they’d make it easier for paramedics to become RNs.  While a lot is different there’s enough the same that there’s some very successful bridge programs out there—just very few and far between.  I would absolutely go to nursing school if it was made a little more possible. 

[Faith-manor]

4 minutes ago, Mrs Tiggywinkle Again said:

And right now there’s a huge issue with Florida scam nursing schools.  2200 people apparently did pass the NCLEX, but it was a diploma for money scheme that targeted immigrants and first gen college students who believed they were getting an appropriate education.  The diploma mills apparently provided false transcripts and documents to allow the students to take the NCLEX.
So there is now a call for much more stringent oversight of education programs by nursing boards, which my RN friends really disagree with. 
 

I have a relative who was the head of a BSN program.  She always talked a lot about how difficult it was to find students who not only qualified for admissions(specific hard sciences in high school for example) but were adequately prepared for the academic rigors of the program.  She began her career very against homeschooling but by the time she retired in 2019, she couldn’t praise her homeschooled students enough.  

My mother in law always said they experienced a high drop out rate in the first semester when she was instructing because the failure of high schools to prepare was quite high. I will say this though. We were considered the crazy home schoolers in our area for insisting on significant high school math and science skills being mastered. This is an area that is largely ignored locally because most of the homeschoolers are for religious/sh entering reasons, not academic and have this automatic assumption that by keeping their kids home, they are automatically doing better than pi pic school students. So we have a lot of homeschooled graduates in the area who think "I will go into nursing" only to find out they are going into exactly nothing at the university until they take math, science, and sometimes even reading comprehension remediation. 

[Murphy101]

6 minutes ago, Mrs Tiggywinkle Again said:

The NCLEX is hard(according to my RN friends) but there are a lot of good prep programs.  I have no idea but it sounds like some of these people were LPNs already or had been a nurse in another country where their licensure didn’t transfer to the US.  I’d also suspect a lot did prep programs. 
https://www.usatoday.com/story/news/nation/2023/01/26/florida-nursing-schools-sold-thousands-fake-diplomas-100-million/11126832002/

I really wish they’d make it easier for paramedics to become RNs.  While a lot is different there’s enough the same that there’s some very successful bridge programs out there—just very few and far between.  I would absolutely go to nursing school if it was made a little more possible. 

If that’s the case? Then frankly I think the program is waste for such people and passing the exam should be enough.  If nothing else, let such people take the exam and be on probation/apprenticeship for 1 year/2000 hours.  I think it’s be very apparent after that much time if they should get their license or not.

[Sneezyone]

1 hour ago, Katy said:

There are either wait lists or highly selective admissions in those cheaper flyover states too. I do know someone who went to one of those for-profit 1 year RN programs that isn’t accredited but does qualify for the RN licensing exam in Florida. It was very expensive but she passed and less than a year later was working enough overtime to make about 100K. But not everyone can finance that. 

I was thinking more along the lines of Bowie State (MD). They have state of the art facilities and would welcome white students as diversity admits too.

Edited January 28, 2023 by Sneezyone

[MagistraKennedy]

On 1/27/2023 at 11:01 AM, Ting Tang said:

 

Is this sort of thing happening all over?  

Not in my area ---- hospital systems are building new facilities left and right, it seems. My nurse friends and I just shake our head and wonder who's going to staff these facilities. 

Louisville, KY area ---
University of Louisville hospital expansion
Plus turning an existing freestanding ER/Surgery center into an inpatient hospital

Norton Healthcare:
Plans to build brand new hospital

Baptist Healthcare
New next gen hospital

VA 
New hospital, to replace the old hospital

[Serenade]

On 1/27/2023 at 6:24 PM, Sneezyone said:

Those folks who want to become nurses tho should be a little more flexible about where they go. Some states have more slots/availability than others and admissions requirements vary widely.

This is a good point. On the parent FB page for DS's uni, many of the parents who are nurses said that the students should try to go the community college route, earn the RN there, get a job, and then complete the BSN while working.  They said that most hospitals and medical facilities will then pay for their employed nurses to upgrade to the BSN.  

RN to BSN Uniform Articulation Agreements

The RN to BSN Uniform Articulation Agreement promotes educational advancement opportunities for registered nurses moving between North Carolina community colleges and the constituent institutions of The University of North Carolina and the signatory campuses of the North Carolina Independent Colleges and Universities (NCICU) to complete BSN degrees. It is a Five Block Degree Plan that includes required general education and nursing prerequisite courses. Students who follow this Five Block Degree Plan will meet the entrance requirements at all of the North Carolina public RN to BSN programs and the signatory NCICU programs.