Are these really the people that should be required to work so much? Isn’t their job about handling life and death daily? Wouldn’t we want exactly these people to come fully rested to work every single day and be fully staffed?
I don’t know if there are jobs with similar stakes that are so carelessly staffed and disgustingly paid.
Who’s we? I’m certainly not okay with it
Yea, “we” the people are not okay with it. “We” the profit driven corporate vampires are okay with it because “profits”.
Momentum is hard to overcome and it’s been done this way for many many years
The guy who is largely attributed to making the medical residency system so punishingly difficult in terms of hours was coke addict btw. William Stewart Halsted. That was like 1890 and residents didn’t have their hours limited until 2003 (and even then, barely)
Yeah, I saw that they were “limited” to 80 fucking hours a week (in the US). Quite the limit.
I’m not okay with it but it’s the type of problem that can only be solved by them. They have to go on strike and protest.
In a vacuum, yes. The problem is that when, say, chip fabricators go on strike, orders for microchips don’t get fulfilled on time and the company loses money. When SAG goes on strike for months, movies get delayed, and people usually cheer them on in solidarity. When MEDICAL professionals go on strike en mass, people will die… Quickly, in some cases. People say they support us, and I get a free breakfast once a year at Denny’s during Nurse’s Week, but nobody’s going to cheer on the picket line outside when their dad or grandmother is INSIDE, sitting in their own poop, or not being fed, or having respiratory distress.
You don’t go into nursing for the money or easy work. You don’t even do it because it’s “just a job to pay the bills” because there’s way easier ways to make this little money. You do it to because you’re the kind of person who is more fulfilled by helping a stranger than by helping yourself, and those people are not ok with risking the life and safety of their patients over a shift differential. A LOT of nurses would cross the line to help them anyway, which would negate the whole effort… It sucks, but that’s it.
I’ve been a nurse for about 10 years now after getting out of the military, so I have some perspective on this, but I don’t know what the way forward is without letting a couple of vulnerable people die to catalyze change in the field.
I understand, but you guys are setting yourselves on fire to keep society warm.
In Japan when bus drivers go on strike they don’t stop the buses, but they stop taking bus fare from riders so the company doesn’t get paid. Maybe something involving medical notes so they can’t get billing codes.
That would be the perfect balance, but we’re not the ones taking the money like the bus drivers. Even if we were, they can always send a bill later. Messing with the notes would be falsifying medical records, which is one of the Cardinals sins of healthcare… and is also a crime.
Hey, regarding false medical notes, I’ve got a recently discovered whopper of falsehood. I’m going to keep this vague.
Patient suddenly can’t walk/stand, has very limited sensation in lower limbs. Goes to ER, spinal cord compression protocol clears and they are admitted. Long weekend of no progress. Patient leaves in a wheel chair, almost no change in symptoms.
Years later, they are collecting medical records for new doc and discover the notes from that stay in the hospital saying that all the symptoms spontaneously resolved before discharge. Wtf
Miracled! I wonder why they would lie about it, unless money?
Nurses can and do strike. People support them because organized nurses who can enforce collective decisions provide the best care.
There was just a victory in New York:
https://www.ajmc.com/view/historic-nyc-nursing-strike-ends-with-3-year-contract-wins
I’m aware this has happened a few times, but I don’t fully understand how. I keep meaning to look into it further, but I’ve never seen a detailed explanation of who was caring for people while this was going on. Maybe it’s buried in one of those articles somewhere, but I don’t have time to read through them right now.
We have to vote. They can’t be left alone.
We vote, but it’s not enough.
Do you? Do we? We currently consistently have about 20-50% of the population in Europe voting for far-right to conservative - parties that don’t give 2 shits about medical staff unless they require treatment. And even then, some of them don’t care about them because “do your job and stop whining”.
And that’s just the people that vote. At municipal level the voter participation is abysmal.
It’s the same situation in the US. My own mother votes for the most vile Republicans against our interests because she’s been so stuffed with hate and tribalism from Fox news all she cares about is that dopamine hit from “my team is winning”. No amount of reasoning will overcome that addictive hit of dopamine.
It’s a carefully manufactured propaganda machine funded by people with power we could only dream about reaching out from here to the EU.
