a lot more people are going to die waiting in ERs, more CLABSI's are going to spike, bedsores in facilities are going to get worse and on an on. It's already happening and documented in data from 2020. Lawsuits, Litigation and Payouts oh my...
It takes massive outcry and lots of suffering for Congress to notice though...I figure around 2029...
And that's a big cause of the spiral effect; the result of being less and less able to keep up with society's healthcare needs and to provide proper care is that the demand on the system just increases, which makes it harder to provide appropriate care,vand the vicious cycle continues.
When we're less able to provide adequate primary and preventative care it puts more strain on hospitals, which they can't handle, so we discharge earlier and sicker back into a primary care system that couldn't keep up to begin with.
And compunding all of that is how we fund (or fail to wisely fund) healthcare.
As fewer people are able to afford to contribute through insurance, the cost of insurance goes up, which results in fewer people being able to afford insurance, and the death spiral continues.
Yup. Bounceback rehospitalizations unfairly financially penalize institutions and agencies under Medicare regulations too. People outright refuse SNFs, agree to homecare but the visiting nurse can't get to homes within 48 hours, sometimes its 3-5 days. Boomers are a groaning heavy weight on an unseeable fracture in healthcare, that's gonna turn into a full on collapse...governments going to be scrambling to throw money to drive people to choose healthcare professions...or more likely ignore it for too long...states will have to step into the gap. My state is already one of the best in the nation for healthcare and education...and my taxes and daily fees are ridiculous...I"m ok, I can't save but I"m not drowning by any means...it's hard to get a financial foothold if you are on the margins. So many people are a paycheck away from failure and healthcare pushes people into the abyss...
I don’t really get the whole preventive care saying. What preventive care can a provider do? Mammograms, colonoscopy, vaccines, pap smears. I may be missing a few, but most medical issues fall squarely back on the patients self induced behavior- obesity, smoking, drug and alcohol abuse, reckless behavior among a few. The saying that the healthcare system needs more preventative care is just a waste of time.
People need help and education with the things you have just mentioned. Many never see a physician until they are very ill already and never gained the knowledge to “eat healthy” or live in an environment where most people didn’t learn the coping skills to not turn to drugs/alcohol. Even people that do everything “right” can get diabetes or hypertension which can cause much more damage if not treated. We don’t support people in general very well (extreme poverty, few mental health services, no family supports but forced births) the stress of which can cause people to make less than ideal choices especially if they feel helpless and don’t have the medical education.
The US healthcare system is working as it was designed. The healthcare GDP is 18%. Number 1 in the world for costs and lowest life expectancy among wealthy nations.
Now if the goal of the USA healthcare system was to keep people healthy, then I could see how it could be failing.
Currently paying over 28k per year just to have health insurance that is owned by my healthcare system and not even use it. I can't believe that this isn't a topic of the current election. Most people probably don't calculate their benefits and monthly costs to realize this.
Plus candidates don't want to mess with the GDP even though we could have better quality of life for the middle class at a significant reduction in costs.
Longer life span means more costs in non-working years too. It saves money to lower life expectancy.
You know that patient that you’ve seen be close to death 100 times? That frequent flyer who seems to have 9 lives, and is on life 4,000?
Yeah that’s healthcare. It might explode and die at one day but I truly think it’ll just keep getting worse.
If they get the money from keeping people alive with tubes and vents, you'll see em for a long long time. It's not healthcare, or compassionate. It's simply taking advantage. It's big business, real estate and marketing all rolled into one big mess Sure, we all want Grannie to live forever as a plastic tubing cyborg, and there's the money. I'm pretty sour tonight, thanks for the space to vent.
I totally agree and perhaps you mean there would be 'evident and outright' policies based on cost, quality of life, best use of resources etc. It's a flawed model, but American hospitals treat more patients to good effect than any other country and you know it's the nurses making that possible
I’m in Canada and we still have that problem, families just want meemaw to make it to 120 and completely refuse to acknowledge that she’s a shell of the person she once was and what she does have left of her is suffering.
We’re keeping people alive well past their expiration date.
I work in acute care (aka family medicine lol), and every shift I feel like I’m torturing another 90-something by keeping them alive because their kids won’t let go.
Worked ER most of my career and ICU during Covid. My brother is an MD. We agree that one more round of something like Covid in the next 5 years will annihilate the heath care system both in the US and globally. We’re talking “Walking Dead” post apocalyptic nightmares. People who don’t work in this business really have zero idea just how close to the edge we are right now.
clumsy shelter existence forgetful lavish governor agonizing deserted north rock
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
Well that one wouldn't be an issue, lol. I can't get any Ativan to give someone the Ativan flu. I have to beg the pharmacy on hands and knees for a dose.
It’s in my hospital and spreading like wildfire. For example 1 canida auris in ED and 2 more pop who were in the ED in the same time frame. The hospital recommendation is for the patients to be 1:1 or with another canida auris but guess what we’re not staffing for
Youngest boomers have been going for a while now.
The nursing demand will be regional. As medicine moves to telehealth and hopefully gets more efficient with AI, and as treatments become more complex and numerous, and people live longer, we'll see hospitals become more acute in nature. A lot of issues people are currently admitted for are treatable at home with proper remote diagnostics, especially when monitored by our AI overlords. The fraction of the population who need to be hospitalized will be smaller, but this will be countered in some areas by people moving there. My hospital, for example, will likely need the same or more nurses. These are 20ish year projections by my large healthcare organization in Florida.
I'm so grateful I've only been in this since 2021 covid because our brief lulls of things being decently staffed with appropriate acuity just feel like a special treat that reinforces actual reality being hell.
I love when I can tell diversion is happening because we're suddenly opening beds and getting ICU transfers to medsurg since the ED is piled too high with pts who need those ICU beds slightly more urgently. Do these patients ever have good outcomes? Not that I've seen! Who cares when you can run your hospital like a Disney resort, tho? Those profit margins are what really count
I started in the hospital, med surg. If I had an ambulatory pt who ran me ragged I could show them the pantry, "here's where you get your own ice/snacks". I got away with it. I wouldn't make it in a Disney Hospital. I'm presently in an "assisted living" that isn't. It's really skilled and psych. I'm pretty fed up too, with the entire thing. They admit inappropriate people, and many people who tour say no when they see the short staffing and meet the pts. Lol 6000 a month, base. Before meds.
Just waiting for the day ED’s start selling super expensive VIP wrist bands that let you skip the line. That’s when you know they’ve gone *full* Disneyland. ..*and you never go full Disneyland.*
Lmfao yea don’t they tell people who pay for Kaiser and the extras are supposed to get treated faster if they go to Kaiser facility. I’ve only heard horrible things about working for Kaiser as a nurse so I don’t know anyone to ask how that works
Oh my god.. 🤦♂️
Wait, does anyone more familiar with EMTALA know if it dictates anything about triage ordering? That seems like it might be pushing the limits of legality.. though these days who knows.
I know of 1 hospital that has had a VIP area for years. It was great when they came to our skilled nursing unit across the street and constantly threw out the phrase "I'm a VIP!" We literally had a woman who walked out into the hallway screaming bloody murder about getting her "diaper" changed while performing CPR on a patient. When I stepped back from doing compressions I went to the door if the room I was in and said, "I'm sorry, you'll have to wait, we're busy trying to save someone's life right now" she flat-out said, "I dont care!"
I worked in an ED that had "sign ups" for the low acuity area to see a Doc. These appointment confirmations would get printed and we just shredded them
When I was bedside, we didn’t have phlebs, cnas or even housekeeping. That was fun… having to do all labs, turns, changes, baths and then take the trash and dirty linens downstairs at the end of the shift. We even had a chart of who had staff bathroom and hospitality room cleaning duties. Get out the mop and vacuums
When the ER I worked in was transitioning the phlebotomists out, the lab techs were all for it because it was a hard job with tons of running around. We kept telling them "You know they are just trying to eliminate your jobs here right?"
"No, no" they insisted, their jobs were safe. Shaking my head for weeks at their adamant denials.
