EM hourly rate approaching that of the nursing staff at my hospital

[FlatFour]

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I was talking with some of the nursing staff at my ED and a lot of them are currently making between 140-160$ / hr (regular RN, not NP or PA). I was subsequently discussing what kind of job offers new EM grads are getting at my program in south Florida and a rate of around $200 / hr seems to be pretty common. Of course we all predicted that rates for EM docs will decrease, but the fact that the hourly rate is spitting distance away from that of a nurse seems infuriating considering the vast difference in the cost and time of training. I am not even going to discuss the fact that a lot of the travel nurses walked away with more than 35k / mo during the pandemic. Hospitals do not value MDs anymore. If they want to slap an RN on my badge and pay me 35k / mo to place IVs and administer meds under someone else's license I'd much rather do that.

 

[DrSnips]

I was talking with some of the nursing staff at my ED and a lot of them are currently making between 140-160$ / hr (regular RN, not NP or PA).

Extra hospitalist shifts for me pay 100 - 120/hr.

 

[Prehealth1011]

If it makes you feel better, that's still more than what hospitalists (physicians) make

 

[bravotwozero]

The travel RN salaries are not going to last long, it isn’t sustainable. Sooner or later the pandemic waves will crest and the demand of RNs will be matched by supply.

 

[grt398]

ICU nurses out in CA are apparently up to $200/hr. The travel nurses at my location get $120/hour for either ICU work or PACU work, while I would get $110/hr if I were to moonlight in house as a fellow so....yea.

 

[Rad2013]

I was talking with some of the nursing staff at my ED and a lot of them are currently making between 140-160$ / hr (regular RN, not NP or PA). I was subsequently discussing what kind of job offers new EM grads are getting at my program in south Florida and a rate of around $200 / hr seems to be pretty common. Of course we all predicted that rates for EM docs will decrease, but the fact that the hourly rate is spitting distance away from that of a nurse seems infuriating considering the vast difference in the cost and time of training. I am not even going to discuss the fact that a lot of the travel nurses walked away with more than 35k / mo during the pandemic. Hospitals do not value MDs anymore. If they want to slap an RN on my badge and pay me 35k / mo to place IVs and administer meds under someone else's license I'd much rather do that.

Someone else’s license? Don’t nurses have their own licenses from State Boards of Nursing?

 

[The Knife & Gun Club]

I was talking with some of the nursing staff at my ED and a lot of them are currently making between 140-160$ / hr (regular RN, not NP or PA). I was subsequently discussing what kind of job offers new EM grads are getting at my program in south Florida and a rate of around $200 / hr seems to be pretty common. Of course we all predicted that rates for EM docs will decrease, but the fact that the hourly rate is spitting distance away from that of a nurse seems infuriating considering the vast difference in the cost and time of training. I am not even going to discuss the fact that a lot of the travel nurses walked away with more than 35k / mo during the pandemic. Hospitals do not value MDs anymore. If they want to slap an RN on my badge and pay me 35k / mo to place IVs and administer meds under someone else's license I'd much rather do that.

A friend of mine who’s job hunting now received an offer for $150/hour in south Miami - admittedly with decent benefits but still.

 

[GassYous]

A friend of mine who’s job hunting now received an offer for $150/hour in south Miami - admittedly with decent benefits but still.

I'm just surprised that they still have a job there

 

[AlmostAnMD]

Nurses at my shop make just over 200/hr here in midwest in the ED

I do think this will result in a flood of nurses in the near future though, and they'll bottom out their own market worse than we are. But for now, good to be an RN.

 

[Dred Pirate]

Someone else’s license? Don’t nurses have their own licenses from State Boards of Nursing?

in all honesty - how many nurses do you know who have lost their license (or had significant disciplinary issue) that was related to them following a physicains orders in good faith? I am guessing most of their license issues is due to diversion or not following orders (missing something, etc)

 

[thegenius]

ICU nurses out in CA are apparently up to $200/hr. The travel nurses at my location get $120/hour for either ICU work or PACU work, while I would get $110/hr if I were to moonlight in house as a fellow so....yea.

I'm in CA and the travel nurses in the ER are up to 200/hr!!! I even heard 250/hr once.

