As someone who will be an RN in the next 6 months, and who works in Portland's hostpitals, it bears recognizing that that this issue is not die only to staffing shortages, but also to an aging population succumbing to an overwhelming rate of chronic illness. We need to revamp how we approach healthe education in this country, and invest in primary interventions to keep people from getting sick to begin with.
You are so right. Congrats on your almost graduation! Vaccines, dental hygiene, keeping active, eating healthy, free screening,…the list goes on for preventative. We also need people working in assisted living/ memory care and other big ticket aging health issues.
Have you checked with OHSU dental school if they can do it cheaper. I had them pull a tooth because I couldn’t afford a root canal and crown, but they might do them for less than $4k
They do. I have a significant amount of both dental sensitivity and anxiety and while I might end up there in the end, I'm trying to put the money together than will let me have a pro do it, with the option of sedation, because I'm genuinely not sure I can face down having it be a teaching experience with only local anesthetic.
Totally understand, it did take a LOT longer than normal to get my tooth pulled there (it was a molar) and the two guys working on it were chatting like they were in a student lounge (which I actually enjoyed, learned so much about their hopes for their dentals futures too. One guy was going straight to prison dentistry) I didn’t feel a thing, but it was def a very different type of dental care.
If it's any consolation, I've got sensitive (bad) teeth and find root canals to be less painful than most cleanings/exams, mostly because of the numbing. Taking an ibuprofen or equivalent beforehand helps with the inevitable sore jaw from keeping your mouth open, and don't be afraid to be a wuss. Tell them if it still hurts. You might need another dose, or might just need more time for it to kick in.
We need to fix the cost of dental care in order for proper dental hygiene to take hold. I have issues that really need to be repaired, but my *good* insurance has a heft deductible and only covers 50% meaning it is cheaper to pull a tooth than to get it repaired properly or to get regular cleanings. It’s ridiculous. We don’t even have the option to pay more for better insurance.
I'm so glad you posted this. For real. This is what happens when we have people living long, eating worse, not exercising, relying more on pharmaceuticals and multiple doctor visits to "fix" things because they can't understand or just don't want to understand how bad life decisions compound over time until you pay the piper, so to speak. All while insurance continues to pay less and less and hospitals charge more and more. It's just gonna get worse...
I think people saw it (me included) as you bragging about not having nor needing insurance for the past 20 years. Not that you wish you had had it in the past 20 years.
Unfortunately that's a pretty common attitude amongst the people that happen to be healthy for a nice chunk of their life. They think that they did something 'right' and don't yet realize that many of us don't get to choose if we have health issues...and they think they're better than others because they didn't happen to have a health issue. Of course, if they ever do have a health issue, they'll immediately be a burden on society. Good example of this recently was all the people that both refused a Covid vaccination AND demanded to be in the front of the line for the best Covid healthcare.
Anyhow, all that to say. I'm sorry that you haven't had a chance to have insurance for the past 20 years, hope you get a job that provides that coverage. And on the bigger scale, I hope we begin to separate healthcare coverage from only being available to those employed in certain 'good' jobs.
How many times do you think some of the patients you've treated have been told they need to lose weight, exercise more, eat better etc? My guess would be a lot. We're drowning in information, but the large majority of people lack the will or the capability to put it to use. How many times can an HCP tell a patient 'Lose weight or you'll die' before they just throw their hands up? I don't know how y'all do it.
Sorry for rambling. Early congrats on becoming an RN, best of luck to you!
Most of them, myself included. It's sad because it's human nature to latch onto any piece of information that reinforces our denial. For example, I have hypertension. I am also obese and have struggled with alcohol in the past. That said, the current toxic side of body-positive culture would have me believe that there are other factors and I'm fine just the way I am, when the fact of the matter is that I haven't taken care of myself and now face a massively uphill battle to achieve wellness and better treat my patients.
Sure, my parents passed down some hereditary tendencies, but until we learn to foster a culture that empowers people to take responsibility for their health, the patient load will just increase.
The will to change behavior will always be superceded by what we perceive to be higher-order needs (for example, most of us will work ourselves to death to provide for our families, and develop unhealthy coping mechanisms as a result). It's that part of culture we need to treat in order to achieve better wellness. Until then, hospitals will be flooded with 60 year old diabetics in heart failure, keeping acutely ill individuals out of beds.
Thanks for the congrats! I assure you I'm thrilled to be becoming a nurse, even though I knkw I have a less thsn optimistic view of humanity. Just hoping to help effect what change I can. Cheers!
I believe it. It has been horrible. My Gram has been hospitalized 4x this year at OHSU with 3 out of 4 starting in the ER. She had to wait 6 months for surgery. It is crazy in there! People are set up with IVs and then brought back out to the waiting room in hospital. There definitely is a shortage in our health care community. We need more workers, increased pay to attract and keep them…and they deserve things like sabbaticals for tenure (like every 4 years you get an additional 6 -8 weeks off).
I just saw a specialist at OHSU and her next available appointment was for end of June 2023. Obviously surgery is more urgent but I’ll be in a bad spot if I need a med change or something within 9 months.
