There are not enough nurses to take care of everyone who needs care, and it's getting worse....

[Hawk_82]

Many nurses WANT to be PRN so they have flexibility regarding when they have to go to work. We would prefer all full time (makes scheduling easy) but we're forced to patch schedules together with PRNs.

There definitely are some nurses who want to be prn, but that is not the case for the majority. Usually they are using the prn job as a second job.

If the nursing pay overall was better, then many wouldn't need a second job. Nursing homes are a great second job because there is zero skill required. Any nurse can do that job with a few hours of training.

 

[Jerome Silberman]

Student loan forgiveness is a good idea.

SJWs should also stop bad-talking traditionally female-dominated careers.

This is probably the easiest and most effective solution, and would likely be most effective if left to state governments with the backing of federal Grant's. The situation in Iowa is similar to the situation across the board, except it's being compounded by the fact that our state is the worst state in the nation for nursing pay. This almost guarantees that the bulk of those that choose to go into the field leave the state immediately for better pay. My wife(no pic) is a nurse in the OR and has been saying for years that the non-traditional students are the people that stick around, as they already have an established life here, while the new grads that get hired are almost immediately searching for work in neighboring states or with traveling firms. This has led to a 'sword of damocles' hanging over the state as the number of nurses dwindles while the aging population demands more and more services. To make matters worse the bargaining unit has been muzzled which effectively takes a major voice out of the conversation on how to attract more talent to a state that people aren't exactly beating down the door to get in to.

 

[unIowa]

How do we solve this problem? It's serious.

Girls are being told to not become nurses. "Become doctors" all the woke people are telling them! And the men aren't stepping up to the plate to take these jobs.

Accordingly, there are not enough nurses entering the profession to take care of everyone who needs care. There is a serious nursing shortage in this country, and it's getting worse. And the average age of nurses is rising. They're going to start retiring in massive numbers. There are not enough young people entering the profession.

Wages are rapidly rising, but that's not helping. And the companies that are paying more to get their ever-smaller slice of the labor market pie can't just raise prices to pay for it. The reimbursement rates are set by the government and the insurers, not the providers.

"Medicare for All" isn't going to fix this problem. Opening the floodgates to everybody will make the situation worse.

I'm going to need a nurse one day and so are you. What are we going to do about this?

"Medicare for all will solve this, it will solve EVERYTHING. Once the federal govt has 100% control of health insurance everyone will be covered and HC costs will go down bc smaller reimbursement checks will start getting cut to providers. Then nurses will come flooding in as their pay goes down due to those lower reimbursement rates." @JRHawk2003

 

[BrunoMars420]

Since the educational system is embedded into the federal and state government we have to use it to our advantage as citizens. I believe we should subsidize certain areas of needs in our economy for public institutions. Local and state governments should work with these companies that need these workers and provide tax incentives if they do a partnership with a school or have their own type of college like a nursing college.

 

[unIowa]

"Medicare for all" will make this problem exponentially worse. Wages will not be permitted to increase to meet the supply and demand curve.

I am just glad that I am a high income earner and have banked lots and lots of $s into an HSA account. Even in a govt run health insurance program there will always be ways for the well to do to get a higher quality of care.

 

[claykenny]

Never heard of providers going broke. Has to be very rare.

Apparently you've missed all the private practices and solo practitioners who have been swallowed up by larger health care systems.

 

[Run&Blade]

Apparently you've missed all the private practices and solo practitioners who have been swallowed up by larger health care systems.

Is that the same as going broke? I think not.

 

[unIowa]

Apparently you've missed all the private practices and solo practitioners who have been swallowed up by larger health care systems.

If we use the movie Arachnophobia as a guide you will see that the town hires a doctor in a facility that they collectively staff to take care of the citizens needs so there is a potential for a form of private govt funded general practitioners. The challenging part taking this route is the town will be invaded by spiders and many people will die before things start to get better.

 

[RNHawk]

I agree with everything being said

 

[Hawk_82]

So they are not underpaid, then, but are paid according to the labor market, right?

The labor market does not work for nursing.

Use Iowa as an example. UIHC is the biggest hospital in Iowa. The nursing wages at Iowa are decided by the bor with some input from administration. It is essentially a one sided negotiation because nurses and the nursing union have no say in wage increases.

Smaller hospitals in Iowa know that they are competing against UIHC for nurses, so they only have to be close in wages. But there are other factors like the kind of work you want to do or how far you want to travel, if you want to uproot your family.

