Good for them. Despite the mantras of "support our frontline workers" many of these employees have been treated like shit by their employers[1], their government who refused to take measures to limit the spread, and their patients - some of whom will continue to actively deny COVID even as they die from it.
I think you're underplaying non-financial incentives.
I would rather have a job that pays $X but offers flexible work hours and vacation time that allows me to be a better parent, than a job that pays $1.5X but won't let me take a day or afternoon off to (e.g.) take my kid to the doctor, etc.
Granted, that probably applies more to WFH desk jobs than front-line nurses.
FWIW, there was a post by an ICU nurse in my local subreddit who said that NOBODY took advantage of extra available shifts even though the hospital was offering double pay.
Her point was for many medical personnel, it's not about money, it's about being exhausted and burnt out.
I think it's also shown in time. I've had jobs that paid me more than my current one, but I was paying for that by my personal time being completely abused on a regular basis, even if it's just a small thing or 3 daily it ends up feeling like you never stop working. I don't have any means of work communication on my phone now, and I've gotten one call that I said I was open to in my current role. To me, shutting my computer and work being completely over till I open it again is such a relief.
This is very reductive and I assume means you've never worked somewhere with an actually decent culture. I understand your cynicism: there are indeed a lot of bullshitters out there. But there are some good places to work here and there, places where the bosses listen and respect the humanity and autonomy of the people around them. Frequently this occurs at a local level rather than across an entire company, but it does happen. (Note: I'm not saying it's an excuse to underpay people, I'm saying this can be an issue entirely independent of pay.)
maybe in tech companies but in more traditional roles like manufacturing and maintenance, its paid in respect for your time. Mandatory overtime is a real thing in the US and less of it means a stronger relationship with your employees. all the money in the world wont replace your weekends.
For what it's worth, in insurance controlled businesses that's easier said than done. I'm not dismissing your point, just saying that there are a lot of complexities.
Good working conditions are also an aspect of the company caring about you. If a company pays you well, but still abuses you, they don't care about you.
Yeah the fact that companies spend money (lots of money) on advertising dollars instead of handing that money to the workers they supposedly support in hazard pay is wild.
Part of the fatigue is the intense level of PPE. Its physically exhausting and usually just theatre because so many healthcare workers are either vaccinated or have already had COVID.
> One reason some hospital staff say they are resisting COVID-19 vaccination is because it's so new and not yet fully approved by the FDA.
> "I want to see more testing done," she says. "It took a long time to get a flu vaccine, and we made a COVID vaccine in 6 months. I want to know, before I start putting something into my body, that the testing is done."
> Many of her co-workers share her feelings, she said.
Would have been nice if the article included responses to these concerns. Plenty of shaming about how dangerous passing covid to patients can be, but I didn't see anything that actually addresses the confidence problem.
edit:
Looks like a different hospital worked on the confidence problem with some success:
> "There was a lot of hesitancy and skepticism," says William Schaffner, MD, a professor of preventive medicine and infectious disease at Vanderbilt University in Nashville. So the infectious disease division put together a multifaceted program including Q&As, educational sessions, and one-on-one visits with employees, "from the custodians all the way up to the C-suite," he says.
Today, HHS data shows the hospital is 83% vaccinated. Schaffner thinks the true number is probably higher, about 90%. "We're very pleased with that," he says.
I find it amusing I’m being downvoted. I’m not questioning the safety or efficacy of the vaccine (I’m vaccinated). I only mean to highlight what a difficult problem this is to solve when even health care workers are struggling with uptake. People, including HN, are truly wrapped around the axle on this issue.
Most people who fall under "health care workers" don't have a medical degree. Many, including techs and nursing assistants, don't have a bachelor's degree either. So, that population isn't really all that different from the general U.S. population in many ways.
Among physicians and medical researchers with PhDs, though, you'll find very little resistance to vaccines.
I've never worked as a nurse or doctor but it's hard to imagine what they go through. Every day they deal with people in serious pain, people with traumatic injuries, rude people, rude people with traumatic injuries, screaming children and babies. Apparently nurses in particular are also routinely disrespected by higher-ups, put in danger by higher-ups, and don't get paid much.
In college I heard insane stories from the nursing majors. Apparently going on shifts working 72+ hours non-stop is the norm. Imagine spending 72 hours in that hell: delivering this guy's meds, then checking this guy's blood pressure while he berates you, then typing in some paperwork, then giving this baby lab work while he's screaming, then doing more paperwork, etc. for 72 hours straight. I can't imagine it, I can barely imagine spending more than 3 hours.