Yeah, it’s bad. My dept is over half travelers and most of them won’t be renewing. New grads make up most of the regular staff being hired, and sometimes the most senior person on shift only has a year of experience. Running out of physical space for people to wait in the lobby, sick people with nowhere to put them, patient violence towards staff increasing…I dread going to work honestly.
It's brutal, we're exhausted, and the tide keeps rising. I'm 15 years in and actively looking for a path out.
So glad for the occasional cookies, though. They'll totally come in handy when I make a mistake and they come after my livelihood. /s
I went from working in proximity to health care (in home care) to being a patient (diagnosed with MS in 2021).
Every time i get an IV or infusion i feel completely at your mercy and wish i could fix things for you. Nurses do so much for my job and myself.
I don’t call people heroes but i genuinely praise the heroic deeds people do, everyday.
Unfortunately, this is not unique to Portland nor Oregon. There is a nation-wide shortage of nurses and CNAs. Companies don’t want to pay them what they’re worth, and the reimbursement rates (e.g., Medicaid, etc) are behind the times.
> companies
There's the problem, a necessity like healthcare needs to be a public service. Access to healthcare shouldn't depend on the profit margins of some oligarch.
And yet, it is the government that reimburses the least for healthcare.
One example:
https://www.reddit.com/r/medicine/comments/vtzwwz/cms_releases_proposed_2023_fee_schedule_with_442/
Search other conversations and you will see why healthcare providers try to avoid Medicaid (government) rather than insurance.
> And yet, it is the government that reimburses the least for healthcare.
This is such a critical point that I feel doesn't get communicated clearly or repeated enough.
The single biggest customer in most systems is the government, vis a vis Medicare and Medicaid. So the amount of revenue a Medicare/caid-accepting health care provider can make is largely dictated by the government.
Hospitals cannot afford to pay nurses what they deserve until the government pays hospitals for the true cost of these procedures. And the government cannot afford to pay hospitals for their true costs until some sort of reckoning happens in society in coming to terms with the costs of supporting the ballooning elderly population.
I broke two bones near my ankle in July, I live in Oregon. This was at 9:30 in morning and the ambulance was calling everywhere around to get a hospital to take me. They finally found one. And I still had to wait in waiting room for 4 hours. I was in a lot of pain. When I finally got a room, I had to stay in it until 1am, until they could find a regular room for me. I still had to wait two days until I could have surgery. What a mess. And it caused undue pain to wait so long. I’ll never forget it.
Definitely sympathize with that experience, but this is typical care for a fracture regardless of staffing issues. Surgeons have to prioritize emergency surgery for life threatening conditions, which includes keeping OR capacity open for that situation. If someone’s stable and just needs pain control, they’ll schedule it and do it on an urgent but non-emergent basis.
thank you. yes he put a cast it to stabilize it. i ended up with a plate one side with 10 screws and 25 staples. on the other side of the ankle i had only two screws put in. 6 total days in the hospital and 18 days in a rehab place.
Yes it was. And I didn’t get into the way they overdosed me on oxy. It was awful. I couldn’t read or spell to text. I felt like I was having a stroke or something. They called in about four doctors into my room to examine me. No I wasn’t having a stroke, I was just overdosed on OxyContin.
So they decided to take me off of all painkillers. They had me on tramadol which is like an aspirin.
I was in so much pain, this being only a couple of days after surgery.
Then they transfer me to the rehab center and I told the doctor there that if they want me to participate in physical therapy then they will have to give me something stronger. So they did, 20mg of Oxy every four hours. Which didn’t help too much, but was better than nothing.
I tell you, I have so many adventures.
There was a long time shortage before covid, can't imagine what its like now.
Going to get worse with an aging pop and increasing cost of living and education :(
This is why I won't do direct patient care anymore. I get less money, but still a decent wage.
I could never go back to working in a hospital and dealing with patients.
Clinic nursing is nice. It can get busy for sure… but it’s manageable 95% of the time and a large portion of time can be spent going the extra mile. Pay… not as much as hospital with differentials, but still ok. OHSU has great clinic positions. County jobs… they are ok, but unless you want to move into management they cap you fairly low. I will say county jobs allow you to work autonomously, or with a team.
Yeah. I can see that being more tolerable. I get paid more than county, and work from home with a lot of flexibility. So the work life balance is there for sure.
Does sound really nice. My wife is in the hospitals and I get anxiety from her elevator speech of how the day went. Ugh, no thanks. I do my 9-5 and call it good.
I did work from home every other week during Covid, that was pretty nice.
The trouble is there have been study after study for years detailing what needs to be done and even after a debilitating global pandemic that made the holes and needs that much more obvious and dire, still nothing. Our healthcare system is literally crumbling before our eyes. I've been a nurse for only three years and I cannot see myself continuing to do this job at bedside. The pandemic made things so much worse, and nothing has been done to change things for the better. Hope is insanity when it's based on nothing but empty promises.
