12,000 Minnesota Nurses Averaging $79,000/Year Strike

[bronx43]

Comparing them to nurses is such a non-sequitur...why pull that one profession out of nowhere? Why nurses and why not paramedics or PTAs or the social workers or administration? Is it because you work closely with nurses on a daily basis and therefore they are a convenient target of your frustration?

I hear this argument that you can't compare things a lot and I think it is pretty dumb. So we shouldn't be allowed to compare anything to anything else? Why shouldn't we compare physicians to nurses? Why not compare paramedics to physicians? Why would it be wrong to compare physicians to lawyers, teachers, police, etc? Because they are so different that it is impossible to wrap our minds around it and actually think about it? The reason you compare residents to nurses is because residents work many more hours, have more education, have at least as much responsibility and stress and yet get paid considerably less. That strikes me as a perfectly reasonable comparison to make.

Of course you can compare. But, the modalities with which you use to compare is flawed. I've already typed up a response explaining why comparisons using effort, education, and responsibility are useless, but in one word - market.

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[fab4fan]

It's so unfortunate that union membership is compulsory in order to work in some hospitals. That's another thing that irks me about unions. Mandatory membership is so insulting.

I think you misunderstood me. I choose to belong even though currently they don't represent nurses in my area. That's how much I believe in their mission.

 

[dpmd]

This did happen to the nurses over the last few decades too. They were being replaced by LPNs and CNAs. The difference is that no one ever argued that an LPN is as good as an RN or that they should be allowed to have the same responsibilities.

An LPN/LVN in certain states used to be able to challenge the RN board exam (I forget if they needed any extra official training). When I was completing my LVN training in the army I know lots of people who opted for this. So in a sense someone was arguing that some LPN/LVN's were as good as RN's. I don't know if this is still allowed though. I'm sure the RN schools didn't like it.

 

[emermed]

Of course you can compare. But, the modalities with which you use to compare is flawed. I've already typed up a response explaining why comparisons using effort, education, and responsibility are useless, but in one word - market.

Bronx43,

You have a one track mind. You do realize that there are many ways to make judgements. Economics is certainly one way, but there are also moral, ethical considerations. The mere fact that things are a certain way ie that the market dictates something, does not make those things right or fair. Further, it is somewhat ridiculous to state that the market dictates resident salary when there are clearly many rules and restrictions that hardly make a residents salary a "market" salary. Thus I think that the "modalities" I discussed are perfectly reasonable in trying to make a judgement about whether residents salaries are fair or not ie if you work more, have more education, and have at least as much responsibility as nurses, it is somewhat unfair to be paid less.

 

[bronx43]

Bronx43,

You have a one track mind. You do realize that there are many ways to make judgements. Economics is certainly one way, but there are also moral, ethical considerations. The mere fact that things are a certain way ie that the market dictates something, does not make those things right or fair. Further, it is somewhat ridiculous to state that the market dictates resident salary when there are clearly many rules and restrictions that hardly make a residents salary a "market" salary. Thus I think that the "modalities" I discussed are perfectly reasonable in trying to make a judgement about whether residents salaries are fair or not ie if you work more, have more education, and have at least as much responsibility as nurses, it is somewhat unfair to be paid less.

Morality and ethics? Are you serious?
Since when did morality and ethics come into play in a free and capitalist nation when it comes to the cost of a good or service? If the price is too high, you don't buy it. If the price is too low, people fight to acquire it, and drive the price up. How does morality come into play? The same principles play in medicine, health care, and any other profession.

If the pay is too low, no one does it. If the pay is too high, there is a glut of people to drive the pay to its equilibrium - or there is an artificial barrier or quota to maintain pay. You knew what the requirements were when you tried to enter the medical profession. You assessed the cost of education and the opportunity cost, and yet you entered it. No one forced you, as you simply employed your right in a free country. I mean, honestly... if you want to talk about moral and ethical, I can't think of a more ethical or moral system than a free country.

 

[emermed]

Morality and ethics? Are you serious?
Since when did morality and ethics come into play in a free and capitalist nation when it comes to the cost of a good or service? If the price is too high, you don't buy it. If the price is too low, people fight to acquire it, and drive the price up. How does morality come into play? The same principles play in medicine, health care, and any other profession.

If the pay is too low, no one does it. If the pay is too high, there is a glut of people to drive the pay to its equilibrium - or there is an artificial barrier or quota to maintain pay. You knew what the requirements were when you tried to enter the medical profession. You assessed the cost of education and the opportunity cost, and yet you entered it. No one forced you, as you simply employed your right in a free country. I mean, honestly... if you want to talk about moral and ethical, I can't think of a more ethical or moral system than a free country.

Really... Your idea of a free market is residency?

"or there is an artificial barrier or quota to maintain pay" there you go

Unlike almost any other job, in residency you don't get to pick where you go, you are matched. It is a system where you get one chance to match, so any thoughts of bargaining are thrown out the window. And is it the case that residents are only able to get a job one day per year because of the market, I hardly think so. If it is a free market, why do you have one year contracts, but your chance of getting a new job anywhere else at the end of one year is essentially nil unless your boss lets you. How is it a free market again when in three years your work environment could have changed dramatically, but again you have essentially no chance of switching jobs.

You state that "You assessed the cost of education and the opportunity cost, and yet you entered it. No one forced you, as you simply employed your right in a free country."

Do you really think the average Pre-med knows exactly what they are getting into? How many of them know what it is really like to be on call? How would they until they have actually experienced it? How many of them even know about the steps, because I run across them all the time who do not. Additionally, should all the people who are entering residency now be given a chance to get out since the health care bill has significantly changed medicine and yet they did not know about the health care bill when they decided to take on so much debt?

"Since when did morality and ethics come into play in a free and capitalist nation when it comes to the cost of a good or service?"

Are you crazy? We have hundreds and hundreds of laws regulating the market place in this country and many of them were put into place for ethical and moral reasons. We have OSHA regulations because it is immoral to say "if you don't want to work around toxic chemicals its your free choice not to work there." We have unions because employers abused workers and made seven year-old kids work seven days a week in the good ole days of unregulated free market. We have work hour restrictions and overtime rules for the same reasons. We need to regulate our financial system because many people choose not to act morally, and when they don't it has wrecked our economy. Morality and ethics definitly matter, perhaps even more so in a free market. With freedom comes a responsibility to act morally. People don't always act morally though so there need to be at least some regulations.

It just cracks me up that your idea of a free market is residency, LOL

 

[bronx43]

Really... Your idea of a free market is residency?

"or there is an artificial barrier or quota to maintain pay" there you go

Unlike almost any other job, in residency you don't get to pick where you go, you are matched. It is a system where you get one chance to match, so any thoughts of bargaining are thrown out the window. And is it the case that residents are only able to get a job one day per year because of the market, I hardly think so. If it is a free market, why do you have one year contracts, but your chance of getting a new job anywhere else at the end of one year is essentially nil unless your boss lets you. How is it a free market again when in three years your work environment could have changed dramatically, but again you have essentially no chance of switching jobs.

You state that "You assessed the cost of education and the opportunity cost, and yet you entered it. No one forced you, as you simply employed your right in a free country."

