Physicians Working as Nurses

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GassYous

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Just saw this nonsense on reddit

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Sorry, I only have the brain of a doctor and the heart of a doctor. Not sure if I’m qualified.
 
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What the actual FK?!
The cRNas wouldn’t even work as icu nurses when we were in trouble. They wanted to be APRN for ICU....

The hospital just have to hand over more money. Everyone has a price.
 
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The hospital just have to hand over more money. Everyone has a price.
Totally agree - there are plenty of properly trained nurses out there, they just have to pay enough. They have a tough job and are probably underpaid by too many places, so these places need to pay them what they're worth during a surge. The rate limiting step at many hospitals for ICU care of COVID patients is appropriate nursing. Supply and demand...

Plus, having a doctor function as a nurse is a fraught with issues. Honestly we aren't trained to be nurses and we don't know their workflows and processes very well. There is a LOT to their jobs that we don't know about and a good nurse brings high value to the system.

In a pinch maybe we can wing it with some extra training, but it's just not the best approach. The best approach is to pay them what they're worth (which right now is quite a lot)!
 
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Just saw this nonsense on reddit
If I was not needed on the floors, and they paid me the same I would do it. Why the hell not? Are we so above and beyond that we can’t help and pitch in on other ways?
Then again, I was a nurse. So I don’t see myself as so special.
Problem I have is the cRNa people will refuse this ****. Which is total BS. Talk about uppety wannabes!
I know. I am the one full of unpopular opinions. I believe we need to check our egos at the door and assist wherever needed.
 
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Totally agree - there are plenty of properly trained nurses out there, they just have to pay enough. They have a tough job and are probably underpaid by too many places, so these places need to pay them what they're worth during a surge. The rate limiting step at many hospitals for ICU care of COVID patients is appropriate nursing. Supply and demand...

Plus, having a doctor function as a nurse is a fraught with issues. Honestly we aren't trained to be nurses and we don't know their workflows and processes very well. There is a LOT to their jobs that we don't know about and a good nurse brings high value to the system.

In a pinch maybe we can wing it with some extra training, but it's just not the best approach. The best approach is to pay them what they're worth (which right now is quite a lot)!
No matter how much you pay them, right now, there aren’t enough of them. You guys realize that systems are literally overwhelmed no?
 
It would even be funnier, “if” someone signs up, nursing board objects and call it scope creeping....

In all honesty, I cannot imaging anyone who is a practicing anesthesiologist can actually stomach being a nurse. Worked at an ICU a few years ago as a nocturnist. Patient went into rapid afib. Instinctively, ordered some esmolol. ICU nurse was not familiar with the drug, since they usually use metoprolol, I just took the vial and gave a few cc. They looked at me as if I had three heads.
Their training is vastly different than physicians, more so with anesthesia. In the OR i need to react in “real time”, and I will reach into Pyxis anytime I want. Their’s unless I see an order or unless it’s something I am familiar with, I won’t do it. Because “I don’t be responsible for hurting the patient....”

I digress.

Rather than asking physicians and spend time, (probably volunteered time from physicians, since you all are so well paid and it’s your calling to do “healthcare”) to “train” a nurse. Just fork over the money and call it a day. Just the other day I learned our healthcare system made a few billion dollars in revenues in 2020. Took some government money too.... just cough it up!
 
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No matter how much you pay them, right now, there aren’t enough of them. You guys realize that systems are literally overwhelmed no?

Plenty of people leaving my neck of the woods to become travelers.
During our surge, they wouldn’t pay “crazy” money, at the same time mandated nurses to work overtime. Lastly, at end of the 4 months, the nurse union finally got the hospital to agree to hazard pay. IIRC, after tax, it was a lousy $300 for the whole time. It works out to be like $1 per hour worked.

I cannot advocate nurses to take more shifts, nor can I advocate my colleagues to take on any nursing work. Especially like you said, if the cRNas cannot work as RNs, there’s something very very very wrong with the picture.
 