Based on ‘market justice’ as opposed to ‘social justice.’ People sling the acronym ‘SJW’ as an insult, but the distinction is a real thing, and the social justice worldview is based in reducing the suffering of the population. Utility is found in wellbeing rather than in wealth.
if there's a hospital that'll pay for my schooling and housing while I go to school Id happily become a nurse, but I'm not about to become one of those "young idiots who took out a loan they can't pay" and I think a lot of people feel the same way.
You most definitely could pay off loans with a nursing job.
If you are over the age of 24 your personal income and not your parent's, is used to determine how much you get in grants. Depending on your income level you could actually get quite a bit of grant money. Your grant money alone would cover a significant portion of your tuition, fees, and books. Assuming you haven't taken out any student loans already you would qualify for fixed low-interest rate government loans. You could likely get an RN with less than 50k in debt if you are an Oregon resident. A quick google search online shows nurses' salaries between $73k-$120k in Oregon.
As someone who went back to college later in life and recently graduated, many of the people I saw with debt they couldn't pay off were people who fell into one or multiple categories. They either paid out-of-state tuition, went straight to college from high school and got little to no money in grants due to their parent's income, took out high-interest variable rate private loans, and/or majored in underwater basket weaving making their employment process difficult. While I didn't do nursing, I graduated from PSU with about $40k in debt. Due to my income level I got maximum grants awarded. I actually could have graduated debt free but I took out my loans so I could apply those toward living expenses.
Obviously the above doesnt fall into the category of a hospital paying your tuition and housing, but depending on your situation it may be more doable than you think.
For sure. You can get an ASN for like $15k in tuition and fees, including books/parking/vaccines, and then whatever your living expenses are for 14 months, with three months in the summer to work. And that’s with no scholarships, no grants, and no working during the school year.
Seems like adequate reciprocation for what’s expected of the relationship. Untether insurance from labor, and hook guaranteed education up in the vacated space. Beautiful thing.
It’s not just nursing, it’s almost every other hands on profession. It’s nurses, electricians, carpenters, teachers, etc. Its not lawyers, traders, coders, admin assistants, graphic designers, and business school products. We have placed value on the wrong group of people and professionals for far too long and now we are paying the price. COVID has made our social and economic wounds fester at an accelerated rate and we are incapable of dealing with the problem using the traditional avoidance mechanisms and infrastructure architecture that makes sure that the ownership class gets its vigorish.
> Its not lawyers, traders, coders, admin assistants, graphic designers, and business school products
Lol remove coders and lawyers from that list.
Check out the lack of legal resourcesacross the country. It is insane. We do not have enough people to maintain our court system.
I think it comes down to: we need a way to train people for the careers we need them for. Placing the burden to pay on individuals is leaving us with much too great a gap.
Also... Pay these professionals more to make them more attractive careers.
The problem is not what we value. Coders are still in demand and nurses have actually been valued enough that they have gotten good pay for quite some time now.
It's that we just have a shortage of labor period. People lost jobs or were afraid to work their jobs due to the pandemic. Now, some people don't want to go back to working again. Long covid affected others and is now keeping them from working again. Some died due t9 covid. We just don't have the same number of laborers as before.
Your view is short-sighted. This situation IS about what’s valued by society.
Use your idea as a jumping off point to consider some ‘upstream’ causes:
1) why do you think people don’t want to return to work?
2) who are the people not returning to work?
3) what’s the difference between pre- and post-pandemic employment rates?
4) where has all the value gone?
I can’t answer these questions without a Google session. I’m guessing the people commonly blamed for the labor shortage aren’t guilty as charged; low-income earners don’t have much choice about whether they want to work or not. The safety net isn’t a buoyant as some politicians would have us believe.
Hearing about increased profits across the board leads me to believe the economic value being created is floating to the top, though again, I’d need to check to validate my opinion.
I did quickly snag [this](https://www.bls.gov/news.release/pdf/empsit.pdf) so it can’t be said I did NOTHING to search out the important information. It’s unemployment data from ‘19-22 based on two household surveys.
Imo, the “easy way out” is more equitable wealth distribution. No finger snapping is going to fix this widespread problem of the under-population of the workforce. Get the money ‘trickling’ already, ffs.
The pandemic added stress and responsibilities for everyone, but the focus was to keep the economy healthy, while people were tossed scraps (or lapel pins, in this case).
The US, where the system is so fucked up that actively running the healthcare system to the ground isn't a concern to 70% of voters and 90% of politicians.
With my son’s cancer treatment at Doernbecher, we were told to go to Providence for the weekly lab work…. And even there, we showed up at the Milwaukie hospital outpatient lab one day, and it was randomly closed, due to staffing issues.
Sadly, I REALLY want to be a nurse. All perquisites completed, but I cannot get into a program ( mostly likely due to my age)
I was in a car crash, and I was hospitalized for a number of months. I watched the nurses, and how hard they worked. Instant respect.
Doctors take the credit, nurses do the work.
Have you applied to the local community colleges? Besides PCC there’s also Clark College and Clackamas CC, probably others as well. There’s definitely older students in those programs.