Do you really think the average Pre-med knows exactly what they are getting into? How many of them know what it is really like to be on call? How would they until they have actually experienced it? How many of them even know about the steps, because I run across them all the time who do not. Additionally, should all the people who are entering residency now be given a chance to get out since the health care bill has significantly changed medicine and yet they did not know about the health care bill when they decided to take on so much debt?

"Since when did morality and ethics come into play in a free and capitalist nation when it comes to the cost of a good or service?"

Are you crazy? We have hundreds and hundreds of laws regulating the market place in this country and many of them were put into place for ethical and moral reasons. We have OSHA regulations because it is immoral to say "if you don't want to work around toxic chemicals its your free choice not to work there." We have unions because employers abused workers and made seven year-old kids work seven days a week in the good ole days of unregulated free market. We have work hour restrictions and overtime rules for the same reasons. We need to regulate our financial system because many people choose not to act morally, and when they don't it has wrecked our economy. Morality and ethics definitly matter, perhaps even more so in a free market. With freedom comes a responsibility to act morally. People don't always act morally though so there need to be at least some regulations.

It just cracks me up that your idea of a free market is residency, LOL

This is ridiculous. How are any of the things you brought up about how price and cost are determined in a market? I never said there should be no regulations in a free market. Obviously, there must be regulations within a free market to keep it... free. I said the mechanism by which cost and price are determined are not influenced by ethics and morality - only by the market. I don't understand how this can even be debated - this is basic economics. It's the idea that you wouldn't pay $10 for something you could get for $5.

And I never said residency was a free market. It's not a market at all. The only aspect of residency that pertains to free market principles is the determination of residents' salaries, which is the least amount of money necessary to retain your services. When I brought up people's decision to go into medicine, it wasn't specifically about residency or its free market qualification. It was another attempt at demonstrating market principle on cost determination.

 

[emermed]

This is ridiculous. How are any of the things you brought up about how price and cost are determined in a market? I never said there should be no regulations in a free market. Obviously, there must be regulations within a free market to keep it... free. I said the mechanism by which cost and price are determined are not influenced by ethics and morality - only by the market. I don't understand how this can even be debated - this is basic economics. It's the idea that you wouldn't pay $10 for something you could get for $5.

And I never said residency was a free market. It's not a market at all. The only aspect of residency that pertains to free market principles is the determination of residents' salaries, which is the least amount of money necessary to retain your services. When I brought up people's decision to go into medicine, it wasn't specifically about residency or its free market qualification. It was another attempt at demonstrating market principle on cost determination.

What are you talking about? Residency isn't "a market at all" yet it is the free market that determines resident salary? OK. You have a third grade understanding of economics and your post is riddled with contradictions. Our economy is clearly no longer just a free market.

"How are any of the things you brought up about how price and cost are determined in a market?"

You don't think that the presence or absence of regulations/rules has an effect on prices? In a completely free market, we could force weak people to work for free/very little but we consider it clearly unethical to do so Again, if residency is not a free market (which you admit that it is not) why would prices be determined by the market?

"And I never said residency was a free market. It's not a market at all. The only aspect of residency that pertains to free market principles is the determination of residents' salaries, which is the least amount of money necessary to retain your services."

Its not a free market but salaries are somehow determined by the market? How are salaries determined by market price when residents have no ability to bargain, strike, switch jobs, etc?

"When I brought up people's decision to go into medicine, it wasn't specifically about residency or its free market qualification. It was another attempt at demonstrating market principle on cost determination."

This makes no sense and I can't tell what you are trying to say... You think people knew exactly what they were getting into when they took on debt, but this year they passed a huge law that significantly changes payment etc.

 

[bronx43]

What are you talking about? Residency isn't "a market at all" yet it is the free market that determines resident salary? OK. You have a third grade understanding of economics and your post is riddled with contradictions. Our economy is clearly no longer just a free market.

"How are any of the things you brought up about how price and cost are determined in a market?"

You don't think that the presence or absence of regulations/rules has an effect on prices? In a completely free market, we could force weak people to work for free/very little but we consider it clearly unethical to do so Again, if residency is not a free market (which you admit that it is not) why would prices be determined by the market?

"And I never said residency was a free market. It's not a market at all. The only aspect of residency that pertains to free market principles is the determination of residents' salaries, which is the least amount of money necessary to retain your services."

Its not a free market but salaries are somehow determined by the market? How are salaries determined by market price when residents have no ability to bargain, strike, switch jobs, etc?

"When I brought up people's decision to go into medicine, it wasn't specifically about residency or its free market qualification. It was another attempt at demonstrating market principle on cost determination."

This makes no sense and I can't tell what you are trying to say... You think people knew exactly what they were getting into when they took on debt, but this year they passed a huge law that significantly changes payment etc.

Jesus Christ, you're thick. Tell me how prices are determined.

 

[emermed]

Jesus Christ, you're thick. Tell me how prices are determined.

Yeah I'm the the thick one Mr. Its Not a Market but the Market Determines Prices

 

[bronx43]

Yeah I'm the the thick one Mr. Its Not a Market but the Market Determines Prices

If you can't tell me how prices are determined, then there's no point to go on.

 

[emermed]

Jesus Christ, you're thick. Tell me how prices are determined.

There is one organization that controls all hiring (NRMP) so the level of options potential employees have is much less than it would be in a free market. Because it is not a free market, prices are not what they would be under a market system. Probably for the lower, since potential employees have no other recourse.

 

[bronx43]

There is one organization that controls all hiring (NRMP) so the level of options potential employees have is much less than it would be in a free market. Because it is not a free market, prices are not what they would be under a market system. Probably for the lower, since potential employees have no other recourse.

Ok, I agree. The point about price determination I am trying to make is that salary is dependent on what it takes to retain your service. Since there are no other recourses, that salary is much lower, like you said. The whole free market discussion was the idea that the reason why hospitals don't have to pay residents more is the same as the reason why an employer in a free market doesn't have to pay an employee more if he/she doesn't have to.

 

[emermed]

Ok, I agree. The point about price determination I am trying to make is that salary is dependent on what it takes to retain your service. Since there are no other recourses, that salary is much lower, like you said. The whole free market discussion was the idea that the reason why hospitals don't have to pay residents more is the same as the reason why an employer in a free market doesn't have to pay an employee more if he/she doesn't have to.

Fair enough

"The whole free market discussion was the idea that the reason why hospitals don't have to pay residents more is the same as the reason why an employer in a free market doesn't have to pay an employee more if he/she doesn't have to."

The fact that they are able to due to artifical market conditions does not make it right, however, and thus ethics/morality is perfectly applicable.

 

[bronx43]

Fair enough

"The whole free market discussion was the idea that the reason why hospitals don't have to pay residents more is the same as the reason why an employer in a free market doesn't have to pay an employee more if he/she doesn't have to."

The fact that they are able to due to artifical market conditions does not make it right, however, and thus ethics/morality is perfectly applicable.

It might be applicable on a philosophical level, but it still can't be a price determination mechanism. How much is a resident worth? How much should a resident be paid for each year of schooling over a nurse? Each hour worked? Each [unit of measurement] of responsibility?

 

[The right Path]

I think you misunderstood me. I choose to belong even though currently they don't represent nurses in my area. That's how much I believe in their mission.