 

[The Knife & Gun Club]

I'm in CA and the travel nurses in the ER are up to 200/hr!!! I even heard 250/hr once.

Just to play devils advocate here - why should doctors make more than nurses? Why not the other way around?

You need both to make the health system function, generate revenue, provide treatments to sick people.

If nurses are the rate limiting commodity, free market capitalism says they should be the highest paid person in the clinical care arena. Docs having x4 the amount of schooling doesn’t make them inherently 4x as valuable.

 

[turkeyjerky]

Just to play devils advocate here - why should doctors make more than nurses? Why not the other way around?

You need both to make the health system function, generate revenue, provide treatments to sick people.

If nurses are the rate limiting commodity, free market capitalism says they should be the highest paid person in the clinical care arena. Docs having x4 the amount of schooling doesn’t make them inherently 4x as valuable.

Also, I think it's reasonable to assume many nurses actually believe they deserve to earn more than us.

 

[Dr Mantis Toboggan]

Just to play devils advocate here - why should doctors make more than nurses? Why not the other way around?

You need both to make the health system function, generate revenue, provide treatments to sick people.

If nurses are the rate limiting commodity, free market capitalism says they should be the highest paid person in the clinical care arena. Docs having x4 the amount of schooling doesn’t make them inherently 4x as valuable.

A 2 year RN degree by far has to have the most lucrative ROI in education right now.

 

[sylvanthus]

I'm just surprised that they still have a job there

They still have doctors in florida?

 

[bravotwozero]

A 2 year RN degree by far has to have the most lucrative ROI in education right now.

2 years, for real? I thought a BSN was a 4 yr degree!

 

[.Lisfranc]

2 years, for real? I thought a BSN was a 4 yr degree!

RN = registered nurse (can be 2 years)
BSN = bachelors of nursing degree (i.e., standard 4 year degree)

 

[Porfirio]

You can become a nurse in 16 months, if you already have a Bachelors degree in something else.

 

[FlatFour]

Just to play devils advocate here - why should doctors make more than nurses? Why not the other way around?

You need both to make the health system function, generate revenue, provide treatments to sick people.

If nurses are the rate limiting commodity, free market capitalism says they should be the highest paid person in the clinical care arena. Docs having x4 the amount of schooling doesn’t make them inherently 4x as valuable.

There are a lot of devils advocates, it’s advocacy for EM physicians that’s lacking.

But fair enough, free market is a free market.

The nurses were overwhelmed with patients, COVID, and fought for better working conditions and more reasonable patient caps. If they didn’t get it, they went somewhere else and the hospital was forced to hire travel staff. Ideally, EM docs would’ve done the same if we weren’t such masochists. I’d be happy being paid the same as a nurse if I was only responsible for 5 active patients at a time and I wasn’t legally responsible for patient outcomes. I’d even help change the bed pan.

 

[Tenk]

Nurses deserve $200/hr.

Physicians deserve $500/hr.

 

[EctopicFetus]

Nurses deserve $200/hr.

Physicians deserve $500/hr.

I hate the term deserve. Why does an avg EP “deserve” $500/hr? For the 2pph. One is a 79 yr old chest painer with a simple workup I could do without leaving my seat. The other patient is there for a covid test.

Meh.. The nurses are making hay. I am happy for them. I want RN/BSN pay to approach NP pay. Ideally to permanently surpass it.

 

[HemorrhagicShock]

I hate the term deserve. Why does an avg EP “deserve” $500/hr? For the 2pph. One is a 79 yr old chest painer with a simple workup I could do without leaving my seat. The other patient is there for a covid test.

Meh.. The nurses are making hay. I am happy for them. I want RN/BSN pay to approach NP pay. Ideally to permanently surpass it.

While I know you're being facetious, I must interject here in case there's a non-medical layperson lurking this thread, or perhaps a naive medical student.

You and I both know that it was a long arduous path to get to the point where you and I could take care of that 79-year-old in our sleep. It took hundreds of chest pain presentations, years of experience, and careful chiseling of the marble to create the fine piece of art and science that is an emergency medicine physician. Add in years of studying, reading textbooks, answering multiple-choice questions, and finally getting our butts handed to us in M&M conferences when we messed up. It required giving up our twenties, it required a sense of "delayed gratification" (still haven't seen much of that gratification though), and it required pouring over hundreds if not thousands of EKGs, both normal and abnormal. It requires a high level of resiliency and mental fortitude to stomach the chronic and ever-present risk that the hordes of 79-year-old chest pain patients (or more likely their families) will sue us for their missed STEMI.