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Plenty of people leaving my neck of the woods to become travelers.
During our surge, they wouldn’t pay “crazy” money, at the same time mandated nurses to work overtime. Lastly, at end of the 4 months, the nurse union finally got the hospital to agree to hazard pay. IIRC, after tax, it was a lousy $300 for the whole time. It works out to be like $1 per hour worked.

I cannot advocate nurses to take more shifts, nor can I advocate my colleagues to take on any nursing work. Especially like you said, if the cRNas cannot work as RNs, there’s something very very very wrong with the picture.
It’s a giant swap game. Nurses trade out and go somewhere else, hospital brings in travelers. Makes no sense. We know they can pay these crazy fees because they pay travelers. Idiotic.

However there would still be a shortage because again the hospitals are overflowing like never before.

Doctors digging their heels and saying no when they may not have any other work on principle alone, because CRNAs won’t do it, is not seeing the big picture. Which is that patients need help.

Quite frankly I don’t see a bunch of middle-aged mostly male anesthesiologists doing nursing work. But if it paid the same and was temporary and helped the patients, what’s the difference? And if you belong in a practice where the CRNA’s refused and the MDs ch to assist, quite frankly that would be the one of the best reasons to get rid of the CRNAs in my opinion after all is said and done. Lack of teamwork mentality.

I am strong on my principles but on this one I have to say leave the egos at the door let’s help the patients. Those patients could be you, your family members or friends. That’s the big picture.

Again, unpopular opinion but I believe it’s the right thing to do if there is no work in your specialty and they pay you your regular wage. Heck these nurses are making more than some pediatricians.
 
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View attachment 327350

Just saw this nonsense on reddit

We also have plenty IMGs working as nurses

I've recently done more nursing stuff (IV, blood draw, ABGs, drip titration, BiPAP set up, Foleys, EKGs, bladder scan, pt triaging especially ambulances, EMS triage, splinting, pushing pt to imaging...) just cause of workload, slow staff

Sometimes you gotta do it if want it done fast and accurate
 
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Yeah no, I didn't slog through medical school and residency for all those tough years to become a doctor so that they can make me a nurse. Would a lawyer mop the bathroom floors just because the janitor wasn't doing it fast enough? Makes zero sense.

There are plenty of nurses and assistants out there playing doctor or administrator. Let the people who went to nursing school act as the nurse they went to school to be. There are also plenty of nurses who are not in the workforce, give them licenses and a place of employment to get them to work. The hospital systems' inability to hold onto staff due to a simple minded obsession with profits is not my issue.
 
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I used to work with a nurse who was an orthopedic surgeon in the Philippines, a great guy.
 
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I have my price. If they pay it, I’ll happily do whatever they tell me... But it won’t be cheap. Money talks
 
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Maybe because I’m just still a resident now but.... if my hospital needed help in nursing duties and needed to pull me away from a rotation (no way I’m doing things on top of doing resident stuff) and they paid me accordingly to other nursing staff, I would do it. I have always been the mindset that as a physician, we have a the capability to do it all. No, I am not a trained nurse but I have the ability to do it. And as said above, in anesthesia we do so many “nursing” tasks already. Although annoying, we would be more than helpful in a pandemic. And yeah I’ve worked with a few IMG people who couldn’t practice in America who are now RNs or scrub techs etc. I am all for patient care and that can only look good for our profession. But definitely if I am willing to do this, then I better be seeing all those nursing managers, APPs stepping up as well. Show some true colors.
 
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I have my price. If they pay it, I’ll happily do whatever they tell me... But it won’t be cheap. Money talks
Right. It doesn't diminish your role as a doctor - it's simply supplementing it during those times when you're not one. But it would require a hefty premium; certainly more than I make as a physician.
Actually, forget it. I'm not sure I can bring myself to insert foleys and change diapers as I try to avoid that end of the patient.
 

We also have plenty IMGs working as nurses

I've recently done more nursing stuff (IV, blood draw, ABGs, drip titration, BiPAP set up, Foleys, EKGs, bladder scan, pt triaging especially ambulances, EMS triage, splinting, pushing pt to imaging...) just cause of workload, slow staff

Sometimes you gotta do it if want it done fast and accurate
I think there's a big difference between "working as a nurse" and doing some "nursing work". Most of the tasks listed above I've done at one time or another, or continue to do.