Membership by choice is how it should be for everyone. That way, as in your example, if you are pleased with their mission, activities, and what they spend their money on- cool. If not then, pass. Otherwise, it's find a job somewhere else. And in California, nearly every hospital is union nowadays.

 

[morning]

Yeah I'm the the thick one Mr. Its Not a Market but the Market Determines Prices

Minus the ad hominem attacks, you aren't exactly wrong here.

Outside of cash-only primary care clinics, physicians really don't have a chance to take advantage of a free market system. However, everyone around them DOES. That is why poor residency salaries are a function of capitalism - the hospital is given a certain amount of money and keeps whatever it can for their own benefit. The physician doesn't have a say in it and has to deal with it.

This contrast between what physicians are forced to accept and what outside parties can do really seems to form most of the problems with medicine.

The current malpractice climate is as capitalist as it can get. Clients want money, lawyers want money, and they basically have free reign to pick it off of the carcasses of doctors. Managed care will fight you as hard as they can to save their dollars from going the drain. Every dollar they can keep, they will battle for. Private medical schools know that they can charge whatever the heck they want for their services, because medical students will pay it and there really isn't a danger of having a half-full entering class. Not anytime soon, anyway.

All these forces are taking advantage of a free market system the physician is prevented from participating in. Would the system be improved if the physician were able to wheel and deal amidst all that chaos, or would it be improved if the rest of these industries were better regulated?

 

[fab4fan]

Membership by choice is how it should be for everyone. That way, as in your example, if you are pleased with their mission, activities, and what they spend their money on- cool. If not then, pass. Otherwise, it's find a job somewhere else. And in California, nearly every hospital is union nowadays.

I worked in a union shop before. Nothing pissed me off more than the people who chose not to belong to the union but still benefitted from the hard work we (union reps) did to get better benefits, pay, etc. They paid a lower rate in dues, and don't you know, who whined and complained the most? The ones who did nothing and didn't belong to the union, yet we had to represent them just as if they were full members. Please...I have no patience for the "Join/don't join philosophy." Don't like unions? Don't work in a hospital where unions exist. Those "non-member members" were a waste of time.

 

[The right Path]

I worked in a union shop before. Nothing pissed me off more than the people who chose not to belong to the union but still benefitted from the hard work we (union reps) did to get better benefits, pay, etc. They paid a lower rate in dues, and don't you know, who whined and complained the most? The ones who did nothing and didn't belong to the union, yet we had to represent them just as if they were full members. Please...I have no patience for the "Join/don't join philosophy." Don't like unions? Don't work in a hospital where unions exist. Those "non-member members" were a waste of time.

Ah yes, those that are happy to receive, but not so much contribute. Those kindsa folks are everywhere. In unions, not in unions, that brownie scout's mom who never helps out with cookie sales........ Aggravating to say the least.

 

[dpmd]

I worked in a union shop before. Nothing pissed me off more than the people who chose not to belong to the union but still benefitted from the hard work we (union reps) did to get better benefits, pay, etc.

My husband worked for a physician who moved his practice to a union hospital. Nothing pissed me off more than the union folks who said he couldn't receive the pay he had been promised as an incentive to move to the new practice, because it was higher than what the other nurses got. Then they had the nerve to force him to pay union dues, despite the fact that his benefits weren't any different than what he had before the union, only his pay was now less. As far as the working conditions, because the people he worked with were all protected by the union they could get away with slacking on their work without getting fired (and the doctor was forced to hire from within the union if anybody left on their own). Made things so much more fun for my husband since he felt obliged to pick up the slack.

 

[fab4fan]

My husband worked for a physician who moved his practice to a union hospital. Nothing pissed me off more than the union folks who said he couldn't receive the pay he had been promised as an incentive to move to the new practice, because it was higher than what the other nurses got. Then they had the nerve to force him to pay union dues, despite the fact that his benefits weren't any different than what he had before the union, only his pay was now less. As far as the working conditions, because the people he worked with were all protected by the union they could get away with slacking on their work without getting fired (and the doctor was forced to hire from within the union if anybody left on their own). Made things so much more fun for my husband since he felt obliged to pick up the slack.

His pay issues were the fault of the person who made that promise, not the union.

Unions certainly aren't perfect, but I have no mercy for slackers who suck up every benefit the union has to offer (and gripe for more) but refuse to join/pay full membership. If you disagree with a union, either don't join or look for a job in a non-union facility.

 

[cpants]

I worked in a union shop before. Nothing pissed me off more than the people who chose not to belong to the union but still benefitted from the hard work we (union reps) did to get better benefits, pay, etc. They paid a lower rate in dues, and don't you know, who whined and complained the most? The ones who did nothing and didn't belong to the union, yet we had to represent them just as if they were full members. Please...I have no patience for the "Join/don't join philosophy." Don't like unions? Don't work in a hospital where unions exist. Those "non-member members" were a waste of time.

I'm sure those non-union members resent the fact that they have to pay you anything, considering they disagree with your organization. Same thing happens in all union organizations. There is tremendous pressure to join the union, and often they have it set up so they just take 75%+ of your dues whether you join or not. I'm sure they would rather work in a hospital which doesn't force them to pay dues to your organization.

I can't speak to the nursing unions, but I have a lot of family members who are in education and disagree with the union's policies (they are basically destroying education and bankrupting our state). Considering the teaching contract requires you to pay 85% of dues whether you join or not, you will face ostracism from your colleagues if you don't join, and you don't get any of their services for your 85% if you don't officially join, most have them have taken the if-you-can't-beat-em-join-em stance and just joined. It's pretty irritating, considering the dues represent about 5% of a teacher's salary.

 

[The right Path]

I'm sure those non-union members resent the fact that they have to pay you anything, considering they disagree with your organization. Same thing happens in all union organizations. There is tremendous pressure to join the union, and often they have it set up so they just take 75%+ of your dues whether you join or not. I'm sure they would rather work in a hospital which doesn't force them to pay dues to your organization.

I can't speak to the nursing unions, but I have a lot of family members who are in education and disagree with the union's policies (they are basically destroying education and bankrupting our state). Considering the teaching contract requires you to pay 85% of dues whether you join or not, you will face ostracism from your colleagues if you don't join, and you don't get any of their services for your 85% if you don't officially join, most have them have taken the if-you-can't-beat-em-join-em stance and just joined. It's pretty irritating, considering the dues represent about 5% of a teacher's salary.

I have family and friends that have been/are teachers as well. When you are an obligatory member of NEA and CTA, you can be rest assured that you are a pocketbook supporter of several political issues (that are not even education related) even if you are in strong disagreement of such.

 

[cpants]

I have family and friends that have been/are teachers as well. When you are an obligatory member of NEA and CTA, you can be rest assured that you are a pocketbook supporter of several political issues (that are not even education related) even if you are in strong disagreement of such.

Yup, it's a sad state of affairs. Even if I am pro-union and grateful for the contract advocacy and professional representation, maybe I don't want a big chunk of my dues going to support, say, improved access to abortion. Maybe I don't want my dues supporting the campaigns of politicians disagree with. Maybe I want to choose to pay nothing to organizations engaging in these activities. At least if you are a nurse, you can go to a non-union hospital to work. As a teacher, you'll be supporting these activities, like it or not.