You and I both know that patient here "only" for a COVID test is paying for your 24/7availability. They're paying for the slight chance that they have a subtle sign of a PE, they're paying for your ability to address their (admittedly stupid and easily "google-able") question at 2am in the middle of the night. They're paying for your always available work note because their boss requires a physician to sign off on a positive covid test in order to isolate at home for the next days.

So yea, an EP easily deserves $500 for those two patients.

 

[Tenk]

I hate the term deserve. Why does an avg EP “deserve” $500/hr? For the 2pph. One is a 79 yr old chest painer with a simple workup I could do without leaving my seat. The other patient is there for a covid test.

Meh.. The nurses are making hay. I am happy for them. I want RN/BSN pay to approach NP pay. Ideally to permanently surpass it.

Because we do. WE LITERALLY RESURRECT DEAD PEOPLE AND SAVE THOSE NEAR DEATH. WHO THE HELL ELSE CAN SAY THAT AS THEIR JOB ?

We are basically necromancers who also happen to pull things out of peoples’ butts.

Our predecessors have sold us short, we deserve a lot more than we get.

Also, the numbers I gave are easily doable if we trim the useless fat and bottom feeders in medicine.

 

[allantois]

I don’t know why we think that nurses pay will flatten out. We might as well get into a situation where travel nursing is the norm. How many nurses are gonna retire altogether after making money traveling?

 

[Rekt]

Hot take, but most nurses don't even work that hard. I'd say the ED is probably the only place where they actually work 24/7. I've been to many ICUs, PICUs, TICUs, floors, etc. They're all a joke compared to the ED. More downtime than not. Mandated breaks. 3 shifts a week or banker hours.

Nurses don't deserve 100/hr. NP's deserve even less than RNs

 

[RustedFox]

NPs deserve a "hubris penalty".

 

[GonnaBeADoc2222]

Just to play devils advocate here - why should doctors make more than nurses? Why not the other way around?

You need both to make the health system function, generate revenue, provide treatments to sick people.

If nurses are the rate limiting commodity, free market capitalism says they should be the highest paid person in the clinical care arena. Docs having x4 the amount of schooling doesn’t make them inherently 4x as valuable.

What a simp take.

Guess what? If I don't see the patient and sign the note, the hospital doesn't bill. I'd say that's pretty rate limiting.

Guess what what? If I really needed to, I could place an IV, hang meds, and wipe butts. By this logic you could send all the nurses home, and just pay me their rate on top of mine.

 

[EctopicFetus]

While I know you're being facetious, I must interject here in case there's a non-medical layperson lurking this thread, or perhaps a naive medical student.

You and I both know that it was a long arduous path to get to the point where you and I could take care of that 79-year-old in our sleep. It took hundreds of chest pain presentations, years of experience, and careful chiseling of the marble to create the fine piece of art and science that is an emergency medicine physician. Add in years of studying, reading textbooks, answering multiple-choice questions, and finally getting our butts handed to us in M&M conferences when we messed up. It required giving up our twenties, it required a sense of "delayed gratification" (still haven't seen much of that gratification though), and it required pouring over hundreds if not thousands of EKGs, both normal and abnormal. It requires a high level of resiliency and mental fortitude to stomach the chronic and ever-present risk that the hordes of 79-year-old chest pain patients (or more likely their families) will sue us for their missed STEMI.

You and I both know that patient here "only" for a COVID test is paying for your 24/7availability. They're paying for the slight chance that they have a subtle sign of a PE, they're paying for your ability to address their (admittedly stupid and easily "google-able") question at 2am in the middle of the night. They're paying for your always available work note because their boss requires a physician to sign off on a positive covid test in order to isolate at home for the next days.

So yea, an EP easily deserves $500 for those two patients.

Medicare says you deserve about $150 per patient a little more for level 5 and cc Less for 4s and under. Of course Medicaid think you deserve about 60-80% of that depending on your state. That’s probably the best marker of what society thinks you are worth.

