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

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  • Tim
    replied
    "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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  • Lithium
    replied
    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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  • nephron
    replied
    Click image for larger version

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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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  • CordMcNally
    replied
    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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  • Lithium
    replied
    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.

    Leave a comment:


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

    Leave a comment:


  • afan
    replied
    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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  • Notsobad
    replied
    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.

    Leave a comment:


  • RocketBooster
    replied
    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.

    Leave a comment:


  • Sundance
    replied
    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)..

    Leave a comment:


  • CordMcNally
    replied
    Originally posted by nastle View Post

    How is the nursing lobby more powerful than doctor lobby ?
    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.

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  • Otolith
    replied
    Currently the head ache factor associated with working as a nurse is not worth the pay

    Anything that fixes the above statement wins...

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  • Tim
    replied
    This will fall flat or raise contempt.
    Computers and tech.
    Why? Computers are so much faster than any humans. Computers have created a productivity circular process that creates imbalances. An imbalance creates an opportunity to exploit the imbalance for the benefit of one and the detriment of another.

    Education in general:
    High school education at one point had value.
    Bachelors degree at one point had value.
    Masters degree at one point had value.
    Doctoral degree at one point had value.
    Well, a pen and paper, reading a text book, a university needed an infrastructure and multiple colleges to do “research”, prestige! And large specialized hard copy libraries. State governments and federal governments funded “needs” for “progress”. What was needed once computers came into existence?
    A data center, data entry “clerks”, keypunching skills, compilers for program debugging, computer programmers, systems analysts, computer operators, larger high volume printers.
    The infrastructure was the gating point. The “teacher” had subject knowledge and guided students through the process of acquiring skills and knowledge. Supercomputers were rare.

    A product to be sold? Take away the infrastructure requirements and opportunities exist. State U was actually a two path choice. A&M (agriculture and mechanics) land and improvements (engineering) and all others (business, sciences, liberal arts, education).
    NP is a small subset. The learning process is much more intuitive and the infrastructure is minimal.
    A BSN vs a NP is the same as MS students no longer needing to attend lectures in person or spend hours in a library to have access to hard copy material needed to learn.
    I have never heard a physician ask, should I get a bachelor of business degree?
    Why would a nurse want a bachelors of nursing?
    No longer really needed because the more valuable certifications and education are available with minimal infrastructure. And the university systems have a product to sell cheaply. A universities status is determined by the graduate programs and research. Not teaching lowly undergraduates. Computers and tech have made it possible, no longer need large infrastructure nor undergraduate degrees. Many have asked, is a college degree worth it? Most engineering and accounting programs are designed now for a master’s degree path. It doesn’t take much to add on a year of classes.
    If NP training required infrastructure and libraries and in person classes, you would see many less NP’s. Computers and tech made it easy.

    Just a note: our society is struggling with regulation of changes caused because computers and technology are so much faster than human capacity and how it can exploit. Crypto is an example. $5billon theft, but infrastructure to benefit from the theft was a problem. The regulations make it difficult to prosecute.
    https://www.newyorker.com/business/c...en-bitcoin/amp
    Society as a whole is being disrupted. Tremendous benefits, but it changes the incentives.




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