 

[Taurus]

I can't wait for the day when they invent robotic nurses. A nurse who actually listens and follows orders without giving attitude. I'm tired of bitter, fat, lazy nurses who think that $79k is not enough for 2 years post-high school education. I'm sure I'm not alone in my feelings.

 

[cpants]

Back to the strike at hand. The nurses claim that this is all about patient safety (although YES, they are demanding raises of 3.5-4% per year in the new contracts). By the way, MN nurses already make 10,000/year more than the national average. Their other proposals (from the AP):

The union wants to write rigid staffing levels into their contracts, reduce the hospitals' ability to "float" nurses from department to department and order hospitals to shut down units, with some exceptions, at 90 percent capacity in the name of patient safety. They also are resisting a proposal to reduce their pensions.

The hospitals say this will increase staffing costs by more than 250 million/year.

I can understand why nurses would propose these things, because combined they will make the job easier and the compensation better, but will the proposals really improve patient safety? I think we all can agree that patient ratios can clearly get out of hand and be unsafe, but what are the staffing ratios in MN and are they currently outrageous? Even if a change is needed on that front, strict ratios are not the best idea, because the complexity of the patients varies so much. A single experienced nurse could easily handle 8 patients s/p appendectomy with few meds and comorbities, but only one s/p CABG with 20+ meds and unstable vitals. This stuff needs to be more common sense based and not set in stone. There is little out there about what strict ratios they are demanding, so I can't comment more on this.

The other proposals are just outrageous. They aren't supposed to be able to float nurses to move staffing where it is needed and lower the very ratios they are compaining about? They are supposed to shut down units at 90%? Why? Essentially they are demanding that MN hospitals decrease their capacities by 10%, or in other words, cut hospital income by 10% while maintaining the same staffing. And they are surprised that the administration is unwilling to consider this proposal?

 

[JaggerPlate]

My husband worked for a physician who moved his practice to a union hospital. Nothing pissed me off more than the union folks who said he couldn't receive the pay he had been promised as an incentive to move to the new practice, because it was higher than what the other nurses got. Then they had the nerve to force him to pay union dues, despite the fact that his benefits weren't any different than what he had before the union, only his pay was now less. As far as the working conditions, because the people he worked with were all protected by the union they could get away with slacking on their work without getting fired (and the doctor was forced to hire from within the union if anybody left on their own). Made things so much more fun for my husband since he felt obliged to pick up the slack.

I don't know if there is anything in the world more corrupt, lazy, creator of complete mediocrity etc, etc, than a union. They are seriously pathetic and remind me of everything I hate in the workforce.

 

[Apollyon]

I don't know if there is anything in the world more corrupt, lazy, creator of complete mediocrity etc, etc, than a union. They are seriously pathetic and remind me of everything I hate in the workforce.

Are you serious? Honestly? You can't think of anything else?

Ever heard the term "civil servant"? "Corrupt, lazy, creator of complete mediocrity".

At least with unions you got a 40 hour work week, 5 days a week, vacation, no child labor, and Worker's Comp for injuries.

 

[JaggerPlate]

a 40 hour work week, 5 days a week, vacation, no child labor, and Worker's Comp for injuries.

And absolutely zero incentive to ever do things efficiently, effectively, or with a purpose. I've worked along side union workers in the past ... maybe it's just who I am as a person, but I've never a. seen people do less because they knew they could b. bully and intimidate people into these organizations. I just hate that idea of such complacency. You bring up a very good point with the term civil servant though ... you may have me there.

 

[The right Path]

Back to the strike at hand. The nurses claim that this is all about patient safety (although YES, they are demanding raises of 3.5-4% per year in the new contracts). By the way, MN nurses already make 10,000/year more than the national average. Their other proposals (from the AP):

The hospitals say this will increase staffing costs by more than 250 million/year.

I can understand why nurses would propose these things, because combined they will make the job easier and the compensation better, but will the proposals really improve patient safety? I think we all can agree that patient ratios can clearly get out of hand and be unsafe, but what are the staffing ratios in MN and are they currently outrageous? Even if a change is needed on that front, strict ratios are not the best idea, because the complexity of the patients varies so much. A single experienced nurse could easily handle 8 patients s/p appendectomy with few meds and comorbities, but only one s/p CABG with 20+ meds and unstable vitals. This stuff needs to be more common sense based and not set in stone. There is little out there about what strict ratios they are demanding, so I can't comment more on this.

The other proposals are just outrageous. They aren't supposed to be able to float nurses to move staffing where it is needed and lower the very ratios they are compaining about? They are supposed to shut down units at 90%? Why? Essentially they are demanding that MN hospitals decrease their capacities by 10%, or in other words, cut hospital income by 10% while maintaining the same staffing. And they are surprised that the administration is unwilling to consider this proposal?

For one thing, I question the 250 million dollar figure. I'd love to see how that is calculated. For simplistic purposes, I offer this scenario: A 500 bed hospital currently staffs 8:1 (for simplistic purpose, assume there is no critical care unit). Generously estimating- each nurse costs $100/h (wages and benefits). So this hospital currently needs 62.5 nurses/day when at full capacity. This costs the hospital $150,000/day and $54,750,000/year. Now if they have to lower their ratio to 4:1 (which essentially doubles their staffing, they can expect their yearly nursing to costs to double. And that figure would be gee.....$54.75 million. So 250 million seems a fantastically gross overestimation. Sometimes you can't just take these "estimated" figures for granted. Follow the logic to determine what is reasonable.

I believe that adequate staffing is a relatively small investment (55 million sounds like a big number, but compare that to the hospital's entire budget for perspective). And I really do believe that the small investment results in cost reduction by decreasing mistakes, litigation, complications, length of stay, diagnostics and treatments, burnout and turnover. It also increases patient satisfaction and hospital reputation which attracts more customers (aka patients) and higher quality medical and nursing staff. The implications are so far reaching and complex that it would be extremely difficult to really get a good estimate of the cost/benefit of a certain ratio. Research does link better outcomes to better ratios.

As far as staffing ratios in Minnesota go- I have no idea what their ranges are. When I tried to find out, all I found out is that California is the only state that has legally mandated ratios. I went to nursing school in California and have only worked in California. When I was in nursing school, doing med/surg clinical rotations RNs had up to 8 patients. Even with simple, uncomplicated patients, the best a nurse could do is give each patient a cursory once-over, throw meds at the patients, and jot down some quick, sketchy "chart by exception" documentation. Please refer to my "Clue characters" scenario (from earlier in this thread). It's not an exaggeration. When I graduated nursing school (2004) I started out in a high acuity med/surg/"step down" unit and the max ratios at that time (by hospital policy) were 6:1, and there were many, many occasions in which that ratio was unsafe for the acuity. Was the reason because we were short? Oh no, it was to pinch pennies. What was the result? More codes, more falls, and staff turnover. I sure as hell GTFO of there.

The ratios can seem very arbitrary, especially when there isn't (to my knowledge) any research that supports a magic ratio. It isn't very feasible, there are so many factors. However, I do believe in setting limits, and erring on the side of safety, because otherwise- and we've all seen it time and again- patient assignments will get pushed beyond what is safe and bad outcomes result. And then what happens, your license is on the line and you could possibly be facing a lawsuit. Will the hospital that forced this assignment on you then have your back? Yeah, no, not so much.