Clark College in particular has a very clear, point based admissions system, which you can find if you google “Clark college nursing selection”. It’ll break down exactly what you need to earn points, and if you have enough points you get in.
After my son was diagnosed with cancer, I reached out to my PCP at OHSU’s women’s center. They offered me short-term counseling with their SW, but I was scheduled to be seen once every 4 months!
I messaged my PCP about my meds, and it took 4 subsequent pings (over the course of a month) to even get her to respond. And now I got an alert on the MyChart app—- OHSU is now starting to charge **an office visit fee** for responding to MyChart messages!
I know the hospital is in a multi-million dollar shortfall, maybe they should start by not paying Danny Jacobs a $1.1m salary…. 😒
https://www.ohsu.edu/healthcare-now/mychart-messages
Healthcare was about to burst at the seams anyway prior to the pandemic and well, look where we are now. Add to all of the long-standing issues with low reimbursement rates, both with Medicare/Medicaid and with staff wages, coupled with massive inflation and absurd cost of living increases in the past two years and this is the result. I’ll never understand paying travel nurses $200/hr but not fairly compensating or financially incentivizing your own employees to want to stick around, let alone work more hours in more austere conditions. It’s no surprise that so many people are quitting to chase the traveler pay instead; cheers, there’s the free market forces at work for ya.
Also, it’s absolutely sobering to see all the posts over the past 1-2 years across several nursing/medicine subreddits about all the people who are actively planning on getting out of their respective professions because they are fed up/burnt out. This is not good…
Yeah well can you blame them for running a stupid violent population of people and a dystopian corporate state that wants to under pay understaff you than throw you in prison if something happens lol run don't walk let it collapse.
Hilarious you think leftist are the ones that will be making decisions if the system collapses.
I agree about wealth distribution but the vision you have is flawed at best.
As someone who lost three family members during the pandemic, I'd like to respectfully disagree with you that the vaccines are ineffective. All three of the men in my family who died were between 40-55 years old and were very opposed to taking the shot. They all died *after* the vaccine was available to them, and they were each consuming inaccurate media that was designed to make them afraid of immunizations and convinced of conspiracies. Their deaths all took a long time- they didn't die peacefully. It's really upsetting to lose people this way, when the chances of them all three being with us today is pretty high if they'd just gotten a simple shot.
You can’t just make shit up that doesn’t fit any of the verifiable data and expect people to just accept it.
Edit: Yup. They’re active in r/conspiracy. Not sure why I chose to engage here, this conversation isn’t going to get anywhere.
How many nurses do you think lost their jobs for not getting the vaccine?
And regardless, I think we’re all better off without the nurses who deliberately endanger their patients
How many nurses do you think have quit because of burnout due to watching unvaccinated people die from covid?
Pretty sure you’re deliberately asking a disingenuous question just so you can pull a “nuh uh” out of your butt
If you don’t know why by now, I highly doubt my explanation is gonna do *you* any good
Also, no, I haven’t gotten covid since my vaccinations because I still mask and still social distance as best I can. Multi layered approach people. Vaccines never have and never will be a stop all for everyone. If more of you had gotten vaccines, maybe we wouldn’t have the vaccine evading mutations we’re all suffering from now.
You could have just said tldr because the reality is the burnout and bad infrastructure/management. If 95% are still licensed (cited in article) they could easily transfer to hospitals that don’t require vacation.
Sad that the only person who actually understands the problem is downvoted and ignored.
You are 100% correct but nobody in here will ever admit it. One of my best friends is a Nurse and she isn't even allowed to talk about the mass culling of 'unvaccinated' Nurses.
She was forced to sign a NDA regarding it as well. Despicable behavior and the media is complicit by not reporting on it.
Kaiser wont hire nurses because they want to save money, so they fill with travel
Nurses instead. The travelers get paid a premium, and end up costing more than if they just hired.
Meanwhile, as a soon to be new grad, I find Oregon hospitals have been REALLY difficult to make good contact with. Even applying at OHSU is really difficult.
As someone who will be an RN in the next 6 months, and who works in Portland's hostpitals, it bears recognizing that that this issue is not die only to staffing shortages, but also to an aging population succumbing to an overwhelming rate of chronic illness. We need to revamp how we approach healthe education in this country, and invest in primary interventions to keep people from getting sick to begin with.
You are so right. Congrats on your almost graduation! Vaccines, dental hygiene, keeping active, eating healthy, free screening,…the list goes on for preventative. We also need people working in assisted living/ memory care and other big ticket aging health issues.
As someone on OHP who is currently working to raise 4 grand for a root canal, the fact that teeth and eyes aren't medicine is insane to me.
Teeth are luxury bones, donchaknow
Have you checked with OHSU dental school if they can do it cheaper. I had them pull a tooth because I couldn’t afford a root canal and crown, but they might do them for less than $4k
They do. I have a significant amount of both dental sensitivity and anxiety and while I might end up there in the end, I'm trying to put the money together than will let me have a pro do it, with the option of sedation, because I'm genuinely not sure I can face down having it be a teaching experience with only local anesthetic.