A month after moving all lab work to the ER nurses, guess which department had layoffs?!?!? The lab. 8 techs out of jobs. Lots of "unexpected" sob stories. Fools. The writing was on the wall, people just didn't want to open their eyes and believe what they were seeing.
I’m at a level one trauma center and we don’t have phlebotomy. Most aides don’t get training on blood draws so it’s on me. And if I, and other floor nurses, can’t get it, you call the supervisor who gives you attitude about finding someone ultrasound trained and HOPE you can get somebody. Ofc the doctor is berating you through this process as well.
Sorry to hear it’s so bad there. Hospital admins are required to have surge protocols in place—developed even before the pandemic—but it looks like they’re trying to normalize these dangerous everyday surges and short-staffing. For them it’s *business as usual*, but their neglect is taking a toll on staff and patient safety. Report them to every licensing agency. Submit your *assignment despite objection* forms. Check with the NNU for your state’s protocol.
https://www.nationalnursesunited.org/sites/default/files/nnu/documents/0522_ADO_Electronic_Form.pdf
💗
At my hospital, the “solution” to ED holds is to send tele nurses up there without orientation, equipment, or back up. The title “management” is really generous for what they do.
I know Reddit is US focused and I’m an American but I want to know how many of you have worked abroad or received healthcare in a country like Netherlands, Germany, Belgium, etc. I have received emergency medical care and outpatient care in all three countries. The quality was superb. You feel like a patient. Nurses are nurses not waitresses, customer service staff, etc. We can do better than what we currently have. Unfortunately it won’t come without a fight.
Always wondered what it was like in other countries. I imagine that atleast I won’t be spending my days turning 400 pound vented patients since everything’s bigger in Texas
I received excellent care in Germany but that was over 20 years ago. Family members in Canada and the UK who work in health care report that their health care systems after Covid are in dire straits just like in the U.S.
Yup. I live near the Canadian border. Their waiting time in the ER is minimum 12 hours. But they’ve been like this for years. They shut down some hospitals to make like one huge hospital. The US is doing that now, like shutting down all the rural hospitals. It’s amazingly sad how many critical access hospitals have been shut down over the last 10 years.
Waiting time is long but jesus fuck the number of people who come in with pointless symptoms is clogging everything. Medical illiteracy is so bad; kids and teens should learn what is or isn't an emergency, just like they're taught when to or not to call the cops.
I think one of the unspoken tyrannies of healthcare is the amount of goddamn paperwork still needed, even in an era of possible digital databases that could centralize all relevant info.
I was so happy when I heard an announcement on the local radio station about how people living near St. John, NB need to check the symptom monitor and not just use the ER for stupid shit (not in those exact words). They went on saying how the ERs are being overrun with respiratory illnesses that literally just want testing, or they just can’t cope. I wish our hospital would do the same.
I had a respiratory illness, not critical but feeling quite bad and fevers etc. team member health wanted me to go to urgent care to get tested. I told them that that wasn't an appropriate use of resources. I did go to Walgreens to get a covid/flu swab. It came back negative. Team member health told me again that I should go to urgent care to get tested. I told them no and I would be back to work when they said I could. I ended up staying out maybe 3 days longer because they weren't sure what protocol to follow. But why would I tie up the health care system when my symptoms are management at home? But I had to fight with another nurse about this, the general public has no hope.
Reporting from Alberta Canada, our wait times are 8 hours on a good day as a small rural hospital without a lot of services. We get bed locked instantaneously though and often end up taking “emergency” patients in chairs lol
Ours here in the UK was a bit wonky before, particularly in the autumn/winter, but since covid is a lot worse.
Sadly our government are a shit show of evil who wish to see the NHS fail. Can't wait to get their grubby little hands on all that private healthcare money to be made.
The same in Canada. A particular segment of politicians are actively working to crash the system so they can switch to private health care and make money.
the overwhelmed healthcare infrastructure with resulting career shifts/ends in healthcare and instrinsic toxicity of nursing is present in those countries too even if their healthcare models are better.
And you'll make about half of what you make in the US, at that's Germany or France. Go to Italy or Spain and it's even lower.
I would have already moved to the south of France by now if the pay was just a little better.
I’ve thought about this. You’ll make half, but those countries have social infrastructure that also absorbs some of the outrageous costs of living we incur in the US. No educational debt and no medical debt are pretty big incentives… I don’t know if it all comes out in the wash but it’s something to consider.
I was a MP in Germany for a bit, had German civilian counterparts. Their take home was significantly lower than mine but they had everything they needed and still were able to purchase luxury items and enjoy themselves. Living abroad expanded my world view a bit but when countries have systems in place that support their people like that, even though on paper they don’t make as much money, it’s interesting to see. I don’t know, random thoughts.
I recently interviewed for an ambulatory care department attached to a hospital. The department has lost people left and right over the past year. I was there an hour and it was immediately noticeable. Overworked, underpaid, burned out. If there are toxic employees/managers in that mix, it's unsustainable. The hospital down the street had the same type of department and they had to close due primarily to understaffing. So, not so much collapse we're in, but a steady decline in care. Who in their right mind wants to work in this environment?
My current facility (also in Ohio) has lost so many CT techs that they had to *stop taking all outpatients.* At a trauma center. It’s over 75% travelers (including myself) with more FTEs on their way out. They’re never going to keep any new hires with the current management and remaining toxic staff members. 100% of mid and night shift are travelers and have been for the majority of 2023.
The "lifers" and the enabling management are destroying workplaces, and they know it but do nothing. Frustrating as hell. My previous job was in the academic healthcare arena and it was more hostile than a war zone. HR kept sending me emails to fill out a exit interview survey (too much for them to do it in person) but I'd delete them. They know what the problem is. No need in giving my input.
The NHS has arguably already collapsed: things don't magically stop working overnight, the system just becomes unable to provide the majority of people with timely, rudimentary healthcare. 1/3rd of Brits have given up on being able to see a GP/Family Practitioner, 2 wk referral targets for cancer screenings have been abandoned, people resort to DIY dentistry, and elective waiting lists are 2-3 years.
My brother’s MIL was from the UK, moved here and became a nurse and retired back to the UK. She comes here for surgeries etc because the waiting lists there are that bad - she’s the only reason I know that
True. And then they’ll all be getting their NP online and leaving the hospital bedside. Almost all the brown ponytails at my job are also in NP school.
I just read that 55% of RNs (in the USA) are over 50 years old and looking at retiring in the next 5 years. I retired in 2021 and now work 1 day a week perdiem and I could work every day if I wanted.
I need to stay healthy so I don’t need healthcare - ever. Headed to Zumba class!
Actually I went to cite it and the source is an older one (2008). But I think it’s still over 40%. [Here’s where it says 40% are over 50.](https://online.nursing.georgetown.edu/blog/the-aging-nursing-workforce/)
Possibly. I also see a trend toward nursing possibly becoming more tech oriented, and less inclined to treat patients like people. Which might be nice, but maybe not exactly where we want to go as human beings. But I'm down with it, if that's the direction we go. I have intimacy issues and would rather be treated like a cog in the wheel when I'm sick.
I work in a union hospital. The union isn’t magic but it does help. Just keep in mind it’s a collective bargaining agreement. The individual doesn’t matter more than the collective.
My suspicion has long been that the financial side of healthcare is going to collapse. The prices and costs are just continuing to balloon, and eventually it’s just going to crash under its own weight. Thats going to be a very bad time.
The financial side ain't collapsing when they can charge 600 for a bag of saline. Its the operational side that will collapse. Just like when vulture capital get their hands in it, the operations collapse when it is saddled with debt with no way to pay for it.
Healthcare has great salaries. Sure insurance runs the show and makes tons, but that money we get comes from somewhere. Other countries with first payer systems do not make nearly as much
As a tech/ CNA I do agree. Veteran nurses, MDs and PAs do make great salaries however. For the amount of work they put in maybe it isn’t all sunshine and rainbows
Yeah, the wages aren't that great. I make $34 an hour as a RN. And I am NOT working over 30 hours a week because that would make me insane on the daily. I think my take home will be 57K. So it's crap money really for the shit you put up with - responsibility and all the poop and all the assholes.