Depending. Where you work and who you work for those same patients are being seen by Jenny McJennyson DNP, RN, BSN, DTF, WAP who makes 1/3 of what you make and admin says their patients are so much happier than the ones seen by docs.

Also, if people believed they deserved $500/hr they wouldn’t work for less. You decide what your time is worth. If Em pay was $20/hr I would go do something else (using extremes for sake of effect). Similarly even those who are burnt out would work if pay was $1,000 an hour. The Em job market is around $180-250 in “normal” places For long term gigs.

The point about 24/7 availability is fascinating to me truly because there is a CPT code for this and Medicare and the AMA assign 0.00000 RVUs For your 24/7 availability.

I’m being a bit facetious for sure. I wouldn’t work for a crap wage and am at the point financially where I dont have to. I find much of what is going on in EM to be completely sickening. I think the oversupply of docs and Jennys has led to a checkmate with regards to EM doc pay.

 

[EctopicFetus]

Because we do. WE LITERALLY RESURRECT DEAD PEOPLE AND SAVE THOSE NEAR DEATH. WHO THE HELL ELSE CAN SAY THAT AS THEIR JOB ?

We are basically necromancers who also happen to pull things out of peoples’ butts.

Our predecessors have sold us short, we deserve a lot more than we get.

Also, the numbers I gave are easily doable if we trim the useless fat and bottom feeders in medicine.

Meh. ICU docs do it, so does anesthesia. Most fields of medicine do something amazing. Ophtho (who aren’t even doctors by my definition) restore vision. @Tenk as I said in the my reply just prior to this one. People including your admin and medicare think that can all be done by NPs and RNs. In my hospital rapid response is handled by mostly RNs no ICU doc maybe a hospitalist.

how many EDs in America are staffed by non EM trained docs. Shows we aren’t that special. How many non neurosurgery trained people are doing craniotomies? How many non Cardiologists are doing heart Caths?

The number you gave aren’t possible assuming no use of MLPs and seeing 2 pph. Assuming between Medicaid and self pay and commercial you end at near Medicare rates you are looking at $150/pt. Thats. About $300/hr in revenue before you pay for a medical director, med mal and other expenses.

 

[EctopicFetus]

I don’t know why we think that nurses pay will flatten out. We might as well get into a situation where travel nursing is the norm. How many nurses are gonna retire altogether after making money traveling?

Cause it only takes 16 months to mint a new one and as pay is up NPs will return To the bedside. We had 2 local NPs come back to the bedside cause the money is way better and less “risk”. I do find the RNs concern about risk to be comical.

 

[Brigade4Radiant]

Lol our job is done easily?!? Then every job is mostly done easily.

Also nursing pay is unlikely to significantly flatten out as they have DNP and other fields of nursing to do like admin, cath lab, cosmetics

They can easily leave in two weeks while it takes doctors getting state licenses and then Credentialing which adds more months.

Either way if their rates go down they will still make more than they did before.

 

[NurWollen]

You can become a nurse in 16 months, if you already have a Bachelors degree in something else.

So in theory I could become a nurse in less time than it's going to take me to finish fellowship...

 

[deleted941485]

So in theory I could become a nurse in less time than it's going to take me to finish fellowship...

By the time you get it the rates would have dropped

 

[grt398]

Just to play devils advocate here - why should doctors make more than nurses? Why not the other way around?

You need both to make the health system function, generate revenue, provide treatments to sick people.

If nurses are the rate limiting commodity, free market capitalism says they should be the highest paid person in the clinical care arena. Docs having x4 the amount of schooling doesn’t make them inherently 4x as valuable.

