Heath care worker stratification according to hierarchical indoctrination...

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drmwvr said:
Self absorbed narcissists...What the heck happened to medical academics? The nurses wouldn't be thinking this way if the doctors weren't....

www.sfgate.com

ER nurse in an overwhelmed hospital recounts 'impossible' decision she had to make

Mikaela Sakal, on being an ER nurse in an overwhelmed hospital and the decision she had...
www.sfgate.com www.sfgate.com
Click to expand...

I’m not sure i understand what you mean? Who’s the narcissist? The article sounds awful and similar to what a lot of what my friends are dealing with.
 
SnapperRocks said:
I’m not sure i understand what you mean? Who’s the narcissist? The article sounds awful and similar to what a lot of what my friends are dealing with.
Click to expand...
Probably because the OP is not experiencing this first hand. Easy to point fingers and call names when it isn’t you in the front lines.
 
An ER that regularly can’t staff itself needs to divert or leave more people in the lobby. It’s unfair to the staff and the patients to just pretend they can always do more
 
sb247 said:
An ER that regularly can’t staff itself needs to divert or leave more people in the lobby. It’s unfair to the staff and the patients to just pretend they can always do more
Click to expand...
I suspect in hard hit cities, all hospitals are going thru something similar.
Guess you can divert to a different city?
 
chocomorsel said:
I suspect in hard hit cities, all hospitals are going thru something similar.
Guess you can divert to a different city?
Click to expand...
"There is no emergency in a pandemic"

You only have the capacity you have. That is limited by staff/space/supplies
 
chocomorsel said:
So what’s your solution?
Click to expand...
Admitting that capacity if finite regardless of need

1. If you walk in, you all sit in the lobby until we get availability (coupled with a much lower gtfo threshold for non-"you dying in the next 24hrs" conditions)
2. Tell the EMS there is no more space, people will sit in the lobby until their is availability (coupled with a much lower gtfo threshold for non-"you dying in the next 24hrs" conditions)
3. End certificate of need laws and bans on freestanding EDs as a longer term solution
 
sb247 said:
Admitting that capacity if finite regardless of need

1. If you walk in, you all sit in the lobby until we get availability (coupled with a much lower gtfo threshold for non-"you dying in the next 24hrs" conditions)
2. Tell the EMS there is no more space, people will sit in the lobby until their is availability (coupled with a much lower gtfo threshold for non-"you dying in the next 24hrs" conditions)
3. End certificate of need laws and bans on freestanding EDs as a longer term solution
Click to expand...
This just results in people dying in the waiting room, which is bad for everyone. Freestanding EDs are not typically equipped for these sorts of patients and would not really help the matter much either.
 
drmwvr said:
Self absorbed narcissists...What the heck happened to medical academics? The nurses wouldn't be thinking this way if the doctors weren't....

www.sfgate.com

ER nurse in an overwhelmed hospital recounts 'impossible' decision she had to make

Mikaela Sakal, on being an ER nurse in an overwhelmed hospital and the decision she had...
www.sfgate.com www.sfgate.com
Click to expand...
You can't safely care for that number of patients at once. This isn't narcissism, this is common sense. If they don't demand action, they are going to have patients dying on their watch. When you are a nurse with 15 patients that are seriously or critically ill, you've got four minutes per patient per hour. That's unacceptable on every level for patients this sick
 
Mad Jack said:
This just results in people dying in the waiting room, which is bad for everyone. Freestanding EDs are not typically equipped for these sorts of patients and would not really help the matter much either.
Click to expand...

the above doesn’t match up with the below, at some point you just have to say we have reached our capacity until more staffshow up or some of our current patients leave/die. There is a limit
Mad Jack said:
You can't safely care for that number of patients at once. This isn't narcissism, this is common sense. If they don't demand action, they are going to have patients dying on their watch. When you are a nurse with 15 patients that are seriously or critically ill, you've got four minutes per patient per hour. That's unacceptable on every level for patients this sick
Click to expand...
 
sb247 said:
the above doesn’t match up with the below, at some point you just have to say we have reached our capacity until more staffshow up or some of our current patients leave/die. There is a limit
Click to expand...
Sending patients to places that have no ability to care for them is not a solution. Freestanding EDs are not equipped to handle critically ill patients for any longer than a brief interim transfer period. They don't have the ventilators or respiratory equipment to do so.

Bringing more staff on board, extending working hours, and pulling staff from the floors can easily be done. Many hospital services have been shut down and those nurses could be diverted to the ER. Working hours could be extended due to need. Without demands, it will not happen. Making reasonable demands is how you get things done.
 
