Nursing Shortage

[Porfirio]

It is getting so bad. All these travel nurses, nurses going NP, and COVID burn out is taking a huge toll on nursing staff where I am. I imagine you all are noticing the same thing. The new thing is for all full time nurses to go day shift and all travel nurses to go night shift. Are you all having the same thing happen?

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[dr.wieners]

Yes. The NP market in my area is pretty saturated so I know coworkers who can't find NP jobs still working as nurses. The main issue around here is nurses taking lucrative travel jobs and the burnout of the constant turnover for those who have sticked around. The last few shifts I worked since being in school I barely knew anyone. Rough times

 

[RustedFox]

Yes. The NP market in my area is pretty saturated so I know coworkers who can't find NP jobs still working as nurses. The main issue around here is nurses taking lucrative travel jobs and the burnout of the constant turnover for those who have sticked around. The last few shifts I worked since being in school I barely knew anyone. Rough times

That dog, though...
Those glasses made me almost spit out my water.

 

[dr.wieners]

That dog, though...
Those glasses made me almost spit out my water.

I have five of them at home if you're in the market

 

[namethatsmell]

Yes. I've worked at places with mostly travel RNs at night. Since travelers generally don't know all the random hospital policies at a given shop, it's probably better that way since there's less admin around to make a fuss about it. And of course it makes many non-travel RNs happy to do mostly days and allows you to retain good staff.



And now for a semi-relevant tangent: how supremely ironic that we're talking about the RN shortage amidst a sea of discussion about the physician job shortage. I'm glad the OP started this thread to help reinforce the current cause-effect scenario...

Could a proliferation of NPs be a root cause of both problems?

If things remain bad enough, could the government and the American Hospital Association eventually consider pruning the wings on their midlevel golden geese to actually address a meaningful and significant workforce misalignment?

Since a purported tenet of the AANP is to help address the physician shortage--and since a physician shortage no longer exists in many fields of medicine--will they decide to reign in the practice of pumping out grads with no clinical experience relevant to independent clinical decision-making?












Answer key: yes, no, no.

Take-home points: You may love medicine, but the system (and it's market forces) does not love you back, especially as an EM doc. Now is the time to keep things simple. Find your way into a job you feel doesn't take advantage of you (whatever that means to you) and that you think is stable enough to ride out the long night ahead. Then burrow in, find ways to protect yourself and your patients, and batten down the hatches.

 

[CajunMedic]

Ours seem to be leaving for the travel contracts and better pay/working conditions an hour away. One of our campuses had 60 available inpatient beds with an ED full of boarders, but no nurses to staff them. We lost 17 experienced ED nurses over the span of 90 days. They came up with the bright idea around Christmas of "We'll pay you a 2000 "referral fee" for anyone that you recommend, but we're going to pay them 2.5 times what we pay you." They'll also float ED and floor nurses from the children's hospital to the Level 1 Trauma Center to get them their scheduled hours

 

[sylvanthus]

The whole situation is ridiculous, pay the staff RNs better, you will retain them and save money in the long run instead of blowing it on contract nurses. But, they clearly arent thinking long term, but looking at their budget for this fiscal quarter or some such BS. On the plus side, if I have no ICU RNs, I cant take admits, the ED is fuxxored, but not a damn thing I can do about it. Ive had to hold my ground and refuse to let any ICU boarders be in the ED as thats a huuuugee liability. I cant get nursing staff to do basic stuff on an admitted pt in the ED when they are just there for a few hours, no way im letting a pt board there. The ED docs prob think im a dick, and I understand it from both perspectives, but no way its safe to have an ICU pt hanging out in an understaffed ED.

 

[Groove]

I continue to find it hilarious that we have an oversupply of emergency physicians yet RNs can command 10-12K per week due to the nursing shortage. I know of 2 that took contracts for that exact amount in TX.

 

[sylvanthus]

Almost got an ED shift this am, shift opened up at 6 am, was gone by 612 when I noticed it. Hahaha well guess I get to be that guy that goes back to the ED 5 years from now with no recent ED experience.

 

[Rekt]

I continue to find it hilarious that we have an oversupply of emergency physicians yet RNs can command 10-12K per week due to the nursing shortage. I know of 2 that took contracts for that exact amount in TX.