Even the youth here in the south vote against their interests because abortion and immigrants bad jesus good. Education has been dismantled and even if they knew what was going on our districts are so gerrymandered it probably wouldn’t matter.
People need to be inoculated against billionaire propoganda, but how do you do that when they control the media and schools?
We’re not going to get anything done done within the system because they control the system. Strikes and violence or extremely disruptive protesting are going to have to happen.
The greatest fear of capitalist administrators is that there might be a slow night in the hospital and a few employees have some down time to take a breath where no “production” is taking place. The shareholders would not be amused. That’s why they staff hospitals with the bare minimum, paying them as little as possible and using them as much as possible.
We’re not. But, just like AI, executives with the ideology of rapists don’t care about our consent.
Who would’ve thought that running every industry and business like mini dictatorships would backfire? Thanks capitalism!
More like the ideology of slave masters, which includes rapists plus oh so much more.
‘How does capitalism keep the unemployed on hand?’ you ask.
Simply by compelling you to work long hours and as hard as possible, so as to produce the greatest amount. All the modern schemes of ‘efficiency’, the Taylor and other systems of ‘economy’ and ‘rationalization’ serve only to squeeze greater profits out of the worker. It is economy in the interest of the employer only. But as concerns you, the worker, this ‘economy’ spells the greatest expenditure of your effort and energy, a fatal waste of your vitality.
It pays the employer to use up and exploit your strength and ability at the highest tension. True, it ruins your health and breaks down your nervous system, makes you a prey to illness and disease (there are even special proletarian diseases), cripples you and brings you to an early grave — but what does your boss care? Are there not thousands of unemployed waiting for your job and ready to take it the moment you are disabled or dead?
That is why it is to the profit of the capitalist to keep an army of unemployed ready at hand. It is part and parcel of the wage system, a necessary and inevitable characteristic of it.
It is in the interest of the people that there should be no unemployed, that all should have an opportunity to work and earn their living; that all should help, each according to his ability and strength, to increase the wealth of the country, so that each should be able to have a greater share of it.
But capitalism is not interested in the welfare of the people. Capitalism, as I have shown before, is interested only in profits. By employing less people and working them long hours larger profits can be made than by giving work to more people at shorter hours. That is why it is to the interest of your employer, for instance, to have 100 people work 10 hours daily rather than to employ 200 at 5 hours. He would need more room for 200 than for 100 persons — a larger factory, more tools and machinery, and so on. That is, he would require a greater investment of capital. The employment of a larger force at less hours would bring less profits, and that is why your boss will not run his factory or shop on such a plan. Which means that a system of profit-making is not compatible with considerations of humanity and the well-being of the workers. On the contrary, the harder and more ‘efficiently’ you work and the longer hours you stay at it, the better for your employer and the greater his profits.
You can therefore see that capitalism is not interested in employing all those who want and are able to work. On the contrary: a minimum of ‘hands’ and a maximum of effort is the principle and the profit of the capitalist system. This is the whole secret of all ‘rationalization’ schemes. And that is why you will find thousands of people in every capitalist country willing and anxious to work, yet unable to get employment. This army of unemployed is a constant threat to your standard of living. They are ready to take your place at lower pay, because necessity compels them to it. That is, of course, very advantageous to the boss: it is a whip in his hands constantly held over you, so you will slave hard for him and ‘behave’ yourself.
from Now and After by Alexander Berkman, Chapter 5: Unemployment. Available to read for free here.
Even in countries where healthcare is socialised, they are run “efficiently” like a capitalist business by administrators who care not for healthcare but for finances, “balancing the books”, and bean counting.
A lot of people have alluded to this already, but I’ll simplify.
“We” are not OK with it. “We” are not the ones making the decisions
Hospitals and such are fine with it because they’re a business now and not as much involved in the health of the public beyond making sure they can still pay them.
This is actually an interesting question.
They experimented with “office hours” for doctors and patients were dying more than double/triple shift.
This because the information lost during handoff was more valuable than doctors being more tired (and by consequence doing more mistakes).