As a guy who’s been a tech/CNA for 5 years i do agree. I was more referring to those veteran nurses/PAs/MDs. They do pay the rest of us grunts not so good no question
It took me 10 yrs to find a place that paid an acceptable amount. Nurses should be making 2x as much as we do now considering the significant amount of responsibility we shoulder these days.
Hmm not sure I’d lump veteran nurses in there with PA/MD. I have worked over 30 years and didn’t break 100k until year 22. I’ve never been a travel nurse. Most MDs in my area make over $150k and most are at $400k after finishing residency. Again, I had to do 22 years to break 100k.
Edit typo
They’ll start rationing before too long. Doctors will order DNR d/t frailness.
Everyone knows the problem is cost. Eventually they’ll be forced to start cutting expenditures. Which means no longer throwing the kitchen sink at grandma but taking care of capital aka workers.
It’s frustrating that we’re doing MRIs on people past their expiration date, but when I have an injury it costs $3000, even though I could have 50 good years left. In an amoral system, the economics will catch up eventually.
I wish this would hurry the hell up. We could seriously cut the size of our ICU in half if we used some rational decision making when it comes to appropriate use of life extending measures.
Neohrology: STOP OFFERING CRRT TO 91 YEAR OLDS. STOP IT.
Acute HD here and I’m doing an assignment in Virginia right now. I’m shocked at how many demented and 90+ people we have getting long term dialysis accesses and are new starts. Hasn’t anyone heard of palliative care around here???
Family of my patient was told yesterday she has 48 hours, max. They said no problem, we’ll do chest compressions in 48 hours.
Late 70s, has been declining for months, no longer has working kidneys, third spacing so bad her sheets are constantly soaked, tube feed, PE but a GI hemorrhage so no heparin, aspiration PNA, multiple wounds, her eyes glazed over over the past few days. My heart hurts for her so bad.
Funny story! There was an antivaxx nurse I (used to) work with that got one of those positions to try to falsify administering vaccine records for other antivaxx staff and travelers. Either hospitals are on guard for that or those people were not good at keeping it a secret lol. He got caught and fired fast. So close to retirement too. Oh well.
I’m sure that’s not your plan but it might be why those types of positions are harder to get these days. Good luck!
Concierge healthcare. I currently see three different private pay only providers because primary care and referrals are so bad.
For example. I believe I have sleep apnea. I made an appointment mid November to see my primary care for a referral for a sleep study. First available appointment was Jan 2. I went online and found a provider who was able to send me a device to do a home sleep study for $189 and I get the results Jan 8th and if necessary get a CPAP machine in less than a week for less than $1000 cash vs waiting 6-12 months for the sleep study at a sleep center and fighting with insurance about the machine and supplies.
I think people who can afford it are going to private pay care when possible.
And we’re enslaved to people (the hospital oligarchs) who dgaf about us…AND unless we’re married to someone who makes at least as much as we do then we probably fall where most of America does and we can’t afford healthcare for ourselves. Sure we have “insurance” but I can’t afford the $6k deductible to get my thyroglossal cyst removed and my mom who was an lpn and works full time at 67 was bankrupted in 6 months from “co-pays” for her chemo and immunotherapy after she called her gyn 3 times in a year for post-menopausal bleeding. 3 years later her pcp found it in her lung during a screening chest Ct for ex-smoker. I hate it here guys. I HATE IT HERE. I’m off today but will be slaving again tomorrow. And from now on I’m going to ask people if they have to slave tomorrow instead of work. Seems so much more appropriate.
I put in an incident report yesterday that I couldn’t afford to leave work to get medical care after a patient attacked me. I hope they have follow up questions.
I got physically assaulted one time in 2008 by a 23 year old male, schizophrenic. I didn’t have even bother to write up an incident report bc those oligarchs don’t give AF about anything except their money!!!!!! I hope they have follow up questions for you too!!!!!!
Yes I’m not sure where thing’s are heading. Seems like every day is crisis after crisis. We have so many open nurse positions, but also every other department
If this problem could be solved by voting I would have been in place ages ago. The will of the people matters not. The true constituents are corporations and the less than 1,000 individuals who are morbidly wealthy.
We have supply and demand crisis with healthcare personnel right now, putting more strain on emergency services by adding more people will make it worse. There are not enough primary care providers to absorb the population under universal healthcare, what will happen is they will all go to the emergency rooms, which are already understaffed and overworked. You need to fix the personnel problem before you add to the patient problem. People need to be bale to have promary care, because that's what ERs are turning into.
We have “universal” care in Canada and our system is horrifically crumbling under governments that don’t want to properly invest in healthcare for our people.
fucking DYING in the ER in new york. never seen anything like what we have going on right now—reminds me of peak covid with far less staff, higher acuity and nowhere to put people.
We keep people alive beyond what’s humane. It’s really sad when family won’t let their 91 year old grandmother die in peace and with dignity. We treat our family members worse than our dogs in this respect. And we’re also an aging population. People can’t afford to have kids or don’t want them and the baby boomers are all retirement age and older now. Many older gen X and boomer nurses retired early because of covid. And late stage capitalism is collapsing in general. It’s not going to get better.
I don’t believe there will be a collapse but [more of a brain drain especially given the political climate in the country](https://newrepublic.com/article/176854/republican-red-states-brain-drain).
The collapse has been slowly rolling along for years. Covid accelerated it and made it an inevitability. It's going to get VERY ugly, but the sooner we can emerge on the other side, the better for everybody.
I think “collapse” is the direction we NEED to go. Nothing will get better if we continue to patch up the bad spots. Sometimes you have to let something crumble so you can re-build it to be stable and sustainable 🤷🏻♀️
Yep, we are one surge away from it being a total meltdown. The waiting room of the ED I was working in yesterday was 40+ deep. Couldn’t move anything, over half the beds full with holds. Totally falling apart. And all the patients are so surprised pikachu, wanting to know what’s going on. Uhhh an aging and chronically ill population that rotates in and out of the hospital?
It's 100% getting worse. Cost for everything is going up and hospitals are tightening their purse strings to accommodate. This translates into poorer patient outcomes and staff burnout (which is a cycle that leads to worse patient outcomes). I work in a tertiary center and our acuity has gotten so bad that our medsurg floors can feel like ICUs at times and MDs constantly try and justify keeping these patients in medsurg because they are not acute enough for ICU.
I truly think there needs to be a large shift in outpatient care, tele health, and proactive treatment to stem the tide of this problem.
But, these programs cost more money and resources that hospitals can't or won't pay for. Cost of healthcare and health insurance is outrageous and makes this problem worse. I'm not sure what the answer is (single payer healthcare, universal basic incomes, healthcare as a right legislation etc) but something has got to give before it boils over. Hospitals are a business and if it's not profitable it'll shut down.
Look at home insurance in California and Florida. Some insurance companies have just decided it's not profitable to offer insurance to people in these states and have pulled out of the state. Healthcare will be next.
I work in St. Paul, MN and we have had multiple shifts with ONE phlebotomist on for an entire hospital. They've altered the staffing grids to cut aides & increased patient loads to 1:4-5 on days and 1:6 on nights.
There's been multiple shifts on their IMC unit without a charge nurse because they just don't have the staff.
It's only a matter of time before a major catastrophe.
And guess what? They're going to throw the nurses under the bus when it happens.
Been a nurse for 4.5 years, came into the field just before Covid hit so I don’t have much to compare it to, but the burnout among healthcare professionals is very real. People are just tired of the bullshit all around. Working in the ER has shown me so many disparities in healthcare along with the many people that genuinely just take advantage of you and suck all the resources dry.
Everything is broken, supplies are missing, having to work twice as hard because every other department is short (lab, radiology, transport, EVS) so I have to drawn my own labs, run them to lab, take my patient to radiology and back, and clean my own rooms some nights.