Mad Jack said:
Sending patients to places that have no ability to care for them is not a solution. Freestanding EDs are not equipped to handle critically ill patients for any longer than a brief interim transfer period. They don't have the ventilators or respiratory equipment to do so.

Bringing more staff on board, extending working hours, and pulling staff from the floors can easily be done. Many hospital services have been shut down and those nurses could be diverted to the ER. Working hours could be extended due to need. Without demands, it will not happen. Making reasonable demands is how you get things done.
Click to expand...
I think you believe I was disagreeing with the nurse, I’m with them

freestanding ed’s help with the medium level crap and ending certificate of need might help long term with more hospitals in general

but either way, at some point a building just has to be able to tell people, we are doing all we can and the rest of you have to wait
 
What most likely needed to happen in the story is for mid-level admin nurse managers to take their white coats off and put their hands on patients. While I haven't worked in Detroit or NYC during this pandemic, step 1, in my mind is to throw all the non-sensical BS that we've tolerated for decades out the window, have everyone put on scrubs, and take care of patients anyway possible. If you exceed your capability, or reach your threshold, then you make a call to the governor for more resources. Sure, in a non-pandemic situation you go on divert, but in these times you're likely taking care of all comers and what REALLY needs to happen is support from those above you (up to the governor) to get more hands on patients.

Also, I can't imagine what these nurses were dealing with but I'm not a fan of quitting in the middle of a shift and locking yourself in a break room. That's pure abandonment and no patient deserves that.
 
Southpaw said:
Also, I can't imagine what these nurses were dealing with but I'm not a fan of quitting in the middle of a shift and locking yourself in a break room. That's pure abandonment and no patient deserves that.
Click to expand...

It was before the shift started.
 
drmwvr said:
Self absorbed narcissists...What the heck happened to medical academics? The nurses wouldn't be thinking this way if the doctors weren't....

www.sfgate.com

ER nurse in an overwhelmed hospital recounts 'impossible' decision she had to make

Mikaela Sakal, on being an ER nurse in an overwhelmed hospital and the decision she had...
www.sfgate.com www.sfgate.com
Click to expand...
Did you and I read the same article? The one where nurses have so many pts they are dying from inadequate staffing? You want to call them narcissists? Sounds like they are begging for help and drowning in virus and dying pts.

Couldnt we have brought up how to help them rather than insulting them? I hope their demands get met.
 
chocomorsel said:
Probably because the OP is not experiencing this first hand. Easy to point fingers and call names when it isn’t you in the front lines.
Click to expand...

Reducing this to "probably" and "you're not there so you have nothing to say" is...weak....

this is a national crisis on the order of hurricanes, major earthquakes, whatever...and in this particular situation, it's Detroit...as if there are greedy administrators counting stacks of hundred dollar bills in some back room....that it's bad isn't a question...abandoning your colleagues and patients in the face of a disaster is not defensible.

As if these 3 are the first ones to realize they need help...the nurses and doctors they left behind can tell you that....
 
It’s a disservice to nursing staff and patient when patients are not adequately cared for.( 1:15).Nothing narcissistic for them walking out when the issue has been brought the administration attention prior to that point. Those daily patients demise is traumatic to those nurses and staff. And for them to walk out was not easy but had to be done.
I might intubate one patient without PPE because that is my natural impulse but would not make it a daily occurrence because It is not safe to me and everyone around me. I won’t expect a nurse to manage 15 critical patients per shift even in a pandemic. It’s bad medicine!!!
 
MoMoGesiologist said:
Did you and I read the same article? The one where nurses have so many pts they are dying from inadequate staffing? You want to call them narcissists? Sounds like they are begging for help and drowning in virus and dying pts.

Couldnt we have brought up how to help them rather than insulting them? I hope their demands get met.
Click to expand...

Dying from inadequate staffing? If they are dying (it's the Washington Post), it's because of whatever diseases they had. In the context of an unprecedented multi casualty incident wherein resources don't simply appear out of thin air, especially in Detroit, disease and trauma are more lethal.

I know I sound like a real tool on this, but I'm not backing down. If there were than many people in the ER, what does that say about the wards and the units? Should everyone leave? What if physicians up and left in protest that they had to function in the setting of unmitigated disaster? Take your ball and go home? Now? Spare me.