This is a textbook example of the risks of lost context
I’d like to see those numbers. I’m not finding clear numbers on shift-length mortality. This meta review (Systematic Review of the Impact of Physician Work Schedules on Patient Safety with Meta-Analyses of Mortality Risk, 2023, DOI: 10.1016/j.jcjq.2023.06.014 ) says
Limiting all resident physicians to 80-hour work weeks and 28-hour shifts in 2003 was associated with an 11% reduction in mortality (p < 0.001). Limited shift durations and shorter work weeks were also associated with improved patient safety in clinical trials and observational studies not specifically tied to policy changes.
I think we can all agree that a 28 hour shift is fucking insane and that anybody doing such a long shift will not be of sound capacity.
And if hand-offs are killing more people than work hours, then that just means that the hand-off procedures are terrible. I’d want to see what kind of hand-offs are being compared and if hand-off methods have different patient events.
I mean, did they increase staff numbers proportionally to hour reduction or did they just have people go home? Because if it’s the latter, then duh.
I’ve also heard that and it makes sense, but if it’s a statistic already at this point, can’t it serve as a way to improve information storing and handover? I have nothing in common with the medical industry, this is just an outside observation.
I fully agree with this as far as why they do extended shifts of 12 hours or more. But, OP did say double and triple shifts so they might not be just referencing the longer shifts. In that case it is corporate greed.
No we’re not. But generally governments everywhere want to starve the medical industry to make it generate profit for the wealthy. The US is their role model.
Glares at Doug Ford
Glares at Tim Houston
Tries to glare at Tim Hortons but it is not available in my region
I mean they deserve it too…
Right in the Tim bits.
ಠ_ಠ
Honestly, I don’t think it’s even about profit everywhere.
I obviously don’t know what it’s like in Canada, but in my country, we also have socialized healthcare (like Canada), we have a shortage of some specialty doctors because they’re expensive to train and expensive to hire, and many go to other, richer countries instead (Finland in particular, as it’s close by). But nobody works huge amounts of overtime usually. Nurses work double or triple shifts, but mostly overtime is voluntary, and the only reason they work 16 or 24 hours in a row is because of stupid traditions and the slight risk of information going missing with the shift change.
The one upside is that they get a bunch of days off after each shift since you only need 2 shifts a week, and actually get to skip one shift every now and then if you don’t want to do overtime.
they kinda are doing that, by UNDERSTAFFING everywhere, replacing expensive MDs for NP/ or even nurses, and PAs. PAs are useful if they can spend time with your medical history like 30min+, anything less than that they are only slighty better than NP/nurses.
No one does this outside of the USA. It is not at all normal, just like being stuck with the imperial system of measurements.
What are you talking about? I live in Europe and this is standard. I know midwives, nurses, and doctors and they have the worst work schedules. I think in France health workers can even be prohibited from striking. The government declared it an “essential” job and when there aren’t enough workers, striking isn’t allowed. THey are always understaffed, so they aren’t allowed to strike. GReat eh?
En France vous avez des lois qui limitent le maximum des heures travaillés par semaine. Oui dans des cas éxtraordinaire c’est possible de les ignorer, mais c’est une grande difference en comparaison avec les états-unis, où ils travaillent pendant 24h sans pause comme c’est une chôse normal
Not really true. At least in Germany, the health workers are also extremely overworked. From nurses to surgeons. It’s a big problem
Source: family and friends who work there
How many hospital administrators making 7 figures are working 24hr shifts?
In Deutschland gibt es eine gesetzliche wöchentliche Höchstarbeitszeit. Ja die kann in Notfällen undso überschritten werden, aber die Leute arbeiten nicht oft 24h am Stück ohne Pause als wäre das etwas völlig normales
In theory, absolutely. Sadly, not always followed
I’ve worked with surgeons in US and Europe. It is definitely worse in the US but surgical culture is also like this in Europe just to a slightly lesser degree.
It’s deeply rooted in medical / surgical culture and much of it comes from not wanting to pay for more of these highly trained workers when you can just squeeze more out of a smaller cohort. Issues with handoffs for patient care are real with shift type work, but this could be improved if it became more standard.
Gen Z is a bit more concerned about these kinds of issues so some changes may be happening soon, but ultimately this will not likely ever self regulate and only legislative changes would effectively change this culture.
It is simply the law.