Anecdotally, the few times I've been to doctors' offices and hospitals, I always notice the stress on doctors. Doctors and nurses are rushing everywhere, and they try to act nice but are simultaneously drained of emotion from disrespectful patients and general fatigue. Ironically sometimes they don't look that healthy, with all due respect, probably because of the immense stress and that it's hard to fit in exercise when you work 12-hour overnight shifts.
Also, I live in Massachusetts where hospitals haven't been near capacity for some time now. Everything I described is just regular operation, pre-Covid.
It's a complicated problem. Tired healthcare providers make more errors. But the majority of harmful errors happen in handing over patient care from one provider to another. Shorter shifts mean more care transitions. A patient in the ICU isn't like a truck that you can park and leave alone for 8 hours.
Most mistakes happen on the hand-offs, known as "continuity of care", which is both shift-to-shift and phase of care back to health. Longer shifts help with the former at the cost of fatigue-based mistakes, so it is a balancing act, but not as simple as "shorter shifts". The challenge is unlike pilots and truckers the process points when you can naturally terminate a shift are far less defined and predictable. Ex: a pilot who's forced to divert and enter a holding pattern will extend his shift, regardless of the number of hours flown; every hospital shift in an ER is like this.
Anyway you slice this problem it just sounds like hospitals aren’t hiring enough employees. Sure maybe transitions produce errors but then I’d argue you had overlapping shifts where your prior carer was transitioned to a new one over a period of hours.
This may vary by region, but I believe that the original idea of the 24 hour shift is that a physician is present, but only working as necessary depending on patients. A slippery slope if the hospital is generally understaffed.
24... 36... 48. The private ambulance company I used to work for allowed you to work 60 hours straight, and then required an 8-12 hour break, if you wanted to work up to another 60.
For example my brother-in-law is a firefighter. He spends 3/4 days straight in the firehouse and then comes home for 3/4 days and works something like 12 hours straight when he is on call and gets rest periods when not actually doing firefighter work. This is possible because the firehouse basically has a small dorm in it. When I ask him when he is going to work he says he has a three day shift coming up. Because he doesn't come home, my sister definitely considers it "non-stop".
I can easily imagine health care workers being on-site for a few days at some sites, like a firefighter. Especially in areas where commutes could be prohibitive.
"Apparently going on shifts working 72+ hours non-stop is the norm."
C'mon, that's 3 straight days, i.e. skipping 2 nights. How can that be 'the norm' anywhere? Extraordinary claims requires extraordinary evidence - or in this case, just any evidence.
Ok, it’s probably not the norm, but i’ve heard from multiple people saying they needed to stay awake for 80+ hours. Maybe because it was college and they were also taking classes?
I can reliably say that they’re still very overworked. 12+ hour shifts is the norm, and sometimes even 24 hours.
yup. And in every scenario they have to show compassion and empathy even to screaming patients or people trying to argue with them. It's very draining.
Most girls I've been on dates with said it's very boring. It's not like ER. If anything they usually say that certain patients get really annoying. Blood, fecal, urine, etc done even bother them.
It was unexpected but still somehow expected since many of them were already overworked before covid hit.
Turns out the healthcare systems didn't get overloaded by just the virus, but also the years or decades old issues bubbling under the surface.
Nurses all the way in Finland are voting with their feet as well. Management that isn't up to par, working hours, pay... David Graeber's essays about how caring work is both underpaid and underappreciated rings true.
Yup, news reports about "hospitals are 90% capacity" or whatever is a business decision by design. They might have a couple more floors available but no staff for them because they aren't scheduled, because patients aren't there. They proactively cut staff wherever possible and then try to react.
There are not enough nurses, and aren't enough doctors sitting idle right now to hire up in the way that you're suggesting...
and if you thought spinning up a chip fab in Texas is taking too long, wait until you try to solve the problem of spinning up more doctors. the residency program that takes up years of their schooling relies on having other doctors mentor them.
Actually regulations limit the number of beds hospitals can have. The theory is that this will cut health care costs to insurers and the government because they assume hospitals will find a way to admit patients until they are full.
It's the same with service sector workers. Having months off, many are realizing actually how shitty their jobs were. I highly recommend yesterday's The Daily podcast. They talk with a bunch of small business owners and service sector workers. Very illuminating.
Spouse worked at a hospital until last fall. As @originalvichy noted, there were years of old, unresolved issues bubbling under the surface. COVID just lay everything bare. She let them know exactly what the problems were for her and for the department at large.
They wouldn't budge on anything, and as last summer's surge was dwindling, were planning on returning to the status quo.
Quebec premier pulled some shady shit using the Emergency Powers (same that gave us the infamous curfew), and strong-armed union negotiations, basically forcing the terms. Now we're dealing with nurses and other supporting medical personnel retiring / leaving for other jobs.
