[avs733]

I had an extremely traumatic accident a week ago and came into a major city hospital as a level one trauma patient.

I came in with absolutely no wait..ambulance directly to a trauma bay, no waiting, no clothing, no nothing.

After about six hours they figure out I was not going to die and was relatively okay. Okay here means two broken legs not “walking around”. Half of the patients at this hospital had covid and I have a five month old at home who isn’t vaccinated (obviously).

Once I got admitted to the trauma floor for a couples days it was like I didn’t exist. The staff seemed totally overwhelmed and it took hours to get some simple things like water. Without visitors, a bag of belongings got delivered by being isolated in a chair well out of my limited reach. Took me eight hours to get my laptop from that bag. I was okay with that because I wanted to interact with as few potential covid vectors as possible but wow.

I think, from my experience there are a couple of things happening:

1) staff are overwhelmed to day with the ratio of patients to staff. I can’t comment why but the nurses I saw weren’t sitting they were constantly moving.

2) staff are demoralized and frustrated. You could hear it in their voices and tone and body language. They were trying but grumpy.

3) shit rolls down hill. Drs. (Save one angel who talked with me for 30 minutes about life) where in and out for brief profunctory conversations that had no communicative value about what was

They need more nurses. And like everywhere else it seems no one is willing to pay them more or treat them better. We can pay execs millions with no qualms and no evidence it works. But as a patient having the worst day of my fucking life, I interact with front line staff and they are out there getting run into the ground and being treated like shit for it.

I’m so sorry for your wife, I was so lucky I had a different experience. But the shared thing, I think, is that the American medical system is going through a full and complete collapse and no one with the power to change things is willing to do anything.

I’m terrified.

[doitLP]

Meanwhile my friend who is a nurse in the UCLA hospital complex says they’re so understaffed because they let so many people go/nurses retired or quit that all nurses are allowed to come to work if they’ve tested positive but their symptoms are improving

[avs733]

This is a perfect sign of what I’m talking about.

They fucked around with these people for so long that when they need them, actually need them, they aren’t there. They rolled the dice in an assumption that they held sufficient economic power to control them. Now they are left exposing patients to covid as a necessity to prevent their operations from completely ceasing.

That is failure by any other name.

[doitLP]

I wouldn’t blame the hospital too much — they were responding to the economic incentive of lockdowns and lack of actual patient pressure by closing entire wings of the hospital and laying people off. I.e there wouldn’t be this nurse shortage at the hospital if the lockdowns never happened.

[irthomasthomas]

Is the explanation simply that so many nurses are being forced to isolate with Omicron? Since even vaccinated staff can still spread it, so they still take the tests often, and isolate for 2 weeks if positive.

[avs733]

I would suggest the explanation is similar to the supply chain.

In the interest of profits we have wrung every ounce of every part of the system that runs healthcare. And at the end of all of those elements are human beings. Such systems are unstable. They work but are not fault tolerant at scale because no one ever really looks at the whole system they just look at a part of the system they control. I’m okay if healthcare is more like an a320 as opposed to an F22 because the F22 needs 50 man hours of maintenance to fly and the a320 does it’s thing in a much more germane fashion. Jwst can have 184 single point of failure actuators because it’s the bleeding edge, healthcare needs to have -184.

The problem is we see humans as humans. A machine breaks, it is not perceived as having agency, autonomy, or humanity we don’t blame it. When people die waiting in an er or healthcare personnel are short with patients or quit in droves there is a person whose actions and motives we can question and blame. We understand that experience slightly more and can find ways to question it.

It isolates the problems from view. When no one’s looking at the whole system (and being listened to) no one can shift course. It was not efficient to build capacity for truly abnormal events, so it didn’t make financial sense For anyone to do so. And now nurses are testing and isolating…and. Not just. And.

[kube-system]

This has been relaxed greatly in 2022 at many hospitals. Most are isolating only for 5 days now under the new CDC guidelines, and some only if the person is symptomatic.

[hutzlibu]

"Is the explanation simply that so many nurses are being forced to isolate with Omicron?"

A explanation why people are frustrated, who work hard and intense, take all the risk - but only get low pay?

[kurthr]

Exactly, "you've been a nurse for 30 years, you're 60yrs old, you tested positive for COVID and you still have symptoms, but if you don't come back into work after 5 days (without pay) you'll also face punishment when you return". Of course, if a patient get's COVID while under your care (and symptomatic) and chooses to sue you, "you're on your own babe!". Also, "it is mandatory that you get vaccinated/boosted, but also come into work the next day or you won't be paid and it will count as one of 4 unscheduled days off per year before termination".

And people wonder why nurses are pissed off?

[avs733]

We focus on human causes because we connect to them better. And because for many many people these are the concrete things that can understand when I’m a stressful situation. Abstract problems like decades of “capacity management” “workflow improvements” and “right sizing” are so abstract they don’t resonate with someone who is standing in an er in pain. They aren’t dumb they are stressed out. Stress is basically fight or flight…it makes us stupid.

Stress is why I made the firefighters put in safety glasses and got angry at them that I couldn’t find my glasses. Both while trapped under a literal oak tree