Not providence but I was at a different ER in the area today and it was terrifying how obviously understaffed they were and how burnt out the staff that was there was. Everything was in disarray, waited hours, they missed absolutely critical medical information that I told to three different people, etc etc. Our healthcare system is truly fucked and it’s pretty scary to see it up close when you need help. We have got to do something.

This may seem odd give the unfortunate circumstances here. Tort reform.

Having worked as an er nurse I know that through-put is complicated. Some things you have to consider are obvious:

1. Not enough staff: nurses, doctors, techs, radiology support.

2. No inpatient beds: the doctor has ordered the patient be admitted for treatment, though the hospital has no beds available—possibly physically occupied or no staff to work them.

3. Shotgun workups: due to no tort reforms (the doc doesn’t want to get sued for missing something). So the provider may feel more inclined to order likely unnecessary and burdensome labs, imaging, and other tests (all the tests have so many compounding time wasting variables, think about backlog for imaging, labs, transporters, staff to carry out lab draws, etc). Yes! The provider shouldn’t act with negligence and should know their stuff! But the fact medical malpractice insurance costs a fortune, and they have to protect themselves and their livelihood. Tort reform would help ease the fear of lawsuits.

4. No primary care: patients that don’t need life saving treatment visit the ER for seasonal cough and cold, stomach aches, etc. The law (EMTALA) requires the ER sees the patient and provides care.

5. Psych patients and drugs: no treatment facilities, patients backlog in the ER and don’t receive any treatment that will ultimately help them get well while they wait hours to days (sometimes sedated or strapped down) for the right treatment.

Side rant on this one: you think safe injection sites enable? This is where they help! They pass out clean needles (preventing infection and abscesses that result in er visits for treatment and usually discharge). Added benefit for having connection to social services and getting patients the right care (maybe not every patient, or the first time, but some do end up seeking treatment).

I’m probably missing something. But I feel a big one is tort reform. If providers didn’t feel obligated to order every test under the sun to avoid a lawsuit they wouldn’t.

Wonder how it photographs in the winter. Does it freeze over?

Exactly. This is what my family members have told me.

I know some health care workers who quit the industry because of harassment over asking patients to wear a mask during peak Covid. I don't know if that contributed a lot to being understaffed overall, but it's stupid that patients and visitors did not want to comply to a very simple request and instead verbally and physically harassed workers.

Ya travelers often aren’t ready to work from day 1 need an orientation period at no fault of their own, they are just new to a job. It is frustrating when the person needing to be trained makes 3x the trainer and more than the provider writing the orders tho. Gets old fast for the permanent staff who either can’t travel (life, kids, house, etc) or like their job. Traveling needs to end as it drains the budgets and perpetuates…. More traveling and lower and lower morale at work.

Interesting, thanks.

I was asking a real question. I kind of guess that there were cheaper, more local options, but wasn't sure.

Yeah. School for these positions is pretty cheap. At least I know my self-described trailer trash ex's mom went into nursing on the cheap without leaving that cheap town.

I don't care, I just like you.

Private hospitals like Providence will never “do the right thing” on their own. They need to be regulated far more aggressively.

Fact on facts

Yeah OK, I should have put another question mark.

The point still stands, I think, at least sometimes.

I'm not sure on specifics, so maybe I'm wrong and it doesn't stand! I can admit that I'm wrong, if so. :)

And overtime exempt salary positions is how you bilk the same people out of tons of overtime pay.

At a minimum wage of $15.74/hour a person would have to work over 26 hours a week in overtime to meet the exempt rate.

$3200/month when you can get an apartment for $1100/month is right about on par.

Oh I agree with you about the management issues. More often than not management, especially middle management, is oblivious to anything that is not staring them directly in the face (and even then that's not always the case).

You can't clue in the clueless.

I agree that it’s not sustainable at all, and until hospital admins start paying their regular staff more, there’s just going to be more travel positions everywhere. Unfortunately most of their heads are up their own asses and they continue to give themselves bonuses while refusing to increase wages. At my last job we got a 4% raise in 2 years (when inflation in one year was 8%) and 2% of the raise was from our union bargaining :(

NACs don't go to nursing school.

Thanks. It a great place to shoot.

Which is your right. And, yes, I am well aware of the use of travelers. That doesn't change the financial impact on the medical in system. It still isn't sustainable.

Every single hospital system in the area uses travel RNs, and I myself do local travel. If we’re going to be understaffed and overworked wherever we go (and still in a pandemic), I’m not going to pick a job that’s $39 vs $69/hour

There are those staff members who have family and therefore cannot travel. You can't do that if you have kids and a partner who also works.

> make over $20/hour.

Well since the minimum wage is over 19 in parts of the state, 20 or so is pretty sad.

> Not only that, paying them so much more is draining the budgets of hospital departments.

I agree, it's not ideal. But it's a very not ideal situation that the hospitals are 100% responsible for. I would be fine with ending travel nursing if they also ended stupidly low pay caps. But I don't know why there are any nurses who aren't travel nurses at this point. Those are the ones being rewarded by the hospitals.

I have friends who work in the ED at PRMC and it is grim right now… don’t get me wrong it’s bad at almost ever ED but Prov especially is struggling. Their administrators brilliant idea to respond to this event? Make floor nurses cover 7-8 patients instead of 4-5. They are not doing anything to retain their current staff and are having problems getting new staff. I attended a nursing school that was basically a direct pipeline to work at PRMC but after spending all their clinicals at that hospital is it any surprise that the nursing students are now looking at other hospitals in the area for their first job? I know I did. Most of the other hospitals pay better too…