And staffing got worse by 3 when they didn't show up for work.
 
drmwvr said:
Dying from inadequate staffing? If they are dying (it's the Washington Post), it's because of whatever diseases they had. In the context of an unprecedented multi casualty incident wherein resources don't simply appear out of thin air, especially in Detroit, disease and trauma are more lethal.

I know I sound like a real tool on this, but I'm not backing down.

And staffing got worse by 3 when they didn't show up for work.
Click to expand...

I’m curious what’s happened since their strike and since this article was published. Health care workers have always been abused for their sense of debt to their patients and society. We’ve all done shifts where there weren’t enough resources. This is over the top.

The pandemic doesn’t make it excusable. The pandemic didn’t happen over night. The administrators need to go to their legislators and the media if they are in such a dire situation. Legislation needs to be passed protecting health care workers as it was in NY. There are people even on this board who are willing to help even if it’s risky, scary, and understaffed. By the way, the bills don’t stop at home. Make no mistake. If you’re coming from far away to help out, it’s not a get rich quick scheme.

I’m scared of what’s going to happen at nursing facilities around the country when we reopen the economy. We will probably trend towards home care but that’s obviously not possible for everyone. The news stories about people not showing up to these facilities are stacking up. I don’t know what the answer is but, unfortunately, i think this is just the beginning for them. I haven’t personally seen anyone address a plan for this issue publicly.
 
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drmwvr said:
Reducing this to "probably" and "you're not there so you have nothing to say" is...weak....

this is a national crisis on the order of hurricanes, major earthquakes, whatever...and in this particular situation, it's Detroit...as if there are greedy administrators counting stacks of hundred dollar bills in some back room....that it's bad isn't a question...abandoning your colleagues and patients in the face of a disaster is not defensible.

As if these 3 are the first ones to realize they need help...the nurses and doctors they left behind can tell you that....
Click to expand...
What is “weak” is you criticizing overwhelmed, overworked nurses without even attempting to empathize with what they are going through.
More people should stand up for themselves instead of being abused.
 
drmwvr said:
Dying from inadequate staffing? If they are dying (it's the Washington Post), it's because of whatever diseases they had. In the context of an unprecedented multi casualty incident wherein resources don't simply appear out of thin air, especially in Detroit, disease and trauma are more lethal.

I know I sound like a real tool on this, but I'm not backing down. If there were than many people in the ER, what does that say about the wards and the units? Should everyone leave? What if physicians up and left in protest that they had to function in the setting of unmitigated disaster? Take your ball and go home? Now? Spare me.

And staffing got worse by 3 when they didn't show up for work.
Click to expand...
Yup. You sound like a total tool. Glad you realize it.
 
drmwvr said:
Dying from inadequate staffing? If they are dying (it's the Washington Post), it's because of whatever diseases they had. In the context of an unprecedented multi casualty incident wherein resources don't simply appear out of thin air, especially in Detroit, disease and trauma are more lethal.

I know I sound like a real tool on this, but I'm not backing down. If there were than many people in the ER, what does that say about the wards and the units? Should everyone leave? What if physicians up and left in protest that they had to function in the setting of unmitigated disaster? Take your ball and go home? Now? Spare me.

And staffing got worse by 3 when they didn't show up for work.
Click to expand...

How would you have handled this?
 
dchz said:
How would you have handled this?
Click to expand...
I'd have gone to work like the vast majority of everyone else at Grace Sinai that night. And it undoubtedly would have sucked. It must've for the day shift people that got held over to cover.
 
drmwvr said:
Dying from inadequate staffing? If they are dying (it's the Washington Post), it's because of whatever diseases they had. In the context of an unprecedented multi casualty incident wherein resources don't simply appear out of thin air, especially in Detroit, disease and trauma are more lethal.

I know I sound like a real tool on this, but I'm not backing down. If there were than many people in the ER, what does that say about the wards and the units? Should everyone leave? What if physicians up and left in protest that they had to function in the setting of unmitigated disaster? Take your ball and go home? Now? Spare me.