Because this isn't a free market. And it's unlikely it will be anytime soon, in the US at least. There are laws that prevent physicians from unionizing if they work in independent practice (doesn't apply to nurses). There are laws against referring to centers you have a financial interest in (doesn't apply in almost any other market, you just have to provide a tiny tiny disclosure). There are laws against "patient abandonment" that don't apply to nurses regardless of whether the patient is polite/rude/pays or not/adheres to treatment or not (but don't forget you can still be blamed via metrics for the patient not following your recommendations). There are laws preventing physician ownership of various structures since Obamacare passed despite having lower costs (thanks to lobbying from the hospital association):

Patient Expenditures in Hospital-Owned vs Physician-Owned Medical Groups

Robinson and Miller determine whether total expenditures per patient were higher in medical groups owned by local hospitals or multihospital systems compared with groups owned by participating physicians in California between 2009 and 2012.

jamanetwork.com

And don't forget forbidding building new surgery centers, despite the fact they have much better outcomes for elective surgeries, which hospitals don't want to give up b/c of the profit margin. And that's just the beginning of why this isn't a free market. Elective plastic surgery is as close as you'll ever get to a free market in medicine. Botox as well. And there's a significant premium on getting your botox done by a plastic surgeon/dermatologist vs a FM doc vs an NP when you look at bigger markets (aka LA/NYC).

Why do we make more than nurses? Because we are genuinely the backstop against really bad things happening to patients. Occasionally we save lives. And fwiw, I wouldn't allow a family member to be seen by a non-MD in any field that I couldn't diagnose the problem myself, because I've seen how bad the care can be by poorly trained midlevels in the ICU. And I can only assume it's the same in other fields.

Now maybe the politicians, hospital administration, and even the average person doesn't care (and based on how "quality metrics" are measured, there's probably some argument to be made for that). But it's hard to look at what the truly wealthy do, aka cash only care at HSS for their ortho surgery, or fly to Mayo etc where there are entire floors dedicated to "Executive" patients, and argue that physicians aren't the gold standard of care and should be paid appropriately if society wishes to maintain that standard.

 

[Kryptocoin]

While I know you're being facetious, I must interject here in case there's a non-medical layperson lurking this thread, or perhaps a naive medical student.

You and I both know that it was a long arduous path to get to the point where you and I could take care of that 79-year-old in our sleep. It took hundreds of chest pain presentations, years of experience, and careful chiseling of the marble to create the fine piece of art and science that is an emergency medicine physician. Add in years of studying, reading textbooks, answering multiple-choice questions, and finally getting our butts handed to us in M&M conferences when we messed up. It required giving up our twenties, it required a sense of "delayed gratification" (still haven't seen much of that gratification though), and it required pouring over hundreds if not thousands of EKGs, both normal and abnormal. It requires a high level of resiliency and mental fortitude to stomach the chronic and ever-present risk that the hordes of 79-year-old chest pain patients (or more likely their families) will sue us for their missed STEMI.

You and I both know that patient here "only" for a COVID test is paying for your 24/7availability. They're paying for the slight chance that they have a subtle sign of a PE, they're paying for your ability to address their (admittedly stupid and easily "google-able") question at 2am in the middle of the night. They're paying for your always available work note because their boss requires a physician to sign off on a positive covid test in order to isolate at home for the next days.

So yea, an EP easily deserves $500 for those two patients.

THIS.

I'm starting a new side gig and was consulting a lawyer. Her rate was $500/hr. And she needed a $6k retainer before we even move forward. No negotiation. Pay her rate or find someone else. She knows her worth and apparently lots of people have no problem paying her that.

I've seen doctors accept a $100/hr gig and then b*tch about how bad medicine is. The irony.

 

[EctopicFetus]

THIS.

I'm starting a new side gig and was consulting a lawyer. Her rate was $500/hr. And she needed a $6k retainer before we even move forward. No negotiation. Pay her rate or find someone else. She knows her worth and apparently lots of people have no problem paying her that.

I've seen doctors accept a $100/hr gig and then b*tch about how bad medicine is. The irony.

When you accept $100/hr you also know your worth. its simple. If someone came to me for a job literally no matter how easy for $100/hr and I had to not be in my home I wouldn't do it. See its simple. My worth is different than another docs worth. Its how we each individually value our time. I have access to a job which sees under 0.5pph and pays over $100/hr. I could do 24s or 48s but instead I sit home or play with my kids and do stuff with them.

 

[southerndoc]

Instead of the cliche of nurses going to school to find and marry a doctor for their money, it's going to be the other way around.

 

[BoardingDoc]

One of my favorite nurses just went per diem here so that she could "travel" to one town over for 130/hr instead of 45/hr. Taking her place is another nurse who is "traveling" as a 30 min commute from her house for a similarly inflated rate.