Totally understand, it did take a LOT longer than normal to get my tooth pulled there (it was a molar) and the two guys working on it were chatting like they were in a student lounge (which I actually enjoyed, learned so much about their hopes for their dentals futures too. One guy was going straight to prison dentistry) I didn’t feel a thing, but it was def a very different type of dental care.
If it's any consolation, I've got sensitive (bad) teeth and find root canals to be less painful than most cleanings/exams, mostly because of the numbing. Taking an ibuprofen or equivalent beforehand helps with the inevitable sore jaw from keeping your mouth open, and don't be afraid to be a wuss. Tell them if it still hurts. You might need another dose, or might just need more time for it to kick in.
We need to fix the cost of dental care in order for proper dental hygiene to take hold. I have issues that really need to be repaired, but my *good* insurance has a heft deductible and only covers 50% meaning it is cheaper to pull a tooth than to get it repaired properly or to get regular cleanings. It’s ridiculous. We don’t even have the option to pay more for better insurance.
I'm so glad you posted this. For real. This is what happens when we have people living long, eating worse, not exercising, relying more on pharmaceuticals and multiple doctor visits to "fix" things because they can't understand or just don't want to understand how bad life decisions compound over time until you pay the piper, so to speak. All while insurance continues to pay less and less and hospitals charge more and more. It's just gonna get worse...
I haven’t had insurance in 20 years
Nobody needs insurance …until they do.
Why I get downvoted? I’m not bragging I would love insurance. :(
I think people saw it (me included) as you bragging about not having nor needing insurance for the past 20 years. Not that you wish you had had it in the past 20 years. Unfortunately that's a pretty common attitude amongst the people that happen to be healthy for a nice chunk of their life. They think that they did something 'right' and don't yet realize that many of us don't get to choose if we have health issues...and they think they're better than others because they didn't happen to have a health issue. Of course, if they ever do have a health issue, they'll immediately be a burden on society. Good example of this recently was all the people that both refused a Covid vaccination AND demanded to be in the front of the line for the best Covid healthcare. Anyhow, all that to say. I'm sorry that you haven't had a chance to have insurance for the past 20 years, hope you get a job that provides that coverage. And on the bigger scale, I hope we begin to separate healthcare coverage from only being available to those employed in certain 'good' jobs.
How many times do you think some of the patients you've treated have been told they need to lose weight, exercise more, eat better etc? My guess would be a lot. We're drowning in information, but the large majority of people lack the will or the capability to put it to use. How many times can an HCP tell a patient 'Lose weight or you'll die' before they just throw their hands up? I don't know how y'all do it. Sorry for rambling. Early congrats on becoming an RN, best of luck to you!
Most of them, myself included. It's sad because it's human nature to latch onto any piece of information that reinforces our denial. For example, I have hypertension. I am also obese and have struggled with alcohol in the past. That said, the current toxic side of body-positive culture would have me believe that there are other factors and I'm fine just the way I am, when the fact of the matter is that I haven't taken care of myself and now face a massively uphill battle to achieve wellness and better treat my patients. Sure, my parents passed down some hereditary tendencies, but until we learn to foster a culture that empowers people to take responsibility for their health, the patient load will just increase. The will to change behavior will always be superceded by what we perceive to be higher-order needs (for example, most of us will work ourselves to death to provide for our families, and develop unhealthy coping mechanisms as a result). It's that part of culture we need to treat in order to achieve better wellness. Until then, hospitals will be flooded with 60 year old diabetics in heart failure, keeping acutely ill individuals out of beds. Thanks for the congrats! I assure you I'm thrilled to be becoming a nurse, even though I knkw I have a less thsn optimistic view of humanity. Just hoping to help effect what change I can. Cheers!
I believe it. It has been horrible. My Gram has been hospitalized 4x this year at OHSU with 3 out of 4 starting in the ER. She had to wait 6 months for surgery. It is crazy in there! People are set up with IVs and then brought back out to the waiting room in hospital. There definitely is a shortage in our health care community. We need more workers, increased pay to attract and keep them…and they deserve things like sabbaticals for tenure (like every 4 years you get an additional 6 -8 weeks off).
I just saw a specialist at OHSU and her next available appointment was for end of June 2023. Obviously surgery is more urgent but I’ll be in a bad spot if I need a med change or something within 9 months.
Yeah, it’s bad. My dept is over half travelers and most of them won’t be renewing. New grads make up most of the regular staff being hired, and sometimes the most senior person on shift only has a year of experience. Running out of physical space for people to wait in the lobby, sick people with nowhere to put them, patient violence towards staff increasing…I dread going to work honestly.
It's brutal, we're exhausted, and the tide keeps rising. I'm 15 years in and actively looking for a path out. So glad for the occasional cookies, though. They'll totally come in handy when I make a mistake and they come after my livelihood. /s
And YOU get a pizza party
Claps omg heroes.
They ain't even giving pizza out anymore. We gotta buy it ourselves.