And staffing got worse by 3 when they didn't show up for work.
Click to expand...
Inadequate staffing definitely impacts care, in addition to the underlying disease. These nurses were abused and stretched thin. Why blame or criticize them? Are you a nurse administrator?
 
drmwvr said:
Self absorbed narcissists...What the heck happened to medical academics? The nurses wouldn't be thinking this way if the doctors weren't....

www.sfgate.com

ER nurse in an overwhelmed hospital recounts 'impossible' decision she had to make

Mikaela Sakal, on being an ER nurse in an overwhelmed hospital and the decision she had...
www.sfgate.com www.sfgate.com
Click to expand...

with this healthcare system and this situation, your work environment can easily turn into an intolerable situation that you have to walk away from, everyone has a different threshold, but at some point it does become reasonable to say, look i have to protect myself and im out of here

every hospital system is handling it differently, few are cooperating.. MOST are doing OK, some are doing great jobs ( I think the big ones are),

Some are awful, they have a toxic administration, they dont care about the workers, they are understaffed and in a poor area, they have poor infrastructure and bad, incompetent providers in the ER and ICU, often not formally trained in those areas. Priorities all out of wack.

IMagine a poor, dysfucintional barely-holding it together hospital to begin with, just overwhelmed with patients, in a poor area, they were barely able to take care of 5 ICU patients now there are 50. The administration is not involved, not understanding, not PAYING, nothing is changing.. your going to continue to work there? at some point you say Im out, you guys have to get your ish together, and in the meantime they can divert somewhere else who does,. not every facility has been able to maintain control, but wont admit it
 
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MoMoGesiologist said:
Inadequate staffing definitely impacts care, in addition to the underlying disease. These nurses were abused and stretched thin. Why blame or criticize them? Are you a nurse administrator?
Click to expand...
This is exactly my point...the hyperbole, the drama...Abused? Really? Are you a nurse?

Reflecting on all of this, "narcissists" was not called for. My objection was that they naively went to the WaPo that then undoubtedly sensationalized the story, never getting the hospitals side of the story as that would not have met the needs of the Post and probably make a really boring story.

Take a stand, sure. Do it when patients aren't depending on them. Organize a coherent coalition. Where are the physicians in this story? They've accomplished nothing that wasn't going to happen anyway but with less fanfare and drama which there is far too much in all of this as it is.
 
drmwvr said:
This is exactly my point...the hyperbole, the drama...Abused? Really? Are you a nurse?

Reflecting on all of this, "narcissists" was not called for. My objection was that they naively went to the WaPo that then undoubtedly sensationalized the story, never getting the hospitals side of the story as that would not have met the needs of the Post and probably make a really boring story.

Take a stand, sure. Do it when patients aren't depending on them. Organize a coherent coalition. Where are the physicians in this story? They've accomplished nothing that wasn't going to happen anyway but with less fanfare and drama which there is far too much in all of this as it is.
Click to expand...
Hmm ok maybe “abuse” is too much. I think as an anesthesiologist if I was asked to supervise 10 CRNAs days/weeks in a row, I would feel abused. But if you feel asking an ED nurse to take care of 10 ICU pts is not abuse, I am willing to concede “abuse” may be too strong a term. It still super sucks though...
 
I fully support those nurses saying, "screw this". I'm not taking responsibility to 15 ICU patients each. Nope
 
MoMoGesiologist said:
Hmm ok maybe “abuse” is too much. I think as an anesthesiologist if I was asked to supervise 10 CRNAs days/weeks in a row, I would feel abused. But if you feel asking an ED nurse to take care of 10 ICU pts is not abuse, I am willing to concede “abuse” may be too strong a term. It still super sucks though...
Click to expand...

If you were supervising 10 crnas you’d probably be making some serious coin.
 
drmwvr said:
This is exactly my point...the hyperbole, the drama...Abused? Really? Are you a nurse?

Reflecting on all of this, "narcissists" was not called for. My objection was that they naively went to the WaPo that then undoubtedly sensationalized the story, never getting the hospitals side of the story as that would not have met the needs of the Post and probably make a really boring story.

Take a stand, sure. Do it when patients aren't depending on them. Organize a coherent coalition. Where are the physicians in this story? They've accomplished nothing that wasn't going to happen anyway but with less fanfare and drama which there is far too much in all of this as it is.
Click to expand...

I disagree. They’re not in the military. They’re not held hostage by needing to finish their training like residents. I think more front line stories should come out. Frightening the public with accurate media coverage is necessary.

I wholeheartedly do not think nursing homes or their administrators have a chance against the pandemic on their own. Staff not showing up is happening all over the world. We need government intervention with funding to raise wages so supply of workers can meet the demand in addition to improving their infrastructure making them better equipped to care for their patients.
 
I gotta be honest i didnt much beyond the first image. Their average age is 26. Sorry but they cant have more than a couple years experience each. So basically a CA2. They are in a terrible position, i feel bad for them but lets call a spade a spade...

There isnt a doc or nurse able to butter bread until about year 6
 
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