Let's remember another thing - there are layers upon layers of "clipboard nurses" in most hospitals. Forget Joint Commission. Forget your stupid committee (or "task force"). Don't worry about how many nursing certification initials are after your name. Take care of patients.
 
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Empty the hospital admin. wings that are full of perfectly capable ex-nurses who are now sitting in offices doing non-productive bureaucratic make-work. Also, enlist all the layers of nurse managers, clipboard wielding JCAHO and gov't worker types doing nonsense work. That could provide a massive potential infusion of much need help.
 
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When they exhausted all the managers CNOs, clip board warriors. I will definitely consider doing it.

I am all for doing what’s right by the patients. But it’s unfathomable to me, when it’s convenient, then we are physicians first, and are completely responsible for whatever sh!? happens to patient. Administration and nurses wash their hands off. But when’s it’s for saving money or “getting paid too much” we are the first one to get chopped.

If you’re not working right now, go for it. But if you already have other responsibilities, i sure wouldn’t want to be trained to do something that other people already trained to do and just “choose” not to do.
 
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Healthcare systems and insurance companies have money to burn and if forced, they could pay enough to fill any position necessary. Society is undergoing a major rotation and it is becoming obvious that the wrong things have been valued and overcompensated. Entertainers (athletes, TV/movie stars, musicians) have been valued higher than the guardians of life and health. Maybe the administrators will be forced to reconsider what fair market value is for quality healthcare workers. If you pay enough, EVERY position can be filled and the clipboard workers will gladly return to patient care in droves.
 
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Empty the hospital admin. wings that are full of perfectly capable ex-nurses who are now sitting in offices doing non-productive bureaucratic make-work. Also, enlist all the clipboard wielding JCAHO and other gov't worker types doing nonsense work. That could provide a massive potential infusion of much need help.
Agreed 100%. And the CRNPs and the CRNAs. For sure. Quite frankly, if they refuse, fire them.
In addition, physicians can step up too.

Edit: Man if I were in charge I would fire so many midlevels who were too good and full of excuses to step up to the bedside.
Damn that would feel good.
Getting excited just thinking about it.
 
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And while we're at it, in my "Scenes I'd like to see" dept......
How about eliminating all the incredibly onerous charting requirements so that our nurses, who are managing as many as 8 patients each, can actually be nurses. (ie: now's a good time for major tort reform).
 
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How about eliminating all the incredibly onerous charting requirements so that our nurses, who are managing as many as 8 patients each, can actually be nurses. (ie: now's a good time for major tort reform).
You mean like eliminating the incredibly onerous charting requirements for doctors, and suspending malpractice at least for Covid-19 patients, which haven't happened in 10 months of pandemic?

Don't hold your breath.
 
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You mean like eliminating the incredibly onerous charting requirements for doctors, and suspending malpractice at least for Covid-19 patients, which haven't happened in 10 months of pandemic?

Don't hold your breath.

Malpractice was suspended in New York
 
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I would not do this off the bat. Once every nurse, CRNA, APP, nurse manager, and C-suite nurse is asked to step up and either accepts or declines and is fired, then I would happily be next in line. I am not too proud to do anything. I will never allow them to utilize the Hippocratic oath nonsense to compel me to do it though. The hospitals and insurers have the money. The government kicked in some as well.

You want workers, pay them what they're worth. Clearly they are worth more than what is being offered. Cough it up or be held accountable by shareholders and constituents with their votes and money. I will never sacrifice myself in these situations. No PPE? I will not work. No COVID testing pre-op? I will not take care of the patient. No pay? No work.
 
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Something I haven’t seen brought up in this forum is the medico-legal implications of physicians working as nurses.

If you carry out the orders of another physician and there’s a bad outcome and patient/family sue, you better believe they’re coming for you. Even if you’re practicing outside of scope, to the patients lawyer MD/DO = $$$.
 