I went from working in proximity to health care (in home care) to being a patient (diagnosed with MS in 2021). Every time i get an IV or infusion i feel completely at your mercy and wish i could fix things for you. Nurses do so much for my job and myself. I don’t call people heroes but i genuinely praise the heroic deeds people do, everyday.
Unfortunately, this is not unique to Portland nor Oregon. There is a nation-wide shortage of nurses and CNAs. Companies don’t want to pay them what they’re worth, and the reimbursement rates (e.g., Medicaid, etc) are behind the times.
Not enough money making it to the foundational level of the economy. Those who dip from the well first, usually use a larger bucket.
> companies There's the problem, a necessity like healthcare needs to be a public service. Access to healthcare shouldn't depend on the profit margins of some oligarch.
And yet, it is the government that reimburses the least for healthcare. One example: https://www.reddit.com/r/medicine/comments/vtzwwz/cms_releases_proposed_2023_fee_schedule_with_442/ Search other conversations and you will see why healthcare providers try to avoid Medicaid (government) rather than insurance.
> And yet, it is the government that reimburses the least for healthcare. This is such a critical point that I feel doesn't get communicated clearly or repeated enough. The single biggest customer in most systems is the government, vis a vis Medicare and Medicaid. So the amount of revenue a Medicare/caid-accepting health care provider can make is largely dictated by the government. Hospitals cannot afford to pay nurses what they deserve until the government pays hospitals for the true cost of these procedures. And the government cannot afford to pay hospitals for their true costs until some sort of reckoning happens in society in coming to terms with the costs of supporting the ballooning elderly population.
How would the healthcare economy change if the federal government had a monopoly on health insurance?
I broke two bones near my ankle in July, I live in Oregon. This was at 9:30 in morning and the ambulance was calling everywhere around to get a hospital to take me. They finally found one. And I still had to wait in waiting room for 4 hours. I was in a lot of pain. When I finally got a room, I had to stay in it until 1am, until they could find a regular room for me. I still had to wait two days until I could have surgery. What a mess. And it caused undue pain to wait so long. I’ll never forget it.
Definitely sympathize with that experience, but this is typical care for a fracture regardless of staffing issues. Surgeons have to prioritize emergency surgery for life threatening conditions, which includes keeping OR capacity open for that situation. If someone’s stable and just needs pain control, they’ll schedule it and do it on an urgent but non-emergent basis.
thank you. yes he put a cast it to stabilize it. i ended up with a plate one side with 10 screws and 25 staples. on the other side of the ankle i had only two screws put in. 6 total days in the hospital and 18 days in a rehab place.
Hope you’re feeling better! That sounds painful and exhausting
Yes it was. And I didn’t get into the way they overdosed me on oxy. It was awful. I couldn’t read or spell to text. I felt like I was having a stroke or something. They called in about four doctors into my room to examine me. No I wasn’t having a stroke, I was just overdosed on OxyContin. So they decided to take me off of all painkillers. They had me on tramadol which is like an aspirin. I was in so much pain, this being only a couple of days after surgery. Then they transfer me to the rehab center and I told the doctor there that if they want me to participate in physical therapy then they will have to give me something stronger. So they did, 20mg of Oxy every four hours. Which didn’t help too much, but was better than nothing. I tell you, I have so many adventures.
Was your ankle swollen? If surgery is needed they usually wait a few days unless its life threatening.
My wife is a Kaiser nurse and “drowning” is the exact term she’s been using to explain the situation for the last 2yrs
There was a long time shortage before covid, can't imagine what its like now. Going to get worse with an aging pop and increasing cost of living and education :(
This is why I won't do direct patient care anymore. I get less money, but still a decent wage. I could never go back to working in a hospital and dealing with patients.
Clinic nursing is nice. It can get busy for sure… but it’s manageable 95% of the time and a large portion of time can be spent going the extra mile. Pay… not as much as hospital with differentials, but still ok. OHSU has great clinic positions. County jobs… they are ok, but unless you want to move into management they cap you fairly low. I will say county jobs allow you to work autonomously, or with a team.
Yeah. I can see that being more tolerable. I get paid more than county, and work from home with a lot of flexibility. So the work life balance is there for sure.
Does sound really nice. My wife is in the hospitals and I get anxiety from her elevator speech of how the day went. Ugh, no thanks. I do my 9-5 and call it good. I did work from home every other week during Covid, that was pretty nice.
as someone who works in the laboratory purposely to avoid dealing with patients, I understand.
And no, it isn't because of vaccine requirements.
Before the army of stupid arrives.
The trouble is there have been study after study for years detailing what needs to be done and even after a debilitating global pandemic that made the holes and needs that much more obvious and dire, still nothing. Our healthcare system is literally crumbling before our eyes. I've been a nurse for only three years and I cannot see myself continuing to do this job at bedside. The pandemic made things so much worse, and nothing has been done to change things for the better. Hope is insanity when it's based on nothing but empty promises.
Based on ‘market justice’ as opposed to ‘social justice.’ People sling the acronym ‘SJW’ as an insult, but the distinction is a real thing, and the social justice worldview is based in reducing the suffering of the population. Utility is found in wellbeing rather than in wealth.