I don't blame either of them at all, but holy hell this system is broken.

 

[GassYous]

One of my favorite nurses just went per diem here so that she could "travel" to one town over for 130/hr instead of 45/hr. Taking her place is another nurse who is "traveling" as a 30 min commute from her house for a similarly inflated rate.

I don't blame either of them at all, but holy hell this system is broken.

They should just trade houses

 

[emergentmd]

Its supply and demand, and when someone is desperate they (or the gov) will pay to get nurses to keep the hospital afloat. Typically a crappy hospital, more power to them. Make Hay now b/c it will not last, covid will not last, and they will be back to making their 30-60/hr.

Their jobs sucks and most docs would never do it.

I never understood someone feeling they deserve to make more just b/c they had more schooling. It is what you are able to make for your boss is what creates your value. A PHD who spent 10 years post grad in latin dancing or library studies make very little b/c they produce less for their bosses.

My hospital ER jobs made me 400K/yr and I worked my butt off. I work less hours now, see less pts, see 1-2pph depending on covid surge and make many times more.

Its all supply and demand that have little correlation to how hard you worked/degree you have.

 

[qwerty89]

Its supply and demand, and when someone is desperate they (or the gov) will pay to get nurses to keep the hospital afloat. Typically a crappy hospital, more power to them. Make Hay now b/c it will not last, covid will not last, and they will be back to making their 30-60/hr.

Their jobs sucks and most docs would never do it.

I never understood someone feeling they deserve to make more just b/c they had more schooling. It is what you are able to make for your boss is what creates your value. A PHD who spent 10 years post grad in latin dancing or library studies make very little b/c they produce less for their bosses.

My hospital ER jobs made me 400K/yr and I worked my butt off. I work less hours now, see less pts, see 1-2pph depending on covid surge and make many times more.

Its all supply and demand that have little correlation to how hard you worked/degree you have.

It is amazing how many people don't understand or don't want to understand this.

the ROI for medicine has definitely changed. When I see people doing expensive SMPs to get into medical school or even paying Stanford 7.5k a year to be a medical scribe "fellow" I always shake my head. Same goes for people doing research years when they already have a competitive application for a competitive specialty. You might not match at MGH but you will match somewhere so just get on with your training. Same goes for internal medicine chiefs who end up doing primary care. What was the point of the extra year?

Why med students are still ranking 4 year EM programs highly blows my mind. The opportunity cost of the extra year of training is astronomical when compounded over 20 or 25 or 30 years. Even in the worst case scenario with 350K W2 income in CA with 0 pre-tax IRA contributions vs 70K as a 4th year resident the difference over 30 years with 7% compounded a year in the market is ~$1,300,000. Assuming you live in Texas with 400k income the difference becomes $1,700,000. This is assuming you spend all your residency salary as a resident with zero savings OR live off of a residents salary as an attending while investing the rest. Equal spending.

Don't get me started on pediatric hospitalist fellowships.

Corporate medicine has made it loud and clear they don't give a crap about your training. So just get it done as quickly as possible.

I don't even know if this rant has anything to do with the thread at this point.

 

[kidthor]

Kaiser near me keeps calling to offer per diem (read that as no benefits) anesthesiologist jobs at $150/hr with no hours guarantee, must agree to work nights/weekends/holidays at the same rate, and act as if they’re doing me a favor.

Nurses are much better at this.

 

[kidthor]

how many EDs in America are staffed by non EM trained docs. Shows we aren’t that special. How many non neurosurgery trained people are doing craniotomies? How many non Cardiologists are doing heart Caths?.

As a visiting anesthesiologist, I’ve always found ED staffing with non EM docs to be odd. It’s like the system prefers the inferior option because it’s cheaper and easier for a de facto inferior product. Till you get regulation or unavoidable guidelines requiring an EM doc at all times, your profession’s integrity is eroded.

Ironically you can’t just hire a smart EMT instead of an RN. They made it so there’s just no substitute (aside from weirdly hiring med students for pennies and calling it an “opportunity”). The nurses from a professional integrity level have it down - I respect it.

 

[GonnaBeADoc2222]

Doctors are simps with inflated lifestyle to income ratios. We had a golden opportunity to reshape this environment during the height of COVID, but blew it.