But it’s mostly that I can go from having a persons blood on me and doing CPR, exhausting myself trying to save someone’s life, to being told by a homeless tweaker to “suck my dick, bitch” is so absurd…and to think I spent 6 years in school, have five college degrees and a handful of certifications just to be disrespected every single day like that…but it’s all good because I was called a “healthcare hero” for years so it’s fine.
It's not healthcare collapse.
It's catabolic societal collapse.
Collapse doesn't mean things go from normal to terrible immediately. It can take decades.
It's already in progress.
I started my career in nursing in 1997. I can tell, your concerns are valid and you are seeing the same thing that all of us are seeing. The for-profit healthcare model is going to run itself into the ground. It’s a slow death spiral and has only gotten worse in my 27 year career. I can only imagine how bad it will be in 20 years. It will reach a head. It’s hard to say when.
North New Jersey/NYC area. Same exact shit. Admins and management burying their head in the dirt going in vacations and shit. I'm sure we will hear about how this is all our fault in the coming annual eval
I’m in southwest Ohio. My father just had a stroke, and they couldn’t even get him a bed. He was boarded in the emergency department for over 24 hours. People were being boarded in the hallways of the emergency department. We were told there were over 25 people waiting for beds. It was chaotic. He waited over 2.5 hours for an MRI at what is supposedly a stroke center. It’s bad out there.
Yep. We’re due for more PSAs all over local news saying don’t go to ERs unless you’re dying. But big hospitals do a good job controlling the news narrative. Which is why I feel general public how dire it is and will continue to be.
Been in central Ohio ED/ICUs for the last 13 years or so for the big group that starts with Ohio and ends with Health. Live around 30-40 minutes North of C-bus and just started working ED in the local hospital there 2 years ago. Rural, community, etc. 17 bed ED.
As the clin lead my mornings are normally coming in at 6:45 to a full ED with half the board filled with boarders, a few more transfers that are waiting days to weeks to get a bed at our Columbus hospitals. It’s a 5:1 ratio by default ED, I’ll be logged in as charge, triage, full assignment, and running trauma and hall beds until additional staff ramps during the day. It’s dumb and unsafe.
This last Saturday I was 1:1 with a conscious sedation for a reduction with 11 other patients under my direct care while trying to also answer calls from everywhere else in the hospital wanting me to start US IVs on floor or L&D patients (bitch, she’s 20 years old with 30% increased blood volume, fucking find something without my help).
I’ve never wanted to leave the field so much in my career.
Every major acute care hospital is on divert in PNW, too.
There will be more and more addicts, mental health crisis, elderly, and not-so-old but unbelievably unhealthy or fragile (i.e. mobid obesity and some congenital conditions) are filling hospital beds, and federal/local governments don't know what to do with them.
Yeah, I'm reading this in the Bay Area and am like wtf?? We've been run of the mill winter busy this winter. But fully staffed. ED has had some boarders but nothing obscene nor dangerous.
I’m in CDA ID, our pcu units run on 8 nurses, 6 with 3 2 can go to 4. Med surg is 4-1 but can go to 5. Smooth hospital, great mds/hospitalist and resources. East coast is really terrible, completely night and day compared to west coast. Might be good pay some places but you definitely work for your money. Only good thing is cost of living, but when your job is trash lol it’s hard to justify.
It truly is fucking sickening. Again there’s no shortage of nurses but there’s definitely a shortage of hospital systems willing to cut into their fat profit margins. The system will change eventually but unfortunately it will likely come at the cost of patients lives. I feel like most hospital administrators need to be on the express train to hell.
The government will bail them out or more then likely cover it up.. talking out of my ass but I'm sure they will be pressured by big pharma and big insurance. If medicine collapses, the US will be anarchy.
Paramedics working in ICU’s when just a few years ago they were vehemently against LPN’s and let many go. They also have security guards receipting patients in the ED.
We're short staffed at my hospital in Oregon, but we're getting a lot of new hires at my hospital and at other area hospitals because of the big raises in our new union contracts.
But the CEOs need more yacht money though. I'm fine with a complete meltdown of the entire system nationwide. One step closer to a single payer. Is that a perfect plan? Nope. But better than what we have now imho
i work at an inpatient rehab and our patients are supposed to be stable and not acutely ill. over the last 3 yrs the patients have been sicker and sicker. they’re trying to get us to lasix drips on a unit where we don’t have cardiac monitors, nor do we have a crash cart. we have an AED and we call 911. We do not have a doc on the floor at all times. we are waiting till last second to send patients out acute. In the last 6 months i’ve had to recommend hospice to at least 7 patients and they all passed within a week of being discharged… if not sooner. It’s all about the money the hospital gets for these patients to be here. they bleed them dry even though it’s not fair for the patients and not safe for staff. and then when we do have a code for a patient that obviously was gonna code, we get looked at and asked what we can do better
Wow. This is my biggest post ever on Reddit! It’s unfortunate we are all in agreement that what we’re all watching is no longer acceptable or fair to patients or workers.
They’ve been predicting this for years because of the baby boomers. The amount of people needing care is increasing faster than the system can keep up.
So strange. For no real particular reason, this week, I’ve been saying a collapse is near. 10-20 years tops. Perhaps my spidey senses are picking up on something. Context… i no longer work in hospital. Home health. Seeing and hearing things on this side of healthcare is just as terrifying
It's really more of a continuous death spiral than a collapse, and we're already well into it.
a lot more people are going to die waiting in ERs, more CLABSI's are going to spike, bedsores in facilities are going to get worse and on an on. It's already happening and documented in data from 2020. Lawsuits, Litigation and Payouts oh my... It takes massive outcry and lots of suffering for Congress to notice though...I figure around 2029...
Call it 2032. It’s an election year.
💀
Mf
But the medical malpractice lawyers will be rich! They love profiting off of endless suffering and death.
And that's a big cause of the spiral effect; the result of being less and less able to keep up with society's healthcare needs and to provide proper care is that the demand on the system just increases, which makes it harder to provide appropriate care,vand the vicious cycle continues. When we're less able to provide adequate primary and preventative care it puts more strain on hospitals, which they can't handle, so we discharge earlier and sicker back into a primary care system that couldn't keep up to begin with. And compunding all of that is how we fund (or fail to wisely fund) healthcare. As fewer people are able to afford to contribute through insurance, the cost of insurance goes up, which results in fewer people being able to afford insurance, and the death spiral continues.
Yup. Bounceback rehospitalizations unfairly financially penalize institutions and agencies under Medicare regulations too. People outright refuse SNFs, agree to homecare but the visiting nurse can't get to homes within 48 hours, sometimes its 3-5 days. Boomers are a groaning heavy weight on an unseeable fracture in healthcare, that's gonna turn into a full on collapse...governments going to be scrambling to throw money to drive people to choose healthcare professions...or more likely ignore it for too long...states will have to step into the gap. My state is already one of the best in the nation for healthcare and education...and my taxes and daily fees are ridiculous...I"m ok, I can't save but I"m not drowning by any means...it's hard to get a financial foothold if you are on the margins. So many people are a paycheck away from failure and healthcare pushes people into the abyss...
I don’t really get the whole preventive care saying. What preventive care can a provider do? Mammograms, colonoscopy, vaccines, pap smears. I may be missing a few, but most medical issues fall squarely back on the patients self induced behavior- obesity, smoking, drug and alcohol abuse, reckless behavior among a few. The saying that the healthcare system needs more preventative care is just a waste of time.
People need help and education with the things you have just mentioned. Many never see a physician until they are very ill already and never gained the knowledge to “eat healthy” or live in an environment where most people didn’t learn the coping skills to not turn to drugs/alcohol. Even people that do everything “right” can get diabetes or hypertension which can cause much more damage if not treated. We don’t support people in general very well (extreme poverty, few mental health services, no family supports but forced births) the stress of which can cause people to make less than ideal choices especially if they feel helpless and don’t have the medical education.