In bigger cities if you get treated badly at on place there is another place you can go to. This is not necessarily the case in Iowa. In smaller towns the only options they might have are to work in a local clinic for garbage pay, travel an hour to work for ok pay but be treated worse or leave the state. These are not good option when you are dealing with a person who is only making 45-60k per year. Most people feel stuck because they can't afford to move and don't want to uproot kids. Therefore they are stuck working a crappy job for low pay.

The labor market is not dictating any of this.

 

[Jerome Silberman]

If we use the movie Arachnophobia as a guide you will see that the town hires a doctor in a facility that they collectively staff to take care of the citizens needs so there is a potential for a form of private govt funded general practitioners. The challenging part taking this route is the town will be invaded by spiders and many people will die before things start to get better.

Problem solved...

 

[srams21]

"Medicare for all will solve this, it will solve EVERYTHING. Once the federal govt has 100% control of health insurance everyone will be covered and HC costs will go down bc smaller reimbursement checks will start getting cut to providers. Then nurses will come flooding in as their pay goes down due to those lower reimbursement rates." @JRHawk2003

I don't think too many people view Medicare for All as a solution for every issue in the healthcare system.

That being said, what do you propose to help fix the nursing shortage? I find it funny that people who dislike any idea proposed for healthcare rarely seem to offer up any other solution.

 

[markfromj]

The labor market does not work for nursing.

Use Iowa as an example. UIHC is the biggest hospital in Iowa. The nursing wages at Iowa are decided by the bor with some input from administration. It is essentially a one sided negotiation because nurses and the nursing union have no say in wage increases.

Smaller hospitals in Iowa know that they are competing against UIHC for nurses, so they only have to be close in wages. But there are other factors like the kind of work you want to do or how far you want to travel, if you want to uproot your family.

In bigger cities if you get treated badly at on place there is another place you can go to. This is not necessarily the case in Iowa. In smaller towns the only options they might have are to work in a local clinic for garbage pay, travel an hour to work for ok pay but be treated worse or leave the state. These are not good option when you are dealing with a person who is only making 45-60k per year. Most people feel stuck because they can't afford to move and don't want to uproot kids. Therefore they are stuck working a crappy job for low pay.

The labor market is not dictating any of this.

Everything you described is the labor market working.

 

[markfromj]

I don't know that all nurses everywhere are underpaid, but in some states they certainly are.

What states?

 

[Jerome Silberman]

What states?

Iowa
Alabama
West Virginia
Kentucky
Nebraska
Mississippi
Oklahoma
Tennessee
South Dakota
Kansas
Arkansas

 

[unIowa]

I don't think too many people view Medicare for All as a solution for every issue in the healthcare system.

That being said, what do you propose to help fix the nursing shortage? I find it funny that people who dislike any idea proposed for healthcare rarely seem to offer up any other solution.

Wages will continue to go up as the shortage increases and that will take care of the issue eventually. This in turn leads to a higher cost of care as it will have an inflationary effect on the HC sector but that is how reality works and Bernie should be happy that nurses are getting paid more, we all should be. I am happy for anyone that has is able to increase their earnings even if they are already stinking rich...why vilify those people, if the situations were reversed 99.99% of the people bitching about these sorts of things would take the money themselves.

 

[srams21]

Wages will continue to go up as the shortage increases and that will take care of the issue eventually. This in turn leads to a higher cost of care as it will have an inflationary effect on the HC sector but that is how reality works and Bernie should be happy that nurses are getting paid more, we all should be. I am happy for anyone that has is able to increase their earnings even if they are already stinking rich...why vilify those people, if the situations were reversed 99.99% of the people bitching about these sorts of things would take the money themselves.

I'm not the one vilifying nurses getting paid more. Ironically, it's much of the righties in this thread that are against the free market doing its thing in this situation.

That being said, I do think aside from this issue, healthcare costs are skyrocketing for numerous different reasons. I think that is an actual issue as well.

 

[Jerome Silberman]

Wages will continue to go up as the shortage increases and that will take care of the issue eventually. This in turn leads to a higher cost of care as it will have an inflationary effect on the HC sector but that is how reality works and Bernie should be happy that nurses are getting paid more, we all should be. I am happy for anyone that has is able to increase their earnings even if they are already stinking rich...why vilify those people, if the situations were reversed 99.99% of the people bitching about these sorts of things would take the money themselves.