Floating is another subject of controversy. Some hospitals will float an RN to any unit, anywhere- just to have a warm body. If that nurse isn't familiar/competent to care for that particular patient population, how safe is that? There is a reason I don't have to float to L&D, peds, etc. Yes, I had a rotation in those units in nursing school, but my competency and certification is in adult critical care and trauma. When my unit is short, we can't just accept just anyone with a pulse and an RN license either, for obvious reasons. Split-shift floats are another issue of contention that I won't even get into at this point. But the bottom line is that floating is a legit safety issue.

I'd have to get more details about the 90% capacity thing in order to comment. The only time I've ever known a unit to shut down is when there is low census for that unit. Then the unlucky patients get shuffled to another unit. I know of hospitals that even do this with their critical care units. Not outrageously risky, but unjustifiably risky, in my opinion. Not to mention time consuming.

Regardless of how I feel about unions in general, I'm not about to dismiss their proposals out of hand as "outrageous". Like fab4fan stated, hospital admin usually does not make policy for safety sake because nurses say "please" or because they want to do the right thing. Change doesn't result unless mandated by state regulations, JCAHO, or the threat of a nursing uprising.

Another point to consider is that if a facility has horrid working conditions, it will not attract the cream of the crop RNs. Although not speaking in absolutes, but when you sell out to the lowest bidder, you tend to get what you pay for.

 

[fab4fan]

For one thing, I question the 250 million dollar figure. I'd love to see how that is calculated. For simplistic purposes, I offer this scenario: A 500 bed hospital currently staffs 8:1 (for simplistic purpose, assume there is no critical care unit). Generously estimating- each nurse costs $100/h (wages and benefits). So this hospital currently needs 62.5 nurses/day when at full capacity. This costs the hospital $150,000/day and $54,750,000/year. Now if they have to lower their ratio to 4:1 (which essentially doubles their staffing, they can expect their yearly nursing to costs to double. And that figure would be gee.....$54.75 million. So 250 million seems a fantastically gross overestimation. Sometimes you can't just take these "estimated" figures for granted. Follow the logic to determine what is reasonable.

I believe that adequate staffing is a relatively small investment (55 million sounds like a big number, but compare that to the hospital's entire budget for perspective). And I really do believe that the small investment results in cost reduction by decreasing mistakes, litigation, complications, length of stay, diagnostics and treatments, burnout and turnover. It also increases patient satisfaction and hospital reputation which attracts more customers (aka patients) and higher quality medical and nursing staff. The implications are so far reaching and complex that it would be extremely difficult to really get a good estimate of the cost/benefit of a certain ratio. Research does link better outcomes to better ratios.

As far as staffing ratios in Minnesota go- I have no idea what their ranges are. When I tried to find out, all I found out is that California is the only state that has legally mandated ratios. I went to nursing school in California and have only worked in California. When I was in nursing school, doing med/surg clinical rotations RNs had up to 8 patients. Even with simple, uncomplicated patients, the best a nurse could do is give each patient a cursory once-over, throw meds at the patients, and jot down some quick, sketchy "chart by exception" documentation. Please refer to my "Clue characters" scenario (from earlier in this thread). It's not an exaggeration. When I graduated nursing school (2004) I started out in a high acuity med/surg/"step down" unit and the max ratios at that time (by hospital policy) were 6:1, and there were many, many occasions in which that ratio was unsafe for the acuity. Was the reason because we were short? Oh no, it was to pinch pennies. What was the result? More codes, more falls, and staff turnover. I sure as hell GTFO of there.

The ratios can seem very arbitrary, especially when there isn't (to my knowledge) any research that supports a magic ratio. It isn't very feasible, there are so many factors. However, I do believe in setting limits, and erring on the side of safety, because otherwise- and we've all seen it time and again- patient assignments will get pushed beyond what is safe and bad outcomes result. And then what happens, your license is on the line and you could possibly be facing a lawsuit. Will the hospital that forced this assignment on you then have your back? Yeah, no, not so much.

Floating is another subject of controversy. Some hospitals will float an RN to any unit, anywhere- just to have a warm body. If that nurse isn't familiar/competent to care for that particular patient population, how safe is that? There is a reason I don't have to float to L&D, peds, etc. Yes, I had a rotation in those units in nursing school, but my competency and certification is in adult critical care and trauma. When my unit is short, we can't just accept just anyone with a pulse and an RN license either, for obvious reasons. Split-shift floats are another issue of contention that I won't even get into at this point. But the bottom line is that floating is a legit safety issue.

I'd have to get more details about the 90% capacity thing in order to comment. The only time I've ever known a unit to shut down is when there is low census for that unit. Then the unlucky patients get shuffled to another unit. I know of hospitals that even do this with their critical care units. Not outrageously risky, but unjustifiably risky, in my opinion. Not to mention time consuming.

Regardless of how I feel about unions in general, I'm not about to dismiss their proposals out of hand as "outrageous". Like fab4fan stated, hospital admin usually does not make policy for safety sake because nurses say "please" or because they want to do the right thing. Change doesn't result unless mandated by state regulations, JCAHO, or the threat of a nursing uprising.

Another point to consider is that if a facility has horrid working conditions, it will not attract the cream of the crop RNs. Although not speaking in absolutes, but when you sell out to the lowest bidder, you tend to get what you pay for.

You make some very good points, particularly about floating and ratios. These are things most doctors just don't get and it's disheartening to see that their take is that nurses argue against floating and for better ratios because they're "lazy." Maybe we're just tired of being afraid for our patients and our licenses.

 

[cpants]

You make some very good points, particularly about floating and ratios. These are things most doctors just don't get and it's disheartening to see that their take is that nurses argue against floating and for better ratios because they're "lazy." Maybe we're just tired of being afraid for our patients and our licenses.

I do get it. If you are an L&D nurse asked to float into the CCU, you'd probably be crapping yourself. An OB asked to run the CCU would probably feel similarly. That said, I don't think there needs to be a ban on floating. As with the ratios, there needs to be some common sense employed here. Let's not forget that RN's are trained as generalists, and your license implies that you are trained and qualified to work as an RN in a wide variety of clinical settings, not just the one you prefer or are accustomed to.

Surely, aside from extreme circumstances, we don't want a floor nurse being forced to cover ICU patients, but I really don't see the problem with expecting surgery or ob nurses to cover medicine or peds floors and visa versa. In the subcritical setting, this shouldn't be an issue. If it is, you need to study more and live up to the license which you hold.

Now if we are really to believe that the nursing ratios are reaching critical mass, then floating is necessary. It doesn't make sense to have some nurses sitting idle while others are unable to safely take care of their patient due to staffing shortages. As a nurse and a hospital employee, you are expected to be a team player and pick up the slack. As a professional, you are expected to have a working knowledge of the curriculum you mastered to get that RN. Yes, that means even 10 years down the road after working full-time in surgery, I expect you to be able to figure out pediatric dosing or assist with a delivery.

As far as the ratio goes, I said in my previous post that we can all agree that there comes a point where the ratio is too high, and safety becomes an issue. The best ratio for patient safety and staff satisfaction would probably be 1:1. That is obviously unrealistic from a financial standpoint. I can't comment on what the MN nurses are asking for, and maybe it is reasonable. I doubt that, however, since they are running a major PR campaign, yet their ratio demands are strangely unpublicized.