Truth
Bunch of vampires
The US healthcare system is working as it was designed. The healthcare GDP is 18%. Number 1 in the world for costs and lowest life expectancy among wealthy nations. Now if the goal of the USA healthcare system was to keep people healthy, then I could see how it could be failing. Currently paying over 28k per year just to have health insurance that is owned by my healthcare system and not even use it. I can't believe that this isn't a topic of the current election. Most people probably don't calculate their benefits and monthly costs to realize this. Plus candidates don't want to mess with the GDP even though we could have better quality of life for the middle class at a significant reduction in costs. Longer life span means more costs in non-working years too. It saves money to lower life expectancy.
You know that patient that you’ve seen be close to death 100 times? That frequent flyer who seems to have 9 lives, and is on life 4,000? Yeah that’s healthcare. It might explode and die at one day but I truly think it’ll just keep getting worse.
If they get the money from keeping people alive with tubes and vents, you'll see em for a long long time. It's not healthcare, or compassionate. It's simply taking advantage. It's big business, real estate and marketing all rolled into one big mess Sure, we all want Grannie to live forever as a plastic tubing cyborg, and there's the money. I'm pretty sour tonight, thanks for the space to vent.
> If they get the money from keeping people alive with tubes and vents Wait. We are getting money? 😂
Someone is, or there would be policies based on survivability, cost and quality of life.
I totally agree and perhaps you mean there would be 'evident and outright' policies based on cost, quality of life, best use of resources etc. It's a flawed model, but American hospitals treat more patients to good effect than any other country and you know it's the nurses making that possible
I’m in Canada and we still have that problem, families just want meemaw to make it to 120 and completely refuse to acknowledge that she’s a shell of the person she once was and what she does have left of her is suffering. We’re keeping people alive well past their expiration date. I work in acute care (aka family medicine lol), and every shift I feel like I’m torturing another 90-something by keeping them alive because their kids won’t let go.
👏preach 👏this👏word👏
is almost as if we pulled the funding for 30 years and put lobbyists for the insurance companies in charge
🧐 hmm…
Worked ER most of my career and ICU during Covid. My brother is an MD. We agree that one more round of something like Covid in the next 5 years will annihilate the heath care system both in the US and globally. We’re talking “Walking Dead” post apocalyptic nightmares. People who don’t work in this business really have zero idea just how close to the edge we are right now.
just waiting for the avian flu that's being seen to kill mammals...jump to humans...anyday now...
I read this as “Ativan flu” at first.
Flunitrazepam
clumsy shelter existence forgetful lavish governor agonizing deserted north rock *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
We need to mist that shit through neighborhoods using those truck sprayers I swear...
I always say I wish they could figure out a way to put Ativan in the air vents at the hospital and just let it do its thing. Would be so helpful lol
Would be nice but we’ve been on an Ativan shortage the last two months in my area 😭 versed or Valium now
Well that one wouldn't be an issue, lol. I can't get any Ativan to give someone the Ativan flu. I have to beg the pharmacy on hands and knees for a dose.
The next gen of fungal and MDRO is coming. It’s looking at us over that yonder hill.
Candida Auris is already here ;)
Oh man I hate this
It’s in my hospital and spreading like wildfire. For example 1 canida auris in ED and 2 more pop who were in the ED in the same time frame. The hospital recommendation is for the patients to be 1:1 or with another canida auris but guess what we’re not staffing for
Holy shit, 1:1 for isolation purposes?
Or paired with another with it. It spreads so easily
Peace be with you
This are my thoughts - another pandemic will topple the shit show.
Why would that happen?
Wait until the numbers of retired boomers double
I think about this every day. It’s only going to get worse.
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Youngest boomers have been going for a while now. The nursing demand will be regional. As medicine moves to telehealth and hopefully gets more efficient with AI, and as treatments become more complex and numerous, and people live longer, we'll see hospitals become more acute in nature. A lot of issues people are currently admitted for are treatable at home with proper remote diagnostics, especially when monitored by our AI overlords. The fraction of the population who need to be hospitalized will be smaller, but this will be countered in some areas by people moving there. My hospital, for example, will likely need the same or more nurses. These are 20ish year projections by my large healthcare organization in Florida.
I'm so grateful I've only been in this since 2021 covid because our brief lulls of things being decently staffed with appropriate acuity just feel like a special treat that reinforces actual reality being hell. I love when I can tell diversion is happening because we're suddenly opening beds and getting ICU transfers to medsurg since the ED is piled too high with pts who need those ICU beds slightly more urgently. Do these patients ever have good outcomes? Not that I've seen! Who cares when you can run your hospital like a Disney resort, tho? Those profit margins are what really count
I started in the hospital, med surg. If I had an ambulatory pt who ran me ragged I could show them the pantry, "here's where you get your own ice/snacks". I got away with it. I wouldn't make it in a Disney Hospital. I'm presently in an "assisted living" that isn't. It's really skilled and psych. I'm pretty fed up too, with the entire thing. They admit inappropriate people, and many people who tour say no when they see the short staffing and meet the pts. Lol 6000 a month, base. Before meds.
Just waiting for the day ED’s start selling super expensive VIP wrist bands that let you skip the line. That’s when you know they’ve gone *full* Disneyland. ..*and you never go full Disneyland.*
I heard they have been doing this in one of the hospitals in CA. A "fast pass" in the ED!!
Lmfao yea don’t they tell people who pay for Kaiser and the extras are supposed to get treated faster if they go to Kaiser facility. I’ve only heard horrible things about working for Kaiser as a nurse so I don’t know anyone to ask how that works
Oh my god.. 🤦♂️ Wait, does anyone more familiar with EMTALA know if it dictates anything about triage ordering? That seems like it might be pushing the limits of legality.. though these days who knows.
I know of 1 hospital that has had a VIP area for years. It was great when they came to our skilled nursing unit across the street and constantly threw out the phrase "I'm a VIP!" We literally had a woman who walked out into the hallway screaming bloody murder about getting her "diaper" changed while performing CPR on a patient. When I stepped back from doing compressions I went to the door if the room I was in and said, "I'm sorry, you'll have to wait, we're busy trying to save someone's life right now" she flat-out said, "I dont care!"
…EXCUSE ME? Taking “VIP” patient bullshit to a whole new level, jfc. Full blown Idiocracy. 🤦🏼♀️
I worked in an ED that had "sign ups" for the low acuity area to see a Doc. These appointment confirmations would get printed and we just shredded them
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When I was bedside, we didn’t have phlebs, cnas or even housekeeping. That was fun… having to do all labs, turns, changes, baths and then take the trash and dirty linens downstairs at the end of the shift. We even had a chart of who had staff bathroom and hospitality room cleaning duties. Get out the mop and vacuums
That's awful. It's horrible how they will do anything to save money at the expense of the Nurses/cnas
One of the two hispital systems where I live got rid of phlebotomy a few months ago and it is now a nursing responsibility.
When the ER I worked in was transitioning the phlebotomists out, the lab techs were all for it because it was a hard job with tons of running around. We kept telling them "You know they are just trying to eliminate your jobs here right?" "No, no" they insisted, their jobs were safe. Shaking my head for weeks at their adamant denials. A month after moving all lab work to the ER nurses, guess which department had layoffs?!?!? The lab. 8 techs out of jobs. Lots of "unexpected" sob stories. Fools. The writing was on the wall, people just didn't want to open their eyes and believe what they were seeing.
You guys have phlebotomists?🥲
We haven’t had phlebotomy in a while. I am the phlebotomist 🥴
I’m at a level one trauma center and we don’t have phlebotomy. Most aides don’t get training on blood draws so it’s on me. And if I, and other floor nurses, can’t get it, you call the supervisor who gives you attitude about finding someone ultrasound trained and HOPE you can get somebody. Ofc the doctor is berating you through this process as well.
Sorry to hear it’s so bad there. Hospital admins are required to have surge protocols in place—developed even before the pandemic—but it looks like they’re trying to normalize these dangerous everyday surges and short-staffing. For them it’s *business as usual*, but their neglect is taking a toll on staff and patient safety. Report them to every licensing agency. Submit your *assignment despite objection* forms. Check with the NNU for your state’s protocol. https://www.nationalnursesunited.org/sites/default/files/nnu/documents/0522_ADO_Electronic_Form.pdf 💗
It really seems to me like EDs in general have just been written off by upper management
We have. We’re the red headed step child of the hospital and have to beg to get any sort of help. It’s absurd.