For example, in Switzerland, no employee may work more than 45 hours per week in the normal case (there are exceptions). Even if the employee and employer agree to ignore this, the employer will get absolutely rekt by the (mandatory) insurance if anything happens to the employee - even an accident in the employee’s free time.
It’s not the same, but similar, in other European countries.
Surprise! Everybody in the world is stuck with imperial system. Got a car that’s all metric? Wheels and tires are in inches. (Yes metric tires are still using inch rim measurements) Every tool on planet earth weather the sockets are sae or metric? All turned by a 1/4, 3/8ths or 1/2 in ratchet. Clearance too tight on ur bottom end bearings? Measured in thousandths of inch. I could go on, but it is incredible what imperial leftovers there are all over the planet that persist through time!
There’s a not-so-small difference between weird and annoying leftovers in specific areas and going all in with it in everyday life and still teaching it to every child.
Right, I was just highlighting the fact that globally we ARE still stuck with imperial system for shit that gets used daily! I can’t fathom why we haven’t moved to centimeters for rim measurements, and why so much machining is still done in thousandths of inch. There’s also no good excuse as to why every lathe and CNC machine on planet earth has 1/2 in chuck keys instead of 13 mm, why ratchets use a 3/8ths drive instead of 10mm. It’s just instilled from decades of use and nobody does anything about getting away from it in automotive or tooling! I’m sure there’s lots of other weird leftovers in other fields, just naming the ones I work with on a daily basis. At least nobody is producing shit with whitworth standards anymore, although I do occasionally have the misfortune of having to work with that as well.
You know what’s funny? I actually think the situation is a lot better than you’re making it out to be.
You’re not entirely wrong. There absolutely are positions in hospitals where people do insane schedules like 24 or 48 hour shifts. But that’s mostly concentrated around emergency medicine, trauma, surgical residency, ICU coverage, and certain on-call specialties. There’s definitely a culture surrounding ER staff and surgeons where sleep deprivation almost gets treated like some badge of honor.
But the majority of the medical world in America does not operate like that.
Most hospitals primarily run on normal shift structures. Nurses on regular floors and patient wings are usually working standard 8 or 12 hour rotations with multiple shift changes throughout the day just like any other industry. And once you get into private practice, some doctors are only in office a few days a week seeing a relatively small number of patients across different locations.
People also forget hospitals are not run exclusively by doctors and nurses. They’re massive operations with huge amounts of support staff, technicians, imaging departments, transport, administration, custodial staff, billing, labs, and so on, most of whom work completely normal schedules.
So yes, what you’re describing does exist. But I don’t think it’s remotely as universal or apocalyptic as people make it sound. A lot of public perception comes from dramatized media where every hospital is portrayed like a nonstop trauma center operating at DEFCON 1 twenty-four hours a day.
Of course not. People take naps when it dies down in open rooms.
Iirc, here in the UK it’s illegal to ask a doctor or nurse to work s triple shift. I think it should be for doubles as well, excepting major emergencies which involve a sudden influx of patients
A double shift is 24 hours. Medical shifts are 12 hours.
Yikes. Might be needed in some surgeries though
Neurosurgery can be 14 hours or more, and in that time, no breaks, lunch or peeing. All in one small room.
That’s insane. I’d have to get a wine hat and some kind of piss jug rigged up.
Catheter condom. Also handy for road trips.
my gf is a nurse and it is absolutely bonkers how the healthcare system works at all, shit is very run down and society as a whole needs a lot of shifting for how taxation affects the health care system. tax the fucking rich and make them pay their fair share and siphon that into healthcare.
gop states are poorly funded i assume, since they have on or few large hospitals that accomadate your needs
Because the alternative is the rich paying more in taxes, and we can’t have that obviously.
Not really.
Universal healthcare could be more than paid for just with what we pay in insurance.
It’s still money, but in this case it’s that profit healthcare is tied to employment causing employers across all industries to want less employees, which means a lot of overtime.
The real solution was shortening the work week to spread the labor around while keeping salaries high.
That seems very US specific. In Europe, we have universal healthcare, but it’s chronically underfunded.
sounds like a billionaire problem
It damn well is, no doubt about it.
always is. Universal healthcare is a reality. We just have a billionaire problem
I don’t understand why people aren’t voting for the uber-rich to pay their fair share. Billionaires pay less tax percentage-wise than any worker out there and it’s all because we focus so much on income tax. The uberrich don’t have income - the have wealth, which isn’t taxed.
