Divemedic has many years of experience working in the US hospital system. He offers this insight about what's going on now in his Florida hospital. I've confirmed that much the same thing is happening in some hospitals in Texas, Tennessee and Colorado, because I have contacts in all of them.
We have been short staffed for nearly three years. They have made up the shortfall by paying huge bonuses to get nurses to work extra shifts. They tried foreign workers. Still, they don’t have enough. Determined to save money now that the COVID funding has dried up, hospital administration announced on Saturday that there will be no more bonuses offered. Once the shifts that are already promised bonuses are paid out, they will be no more. Nurses who were making $2500 a day for working a 12 hour over time shift are now being asked to work the same overtime hours, but for $600-$900 each 12 hour shift.
I know that I was working 60 hours or more a week. I was making good money to do that, but now that the money has dried up, I am not working those kinds of hours for a fraction of the pay. No one that I know is willing to do that.
So now the entire staff of the ED is not taking any extra shifts. They are working their contracted hours, and that is it.
. . .
Now instead of 60% staffed, you are more like 45% staffed. Instead of 10 nurses, you only have 7. Now picture that across the entire hospital. A 600 bed hospital with a 50 bed ED requires 100 nurses or more each shift. You only have 50 or 60. Now what do you do? There aren’t enough foreign workers to fill that many spots.
My hospital can’t be alone in this. Here is the warning: there is a potential collapse of health care coming. It takes 3 to 4 years to train a nurse to the point where they are licensed, and another 2 years or so for that nurse to be proficient enough in their job to staff an ED, even longer for places like the ICU.
There's more at the link.
Add to this massive politically correct indoctrination and racially based "reverse discrimination" by some doctors and hospitals, and we get a very nasty picture indeed.
Best advice? Don't get sick or injured badly enough to need hospital treatment. If you do, pray your local hospital (or wherever you're admitted) has enough qualified, competent staff to treat you appropriately and professionally, and isn't hamstrung by political correctness.
There's also the question of whether the right medications will be available, in sufficient quantities, to keep us alive.
As of Thursday [2022/09/15], the Food and Drug Administration reported 184 drug shortages nationwide. The Association of Health-System Pharmacists put the figure higher, tracking a scarcity of 210 drugs.
U.S. drug shortages may be caused by a host of issues, including manufacturing and quality problems and delays and discontinuations, along with a regulatory system seen by many healthcare providers as more reactive than proactive in making fixes.
It's a long-standing problem worsened by supply chain issues and huge demands during the COVID-19 pandemic, with many drugs languishing on the shortage lists for months or years.
. . .
Hospitals may face more challenges from shortages of fluids or diluents, intravenous oncology and antibiotic medications, "and supportive care, as well as supplies such as needles that are necessary to deliver the medications," Mesfin Tegenu, CEO and chairman of RxParadigm, a Delaware-based pharmacy benefits manager, told UPI in an email.
By contrast, doctors' offices may have more challenges from shortages of drugs dispensed at the pharmacy level, such as cardiovascular and analgesic medications, he said.
. . .
"It's the juggling act on top of severe staffing shortages. I think that's what is making it worse right now. Before it was 'drug shortages on top of COVID.' Now it's 'drug shortages on top of staffing shortages,'" said Erin Fox, senior pharmacy director at University of Utah Health and adjunct professor at the University of Utah College of Pharmacy.
Again, more at the link.
This strikes close to home. I've had two heart attacks, both requiring emergency admission to hospital. In each case, the medications I needed were on hand, and a cardiologist was available within an hour or two, and the ER and cardiac unit staff were able to keep me alive and kicking until corrective procedures could be performed. Today? I have to wonder . . . and that's a scary thought.
Peter
The signs of the collapse are everywhere if one just opens their eyes to see. The plandemic, energy shortages,food shortages,the supply chain breaking down, businesses going under,the health care system in crisis, social order breaking down, rising crime rates, war and the immense divides between the people of this country are all signs of the coming destruction of the America that I grew up in.
ReplyDeleteThere appears that there is nothing that can be done to save this once great republic. The next election will not turn this country around and at best it will buy us a little more time. The root cause of our problems is not political and so our solution is not political. My mind wandered back to the last time I read "The Harbinger" and Chronicles 7:14...
If My people who are called by My name will humble themselves, and pray and seek My face, and turn from their wicked ways, then I will hear from heaven, and will forgive their sin and heal their land.
The choice is up to each and every one of us. It is a time for choosing,choose wisely. May God have mercy on us all.
This is fairly closely related to how staffing crises have been worsened by airlines, train operators and shipowners. There's a trend here. I'm sure there are more, but these are the ones I'm aware of.
