[SQueeeeeL]

> this person who represents the circumspect nursing community seemingly took even more additional circumspect care in phoning it in. When a lot of people in such a situation would have probably given up much earlier and perhaps even lost their composure & ability to work completely.

Remember y'all, every single nurse must be a superhuman who can deal with an infinite amount of stress of they're not a "real nurse". If only owners who didn't staff enough people in their medical facilities weren't "real owners" of said facilities, I think that would fix a lot of our issues.

[hallway_monitor]

Can nurses unionize? It seems like they need it very badly. They get the short end of the stick with everything in medicine.

[ejb999]

Yes they can unionize, and no it won't solve anything - most hospitals near me are unionized and they are still running critically short on nurses - you can't hire (or schedule) people that don't exist or don't work for you.

The real problem is there are not enough nurses, and a big reason for that is there are not enough nursing schools or slots in the existing nursing schools and it is extremely competitive to get into these schools - even with outstanding grades.

Just checked, the biggest hospital near me (in a medium-ish sized city) currently has 350+/- open nursing positions they are trying to hire for.

[linsomniac]

As the husband of a nurse who left the profession ~a year pre pandemic, it's not entirely that there aren't enough nurses. It's more that there are not enough nurses because healthcare administration tries to pile on too many patients, and too few CNAs. Nurses are treated like cannon fodder.

This will, indeed, lead to having open nursing positions, but may not be as indicative of a lack of nurses as you think. It's entirely likely that those 350 open positions are currently filled by "travel nurses", making 3-5x the base salary, in which case it's more a case of those 350 positions being for people looking to take drastic pay cuts.

It's a situation the healthcare industry has fostered and it's coming home to roost, meanwhile politicians are getting involved to try to cap the nurses salaries.

And I'd put a tenner on much of the problems being rooted in the undervaluing of women's work.

[ejb999]

Traveling nurses are definitely part of the problem, (why wouldn't someone go for the much higher salary) - but more nurses causes that problem to go away - simple supply and demand.

From the The American Association of Colleges of Nursing (AACN) website:

>>>According to AACN’s report on 2021-2022 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, U.S. nursing schools turned away 91,938 qualified applications (not applicants) from baccalaureate and graduate nursing programs in 2021 due to insufficient number of faculty, clinical sites, classroom space, and clinical preceptors, as well as budget constraints. <<<

Thats almost 100K potential nurses that were qualified to enroll, but there we no slots available for them.

[ftth_finland]

> Traveling nurses are definitely part of the problem, (why wouldn't someone go for the much higher salary)

Sounds more like being part of the solution. More traveling nurses equal more pay.

Eventually things will reach an equilibrium where base pay will rise enough to either attract more nurses back to the profession and/or make it profitable to train more nurses.

[linsomniac]

I understand you are saying that nurses are overworked because of there aren't enough nurses.

I don't think you are understanding that I'm saying that health care administration tends to staff at a level that overworks and undersupports nurses. Which causes many qualified nurses to leave the front-lines for nursing adjacent (one nurse friend is doing CPAP equipment rental) or leaving nursing entirely (my wife).

[ftth_finland]

Why aren’t more nurses opting to become traveling nurses?

[linsomniac]

A lot of them are. And those that are are making $125-175K/year. It does mean relocating, or adding 1-2 hours commute on top off a 12 hour shift (that typically takes more like 14 hours once you add shift handoff and finishing paperwork that you don't have time to do during your shift because you have double the optimal patient load and half the CNA support...

Nursing is a really tough career.

[ftth_finland]

Let me rephrase, why aren’t nurses quitting en masse to become traveling nurses?

If you are going to be miserable at work, at least be miserable and well paid.

Why is there a need to relocate or commute as a traveling nurse?

If there is a national nurse shortage, why cannot you be a traveling nurse locally?

[ticviking]

That seems an awful lot to me like the "medical guild" is preventing enough people from being able to enter this profession to meet demand, which otherwise would be met at prevailing wage. I never once thought of nursing school spots as competitive when I was a student, you needed good grades but class ranking wouldn't come into it.

I'm aware I'm not an expert here, and I'd love to understand what the actual barrier to training more nurses is.

[kennend3]

You called it.

I have family looking to become a doctor in Canada, a country desperate for doctors.

There is so much demand to get into the limited slots you can have a near-perfect score and still not get admitted.

Canada's solution to this problem? Introduce a new test (CASPER) to further limit those who can apply.

One of my daughters friends scored very well on the MCAT (Medical College Admission Test) but failed CASPER (????).

These systems seemed "rigged" to artificially limit supply and drive up wages.

She's now looking to the US so in the end, does Canada win by sending its medical professionals elsewhere?

The unions are great, and had a place but now they work against the public's best interest by limiting supply to drive up wages. Cant be a nurse in Canada without joining the union.

Everyone knows Salary is driven by salary/demand. Limit the supply what happens the price?

[kennend3]

Thinking about this more.. here's a classic example:

https://www.cbc.ca/news/canada/newfoundland-labrador/dr-paul...

An American doctor volunteers three months of FREE service and is denied a license?

Normally they would use "lacks Canadian experience" but in this case he was Canadian trained.

Not to worry, the licensing group found an excuse to deny his license.

Because of COVID he was seeing patients virtually or over the phone. They managed to dig up some obscure ruling that doctors need to see patients in person, so license denied.

And the general public, could they not have benefitted from 3 months of free service? This area is absolutely DESPERATE for a doctor, but the barriers to entry must be protected at all costs.

[nradov]

There are many former nurses who have the academic qualifications but have since left the profession. Some of those could be drawn back in with better pay and working conditions.

[mindslight]

One of the main places nurses tend to go to leave the fray is the medical billing / "insurance" industry. Who else has extensive experience with ICD billing codes? So not only does the financial cancer strangle the people supplying actual healthcare, it shrinks the supply of them as well.

[nradov]

That's really not what happens. Most nurses doing clinical work aren't experts on the CPT and ICD-10 codes used in billing. Medical coders attend specialized courses to learn the detailed coding rules, and then pass a certification test. They get paid much less than an RN.

Some nurses do go to work for payers, mainly doing case reviews and utilization management. This is absolutely necessary to prevent waste, fraud, and abuse. Even in socialized medical systems they have people doing similar oversight work.

[mindslight]

Sure, I agree the "insurance" industry employs people that aren't nurses, too.

The "oversight" function provided by "insurance" companies is terrible and hostile. It does nothing to stop every day waste, like rushed appointments, doctors telling you to come back in a few weeks for another billable event, repeated tests, etc. Meanwhile it creates administrative hoops based around rejustifying treatments that have already been justified by the front line doctors, to the point that many providers employ "nurse navigators" to wade through the hassle - care-providing potential is wasted on both sides of this pointless adversarial setup.

[LorenPechtel]

They still have current licenses??

[JshWright]

There are plenty of facilities where nurses are unionized (and it is almost universally a net benefit to both the staff and patients).

[TYPE_FASTER]

Interesting read on the impact of consolidation on the healthcare labor market: https://www.competitionpolicyinternational.com/wp-content/up...