Should start up some MD to RN programs

 

[RustedFox]

Should start up some MD to RN programs

No joke; a muggle buddy of mine asked me: "Why can't you just get a PA job if there are so many of them?"
He's a good dude. Best friends since sixth grade. Just is a muggle in as much as he has zero medical knowledge. Still knows enough not to go to the ER for dumb@ssery.

If it were only like that.

 

[southerndoc]

No joke; a muggle buddy of mine asked me: "Why can't you just get a PA job if there are so many of them?"
He's a good dude. Best friends since sixth grade. Just is a muggle in as much as he has zero medical knowledge. Still knows enough not to go to the ER for dumb@ssery.

If it were only like that.

Some of the travel nurses are making $120-150/hr (more with OT).

 

[RustedFox]

Some of the travel nurses are making $120-150/hr (more with OT).

- and yet, here we are.

 

[southerndoc]

- and yet, here we are.

There are some docs that aren't making that much. A friend of mine is a nurse who went to medical school. He still maintains his nursing license. He works in urgent care now, but is thinking of going to work as a travel RN to make more money with significantly less liability.

 

[RustedFox]

There are some docs that aren't making that much. A friend of mine is a nurse who went to medical school. He still maintains his nursing license. He works in urgent care now, but is thinking of going to work as a travel RN to make more money with significantly less liability.

- and yet, here we are.

 

[Mbekweni]

Some of the travel nurses are making $120-150/hr (more with OT).

At least that's what their travel company makes. I think they usually take a 30% cut or so.

 

[Porfirio]

Friend of mine who is an ICU nurse made $30-40k a month since this COVID crap started. Granted she has to travel around. She has no plans to stop.

 

[namethatsmell]

Friend of mine who is an ICU nurse made $30-40k a month since this COVID crap started. Granted she has to travel around. She has no plans to stop.

She's wise to make that hay while the sun shines.

 

[bravotwozero]

Some of the travel nurses are making $120-150/hr (more with OT).

$180 if they're willing to go to El Paso. No joke, an ED Nurse actually showed me that offer.

 

[Apollyon]

I knew of a dentist in one of the states where I worked that abandoned dentistry, went to nursing school, and is now very happy as an ICU nurse.

 

[southerndoc]

I knew of a dentist in one of the states where I worked that abandoned dentistry, went to nursing school, and is now very happy as an ICU nurse.

Trust me, on my second suit I've thought of throwing in the towel.

 

[GeneralVeers]

I couldn't do nursing even for what they pay these travelers. They have even less control over their work and scheduling than we do, and nursing culture is beyond toxic. Also I can't clean up poop.

 

[emergentmd]

This just shows how good and spoiled EM docs are. Even at our worse and RN best, most here would not trade jobs.

Our job is magnitudes better than RNs working in the worse COVID hospitals. Most of my friends in Texas are making 200+/hr who do not have to be in full PPP taking care of sickie ICU pts.

 

[sylvanthus]

Is it sad that the thought has crossed my mind of doing a NP online program for when they fire us all and replace us with midlevels? Least Id have a job then.

Farging sad state of affairs.

 

[Rekt]

Is it sad that the thought has crossed my mind of doing a NP online program for when they fire us all and replace us with midlevels? Least Id have a job then.

Farging sad state of affairs.

I mean soon there's enough residencies that we'll be making NP level wages anyway. Wouldn't they just hire new grads for 100$/hr. Unless you mean freely wreak havoc on other specialties.

 

[emergentmd]

NPs are killing their profession. If you think they are minting alot of EM docs, look at all of the online Phoenix NPs degrees where they work full time.

NPs were hard to find 5 yrs ago. Now many can't even get a full time job. Wait another 5 yrs when they start to become ubiquitous and their pay will start to settle alittle above RN pay.

Its all supply and demand.

 

[turkeyjerky]

NPs are killing their profession. If you think they are minting alot of EM docs, look at all of the online Phoenix NPs degrees where they work full time.

NPs were hard to find 5 yrs ago. Now many can't even get a full time job. Wait another 5 yrs when they start to become ubiquitous and their pay will start to settle alittle above RN pay.

Its all supply and demand.