ReplyDeleteThe cost of fielding an employee rises as alternative career paths become available for them to consider given all circumstances. As a means of cost containment, companies offer overtime rather than increase staffing. "Running lean" was the term I heard. The cost per man-hour decreases even with overtime- I.e., with a need for 120 man-hours, it is cheaper to use 2 employees with 20 hours of overtime each, rather than pay benefits and salary to 3 employees. The problem is that sort of cost containment has an expiration date. People burn out. In my case, when my company asked me to work overtime a few months ago, I said "I'll do it for double time, if you can't get anyone else at time and half. Otherwise, no. When they agreed, I took the work, and then they changed the job I was told I was going to be doing, to something that I wouldn't have chosen even had they offered double time, lol.
Other transportation-related industries are dealing with the same thing. I don't see health care being all that different. The short=term Covid-related OT strategies have run their course.
fundamentally transform America.
ReplyDeleteI got laid off 3 years ago. The advice I have gotten about job interviews is play the game, tell them what they want to hear. Lying has endemic, and you can't make good decisions without good information. The company for whom I worked it was all about the spin and showing how well things were going. Negative information was never tolerated.
ReplyDeleteLike many blond men, I'm grayer than most men my age. Age discrimination is quite real and a lifetime spent getting skills and experience often means little. Those making hiring decisions are making assumptions about how hard I can work based on my hair color. So I've gone into business for myself and set my own hours.
So our current business climate is based on lies, assumptions and ignoring experience. (I've worked a number of part time jobs since, these trends are my experience with EVERY employer) Add to these low wages (Take CPI calculator to min wage in 1970) and high inflation and why should employees care? They are getting lied to and screwed by employers and government alike. Even if recent high school graduates can't articulate it they feel it.
The question is - What will we make of the great reset? Will we start focusing in on truth, fostering a healthy middle class and paring back government and governmental over reach? Or will we continue our fascination with pronouns and cricket pie?
Good grief. $600-$900 for a 12 hour shift comes out to $50-$75 PER HOUR. Those are damn good wages, even (especially?) for a field requiring a college degree...which what A RN degree is...a 4 year college degree.
ReplyDeletestolen elections have consequences
ReplyDelete@CDH: Yes, but that is for an overtime shift at time and a half. That works out to a base rate of $33 to $50 an hour.
ReplyDeleteContrast that with local wages: The sandwich makers at WaWa and the cashiers at tractor supply are making $18 an hour, and you don't even need to be a high school graduate for those jobs.
$2,500 a day? That's $208/hour for a 12 hour day.
ReplyDeleteIf they work just five twelve hour days a week, that's $12,480 for the week while still getting two days off for R and R. And THAT is $49,920 a month.
And they're complaining?
That cannot continue. And like Vox says, "What cannot continue, will not continue".
They - and us - best be getting ready for the bad times ahead.
Peter, just to add another data point. Here in So. Ill the same thing has happened. I retired in Dec '21 after 40 + years as an RN/CRNA. As you can guess I'm nearly 70. 24 years Army active and reserve. Within weeks I was a patient in the same hospital. The situation is exactly as described if not worse. Lucky for me I have a personal nurse with 40 years of experience as well. Nine months later they cancel all bonuses including physicians. The nearly 100 strong anesthesia group summarily axed and to be replaced by a contract service. It's about to get very ugly.
ReplyDeleteAbide with God. Stay until you go. You are never really ready to Go.
ReplyDeleteWho would have thought a vax mandate, masking mandate, and turning hospitals into Covid death camps by not allowing early treatment, would have an impact on staffing..,
ReplyDeleteCollapse, no. Triage at levels that we haven’t seen since the 70s, maybe WW2, that’s a lot more likely.
ReplyDeleteTRIAGE is what medical people and services do. They don’t collapse, just because they haven’t got the resources to do everything that should or could be done, so they start making decisions regarding who can be saved, who cannot and how to save the most lives for the least cost.
This is almost as close to the bone for me as it is for Peter. My brother is currently in hospital with a heart condition and a laundry-list of complications . He may survive this round, but he will never be healthy. It is only a well-resourced health service that can provide a bed and the level of care that will keep him alive. It hurts like hell, but every thinking adult knows that people die, and that includes the ones that we love.
So , no, the medical system is unlikely to collapse. It is more likely to revert to the levels of care available 50, 70 or more years ago. I was growing up in the 70s. The death rate was higher then than it was under Covid, but we thought that life was pretty good and that the “latest advances” in medical care were something to be excited about. Maybe we need to think about that.
Maybe we also need to think hard about what we are doing to reduce our own risk. Overweight? Type2Diabetic or heading that way? Hypertension? There are things you can do to reduce your risk and rener yourself far less likely to end up needing hospital care. Take responsibility for your own care...