You can get all 3 improvements if you're starting with an absolutely terrible worst-of-all-worlds system, like the one we have in the US. The main losers of any reform would be administrative paper pushers, but needless fakejobs aren't good for anybody.
There is a relevant speech by a surgeon who along with other doctors started their own practice [1]. It's called "Why Aren't There More Free Market Surgery Centers and Clinics".
> The last two payments I received from Medicare were as follows: $285 for a six-hour cardiac anesthetic and $78 for the anesthesia services required for a knee replacement. These fees had been imposed through a mechanism referred to as the resource-based relative value scale, more appropriately called the Rosemary’s baby of healthcare. According to the folks at Harvard who gave birth to this creature, every physician service had a price and they knew what those prices were.
> Prices are signals, after all, and Medicare was sending me a signal regarding what they thought the service I provided was worth, or they meant to intentionally cull the ranks. I felt obligated to respond with a rational signal of my own and as I’ve mentioned, I quit participating in their scheme.
> To further bolster this bankrupt-hospital narrative, physicians and surgeons were told there was no money to buy the equipment and supplies they needed. It was becoming increasingly obvious that it was time to get out. I had no desire to be controlled by the rising administrator class.
Next he discusses how under the guise of protection of customers and care about the citizens, government (lobbied by hospitals) tried to close their practice up because they charged 1/10th of what "not-for-profit" hospitals did.
Every other developed country I'm aware of uses price controls for their healthcare system, usually by declaring price lists regardless of payer, by establishing a state-directed monopsony, or by taking direct control of healthcare providers.
Clearly it can work since AFAIK everyone is doing it, and it seems to be basically fine. Not perfect, but fine.
And that's why author's practice survived despite the hostility of the US government. They started treating Canadian patients:
> The first patients to arrive after we posted prices were Canadians. This was instructive, as these patients had so-called insurance coverage. There was no access, however, to the care that many of them required. The most common story then as now for the Canadians was a patient waiting two years to see a gynecologist for a hysterectomy to stop their bleeding, bleeding usually so severe that intermittent transfusions were required. For $8,000, which covers the facility, surgeon, anesthesia, pathology, and an overnight stay at the surgery center, Canadians can end their nightmare. The first question a Canadian asks when they call us is how long they’ll have to wait. Our answer that there is no waiting time is met with disbelief. A Canadian friend of mine has told me the old joke that no Canadian is truly content unless standing in line.
All thanks to the success of a "state-directed monopsony" of a "developed country".
It's not only in the US. It's everywhere. And no, Covid-19 wasn't entirely at fault. This virus its just showing the cracks the entire western world's health system.
I know someone who works in hospital / physician group admin that said doctors are straight up quitting right now unless the hospital bends to their demands to only work 3 days a week. They can't hire doctors either and they have no way to accept new patients at the moment.
Seems reasonable, depending on shift length. Some doctors work 24 hour shifts, three 24 hour shifts a week would be brutal. Even three 12 hour shifts would be 36 hours, not much less than a standard 40 hour week.
Readit News
[1] https://www.nwahomepage.com/knwa/mercy-employees-frustrated-...
I would rather have a job that pays $X but offers flexible work hours and vacation time that allows me to be a better parent, than a job that pays $1.5X but won't let me take a day or afternoon off to (e.g.) take my kid to the doctor, etc.
Granted, that probably applies more to WFH desk jobs than front-line nurses.
Her point was for many medical personnel, it's not about money, it's about being exhausted and burnt out.
Money can't fix that.
Dead Comment
Dead Comment
> "I want to see more testing done," she says. "It took a long time to get a flu vaccine, and we made a COVID vaccine in 6 months. I want to know, before I start putting something into my body, that the testing is done."
> Many of her co-workers share her feelings, she said.
Would have been nice if the article included responses to these concerns. Plenty of shaming about how dangerous passing covid to patients can be, but I didn't see anything that actually addresses the confidence problem.
edit:
Looks like a different hospital worked on the confidence problem with some success:
> "There was a lot of hesitancy and skepticism," says William Schaffner, MD, a professor of preventive medicine and infectious disease at Vanderbilt University in Nashville. So the infectious disease division put together a multifaceted program including Q&As, educational sessions, and one-on-one visits with employees, "from the custodians all the way up to the C-suite," he says.
Today, HHS data shows the hospital is 83% vaccinated. Schaffner thinks the true number is probably higher, about 90%. "We're very pleased with that," he says.
Among physicians and medical researchers with PhDs, though, you'll find very little resistance to vaccines.
In college I heard insane stories from the nursing majors. Apparently going on shifts working 72+ hours non-stop is the norm. Imagine spending 72 hours in that hell: delivering this guy's meds, then checking this guy's blood pressure while he berates you, then typing in some paperwork, then giving this baby lab work while he's screaming, then doing more paperwork, etc. for 72 hours straight. I can't imagine it, I can barely imagine spending more than 3 hours.