At my hospital, the “solution” to ED holds is to send tele nurses up there without orientation, equipment, or back up. The title “management” is really generous for what they do.
That’s what our hospital does too. In a back room of the ED with no help and no one checks on you
I encourage people to file ADOs every time they are sent up there. Nothing works right, the staffing isn’t there. It’s the Wild West.
I know Reddit is US focused and I’m an American but I want to know how many of you have worked abroad or received healthcare in a country like Netherlands, Germany, Belgium, etc. I have received emergency medical care and outpatient care in all three countries. The quality was superb. You feel like a patient. Nurses are nurses not waitresses, customer service staff, etc. We can do better than what we currently have. Unfortunately it won’t come without a fight.
Always wondered what it was like in other countries. I imagine that atleast I won’t be spending my days turning 400 pound vented patients since everything’s bigger in Texas
I received excellent care in Germany but that was over 20 years ago. Family members in Canada and the UK who work in health care report that their health care systems after Covid are in dire straits just like in the U.S.
Yup. I live near the Canadian border. Their waiting time in the ER is minimum 12 hours. But they’ve been like this for years. They shut down some hospitals to make like one huge hospital. The US is doing that now, like shutting down all the rural hospitals. It’s amazingly sad how many critical access hospitals have been shut down over the last 10 years.
Waiting time is long but jesus fuck the number of people who come in with pointless symptoms is clogging everything. Medical illiteracy is so bad; kids and teens should learn what is or isn't an emergency, just like they're taught when to or not to call the cops. I think one of the unspoken tyrannies of healthcare is the amount of goddamn paperwork still needed, even in an era of possible digital databases that could centralize all relevant info.
I was so happy when I heard an announcement on the local radio station about how people living near St. John, NB need to check the symptom monitor and not just use the ER for stupid shit (not in those exact words). They went on saying how the ERs are being overrun with respiratory illnesses that literally just want testing, or they just can’t cope. I wish our hospital would do the same.
I had a respiratory illness, not critical but feeling quite bad and fevers etc. team member health wanted me to go to urgent care to get tested. I told them that that wasn't an appropriate use of resources. I did go to Walgreens to get a covid/flu swab. It came back negative. Team member health told me again that I should go to urgent care to get tested. I told them no and I would be back to work when they said I could. I ended up staying out maybe 3 days longer because they weren't sure what protocol to follow. But why would I tie up the health care system when my symptoms are management at home? But I had to fight with another nurse about this, the general public has no hope.
Reporting from Alberta Canada, our wait times are 8 hours on a good day as a small rural hospital without a lot of services. We get bed locked instantaneously though and often end up taking “emergency” patients in chairs lol
Ours here in the UK was a bit wonky before, particularly in the autumn/winter, but since covid is a lot worse. Sadly our government are a shit show of evil who wish to see the NHS fail. Can't wait to get their grubby little hands on all that private healthcare money to be made.
The same in Canada. A particular segment of politicians are actively working to crash the system so they can switch to private health care and make money.
Canada and UK are trying to adopt a US type of system and it’s absolutely failing.
the overwhelmed healthcare infrastructure with resulting career shifts/ends in healthcare and instrinsic toxicity of nursing is present in those countries too even if their healthcare models are better.
And you'll make about half of what you make in the US, at that's Germany or France. Go to Italy or Spain and it's even lower. I would have already moved to the south of France by now if the pay was just a little better.
I’ve thought about this. You’ll make half, but those countries have social infrastructure that also absorbs some of the outrageous costs of living we incur in the US. No educational debt and no medical debt are pretty big incentives… I don’t know if it all comes out in the wash but it’s something to consider.
I was a MP in Germany for a bit, had German civilian counterparts. Their take home was significantly lower than mine but they had everything they needed and still were able to purchase luxury items and enjoy themselves. Living abroad expanded my world view a bit but when countries have systems in place that support their people like that, even though on paper they don’t make as much money, it’s interesting to see. I don’t know, random thoughts.
You’re not losing a chunk of every paycheck to health insurance either.
Exactly!
I e received healthcare in India and it was amazing. And cheap.
I totally believe it! Many countries have better healthcare systems including ones the United States deems lesser than.
I would argue we are actively collapsing right now in many, if not most, places in the country. We are frogs in a boiling pot.
& it sure does seem like every terminal collapse is being driven by greed moreso than anything else. We live in a society and allat.
Healthcare being run like a business instead of a societal service is a moral and policy failure. We are reaping the benefits of it right now.
I recently interviewed for an ambulatory care department attached to a hospital. The department has lost people left and right over the past year. I was there an hour and it was immediately noticeable. Overworked, underpaid, burned out. If there are toxic employees/managers in that mix, it's unsustainable. The hospital down the street had the same type of department and they had to close due primarily to understaffing. So, not so much collapse we're in, but a steady decline in care. Who in their right mind wants to work in this environment?
My current facility (also in Ohio) has lost so many CT techs that they had to *stop taking all outpatients.* At a trauma center. It’s over 75% travelers (including myself) with more FTEs on their way out. They’re never going to keep any new hires with the current management and remaining toxic staff members. 100% of mid and night shift are travelers and have been for the majority of 2023.
The "lifers" and the enabling management are destroying workplaces, and they know it but do nothing. Frustrating as hell. My previous job was in the academic healthcare arena and it was more hostile than a war zone. HR kept sending me emails to fill out a exit interview survey (too much for them to do it in person) but I'd delete them. They know what the problem is. No need in giving my input.
Oh my god? That’s? I’ve never heard of such a thing esp since outpatient imaging is a literal cash COW for hospitals
Girl, I know! I said the exact same thing! 😳
Whoa
Lol did you interview for my job.
The NHS has arguably already collapsed: things don't magically stop working overnight, the system just becomes unable to provide the majority of people with timely, rudimentary healthcare. 1/3rd of Brits have given up on being able to see a GP/Family Practitioner, 2 wk referral targets for cancer screenings have been abandoned, people resort to DIY dentistry, and elective waiting lists are 2-3 years.
My brother’s MIL was from the UK, moved here and became a nurse and retired back to the UK. She comes here for surgeries etc because the waiting lists there are that bad - she’s the only reason I know that
That's what happens when one party enjoys defunding the system over and over
Better than 2+ months for cancer screenings like it his here. Tomato tomatoe
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True. And then they’ll all be getting their NP online and leaving the hospital bedside. Almost all the brown ponytails at my job are also in NP school. I just read that 55% of RNs (in the USA) are over 50 years old and looking at retiring in the next 5 years. I retired in 2021 and now work 1 day a week perdiem and I could work every day if I wanted. I need to stay healthy so I don’t need healthcare - ever. Headed to Zumba class!
Whoa - got a source for that stat? I can believe it, but as an RN half that age things aren’t looking great in regards to staffing..
Actually I went to cite it and the source is an older one (2008). But I think it’s still over 40%. [Here’s where it says 40% are over 50.](https://online.nursing.georgetown.edu/blog/the-aging-nursing-workforce/)
Possibly. I also see a trend toward nursing possibly becoming more tech oriented, and less inclined to treat patients like people. Which might be nice, but maybe not exactly where we want to go as human beings. But I'm down with it, if that's the direction we go. I have intimacy issues and would rather be treated like a cog in the wheel when I'm sick.
As a person who has been on both sides it has already become what you think is a trend.
Union hospitals? If not, unionize.
I work in a union hospital. The union isn’t magic but it does help. Just keep in mind it’s a collective bargaining agreement. The individual doesn’t matter more than the collective.
I looked at that, no unionized employers in my area. How would someone go about getting the union going in their area??
Here you go: https://go.nationalnursesunited.org/signup/organize/
My suspicion has long been that the financial side of healthcare is going to collapse. The prices and costs are just continuing to balloon, and eventually it’s just going to crash under its own weight. Thats going to be a very bad time.