 

[cpants]

For one thing, I question the 250 million dollar figure. I'd love to see how that is calculated. For simplistic purposes, I offer this scenario: A 500 bed hospital currently staffs 8:1 (for simplistic purpose, assume there is no critical care unit). Generously estimating- each nurse costs $100/h (wages and benefits). So this hospital currently needs 62.5 nurses/day when at full capacity. This costs the hospital $150,000/day and $54,750,000/year. Now if they have to lower their ratio to 4:1 (which essentially doubles their staffing, they can expect their yearly nursing to costs to double. And that figure would be gee.....$54.75 million. So 250 million seems a fantastically gross overestimation. Sometimes you can't just take these "estimated" figures for granted. Follow the logic to determine what is reasonable.

I believe that adequate staffing is a relatively small investment (55 million sounds like a big number, but compare that to the hospital's entire budget for perspective). And I really do believe that the small investment results in cost reduction by decreasing mistakes, litigation, complications, length of stay, diagnostics and treatments, burnout and turnover. It also increases patient satisfaction and hospital reputation which attracts more customers (aka patients) and higher quality medical and nursing staff. The implications are so far reaching and complex that it would be extremely difficult to really get a good estimate of the cost/benefit of a certain ratio. Research does link better outcomes to better ratios.

I'm not really grasping your conclusion here. You've shown that in just one 500 bed hospital, this decreasing the ration could increase staffing costs by 50 million plus. The hospitals affected by this strike could easily be facing 250 million or more in increased staffing costs by adopting the MNA's proposals. I don't know if you have noticed, but hospitals don't usually have a ton of cash lying around. In fact they are going broke all over the country.

 

[fab4fan]

I do get it. If you are an L&D nurse asked to float into the CCU, you'd probably be crapping yourself. An OB asked to run the CCU would probably feel similarly. That said, I don't think there needs to be a ban on floating. As with the ratios, there needs to be some common sense employed here. Let's not forget that RN's are trained as generalists, and your license implies that you are trained and qualified to work as an RN in a wide variety of clinical settings, not just the one you prefer or are accustomed to.

Surely, aside from extreme circumstances, we don't want a floor nurse being forced to cover ICU patients, but I really don't see the problem with expecting surgery or ob nurses to cover medicine or peds floors and visa versa. In the subcritical setting, this shouldn't be an issue. If it is, you need to study more and live up to the license which you hold.

Now if we are really to believe that the nursing ratios are reaching critical mass, then floating is necessary. It doesn't make sense to have some nurses sitting idle while others are unable to safely take care of their patient due to staffing shortages. As a nurse and a hospital employee, you are expected to be a team player and pick up the slack. As a professional, you are expected to have a working knowledge of the curriculum you mastered to get that RN. Yes, that means even 10 years down the road after working full-time in surgery, I expect you to be able to figure out pediatric dosing or assist with a delivery.

As far as the ratio goes, I said in my previous post that we can all agree that there comes a point where the ratio is too high, and safety becomes an issue. The best ratio for patient safety and staff satisfaction would probably be 1:1. That is obviously unrealistic from a financial standpoint. I can't comment on what the MN nurses are asking for, and maybe it is reasonable. I doubt that, however, since they are running a major PR campaign, yet their ratio demands are strangely unpublicized.

About the only thing I could do on another unit is give some meds, start some IVs and the very basics. I work in a specialty area and haven't worked in a hospital setting for several years. I know enough to know that there's plenty going on in med surg that I don't know how to handle anymore, just as someone rotated to my dept. would be stressed out.

A nurse is not a nurse, and it's a shame that doctors like you see nurses as mere pegs that can be put in empty slots. It shows how little you know about what nurses do from day to day.

At my facility, you are given the choice to float or stay home and use PTO. So far, no one is forced to float if they don't want to/don't feel comfortable. Floating isn't an option where I work, but I have all they sympathy in the world for those who have to deal with it, because I remember how stressful it was when I had to do it.

 

[cpants]

About the only thing I could do on another unit is give some meds, start some IVs and the very basics. I work in a specialty area and haven't worked in a hospital setting for several years. I know enough to know that there's plenty going on in med surg that I don't know how to handle anymore, just as someone rotated to my dept. would be stressed out.

A nurse is not a nurse, and it's a shame that doctors like you see nurses as mere pegs that can be put in empty slots. It shows how little you know about what nurses do from day to day.

At my facility, you are given the choice to float or stay home and use PTO. So far, no one is forced to float if they don't want to/don't feel comfortable. Floating isn't an option where I work, but I have all they sympathy in the world for those who have to deal with it, because I remember how stressful it was when I had to do it.

Hey, I don't doubt that it's challenging, and I don't assume that nurses are equivalent pegs which can be plugged into slots. I fully expect that nurses out of their comfort zones will not perform as quickly or as well as the normal staff. That doesn't mean the practice of floating should be banned in nursing contracts, especially on a union-wide scale. Do you even understand the implications of this? Instead of plugging in a competent, on-staff RN from a quieter ward to care for the simpler cases on a busy ward, hospitals will be forced to pay overtime, increase ratios, hire more nurses, or some other unpalatable option. To me it makes a lot more sense to use the staff on hand in an intelligent way. Obviously you don't plug a veteran peds nurse in to take care of 4 s/p MI patients on the cardiac ward, but maybe she can handle a couple of the overnight observations for Afib or patients ready for d/c in the morning, freeing up the regular ward staff to take the more complex cases. You know as well as I that there are plenty of patients on the ward who just need the basics: meds, IV care, vitals, etc. Heck, sometimes it seems like half of our patients are social admits. It should be up to your nurse managers to make these staffing calls.

You should be able to adapt to a new environment pretty quickly, and you aren't in a vacuum. There are plenty of colleagues around to ask if you have a question or need some guidance. Most of the nurses I've dealt with are very competent and very intelligent, and I don't doubt that they can handle this kind of staffing. I understand why they hate it, but I think they can handle it. Unfortunately, this isn't an ideal world where every nurse can be subspecialized to care for only a select type of patients.

 

[The right Path]

I'm not really grasping your conclusion here. You've shown that in just one 500 bed hospital, this decreasing the ration could increase staffing costs by 50 million plus. The hospitals affected by this strike could easily be facing 250 million or more in increased staffing costs by adopting the MNA's proposals. I don't know if you have noticed, but hospitals don't usually have a ton of cash lying around. In fact they are going broke all over the country.

How can you easily accept that figure to be fact when my very generous hypothetical example is nowhere near the ballpark of 250 mil. And yeah, very well aware of hospitals' financial strains, thank you. There are a ton of wasted and misspent resources. Reimbursements are limited by what medicare (and other insurance companies) contend is fitting for the diagnosis. They don't reimburse for treatment costs associated with iatrogenic/nosocomial complications anymore. Claims of malpractice are extremely expensive if they settle, and even more so if taken to trial. Those costs are trumped by the relative pittance of adequate staffing. And further those costs are mitigated by adequate staffing resulting in better care and outcomes. Saying that there isn't enough cash for safe staffing is like saying you can't afford your BP meds but spend every Saturday night at the bar. I'm not hearing that noise.