I dont doubt that on a long enough timeline, but the question is will it be fast enough to adequately address the issue? Our country is on the verge of crisis and to avoid an unreasonable drop in level of care these issues need to be addressed yesterday.

 

[goldmom]

Yep. Even in Iowa where there aren't any truly large metros, they are seeing people flood the few mid-sized metros in the state/region coming from smaller towns to work for large healthcare systems.

Btw, your son works for a system affilated with UF? So, he's kind of a Gator then? How does that go over

Ha ha he is NOT a gator, he just takes their money! He went to TCU and UT, got post grads at UNF and Ohio U. And grew up in a 100% Seminole house. He's going to start his Ph.D at uf though - it's nearly free as an employee - so that's too good to turn down.

 

[unIowa]

I'm not the one vilifying nurses getting paid more. Ironically, it's much of the righties in this thread that are against the free market doing its thing in this situation.

That being said, I do think aside from this issue, healthcare costs are skyrocketing for numerous different reasons. I think that is an actual issue as well.

HC costs are skyrocketing due to demographics, the huge boomers generation now moving into their later stage of life plus we are generally a very unhealthy populace.

1. Kill the Boomers
2. Make processed foods/oils illegal

HC prices plummet and outcomes improve

 

[goldmom]

I don't know that all nurses everywhere are underpaid, but in some states they certainly are. I was just commenting on market forces not playing into it as much as other fields. When everyone everywhere will eventually need health services, those services are mandated by law and the 'consumer' has little choice in providers at the time of need, market forces have little to do with pay scale.

As long as the workers have a choice in their employer, the market will have a say in compensation.

 

[unIowa]

I dont doubt that on a long enough timeline, but the question is will it be fast enough to adequately address the issue? Our country is on the verge of crisis and to avoid an unreasonable drop in level of care these issues need to be addressed yesterday.

Everything is a crisis these days. I will say this, if you put the govt in charge of all of it things will initially get better before it ultimately gets much much worse as the speed and quality of care will suffer greatly IMO.

 

[goldmom]

HC costs are skyrocketing due to demographics, the huge boomers generation now moving into their later stage of life plus we are generally a very unhealthy populace.

1. Kill the Boomers
2. Make processed foods/oils illegal

HC prices plummet and outcomes improve

You forgot a sarcasm emoji.

 

[unIowa]

You forgot a sarcasm emoji.

No I didn't.

 

[bdcolt45er]

I dont doubt that on a long enough timeline, but the question is will it be fast enough to adequately address the issue? Our country is on the verge of crisis and to avoid an unreasonable drop in level of care these issues need to be addressed yesterday.

As quality and safety go down due to fewer nurses the boomers will die faster.
It's a classic win win situation.

 

[goldmom]

No I didn't.

Then I guess I'll have to overcome my non-use of the Second Amendment.
Note no use of an emoji...

 

[seminole97]

Ask the administrators and insurance companies responsible for ruining health care.

The market would solve it, but it isn’t allowed to:

“The reimbursement rates are set by the government”

Price fixing and shortages?
It’s like we don’t have forty centuries of economic history to figure out how this happens.
Or we have a lot of ignorant people.
One of those.

 

[Jerome Silberman]

Everything is a crisis these days. I will say this, if you put the govt in charge of all of it things will initially get better before it ultimately gets much much worse as the speed and quality of care will suffer greatly IMO.

I'm going to break from Soro's big liberal playbook and say that this is an issue that is best handled at the state level, with perhaps federal grants incentivizing nurses do time in higher need states, similar to the Teach for America program.

 

[unIowa]

Then I guess I'll have to overcome my non-use of the Second Amendment.
Note no use of an emoji...

 

[goldmom]

As quality and safety go down due to fewer nurses the boomers will die faster.
It's a classic win win situation.

It's like with any other generation. The ones who didn't take care of themselves will die off quickly anyway. The rest of us just include half the Democratic field for Prez.

 

[Jerome Silberman]

As quality and safety go down due to fewer nurses the boomers will die faster.
It's a classic win win situation.

That seems to be route we're headed down.

 

[Hawk_82]

Everything you described is the labor market working.

The labor market works when there are options. It does not work when there are no reasonable options. This is why monopolies are illegal.

Nursing in the state of Iowa has the same effect as a monopoly. Most of these low wage nurses can not afford to leave the state, they don't have daycare for their kids if they had to drive an hour extra. Where are the options in that.

It is essentially taking advantage of people because you know they don't have the ability to fight it.