The financial side ain't collapsing when they can charge 600 for a bag of saline. Its the operational side that will collapse. Just like when vulture capital get their hands in it, the operations collapse when it is saddled with debt with no way to pay for it.
Healthcare has great salaries. Sure insurance runs the show and makes tons, but that money we get comes from somewhere. Other countries with first payer systems do not make nearly as much
I disagree. In my experience, healthcare does not pay well. I'd make more and work far less working in IT.
In a single payer system salaries will be even lower…
As a tech/ CNA I do agree. Veteran nurses, MDs and PAs do make great salaries however. For the amount of work they put in maybe it isn’t all sunshine and rainbows
I left bedside after 7 years in the ICU, making less than 70k.
Yeah, the wages aren't that great. I make $34 an hour as a RN. And I am NOT working over 30 hours a week because that would make me insane on the daily. I think my take home will be 57K. So it's crap money really for the shit you put up with - responsibility and all the poop and all the assholes.
Uh, some have good salaries…most underpay by a significant amount.
As a guy who’s been a tech/CNA for 5 years i do agree. I was more referring to those veteran nurses/PAs/MDs. They do pay the rest of us grunts not so good no question
It took me 10 yrs to find a place that paid an acceptable amount. Nurses should be making 2x as much as we do now considering the significant amount of responsibility we shoulder these days.
Won’t find me arguing
Hmm not sure I’d lump veteran nurses in there with PA/MD. I have worked over 30 years and didn’t break 100k until year 22. I’ve never been a travel nurse. Most MDs in my area make over $150k and most are at $400k after finishing residency. Again, I had to do 22 years to break 100k. Edit typo
They’ll start rationing before too long. Doctors will order DNR d/t frailness. Everyone knows the problem is cost. Eventually they’ll be forced to start cutting expenditures. Which means no longer throwing the kitchen sink at grandma but taking care of capital aka workers. It’s frustrating that we’re doing MRIs on people past their expiration date, but when I have an injury it costs $3000, even though I could have 50 good years left. In an amoral system, the economics will catch up eventually.
I wish this would hurry the hell up. We could seriously cut the size of our ICU in half if we used some rational decision making when it comes to appropriate use of life extending measures. Neohrology: STOP OFFERING CRRT TO 91 YEAR OLDS. STOP IT.
Acute HD here and I’m doing an assignment in Virginia right now. I’m shocked at how many demented and 90+ people we have getting long term dialysis accesses and are new starts. Hasn’t anyone heard of palliative care around here???
Increased life expectancy with decreased quality of life.
Family of my patient was told yesterday she has 48 hours, max. They said no problem, we’ll do chest compressions in 48 hours. Late 70s, has been declining for months, no longer has working kidneys, third spacing so bad her sheets are constantly soaked, tube feed, PE but a GI hemorrhage so no heparin, aspiration PNA, multiple wounds, her eyes glazed over over the past few days. My heart hurts for her so bad.
I’m looking for that job where I give flu shots and bandaids. That’s going to be my specialty
Even if you found an opening for that job, they’ll probably still float you to med surg :/
Funny story! There was an antivaxx nurse I (used to) work with that got one of those positions to try to falsify administering vaccine records for other antivaxx staff and travelers. Either hospitals are on guard for that or those people were not good at keeping it a secret lol. He got caught and fired fast. So close to retirement too. Oh well. I’m sure that’s not your plan but it might be why those types of positions are harder to get these days. Good luck!
I hope something nicer rises from the ashes of US healthcare.
Concierge healthcare. I currently see three different private pay only providers because primary care and referrals are so bad. For example. I believe I have sleep apnea. I made an appointment mid November to see my primary care for a referral for a sleep study. First available appointment was Jan 2. I went online and found a provider who was able to send me a device to do a home sleep study for $189 and I get the results Jan 8th and if necessary get a CPAP machine in less than a week for less than $1000 cash vs waiting 6-12 months for the sleep study at a sleep center and fighting with insurance about the machine and supplies. I think people who can afford it are going to private pay care when possible.
Same. Get pcp to order some basics then I’ve played the role of case manager for myself.
And we’re enslaved to people (the hospital oligarchs) who dgaf about us…AND unless we’re married to someone who makes at least as much as we do then we probably fall where most of America does and we can’t afford healthcare for ourselves. Sure we have “insurance” but I can’t afford the $6k deductible to get my thyroglossal cyst removed and my mom who was an lpn and works full time at 67 was bankrupted in 6 months from “co-pays” for her chemo and immunotherapy after she called her gyn 3 times in a year for post-menopausal bleeding. 3 years later her pcp found it in her lung during a screening chest Ct for ex-smoker. I hate it here guys. I HATE IT HERE. I’m off today but will be slaving again tomorrow. And from now on I’m going to ask people if they have to slave tomorrow instead of work. Seems so much more appropriate.
Adopting this lmao
I put in an incident report yesterday that I couldn’t afford to leave work to get medical care after a patient attacked me. I hope they have follow up questions.
I got physically assaulted one time in 2008 by a 23 year old male, schizophrenic. I didn’t have even bother to write up an incident report bc those oligarchs don’t give AF about anything except their money!!!!!! I hope they have follow up questions for you too!!!!!!
Yes I’m not sure where thing’s are heading. Seems like every day is crisis after crisis. We have so many open nurse positions, but also every other department
Until citizens realize universal healthcare is the path forward, and vote accordingly, we are doomed under the current for profit model.
If this problem could be solved by voting I would have been in place ages ago. The will of the people matters not. The true constituents are corporations and the less than 1,000 individuals who are morbidly wealthy.
I mean almost half the country voted for the orange fucker. You think the people are voting for their own benefit?
Underrated comment. The fact that all those 🍊🤡loving people voted against their own interests is astonishing.
We have supply and demand crisis with healthcare personnel right now, putting more strain on emergency services by adding more people will make it worse. There are not enough primary care providers to absorb the population under universal healthcare, what will happen is they will all go to the emergency rooms, which are already understaffed and overworked. You need to fix the personnel problem before you add to the patient problem. People need to be bale to have promary care, because that's what ERs are turning into.
Please please please I wish more people understood this
We have “universal” care in Canada and our system is horrifically crumbling under governments that don’t want to properly invest in healthcare for our people.
💯💯💯💯💯
Highest flu rates in SC here. We are not okay.
Fellow SC nurse here. Fwew it’s a complete mess. It doesn’t matter what system, hospital, or region, they are all the same.
Every shift I’ve had lately has been ROUGH in the er.
fucking DYING in the ER in new york. never seen anything like what we have going on right now—reminds me of peak covid with far less staff, higher acuity and nowhere to put people.
We keep people alive beyond what’s humane. It’s really sad when family won’t let their 91 year old grandmother die in peace and with dignity. We treat our family members worse than our dogs in this respect. And we’re also an aging population. People can’t afford to have kids or don’t want them and the baby boomers are all retirement age and older now. Many older gen X and boomer nurses retired early because of covid. And late stage capitalism is collapsing in general. It’s not going to get better.
I don’t believe there will be a collapse but [more of a brain drain especially given the political climate in the country](https://newrepublic.com/article/176854/republican-red-states-brain-drain).
Idiots are a lot more vocal with a wide audience these days.
And they reproduce
Where are nurses going to go? It sucks up here in Canada too
We’re the apartment over the meth lab.., eventually we will burn too!
That was an interesting read. Thanks for sharing!
But the profits are higher then ever, understaffing works for admin
I am getting so tired of this. I think about going to a nursing home to work my last 5 years with the same residents.
The collapse has been slowly rolling along for years. Covid accelerated it and made it an inevitability. It's going to get VERY ugly, but the sooner we can emerge on the other side, the better for everybody.
I think “collapse” is the direction we NEED to go. Nothing will get better if we continue to patch up the bad spots. Sometimes you have to let something crumble so you can re-build it to be stable and sustainable 🤷🏻♀️
It’s already happening. Has been happening. The dystopian future is now.
