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  • #16
    Originally posted by CordMcNally View Post

    Are you actually asking how or are you asking that because you don't think it's true? Physician lobbying power is weak because physicians are generally weak as a group. The nursing lobby has more pull because they aren't weak. Case in point: remember during the first wave of COVID in New York when nurses were getting paid 4-5x their normal rates to go work there while physicians were being asked to volunteer? Everybody knows we're softer than nurses.
    I actually think inflation plus staffing costs Is going to translate in more hospitals coming at physician pay.

    that seems to be the trend in my region (despite record revenues)..

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    • #17
      Easy fix: pay nurses better and maintain safe nurse to patient ratios. 1:6. 1:7, 1:8 is not safe and terrible for healthcare.

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      • #18
        It is a real problem. We can barely get applicants for our RN positions. We try to shift some nursing duties to MAs but we are way down in MA staffing. We gave everyone in the company a raise a couple of months ago as a retention play. We are struggling to hire schedulers. Etc.

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        • #19
          There are enough RNs to fill the openings but they don't want the work. Unlike medicine, many people do the education, work in the field for a while and leave. Raising salaries and improving working conditions would help a lot.

          Like everywhere else, we are desperately short of RNs. We have long tried to use people with less education and fewer skills to do things that do not require RNs. Nurse extenders are as important as physician extenders.

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          • #20
            I'm honestly not aware of an industry that isn't short-staffed. I don't know where all the workers went.

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            • #21
              Chart and table of U.S. population from 1950 to 2022. United Nations projections are also included through the year 2100.
              • The current population of U.S. in 2022 is 334,805,269, a 0.57% increase from 2021.
              • The population of U.S. in 2021 was 332,915,073, a 0.58% increase from 2020.
              • The population of U.S. in 2020 was 331,002,651, a 0.59% increase from 2019.
              • The population of U.S. in 2019 was 329,064,917, a 0.6% increase from 2018.
              Unemployment refers to the share of the labor force that is without work but available for and seeking employment.
              • U.S. unemployment rate for 2020 was 8.31%, a 4.64% increase from 2019.
              • U.S. unemployment rate for 2019 was 3.67%, a 0.23% decline from 2018.
              • U.S. unemployment rate for 2018 was 3.90%, a 0.46% decline from 2017.
              • U.S. unemployment rate for 2017 was 4.36%, a 0.51% decline from 2016.
              https://usafacts.org/state-of-the-un...47657bc95f9e40
              Labor for participation rates are down 1.2%

              Population increases but labor force Participation decreases and higher unemployment for those seeking jobs.
              To be honest, the data is suspect. Demographics are probably an impact but the estimates for population and employment and participation are estimates. Birth and deaths are used but the immigration numbers are about 2m new residents as well.

              More people and fewer working. Short answer.
              I'll leave it to the "experts" to explain what is happening, why and the actual cause. Too much political messaging.

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              • #22
                Originally posted by CordMcNally View Post
                I'm honestly not aware of an industry that isn't short-staffed. I don't know where all the workers went.
                From what I recall in listening to some podcast (Indicator?) the two most widely accepted explanations for all of the open jobs (and why no one wants them) are more workers getting pushed into retirement and a drop in net international migration secondary to COVID. I don’t think all the checks from the federal government has helped.

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                • #23
                  Originally posted by Lithium View Post

                  From what I recall in listening to some podcast (Indicator?) the two most widely accepted explanations for all of the open jobs (and why no one wants them) are more workers getting pushed into retirement and a drop in net international migration secondary to COVID. I don’t think all the checks from the federal government has helped.
                  I wonder what's pushing the workers into retirement? It seems like a majority of service industry jobs are younger people. I don't think they've taken the jobs vacated by people pushed into retirement. I don't know...not much makes sense these days.

                  Edit: Looking at some immigration data it looks like immigration went down in 2020 but rebounded to the point that at the end of 2021 there were more foreign-born people in the US than ever before.

                  Immigrant Population Hits Record 46.2 Million in November 2021 (cis.org)

                  It seems that 'Southern Border Encounters' are much higher now than they were recently.