I do get it. If you are an L&D nurse asked to float into the CCU, you'd probably be crapping yourself. An OB asked to run the CCU would probably feel similarly. That said, I don't think there needs to be a ban on floating. As with the ratios, there needs to be some common sense employed here. Let's not forget that RN's are trained as generalists, and your license implies that you are trained and qualified to work as an RN in a wide variety of clinical settings, not just the one you prefer or are accustomed to.

I'm relieved that you see the inappropriateness of some floating scenarios. Don't think that never happens. I didn't read anywhere that the Minnesota nurses are seeking to ban floating across the board. Set that strawman aside.

And please, don't presume to tell me how nurses are educated and trained. Of course nursing students are rotated through various settings. So are med students, and yet after med school you won't be expected to fly solo in any setting. Newgrads are given facility and unit specific orientation when they start. In fact, by law the hospital must keep record of demonstrated competencies. An experienced nurse has to go through a similar process when changing to a different unit. Nurses that work in units with similar competencies can be reasonably floated amongst each other. (i.e. renal/endocrine med/surg, ortho med/surg, general med/surg). Nurses in critical care units (medical, surgical, cardiac, neuro) can float amongst each other. However, even then a CCU nurse is not coming in to manage a patient in my unit with a ventric and I'm not going to float to CCU and try to figure out an IABP. L & D float with postpartum. See how that all makes sense? That isn't how it is done in every hospital.

It's about so much more than familiarity and preference.

Surely, aside from extreme circumstances, we don't want a floor nurse being forced to cover ICU patients, but I really don't see the problem with expecting surgery or ob nurses to cover medicine or peds floors and visa versa. In the subcritical setting, this shouldn't be an issue. If it is, you need to study more and live up to the license which you hold.

This is extremely presumptuous and incorrect. I think I've adequately covered that. You won't see a cardiologist come deliver a baby in a pinch because the OB didn't get there on time. But, didn't that cardiologist have a rotation in OB/GYN in med school? Yes, but does that make him/her competent to deliver a baby? Hell no. Who would put their license at risk for that nonsense? Get real.

Now if we are really to believe that the nursing ratios are reaching critical mass, then floating is necessary. It doesn't make sense to have some nurses sitting idle while others are unable to safely take care of their patient due to staffing shortages. As a nurse and a hospital employee, you are expected to be a team player and pick up the slack.

Yes, obviously. No one is arguing against floating in and of itself. But no one should be expected to put patient safety or their license on the line in order to act as a warm body with a license.


As a professional, you are expected to have a working knowledge of the curriculum you mastered to get that RN.

I've already covered this.

Yes, that means even 10 years down the road after working full-time in surgery, I expect you to be able to figure out pediatric dosing or assist with a delivery.

You? You expect? Who are you to expect anything that you clearly know very little about? After you've spent 10 years in family practice should I still expect you to manage vent setting? No? But didn't you learn that in med school?

Yes, 6 years out of nursing school, I can still calculate dosages. If you think that is all there is to taking care of peds patients, you're wrong. And yes, after 6 years I can still confidently palpate a fundus and recognize that sinusoidal waveforms on the FHM are very ominous. Golly gee, I can still even hold a leg up. Unfortunately, that still does not make me competent to be thrown into the delivery room.

I realize I'm getting a little snarky by this point, but really the audacity of some of your posts.....


As far as the ratio goes, I said in my previous post that we can all agree that there comes a point where the ratio is too high, and safety becomes an issue. The best ratio for patient safety and staff satisfaction would probably be 1:1. That is obviously unrealistic from a financial standpoint. I can't comment on what the MN nurses are asking for, and maybe it is reasonable. I doubt that, however, since they are running a major PR campaign, yet their ratio demands are strangely unpublicized.

You basically state that you're opposing something without knowing the facts. I surfed around the internet regarding this topic and yeah, the articles are scarce in detail. However, going to the source of the MNA proposal, for med/surg they are asking for 4:1 ratio (the proposal delineates ratios for other populations as well). There, now feel free to comment, though I'd be more interested if you can provide evidence that staffing at ratios greater than 4:1 are just as safe. In one of MNA's documents, they refer to a study published in JAMA in 2002 that reports the 30-day mortality of a patient increases by 7 percent for each additional surgical patient greater than 4. There very well may be studies published that have findings that contradict that study. That would at least lend some credibility to your otherwise specious opinions on what appropriate staffing ratios are.

Hey, I don't doubt that it's challenging, and I don't assume that nurses are equivalent pegs which can be plugged into slots. I fully expect that nurses out of their comfort zones will not perform as quickly or as well as the normal staff. That doesn't mean the practice of floating should be banned in nursing contracts, especially on a union-wide scale. Do you even understand the implications of this? Instead of plugging in a competent, on-staff RN from a quieter ward to care for the simpler cases on a busy ward, hospitals will be forced to pay overtime, increase ratios, hire more nurses, or some other unpalatable option. To me it makes a lot more sense to use the staff on hand in an intelligent way. Obviously you don't plug a veteran peds nurse in to take care of 4 s/p MI patients on the cardiac ward, but maybe she can handle a couple of the overnight observations for Afib or patients ready for d/c in the morning, freeing up the regular ward staff to take the more complex cases. You know as well as I that there are plenty of patients on the ward who just need the basics: meds, IV care, vitals, etc. Heck, sometimes it seems like half of our patients are social admits. It should be up to your nurse managers to make these staffing calls.

Again, we as nurses know what assignments are appropriate and what are not. There are cross-trained float pool nurses whose role by definition is to fill in staffing gaps. Obviously, sometimes this is not enough and generally speaking we are not thrilled to float, but we have no problem meeting patient care needs so long as the assignments do not threaten patients' safety or our licenses. And just because we KNOW what is safe, that doesn't protect us from inappropriate demands from management. Safe floating restrictions need to be written into policy- and upheld in practice.

You should be able to adapt to a new environment pretty quickly, and you aren't in a vacuum. There are plenty of colleagues around to ask if you have a question or need some guidance. Most of the nurses I've dealt with are very competent and very intelligent, and I don't doubt that they can handle this kind of staffing. I understand why they hate it, but I think they can handle it. Unfortunately, this isn't an ideal world where every nurse can be subspecialized to care for only a select type of patients.

Yeah, nurses by nature need to be adaptable. That isn't the problem. And most nurses are very helpful and supportive of nurses that float to their unit. However, it is a huge burden to micromanage another nurse's assignment because the float nurse is completely out of his/her element.

This isn't an ideal world, no doubt. However, as healthcare has become increasingly complex, nurses do need specialized knowledge and skills to properly meet the needs of the patients they care for. Research demonstrates that better outcomes are linked to higher percentages of nurses that hold specialty certification. Like physicians, nurses are not interchangable. They are not plug and chug automatons (sorry Taurus) working on the assembly line.

Cheers. Good talk.

 

[glade]

In reading a few posts in this thread, it seems that people are missing the point. We can sit here all day and masturbate about whether it's fair that nurses make that much or whatever. That's irrelevant. The relevant points are simply:

1) The same people who see no problem with nurses striking, including nurses themselves, go crazy over the concept of doctors striking. They start suddenly talking about "putting the patient first" or incorrectly quoting the Hippocratic Oath or other nonsense. Whether you are FOR or AGAINST nursing strikes, you must also be FOR or AGAINST physician strikes. Period. And if you are FOR nurses striking to get more money or to work less hours or WHATEVER, you must also be FOR physicians striking for the same reasons. Otherwise, you're an imbecile.