Business has a labor market. If you work hard in business you can move up the ladder, if you don't move up, you can leave. There are a lot more businesses than there are hospitals and clinics so it is possible to find what you want. The idea that nurses get paid according to supply and demand, reality is that is not really the case.

 

[unIowa]

I'm going to break from Soro's big liberal playbook and say that this is an issue that is best handled at the state level, with perhaps federal grants incentivizing nurses do time in higher need states, similar to the Teach for America program.

Most providers are not funded by state/federal govt dollars (not talking about reimbursements) so that won't work. Someone mentioned educational incentives for those going into and who work in the nursing sector, to me that makes the most sense. Something like how certain subject matter teachers can get loans forgiven via working in low income, special needs, subject matter specific, or a combo of those things.

That doesn't solve something in the short term but it does allow us to start filling up the pipe so this sort of shortage isn't a problem for future generations. Provide Incentives for the behaviors you want at the appropriate levels and you will be amazed at what can happen.

 

[srams21]

Then I guess I'll have to overcome my non-use of the Second Amendment.
Note no use of an emoji...

 

[Jerome Silberman]

The market would solve it, but it isn’t allowed to:

“The reimbursement rates are set by the government”

Price fixing and shortages?
It’s like we don’t have forty centuries of economic history to figure out how this happens.
Or we have a lot of ignorant people.
One of those.

Healthcare is a different animal that won't fit into the free market box. It's just not realistic to rely on market forces when the reality of the situation is the only choice we have at the end of the day is between getting care and forgoing care. You can't expect people to ignore the drive to live for the sake of allowing the market to dictate rates.

 

[Jerome Silberman]

Most providers are not funded by state/federal govt dollars (not talking about reimbursements) so that won't work. Someone mentioned educational incentives for those going into and who work in the nursing sector, to me that makes the most sense. Something like how certain subject matter teachers can get loans forgiven via working in low income, special needs, subject matter specific, or a combo of those things.

That doesn't solve something in the short term but it does allow us to start filling up the pipe so this sort of shortage isn't a problem for future generations. Provide Incentives for the behaviors you want at the appropriate levels and you will be amazed at what can happen.

Totally agree. I tend to view fields like nursing as being similar to maintaining a standing army. The ability to go into operations needs to be ever present, with a plan for bolstering the core of veterans with new talent should the need arise.

 

[Bloody Run Hawk]

There are shortages in many healthcare professions. Pay is not keeping up with the demand. Most workers are lucky to keep up with the price of inflation. The jobs are becoming increasingly demanding and morale is poor.

 

[unIowa]

Totally agree. I tend to view fields like nursing as being similar to maintaining a standing army. The ability to go into operations needs to be ever present, with a plan for bolstering the core of veterans with new talent should the need arise.

It also helps keep wages in this specific labor market down which also should help keep overall HC costs from rising too rapidly. Just have to look at the chain reaction of events and how those things play out in the long term, I don't like decisions that are made only considering the short term. Now, I get sometimes those short term/put out the fire decisions have to be made but they mostly have to be made bc of poor planing from the decade prior.

In this case I think people just need to expect slower and a bit lower quality of care and in the mean time hopefully those nurses that are in this situation get a bump in their compensation.

 

[theiacowtipper]

Some of these same issues apply to the market for EMS workers. The shortage for paramedics is significantly more acute, with some ambulance services simply staffing with basic level providers instead of paramedics.

Link to paramedic wages below, note that to become a paramedic requires about two years old college, start to finish. Median salary of 34k a year. That’s it.

Our wage problem is that our patient population is dominated by Medicare and Medicaid, who reimburse barely over costs. Medicaid under cost. Employers aren’t getting rich, they can’t afford to pay more. Prospective students ask why should they become paramedics when they can do nursing for the same length of school?

 

[Run&Blade]

Some of these same issues apply to the market for EMS workers. The shortage for paramedics is significantly more acute, with some ambulance services simply staffing with basic level providers instead of paramedics.

Link to paramedic wages below, note that to become a paramedic requires about two years old college, start to finish. Median salary of 34k a year. That’s it.

Our wage problem is that our patient population is dominated by Medicare and Medicaid, who reimburse barely over costs. Medicaid under cost. Employers aren’t getting rich, they can’t afford to pay more. Prospective students ask why should they become paramedics when they can do nursing for the same length of school?

The ambulance in our town can’t actually take you to hospital because it lacks a paramedic. They just stabilize until a “real” ambulance comes.