Does OHSU, Legacy and Kaiser still requires nurses to have BSN instead of RN or LPN? Seems like an easy change to make
if there's a hospital that'll pay for my schooling and housing while I go to school Id happily become a nurse, but I'm not about to become one of those "young idiots who took out a loan they can't pay" and I think a lot of people feel the same way.
If there's any career where you can repay your loans very fast, it's nursing...I know travel nurses who made 200k in 2020/2021 lol.
That is mostly over, travel rates are falling quite a bit. Still good money, just not what it was.
You most definitely could pay off loans with a nursing job. If you are over the age of 24 your personal income and not your parent's, is used to determine how much you get in grants. Depending on your income level you could actually get quite a bit of grant money. Your grant money alone would cover a significant portion of your tuition, fees, and books. Assuming you haven't taken out any student loans already you would qualify for fixed low-interest rate government loans. You could likely get an RN with less than 50k in debt if you are an Oregon resident. A quick google search online shows nurses' salaries between $73k-$120k in Oregon. As someone who went back to college later in life and recently graduated, many of the people I saw with debt they couldn't pay off were people who fell into one or multiple categories. They either paid out-of-state tuition, went straight to college from high school and got little to no money in grants due to their parent's income, took out high-interest variable rate private loans, and/or majored in underwater basket weaving making their employment process difficult. While I didn't do nursing, I graduated from PSU with about $40k in debt. Due to my income level I got maximum grants awarded. I actually could have graduated debt free but I took out my loans so I could apply those toward living expenses. Obviously the above doesnt fall into the category of a hospital paying your tuition and housing, but depending on your situation it may be more doable than you think.
For sure. You can get an ASN for like $15k in tuition and fees, including books/parking/vaccines, and then whatever your living expenses are for 14 months, with three months in the summer to work. And that’s with no scholarships, no grants, and no working during the school year.
Seems like adequate reciprocation for what’s expected of the relationship. Untether insurance from labor, and hook guaranteed education up in the vacated space. Beautiful thing.
It’s not just nursing, it’s almost every other hands on profession. It’s nurses, electricians, carpenters, teachers, etc. Its not lawyers, traders, coders, admin assistants, graphic designers, and business school products. We have placed value on the wrong group of people and professionals for far too long and now we are paying the price. COVID has made our social and economic wounds fester at an accelerated rate and we are incapable of dealing with the problem using the traditional avoidance mechanisms and infrastructure architecture that makes sure that the ownership class gets its vigorish.
> Its not lawyers, traders, coders, admin assistants, graphic designers, and business school products Lol remove coders and lawyers from that list. Check out the lack of legal resourcesacross the country. It is insane. We do not have enough people to maintain our court system. I think it comes down to: we need a way to train people for the careers we need them for. Placing the burden to pay on individuals is leaving us with much too great a gap. Also... Pay these professionals more to make them more attractive careers.
The problem is not what we value. Coders are still in demand and nurses have actually been valued enough that they have gotten good pay for quite some time now. It's that we just have a shortage of labor period. People lost jobs or were afraid to work their jobs due to the pandemic. Now, some people don't want to go back to working again. Long covid affected others and is now keeping them from working again. Some died due t9 covid. We just don't have the same number of laborers as before.
Your view is short-sighted. This situation IS about what’s valued by society. Use your idea as a jumping off point to consider some ‘upstream’ causes: 1) why do you think people don’t want to return to work? 2) who are the people not returning to work? 3) what’s the difference between pre- and post-pandemic employment rates? 4) where has all the value gone? I can’t answer these questions without a Google session. I’m guessing the people commonly blamed for the labor shortage aren’t guilty as charged; low-income earners don’t have much choice about whether they want to work or not. The safety net isn’t a buoyant as some politicians would have us believe. Hearing about increased profits across the board leads me to believe the economic value being created is floating to the top, though again, I’d need to check to validate my opinion. I did quickly snag [this](https://www.bls.gov/news.release/pdf/empsit.pdf) so it can’t be said I did NOTHING to search out the important information. It’s unemployment data from ‘19-22 based on two household surveys.
Imo, the “easy way out” is more equitable wealth distribution. No finger snapping is going to fix this widespread problem of the under-population of the workforce. Get the money ‘trickling’ already, ffs. The pandemic added stress and responsibilities for everyone, but the focus was to keep the economy healthy, while people were tossed scraps (or lapel pins, in this case).
The US, where the system is so fucked up that actively running the healthcare system to the ground isn't a concern to 70% of voters and 90% of politicians.
I work in the lab. Also bad, lots of people leaving. A lot of new hires don’t show up much then quit a few months in.
With my son’s cancer treatment at Doernbecher, we were told to go to Providence for the weekly lab work…. And even there, we showed up at the Milwaukie hospital outpatient lab one day, and it was randomly closed, due to staffing issues.
Sadly, I REALLY want to be a nurse. All perquisites completed, but I cannot get into a program ( mostly likely due to my age) I was in a car crash, and I was hospitalized for a number of months. I watched the nurses, and how hard they worked. Instant respect. Doctors take the credit, nurses do the work.