2) This is like when I talk about ER physicians. They make less than other specialties. But the problem is it's all relative. Relative to how much (or, rather, little) they work, they get paid much better than other specialties. Now, I don't expect ER physicians to lose any sleep over that, nor would I if I were in their shoes. So I don't expect nurses to lose any sleep over making somewhat close to what a primary care physician makes. But neither should they be shocked or stunned that other people are pissed at them for doing so. That's the funny part, they always act like you're not allowed to be upset at them.

 

[fab4fan]

In reading a few posts in this thread, it seems that people are missing the point. We can sit here all day and masturbate about whether it's fair that nurses make that much or whatever. That's irrelevant. The relevant points are simply:

1) The same people who see no problem with nurses striking, including nurses themselves, go crazy over the concept of doctors striking. They start suddenly talking about "putting the patient first" or incorrectly quoting the Hippocratic Oath or other nonsense. Whether you are FOR or AGAINST nursing strikes, you must also be FOR or AGAINST physician strikes. Period. And if you are FOR nurses striking to get more money or to work less hours or WHATEVER, you must also be FOR physicians striking for the same reasons. Otherwise, you're an imbecile.

2) This is like when I talk about ER physicians. They make less than other specialties. But the problem is it's all relative. Relative to how much (or, rather, little) they work, they get paid much better than other specialties. Now, I don't expect ER physicians to lose any sleep over that, nor would I if I were in their shoes. So I don't expect nurses to lose any sleep over making somewhat close to what a primary care physician makes. But neither should they be shocked or stunned that other people are pissed at them for doing so. That's the funny part, they always act like you're not allowed to be upset at them.

I never said a word against doctors striking. If they had a union, I would support their right to strike.

And again, a lot of nurses make nowhere near that much-vaunted 79K figure.

 

[glade]

I never said a word against doctors striking. If they had a union, I would support their right to strike.

And again, a lot of nurses make nowhere near that much-vaunted 79K figure.

First of all, I wasn't referencing something you posted. Second of all, that's a cop out because it's a circular argument. There's no reason for physicians to have a union unless they are going to strike. And everyone is against physicians striking, so there's no reason for them to have a union. So to say "IF they had a union, I'd be all for letting them strike" is just a statement made to sound reasonable when you know that physicians DON'T and WON'T have a union directly BECAUSE of the whole "we need to put the patient first blah blah blah" attitude. It's like if I said I'd be all for nurses being called "doctor" if they went to medical school -- wow, great, thanks for throwing me that bone. And as for nurses not making that much, sure. Since it's an average, that's true. And it must also therefore be true that there are a lot of nurses making MUCH MORE than the vaunted 79K figure, by definition, which makes it much worse.

 

[fab4fan]

First of all, I wasn't referencing something you posted. Second of all, that's a cop out because it's a circular argument. There's no reason for physicians to have a union unless they are going to strike. And everyone is against physicians striking, so there's no reason for them to have a union. So to say "IF they had a union, I'd be all for letting them strike" is just a statement made to sound reasonable when you know that physicians DON'T and WON'T have a union directly BECAUSE of the whole "we need to put the patient first blah blah blah" attitude. It's like if I said I'd be all for nurses being called "doctor" if they went to medical school -- wow, great, thanks for throwing me that bone. And as for nurses not making that much, sure. Since it's an average, that's true. And it must also therefore be true that there are a lot of nurses making MUCH MORE than the vaunted 79K figure, by definition, which makes it much worse.

No, I really mean I don't know what prevents doctors from unionizing. Are there actual restraints on this? Because I do believe in the right to strike. Sometimes putting the patient first takes extreme measures.

Of course, if you want to just see people as adversaries, fine, label it a circular argument. Maybe that makes you feel better. The OP really isn't about doctors striking, anyway. It's about nurses striking.

 

[hithere3387]

No, I really mean I don't know what prevents doctors from unionizing. Are there actual restraints on this? Because I do believe in the right to strike. Sometimes putting the patient first takes extreme measures.

Of course, if you want to just see people as adversaries, fine, label it a circular argument. Maybe that makes you feel better. The OP really isn't about doctors striking, anyway. It's about nurses striking.

From what I've read, there are, in fact, anti-trust laws that prevent physicians from unionizing on a large scale. I don't understand the details entirely, but it's illegal for independent companies to form groups in an effort to set prices. As the majority of physicians are hired as independent contractors, they fall under that category.

 

[glade]

No, I really mean I don't know what prevents doctors from unionizing.

Sure, you do. And if you don't, I'll just state it plainly.

Nurses are viewed as "blue collar" workers. It doesn't matter that some of them may make six figures. They're still viewed as "the working class." When nurses strike, everyone is sympathetic in the public. It's like "oh, those poor nurses, they're selfless and caring and they're being taken advantage of."

Doctors are viewed as "white collar" workers. You can work 110 hours/week to make your money, nobody cares. All they know is you make "a lot of money." So if a doctor strikes, a) it's viewed as "some idiot rich guy who just wants more money, what a jerk, let's key his car" and b) suddenly everyone remembers that the doctor is in charge and so its viewed as "he cares more about his money than about ME being sick." The entire rest of the time, you can treat your doctor like he doesn't know anything or you can refuse to do what he recommends, but if the doctor wants to stop taking care of you, it's like "YOU CAN'T DO THAT!! YOU HAVE TO KEEP PUTTING UP WITH ME!!" I've seen it before and I'll see it again.

A nurse strike is not considered "abandonment." But a doctor strike would bring out all these activists and *****s to lecture everyone on "the paramount importance of caring for patients" and so on.

 

[morning]

Sure, you do. And if you don't, I'll just state it plainly.

Nurses are viewed as "blue collar" workers. It doesn't matter that some of them may make six figures. They're still viewed as "the working class." When nurses strike, everyone is sympathetic in the public. It's like "oh, those poor nurses, they're selfless and caring and they're being taken advantage of."

Doctors are viewed as "white collar" workers. You can work 110 hours/week to make your money, nobody cares. All they know is you make "a lot of money." So if a doctor strikes, a) it's viewed as "some idiot rich guy who just wants more money, what a jerk, let's key his car" and b) suddenly everyone remembers that the doctor is in charge and so its viewed as "he cares more about his money than about ME being sick." The entire rest of the time, you can treat your doctor like he doesn't know anything or you can refuse to do what he recommends, but if the doctor wants to stop taking care of you, it's like "YOU CAN'T DO THAT!! YOU HAVE TO KEEP PUTTING UP WITH ME!!" I've seen it before and I'll see it again.

A nurse strike is not considered "abandonment." But a doctor strike would bring out all these activists and *****s to lecture everyone on "the paramount importance of caring for patients" and so on.

I've always felt that doctors should present themselves as small business owners (obviously, only the ones who are in private practice.) When you say "doctor" people think you're a millionaire. But everyone goes ape**** over the small business owners. Witness the hullaballoo over "Joe the Plumber" simply because he was a dude who claimed he was probably going to start a small business sometime in the future.