@Bob. That isn't how it works. You only get that money for EXTRA shifts. You work 3 shifts at your normal pay. Then for picking up extra shifts, you get $1000 plus double time for the overtime days. A five day week is a 60 hour work week, which then gets you $7250 for the week.
ReplyDeleteAnd while not mentioned, this will cause the closure of even more 'rural' hospitals... Dammit...
ReplyDelete"Collapse, no. Triage at levels that we haven’t seen since the 70s, maybe WW2, that’s a lot more likely."
ReplyDelete^That, right there.
We use a five-level acuity model.
A 1 is someone dead who we're doing CPR on.
A 2 is a heart attack, a stroke, or an unstable patient, physically or mentally.
A 3 is someone moderate to serious, but stable, requiring multiple interventions (imaging, labs, etc.). This is two thirds of all legit ER patients.
A 4 is someone with a broken bone, needing stitches, or having a simple UTI. Urgent, but not serious.
A 5 is someone with nothing-burger complaints, and/or a total waste of time: headache for 20 years, sore throat, ran out of my meds I've been on for years, my 30-year chronic back hurts, etc.
We're going to start letting the 4s and 5s sit in the lobby for ten or twenty hours, and telling the 5s they either need to go to Urgent Care (which means they have to pay up front - the Horror!!!), or else wait two weeks to see their own doctor on his schedule, rather than misuse the system and come to the ER, unless the place is literally empty. And the 3s that could've solved their own problems are getting short shrift as well. 10th visit this month? Your fault; wait in flourescent light therapy room as punishment for being repeatedly terminally stupid. (Actual Example: woman diagnosed with gallstones six months ago, here for her third abdominal pain flare-up, who arrives with fingers covered in the red residue of a party-sized bag of Flaming Hot Cheetos. I am not making this one up.)
Manlingerers and hypochondriacs are getting kicked to the curb at light speed too. If chronic fatigue, "fibromyalgia", or 20 ER visits for pain meds for your chronic problem are in your history (and we can see every ER visit you've made within 500 miles going back years and years), expect to spend a lot of time in the lobby watching Lifelock infomercials and reruns of Gilligan's Island.
And calling an ambulance for your snivvel complaints and miscellaneous B.S. will just get us to have them dump you in the waiting room, you won't jump the line, and you'll get a $1500 bill copay for unnecessary transport.
COVIDiocy and stupid vaxx mandates cost us half the ICU nurses, and 1/4 of the ER staff, not counting the ones it literally killed or crippled, and they're never coming back.
Hospital manglement (not a typo) was informed by multiple staffers that the troop morale "check engine" light was on two months ago; they don't care, and don't want to hear it. Okay, suture self.
If you don't make time and budget for scheduled maintenance on your car, it will make the time for repairs for you, at three times the cost or more vs. the price of Preventive Maintenance. The same is true of employees, in any job.
Hospital manglement forgets this to their own peril. And patients are about to learn firsthand that "prevention is the best cure". And the Emergency Department is for emergencies. Failure to plan ahead and chronic gross human stupidity are seldom emergent.
Thanks, Aesop.... you said it a lot better than I could.
ReplyDeleteThere’s a certain amount of evidence that the majority of deaths in western medical systems are the result of lifestyle diseases.
ReplyDeleteMaybe with 1950s health systems, we need to adopt 1950s levels of responsibility for our own health.
@Michael Downing
ReplyDelete"If my people who are called by My name ...". Amen! I've been trying to tell people that for a while. It's good to hear it from somebody else. I hope to see you on the other side.
God bless.
-Outlier
@ Aesop
ReplyDeleteI'd laugh if it didn't hurt so much, very happy to be retired in the sunny climes.
very old DDS who over my career has worked/taught at three hospitals and two schools in NYC
And all this is happening because the people at the top decided to wreck a system they judged too white, too heterosexual, too capitalist,…
ReplyDeleteI'm an RN at a new, 200-bed hospital in Illinois. My experience matches the writer's. Large overtime pay, regular pay with 'raises' that are lower than inflation, even before the recent years. The big overtime dollars recently went away, and one by one the traveler nurses are leaving as their contracts dry up.
ReplyDeleteI have no idea what our glorious leaders plan for the future. They are telling ICU to expect 4 patients per RN. Normal load for a level 1 ICU is 1-2, with 3 on the occasional bad night. 4 patients per ICU nurse is asking for lots of missed care and unnecessary death. We have one whole floor unused for the last year because there are simply not enough RNs to staff that unit. New staff leave as soon as they are out of training, since RNs are in such demand they can go anywhere and make better money.