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Something I haven’t seen brought up in this forum is the medico-legal implications of physicians working as nurses.

If you carry out the orders of another physician and there’s a bad outcome and patient/family sue, you better believe they’re coming for you. Even if you’re practicing outside of scope, to the patients lawyer MD/DO = $$$.
Agreed.
 
You mean like eliminating the incredibly onerous charting requirements for doctors, and suspending malpractice at least for Covid-19 patients, which haven't happened in 10 months of pandemic?

Don't hold your breath.

What charting requirements for anesthesiologists are overly onerous? I chart exactly what i want to and it takes about 3 min per case.
 
Hard pass. The hospital isn't doing that because they're worried about a surge. They're doing it because they'd rather repurpose their existing staff rather than pony up for actual nurses. Back during the initial surge then maybe. But after going through another surge and seeing how hospitals have the ability to properly prepare there's no reason for this.

"Substantial pay" is such a fallacy. Travel nurses get $100-$150/hr now. That's less than what most physicians make. Makes no sense that they'd pay you more than they can hire a travel nurse for.
 
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Hard pass. The hospital isn't doing that because they're worried about a surge. They're doing it because they'd rather repurpose their existing staff rather than pony up for actual nurses. Back during the initial surge then maybe. But after going through another surge and seeing how hospitals have the ability to properly prepare there's no reason for this.

"Substantial pay" is such a fallacy. Travel nurses get $100-$150/hr now. That's less than what most physicians make. Makes no sense that they'd pay you more than they can hire a travel nurse for.
There aren’t enough travel nurses period.
 
There aren’t enough travel nurses period.
Correction* There aren't enough travel nurses willing to work for "normal" base nursing wages. They figure, and rightfully so, if they are going to travel and bust their asses in a new system, that they should be paid accordingly.
 
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Correction* There aren't enough travel nurses willing to work for "normal" base nursing wages. They figure, and rightfully so, if they are going to travel and bust their asses in a new system, that they should be paid accordingly.
How do you know this for a fact? Where do you think all these travel nurses come from? Are they sitting at home twiddling their thumbs or something?

When hospitals are used to operating under capacity, and now are bursting at the seams and putting tents outside, where do they find these RNs just waiting for a payday?

Try and think practically here instead of imagining some magical extra pool of nurses that don’t exist.

And the whole point of traveling is to make more money as you explore the world. That’s how the travel nursing industry works. So unless you live and work in CA which has some of the best salaries in the US, you are going to make more money when you travel.
 
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Maybe you should take a step back and realize that you're not familiar with everyone's mindset. There are plenty of people that took themselves out of the workforce because they don't want to catch covid or are just fed up with the bs. I personally know some that are staying at home rather than working.
 
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Maybe you should take a step back and realize that you're not familiar with everyone's mindset. There are plenty of people that took themselves out of the workforce because they don't want to catch covid or are just fed up with the bs. I personally know some that are staying at home rather than working.
And they would come back and work with those Covid patients they were trying to avoid?

It’s not about a mindset as much as it’s about common sense.

There are not an unlimited supply of RNs just like there are not an unlimited supply of docs. This is common sense. Law of supply and demand. Has this ever happened before where hospitals are ripping at the seams all at the same time?

Whether or not you think you worked too hard to now work as a nurse is irrelevant. You don’t have to. Doesn’t change the fact that there are currently too many patients for many systems to handle with the current limited supply of nurses.
 
How do you know this for a fact? Where do you think all these travel nurses come from? Are they sitting at home twiddling their thumbs or something?

When hospitals are used to operating under capacity, and now are bursting at the seams and putting tents outside, where do they find these RNs just waiting for a payday?

Try and think practically here instead of imagining some magical extra pool of nurses that don’t exist.

And the whole point of traveling is to make more money as you explore the world. That’s how the travel nursing industry works. So unless you live and work in CA which has some of the best salaries in the US, you are going to make more money when you travel.
Where do travel nurses come from?