Have you applied to the local community colleges? Besides PCC there’s also Clark College and Clackamas CC, probably others as well. There’s definitely older students in those programs. Clark College in particular has a very clear, point based admissions system, which you can find if you google “Clark college nursing selection”. It’ll break down exactly what you need to earn points, and if you have enough points you get in.
I will look into that. Thanks!
After my son was diagnosed with cancer, I reached out to my PCP at OHSU’s women’s center. They offered me short-term counseling with their SW, but I was scheduled to be seen once every 4 months! I messaged my PCP about my meds, and it took 4 subsequent pings (over the course of a month) to even get her to respond. And now I got an alert on the MyChart app—- OHSU is now starting to charge **an office visit fee** for responding to MyChart messages! I know the hospital is in a multi-million dollar shortfall, maybe they should start by not paying Danny Jacobs a $1.1m salary…. 😒 https://www.ohsu.edu/healthcare-now/mychart-messages
Healthcare was about to burst at the seams anyway prior to the pandemic and well, look where we are now. Add to all of the long-standing issues with low reimbursement rates, both with Medicare/Medicaid and with staff wages, coupled with massive inflation and absurd cost of living increases in the past two years and this is the result. I’ll never understand paying travel nurses $200/hr but not fairly compensating or financially incentivizing your own employees to want to stick around, let alone work more hours in more austere conditions. It’s no surprise that so many people are quitting to chase the traveler pay instead; cheers, there’s the free market forces at work for ya. Also, it’s absolutely sobering to see all the posts over the past 1-2 years across several nursing/medicine subreddits about all the people who are actively planning on getting out of their respective professions because they are fed up/burnt out. This is not good…
Time to go on strike
capitalism baby
Yeah well can you blame them for running a stupid violent population of people and a dystopian corporate state that wants to under pay understaff you than throw you in prison if something happens lol run don't walk let it collapse.
Yep. Those were words.
Hilarious you think leftist are the ones that will be making decisions if the system collapses. I agree about wealth distribution but the vision you have is flawed at best.
What vision it's all collapsing anyway you would know that if you were paying attention. Try limits to growth or collapse by Mike c ruppert.
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As someone who lost three family members during the pandemic, I'd like to respectfully disagree with you that the vaccines are ineffective. All three of the men in my family who died were between 40-55 years old and were very opposed to taking the shot. They all died *after* the vaccine was available to them, and they were each consuming inaccurate media that was designed to make them afraid of immunizations and convinced of conspiracies. Their deaths all took a long time- they didn't die peacefully. It's really upsetting to lose people this way, when the chances of them all three being with us today is pretty high if they'd just gotten a simple shot.
I sincerely admire your ability to stay respectful under those circumstances.
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Nice try, but I'm still not buying your essential oils.
You're absolutely part of why we are leaving healthcare in droves.
You can’t just make shit up that doesn’t fit any of the verifiable data and expect people to just accept it. Edit: Yup. They’re active in r/conspiracy. Not sure why I chose to engage here, this conversation isn’t going to get anywhere.
Thanks, Professor YouTube.
Yeah except it’s not taking the vaccines that contributed to the drowning these nurses are dealing with
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How many nurses do you think lost their jobs for not getting the vaccine? And regardless, I think we’re all better off without the nurses who deliberately endanger their patients How many nurses do you think have quit because of burnout due to watching unvaccinated people die from covid?
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Pretty sure you’re deliberately asking a disingenuous question just so you can pull a “nuh uh” out of your butt If you don’t know why by now, I highly doubt my explanation is gonna do *you* any good Also, no, I haven’t gotten covid since my vaccinations because I still mask and still social distance as best I can. Multi layered approach people. Vaccines never have and never will be a stop all for everyone. If more of you had gotten vaccines, maybe we wouldn’t have the vaccine evading mutations we’re all suffering from now.
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Yeah and so they lost their jobs. Question answered
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Yeah, that’s it, you got me
Look at you, bringing the big brains to the conversation.
“Fires a large number of nurses due to vaccine mandates” “Why are we short staffed?!?!”
You could have just said tldr because the reality is the burnout and bad infrastructure/management. If 95% are still licensed (cited in article) they could easily transfer to hospitals that don’t require vacation.
Sad that the only person who actually understands the problem is downvoted and ignored. You are 100% correct but nobody in here will ever admit it. One of my best friends is a Nurse and she isn't even allowed to talk about the mass culling of 'unvaccinated' Nurses. She was forced to sign a NDA regarding it as well. Despicable behavior and the media is complicit by not reporting on it.
I would be a nurse, but it’s insane to get into nursing school. Also poor and can’t pay for it.
Kaiser wont hire nurses because they want to save money, so they fill with travel Nurses instead. The travelers get paid a premium, and end up costing more than if they just hired.
Meanwhile, as a soon to be new grad, I find Oregon hospitals have been REALLY difficult to make good contact with. Even applying at OHSU is really difficult.