                  I'm too lazy to compile all the data and wouldn't really know if I trust myself to analyze it correctly.

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                  • #24
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                    This graph kind of explains it all. If you look at the percentage of people 20-65 (working age), now being expected to provide services for a much larger percentage of people 65 and older and not having enough kids to replenish the population, you can see why this is a pre-covid and post-covid problem. Those over 65 need more healthcare resources then other demographics and there simply aren't enough workers to take care of them. I think most developed countries are going through this, but I think we used to have a more robust immigration system to help fill in the gaps. Even amongst the working age population, the number of those on disability has skyrocketed
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                    Claiming mandatory patient/nursing ratios and higher pay will "fix" the nursing shortage is nursing lobby propaganda. There simply aren't enough nurses or working age people to take care of everyone and it's only going to worse. Mandating a patient:nurse ratio would only exacerbate the problem. Airlines can cut flights and raise prices when they cannot staff flights. Hospitals can't raise prices or deny services when they can't staff for adequate care.

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                    • #25
                      Originally posted by CordMcNally View Post

                      I wonder what's pushing the workers into retirement? It seems like a majority of service industry jobs are younger people. I don't think they've taken the jobs vacated by people pushed into retirement. I don't know...not much makes sense these days.
                      I don’t have all the answers obviously, but I think there’s been a significant increase in teachers, nurses, veterinarians, police officers who have been pushed to their limit and punched out earlier than they would have had there been no pandemic.

                      Then in the low wage fields, you always have a lot of turnover among teenagers and college students. Before I went to medical school I never made more than $8 an hour. I don’t think much has changed to slow the outflow, but the inflow into the low wage jobs has been restricted. US birth rates have been declining for the last generation, which is leading to drops in university enrollments.

                      So I guess if you’re 18 and on the academic margin, you have a choice between working in a call center for $12-$15 an hour or perhaps taking orders for Chalupas and wearing a mask all day, or you can go to a college. Student loan interest is deferred for the foreseeable future and then forgiveness is an option. Admissions committees need to fill their class, and I’ve read that because many schools are 60% female they are relaxing standards even more for males. I know which option I’d choose.

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                      • #26
                        "Hospitals can't raise prices or deny services when they can't staff for adequate care."
                        Actually, this is debatable. Many "underserved" areas are actually due to care being unavailable and in rural areas the healthcare is nonexistent. No hospital, no doctor, no problem. ER's get full and patients wait. Electives get cancelled. But the definition of "elective" basically means care might be available, but no vacancy. Service is not denied, it is just not provided. If you don't think that is true, just look at the VA backlog fiasco and ER's having long wait times and only the most critical situations get treatment. Doctors not accepting new patients is common. Long wait times for appointments. The healthcare system knows exactly how to deny care.

                        https://www.linkedin.com/pulse/facto...tal%20closures.

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                        • #27
                          CNA can be made to act like RN too , What functions can RN Perform which they cannot?

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                          • #28
                            1. Secondary to covid the job description changed for the worse. This was not offset by pay increase
                            2. This created short staffing which made #1 worse and snowballed
                            3. Homelife: many spouses of nurses or retirement accounts of nurses received increased pay secondary to the covid market allowing people to just simply quit/retire
                            4. Homelife: headache associated with keeping kids out of day care or school with exposures and in person changing to remote constantly made work/life stress not worth it
                            5. All while RN is viewed by many as no longer a career but a stepping stone to NP, CNA, ect...


                            Solution reduce covid induced headaches at work/home and increase pay.

                            i.e Make it more beneficial to work as nurse than not. It's not just a pay issue

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                            • #29
                              I also see many of the new nurses, not wanting to take full time jobs locally, they are bouncing around doing travel nursing, and going to where ever is going to pay them the most. Others quit the local hospital system (we have two) , sign up for agency and just go to whom ever pays the best.

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                              • #30
                                That is called "capitalism".

                                If you raise their pay for holding hospital jobs, then they will come back from the agencies.

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