Totes--although I disagree with your characterization of it as a "profession". Far from it, they're a bunch of f'ing amateurs

 

[RustedFox]

Totes--although I disagree with your characterization of it as a "profession". Far from it, they're a bunch of f'ing amateurs

Amateurs that are displacing board certified EM physicians because lolz, they're cheaper to pay and adminz don't care.

They don't even take a board exam. We take how many? They write a book report.

 

[sylvanthus]

Dude its a hard book report man, and the have “cLiNicaL eXPerieNce!”. Were gonna have flight attendents flying planes next because , you know, they have experience on flights and have seen other people do it.

 

[Rekt]

Dude its a hard book report man, and the have “cLiNicaL eXPerieNce!”. Were gonna have flight attendents flying planes next because , you know, they have experience on flights and have seen other people do it.

Heart of a flight attendant, brain of a pilot.

-Advanced attendant pilot

 

[namethatsmell]

Amateurs that are displacing board certified EM physicians because lolz, they're cheaper to pay and adminz don't care.

I just had a flash daydream of tying admin compensation to NP/PA misadventures/outcomes/excess care costs/lawsuits. And if admins choose to have a workforce that exceeds a certain MD : NP/PA ratio, they're liable to be personally named in all claims where a PA/NP was involved. I wonder if a good plaintiff's lawyer could actually pull this off in our current climate since it's the wise admins who are propagating a system without sufficient oversight in lieu of one properly staffed by folks with the highest level of relevant KSAs.

 

[RustedFox]

I just had a flash daydream of tying admin compensation to NP/PA misadventures/outcomes/excess care costs/lawsuits. And if admins choose to have a workforce that exceeds a certain MD : NP/PA ratio, they're liable to be personally named in all claims where a PA/NP was involved. I wonder if a good plaintiff's lawyer could actually pull this off in our current climate since it's the wise admins who are propagating a system without sufficient oversight in lieu of one properly staffed by folks with the highest level of relevant KSAs.

Sorry; my smooth brain doesn't know what a KSA is.

 

[namethatsmell]

Sorry; my smooth brain doesn't know what a KSA is.

Knowledge, Skills, and Abilities

 

[sloh]

This thread is so kafkaesque.

 

[Apollyon]

Just for history, but, did you know that flight attendants started out as nurses?

And, honest, props for not saying "stewardesses" (which happens to be the longest word you can type with only the left hand on a QWERTY keyboard)!

 

[RustedFox]

Just for history, but, did you know that flight attendants started out as nurses?

And, honest, props for not saying "stewardesses" (which happens to be the longest word you can tow with only the left hand on a QWERTY keyboard)!

- and here I got a kick out of typing "Carafate" with my left hand only.

 

[Boatswain2PA]

NPs are killing their profession. If you think they are minting alot of EM docs, look at all of the online Phoenix NPs degrees where they work full time.

They are also killing the PA profession. Hundreds of new NP grads every year in my rural state, most with student loans so desperate to take any job at any pay. Add that adminiscritters prefer NP > PA because less need for expensive physician supervision.

 

[emergentmd]

Yes, PA field is dying. I would not recommend anyone go into PA school. Better to go to RN then NP and if you can't find a job, you can make a good living as an RN.

The proliferation of online is ridiculous. It feels like more than half of all new RNs are doing their NP. There are so many jobs they can take from docs.

Its all a money grab. The cost of running these programs must be miniscule. On top of these online programs, the NP students have to find their own preceptors with little help. So what are they getting paid to do? A bunch of online lectures and study guides?

 

[sylvanthus]

- and here I got a kick out of typing "Carafate" with my left hand only.

Im a fan of sedated.

 

[Fart Daddy Smooth]

Friend of mine who is an ICU nurse made $30-40k a month since this COVID crap started. Granted she has to travel around. She has no plans to stop.

I did one ICU contact for 8 twelve hour shifts in Detroit for ~$10k after taxes and it wasn't worth it. Absurd workloads (3-4 vents/RN), no PPE available (I had to bring my own), you don't have any work buddies to commiserate with, and at the end of it you can relax by eating takeout in your hotel room. Those big contracts make you earn every penny.

Yes, that's a lot of money for two weeks work. No it did not make up for the hellish experience

 

[Brigade4Radiant]

The thing about NP is that many are going into derm and gain large Instagram followings.

Not a bad pathway if they can’t get an NP job they still make more due to RN shortage.