Mods, jail.
the rich hospital admins, they skimp out on hiring more mds to rotate the burnouts.
You know, healthcare jobs are the only ones I see “advertised” here in the Southwest. There are billboards for all sorts of medical careers. I’ve had friends and acquaintances talk about being a nurse as a backup career plan.
Nursing is a career path where you cannot rise to the top ranks. Nurses cannot ever rise above doctors, because the next step up is a doctor. The repeat clients in a hospital setting in the southwest are drug addicts or psych patients. The “average” person going to the hospital is going there with something severe. Not to say that everyone doesn’t deserve care, but know your patient base. Nurses are strapped in the entire shift, and being late from lunch is like being late to work. It’s incredibly stressful, and there are studies that essentially show that nurses are worked to the mental and physical limit in their lifetime.
Nurses are treated like shit, and there’s a steady stream of them leaving the profession or moving into admin positions where they’ll settle in; you’re way better off in every way to just aspire to the admin jobs with a master’s of public health. Tell your friends. You’re welcome.
Nurses can absolutely advance careers.
Either through more training to become a professional in a specific topic (or expanding to freelancing on the side) or going into a more administrative part of the hospital like schedules, ordering etc.
But medically speaking, you are right. Only as far as you can until you need to study humane medicine.i think its because GOP constantly attack healthcare funding, or it scares away potential health employees from working in those states, thats why they dont go to the red states, plus, they are now so desperate they are willing to pay MDs and some nurses to work there some bank apparently. i dont think they care about getting promotions, if thier COL is met, in many places they are making bank from just working shifts in the region(travelling nurses). i notice obesity related clinics(surgeries, do make bank there because the south is so overweight). seems healthcare quality in the south is quite lacking in non-affluent or blue areas.
My personal take is that since doctors are all paid commensurate with the cost of housing, they can go literally anywhere they want.
I’ve noticed over the years that here in AZ, many doctors here long term are centrist politically, unless they’re working for an aid organization like the AIDS foundation or a clinic that caters to the “needy”. Those that live here, want to live here. That said, the ones that aren’t in love with AZ dip out with no warning lol. Me personally, I’d move to Cali with zero hesitation. When abortion was momentarily made illegal here a few years ago, doctors just fucking left, mine included lol.
Nursing can advance quite a bit. A nurse can become a nurse practitioner, for instance. NPs can even open their own practice in some places. Or get a DNP, become a doctor nurse. Sure that pushes one more towards the admin side, but that doesn’t mean it’s removed from the world of nursing either.
But I guess one could say the same about being a physician as well. Where is there to go? It’s not really about advancing positions, but just doing more stuff that gets you paid more. Whether that be research/education/administration/specializing/whatever else.
How is nursing a backup? Are the requirements that low in the US (I’m assuming “Southwest” is in the US?)
No, the requirements aren’t that low. But there are levels of nursing. Each requiring different levels of education and licensing. From LPN, Licensed Practical Nurse the entry level that takes about a year, to RN, Registered Nurse, can take 2 to 4 years. A 4 year BS degree is a degreed RN. Then you can continue to other licensing degrees like RN-P, Registered Nurse Practitioner-- with a limited doctor scope of medicine to take the pressure off of General Practitioner doctors. And a host of specialties nurses can go into. With median wages around $90,000US. And easy opportunities to earn well over $100,00US per year.
Much of the staffing issues centers around many nurses wanting to only work 20 to 25 hours a week. I have a friend that was head of a nursing department in a hospital for many years, and she was always complaining that she couldn’t get nurses to work more than 30 hours a week. And most refused to work more than 25 hours.
With how hard nurses work, I wouldn’t work more than 30 either lol. I’m willing to bet they’re doing 3 10s, some overnight.
Nurses don’t need much training for the lower tiers (e.g. bed pushers).
Or you can change careers and need to do training but the barrier to entry is IMO way lower than say business analyst where you need to know economy topics.
Diagnostics do doctors, medicine orders do doctors. What do nurses do that arent ordered/instructed by doctors beforehand? And what about it can’t be learned a few months in advance?