Anecdotally, the few times I've been to doctors' offices and hospitals, I always notice the stress on doctors. Doctors and nurses are rushing everywhere, and they try to act nice but are simultaneously drained of emotion from disrespectful patients and general fatigue. Ironically sometimes they don't look that healthy, with all due respect, probably because of the immense stress and that it's hard to fit in exercise when you work 12-hour overnight shifts.
Also, I live in Massachusetts where hospitals haven't been near capacity for some time now. Everything I described is just regular operation, pre-Covid.
Try being in EMS.
24... 36... 48. The private ambulance company I used to work for allowed you to work 60 hours straight, and then required an 8-12 hour break, if you wanted to work up to another 60.
Funny tradition that refuses to die.
Absolutely not and it’s insane to even think that could be true.
For example my brother-in-law is a firefighter. He spends 3/4 days straight in the firehouse and then comes home for 3/4 days and works something like 12 hours straight when he is on call and gets rest periods when not actually doing firefighter work. This is possible because the firehouse basically has a small dorm in it. When I ask him when he is going to work he says he has a three day shift coming up. Because he doesn't come home, my sister definitely considers it "non-stop".
I can easily imagine health care workers being on-site for a few days at some sites, like a firefighter. Especially in areas where commutes could be prohibitive.
Around here the absolute maximum I've heard about is 12.5h and that includes at least two mandatory breaks.
C'mon, that's 3 straight days, i.e. skipping 2 nights. How can that be 'the norm' anywhere? Extraordinary claims requires extraordinary evidence - or in this case, just any evidence.
I can reliably say that they’re still very overworked. 12+ hour shifts is the norm, and sometimes even 24 hours.
Deleted Comment
Turns out the healthcare systems didn't get overloaded by just the virus, but also the years or decades old issues bubbling under the surface.
Nurses all the way in Finland are voting with their feet as well. Management that isn't up to par, working hours, pay... David Graeber's essays about how caring work is both underpaid and underappreciated rings true.
and if you thought spinning up a chip fab in Texas is taking too long, wait until you try to solve the problem of spinning up more doctors. the residency program that takes up years of their schooling relies on having other doctors mentor them.
Deleted Comment
testing tests all patients being admitted to the hospital
no wonder they are overworked
They wouldn't budge on anything, and as last summer's surge was dwindling, were planning on returning to the status quo.
She walked.
https://calgary.ctvnews.ca/mobile/when-is-the-strike-vote-fa...
No one wants to pay more taxes, No one wants healthcare workers get less money, No One wants substandard care..
You can not have All 3, More Care, and More Pay requires more Taxes... Canadian's however do not want to pay more Taxes.
> The last two payments I received from Medicare were as follows: $285 for a six-hour cardiac anesthetic and $78 for the anesthesia services required for a knee replacement. These fees had been imposed through a mechanism referred to as the resource-based relative value scale, more appropriately called the Rosemary’s baby of healthcare. According to the folks at Harvard who gave birth to this creature, every physician service had a price and they knew what those prices were.
> Prices are signals, after all, and Medicare was sending me a signal regarding what they thought the service I provided was worth, or they meant to intentionally cull the ranks. I felt obligated to respond with a rational signal of my own and as I’ve mentioned, I quit participating in their scheme.
> To further bolster this bankrupt-hospital narrative, physicians and surgeons were told there was no money to buy the equipment and supplies they needed. It was becoming increasingly obvious that it was time to get out. I had no desire to be controlled by the rising administrator class.
Next he discusses how under the guise of protection of customers and care about the citizens, government (lobbied by hospitals) tried to close their practice up because they charged 1/10th of what "not-for-profit" hospitals did.
https://mises.org/wire/why-arent-there-more-free-market-surg...
Clearly it can work since AFAIK everyone is doing it, and it seems to be basically fine. Not perfect, but fine.
> The first patients to arrive after we posted prices were Canadians. This was instructive, as these patients had so-called insurance coverage. There was no access, however, to the care that many of them required. The most common story then as now for the Canadians was a patient waiting two years to see a gynecologist for a hysterectomy to stop their bleeding, bleeding usually so severe that intermittent transfusions were required. For $8,000, which covers the facility, surgeon, anesthesia, pathology, and an overnight stay at the surgery center, Canadians can end their nightmare. The first question a Canadian asks when they call us is how long they’ll have to wait. Our answer that there is no waiting time is met with disbelief. A Canadian friend of mine has told me the old joke that no Canadian is truly content unless standing in line.
All thanks to the success of a "state-directed monopsony" of a "developed country".