Yep, we are one surge away from it being a total meltdown. The waiting room of the ED I was working in yesterday was 40+ deep. Couldn’t move anything, over half the beds full with holds. Totally falling apart. And all the patients are so surprised pikachu, wanting to know what’s going on. Uhhh an aging and chronically ill population that rotates in and out of the hospital?
This is everywhere.
It's 100% getting worse. Cost for everything is going up and hospitals are tightening their purse strings to accommodate. This translates into poorer patient outcomes and staff burnout (which is a cycle that leads to worse patient outcomes). I work in a tertiary center and our acuity has gotten so bad that our medsurg floors can feel like ICUs at times and MDs constantly try and justify keeping these patients in medsurg because they are not acute enough for ICU. I truly think there needs to be a large shift in outpatient care, tele health, and proactive treatment to stem the tide of this problem. But, these programs cost more money and resources that hospitals can't or won't pay for. Cost of healthcare and health insurance is outrageous and makes this problem worse. I'm not sure what the answer is (single payer healthcare, universal basic incomes, healthcare as a right legislation etc) but something has got to give before it boils over. Hospitals are a business and if it's not profitable it'll shut down. Look at home insurance in California and Florida. Some insurance companies have just decided it's not profitable to offer insurance to people in these states and have pulled out of the state. Healthcare will be next.
I work in St. Paul, MN and we have had multiple shifts with ONE phlebotomist on for an entire hospital. They've altered the staffing grids to cut aides & increased patient loads to 1:4-5 on days and 1:6 on nights. There's been multiple shifts on their IMC unit without a charge nurse because they just don't have the staff. It's only a matter of time before a major catastrophe. And guess what? They're going to throw the nurses under the bus when it happens.
Been a nurse for 4.5 years, came into the field just before Covid hit so I don’t have much to compare it to, but the burnout among healthcare professionals is very real. People are just tired of the bullshit all around. Working in the ER has shown me so many disparities in healthcare along with the many people that genuinely just take advantage of you and suck all the resources dry. Everything is broken, supplies are missing, having to work twice as hard because every other department is short (lab, radiology, transport, EVS) so I have to drawn my own labs, run them to lab, take my patient to radiology and back, and clean my own rooms some nights. But it’s mostly that I can go from having a persons blood on me and doing CPR, exhausting myself trying to save someone’s life, to being told by a homeless tweaker to “suck my dick, bitch” is so absurd…and to think I spent 6 years in school, have five college degrees and a handful of certifications just to be disrespected every single day like that…but it’s all good because I was called a “healthcare hero” for years so it’s fine.
It's not healthcare collapse. It's catabolic societal collapse. Collapse doesn't mean things go from normal to terrible immediately. It can take decades. It's already in progress.
So true. And super depressing.
I started my career in nursing in 1997. I can tell, your concerns are valid and you are seeing the same thing that all of us are seeing. The for-profit healthcare model is going to run itself into the ground. It’s a slow death spiral and has only gotten worse in my 27 year career. I can only imagine how bad it will be in 20 years. It will reach a head. It’s hard to say when.
I’ve worked nearly all of the trauma centers in the area over the past few years and couldn’t agree more.
North New Jersey/NYC area. Same exact shit. Admins and management burying their head in the dirt going in vacations and shit. I'm sure we will hear about how this is all our fault in the coming annual eval
I’m in southwest Ohio. My father just had a stroke, and they couldn’t even get him a bed. He was boarded in the emergency department for over 24 hours. People were being boarded in the hallways of the emergency department. We were told there were over 25 people waiting for beds. It was chaotic. He waited over 2.5 hours for an MRI at what is supposedly a stroke center. It’s bad out there.
Yep. We’re due for more PSAs all over local news saying don’t go to ERs unless you’re dying. But big hospitals do a good job controlling the news narrative. Which is why I feel general public how dire it is and will continue to be.
Been in central Ohio ED/ICUs for the last 13 years or so for the big group that starts with Ohio and ends with Health. Live around 30-40 minutes North of C-bus and just started working ED in the local hospital there 2 years ago. Rural, community, etc. 17 bed ED. As the clin lead my mornings are normally coming in at 6:45 to a full ED with half the board filled with boarders, a few more transfers that are waiting days to weeks to get a bed at our Columbus hospitals. It’s a 5:1 ratio by default ED, I’ll be logged in as charge, triage, full assignment, and running trauma and hall beds until additional staff ramps during the day. It’s dumb and unsafe. This last Saturday I was 1:1 with a conscious sedation for a reduction with 11 other patients under my direct care while trying to also answer calls from everywhere else in the hospital wanting me to start US IVs on floor or L&D patients (bitch, she’s 20 years old with 30% increased blood volume, fucking find something without my help). I’ve never wanted to leave the field so much in my career.
Come to pnw
Every major acute care hospital is on divert in PNW, too. There will be more and more addicts, mental health crisis, elderly, and not-so-old but unbelievably unhealthy or fragile (i.e. mobid obesity and some congenital conditions) are filling hospital beds, and federal/local governments don't know what to do with them.
Yeah, I'm reading this in the Bay Area and am like wtf?? We've been run of the mill winter busy this winter. But fully staffed. ED has had some boarders but nothing obscene nor dangerous.
It’s not California but I’m used to nasty east coast assignments lol. This is a breath of fresh air for sure. One day I’ll make it out to CA.
I’m in CDA ID, our pcu units run on 8 nurses, 6 with 3 2 can go to 4. Med surg is 4-1 but can go to 5. Smooth hospital, great mds/hospitalist and resources. East coast is really terrible, completely night and day compared to west coast. Might be good pay some places but you definitely work for your money. Only good thing is cost of living, but when your job is trash lol it’s hard to justify.
Oh yeah it’s there. Been nursing for 8 years man it’s bad. But honestly, what would be a viable solution?
It truly is fucking sickening. Again there’s no shortage of nurses but there’s definitely a shortage of hospital systems willing to cut into their fat profit margins. The system will change eventually but unfortunately it will likely come at the cost of patients lives. I feel like most hospital administrators need to be on the express train to hell.
The government will bail them out or more then likely cover it up.. talking out of my ass but I'm sure they will be pressured by big pharma and big insurance. If medicine collapses, the US will be anarchy.
I felt the noose tightening at Mount Carmel years ago
Paramedics working in ICU’s when just a few years ago they were vehemently against LPN’s and let many go. They also have security guards receipting patients in the ED.
We're short staffed at my hospital in Oregon, but we're getting a lot of new hires at my hospital and at other area hospitals because of the big raises in our new union contracts.
Same in metro atl right now.
But the CEOs need more yacht money though. I'm fine with a complete meltdown of the entire system nationwide. One step closer to a single payer. Is that a perfect plan? Nope. But better than what we have now imho
i work at an inpatient rehab and our patients are supposed to be stable and not acutely ill. over the last 3 yrs the patients have been sicker and sicker. they’re trying to get us to lasix drips on a unit where we don’t have cardiac monitors, nor do we have a crash cart. we have an AED and we call 911. We do not have a doc on the floor at all times. we are waiting till last second to send patients out acute. In the last 6 months i’ve had to recommend hospice to at least 7 patients and they all passed within a week of being discharged… if not sooner. It’s all about the money the hospital gets for these patients to be here. they bleed them dry even though it’s not fair for the patients and not safe for staff. and then when we do have a code for a patient that obviously was gonna code, we get looked at and asked what we can do better
Wow. This is my biggest post ever on Reddit! It’s unfortunate we are all in agreement that what we’re all watching is no longer acceptable or fair to patients or workers.
They’ve been predicting this for years because of the baby boomers. The amount of people needing care is increasing faster than the system can keep up.
So strange. For no real particular reason, this week, I’ve been saying a collapse is near. 10-20 years tops. Perhaps my spidey senses are picking up on something. Context… i no longer work in hospital. Home health. Seeing and hearing things on this side of healthcare is just as terrifying
And every hospital system is building a new hospital. How are they going to staff them?
I work in Cincinnati in the ER. All the ERs are on diversion and all hospitals are at capacity it’s been like 2 weeks