 

[EctopicFetus]

Doctors are simps with inflated lifestyle to income ratios. We had a golden opportunity to reshape this environment during the height of COVID, but blew it.

Cause so many clowns were just excited to be called “heroes” all while being taken advantage of.

As someone pointed out above 1) as long as non em docs are viewed by hospitals and payers as equal to em docs we will be a joke and 2) education and length or difficulty of it has nothing to do with earnings.

I make more than plenty of people who went to a 4 year em residency. I also make more than most em docs at least based on every survey I have ever seen and work less than them.

I don’t need to negotiate with an employer since I am the employer. That’s the trick. There is a lot of money in owning a business if you know how to run it.

 

[grt398]

One of my favorite nurses just went per diem here so that she could "travel" to one town over for 130/hr instead of 45/hr. Taking her place is another nurse who is "traveling" as a 30 min commute from her house for a similarly inflated rate.

I don't blame either of them at all, but holy hell this system is broken.

This is probably 50%+ of the nurses in the ICU's in my fellowship. They literally worked at another hospital 30-45 minutes away and now "Travel" here, while the former permanent nurses here go to their hospital. And triple their pay. It's crazy.

 

[Dred Pirate]

One of my favorite nurses just went per diem here so that she could "travel" to one town over for 130/hr instead of 45/hr. Taking her place is another nurse who is "traveling" as a 30 min commute from her house for a similarly inflated rate.

I don't blame either of them at all, but holy hell this system is broken.

I know a few that use friends/families address so that they meet the 50 mile rule - but then "travel" to a job 20 miles away for stupid money. Again, I don't blame anyone for getting theirs, but it is so jacked up

 

[turkeyjerky]

Doctors are simps with inflated lifestyle to income ratios. We had a golden opportunity to reshape this environment during the height of COVID, but blew it.

That's revisionist history. CMGs and large hospital systems had important, albeit seemingly minor, built-in structural advantages allowing them to consolidate market dominance during the initial phase of the pandemic.

 

[ToliBro]

Will preface this with noting that physicians should be able to make a good living due to the sacrifices required to achieve independent practice, that I don't support the vast expansion of midlevel independence, etc. Please don't hurt me.

As a travel nurse, I will note that the huge, huge pay I've heard about is fairly limited. I've made in the 110 range for a while (Midwest, ICU) and the only people making significantly more are either getting some of the very limited contracts for hard to fill areas or they're getting an overtime hourly rate. The agencies also leave out a lot of fine print; with nontax stipends and such, your take home is a lot lower unless you have both a mortgage somewhere else and you're renting a room somewhere near the hospital for market rates (my 110 drops a bit when I factor in employer-side taxes). The huge pay contracts are usually of limited duration and the hospital has no issue terminating it after a week if they want, so stability is basically nonexistent. Some of them, like the Krucial contracts that pay out huge $$$, house you in dormitory-style accommodation where your bags are searched for alcohol, you can't enter anyone else's room, and you have a curfew to leave the hotel between shifts with someone signing you in and out so you spend the whole contract working or being a monk in a motel. Benefits and such are more limited than staff jobs as well. The hospital treats you as being at the bottom of the pile, so inappropriate assignments are common-- I haven't ever circulated the OR and the last time I had a laboring mother was 11 years ago for like maybe 5 hours of clinical but that hasn't stopped them trying to make me work either. I'm not going to bleat "losin' mah lyyuu-sens" but I have no urge to be named in a malpractice suit with more exposure than otherwise for working outside my usual areas of practice.

It's great money, I plan on doing it for the next year to build reserves to pay for pre-med, but it's got definite downsides and doesn't reach attending level pay except in certain low-stability contracts. I doubt it'll be around for more than 2022, acuity will drop as covid vaccination and stuff like Paxlovid become more common. I also expect states to start enacting laws at the direction of hospitals to cap our pay; there's already been House hearings on our pay so there might even be a federal response.

 

[kidthor]

I also expect states to start enacting laws at the direction of hospitals to cap our pay; there's already been House hearings on our pay so there might even be a federal response.

First of all - fantastic post and insight.

I highly doubt, however, there would be any laws capping nursing pay. The backlash would be so severe and it would be perceived anti-American/competition.

That said, it's a crazy time.