1) PACU nurses which staff 6 nurses to watch 8 patients - 4 are perma on instagram
2) Pre-op nurses which staff 5 nurses for 10 bays - 2 are perma updating their facebook status
3) Floor nurses that decide they would rather earn 4x their weekly wages and take an assignment to NYC or LA
4) Not every part of the US is hit equally. Plenty of "less" overhelmed hospital systems that have nursing to spare.

If I were a young nurses with no significant other limitations, I would perma travel in this covid climate. The demand is there. Use that to your advantage like any other field would do and make bank. I've even seen nurses quit their perm employment to be rehired as travel nurses 2 weeks later at 2-3x the rate in my institution. Money talks.
 
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Where do travel nurses come from?

1) PACU nurses which staff 6 nurses to watch 8 patients - 4 are perma on instagram
2) Pre-op nurses which staff 5 nurses for 10 bays - 2 are perma updating their facebook status
3) Floor nurses that decide they would rather earn 4x their weekly wages and take an assignment to NYC or LA
4) Not every part of the US is hit equally. Plenty of "less" overhelmed hospital systems that have nursing to spare.

If I were a young nurses with no significant other limitations, I would perma travel in this covid climate. The demand is there. Use that to your advantage like any other field would do and make bank. I've even seen nurses quit their perm employment to be rehired as travel nurses 2 weeks later at 2-3x the rate in my institution. Money talks.
What is “perma?”
And you just answered my questions. Hospitals are robbing Peter to pay Paul.
And while not every part of the US is hit equally, this is the worst is has ever been since the pandemic. This has now affected the US on a mass scale and those few nurses who are in the low hit areas are not enough. The most populated states/areas are struggling and can not be fed enough nurses from less populated affected regions to fill the gap.
And I am all for many of these places to shut down the ORs and use the same staff you mentioned above to work in the unit. However, plenty of y’all on this exact board disagree and want to keep working elective case in the middle of the worst of this pandemic.
 
There aren’t enough travel nurses period.
Where do travel nurses come from?

1) PACU nurses which staff 6 nurses to watch 8 patients - 4 are perma on instagram
2) Pre-op nurses which staff 5 nurses for 10 bays - 2 are perma updating their facebook status
3) Floor nurses that decide they would rather earn 4x their weekly wages and take an assignment to NYC or LA
4) Not every part of the US is hit equally. Plenty of "less" overhelmed hospital systems that have nursing to spare.

If I were a young nurses with no significant other limitations, I would perma travel in this covid climate. The demand is there. Use that to your advantage like any other field would do and make bank. I've even seen nurses quit their perm employment to be rehired as travel nurses 2 weeks later at 2-3x the rate in my institution. Money talks.

I agree. In general i think we should have less government, however, the role for government exists when free markets break down. Right now is an example of hospitals not being able to afford to staff patient care appropriately. Supply will meet demand if wages are subsidized. There is supply left in the reserve. Many people have a price to work a little bit more. For instance, nurses working 40 hours may be willing to work 50 hours. This work isn’t free or cheap. It also alienates permanent staff when temporary workers are brought in for higher wages, less hours, and a list of demands with no leniency like defined work hours that permanent staff couldn’t even dream of. If the public wants appropriate care, it’s time to pay up for both temp workers and loyal permanent staff.
 
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I agree. In general i think we should have less government, however, the role for government exists when free markets break down. Right now is an example of hospitals not being able to afford to staff patient care appropriately. Supply will meet demand if wages are subsidized. There is supply left in the reserve. Many people have a price to work a little bit more. For instance, nurses working 40 hours may be willing to work 50 hours. This work isn’t free or cheap. It also alienates permanent staff when temporary workers are brought in for higher wages, less hours, and a list of demands with no leniency like defined work hours that permanent staff couldn’t even dream of. If the public wants appropriate care, it’s time to pay up for both temp workers and loyal permanent staff.
The working more would certainly help. Many are already doing that. But everyone has a limit on how much more theme can handle.
And yeah of course it’s idiotic to bring in travelers and not increase the wages of the permanent staff even temporarily. Unfortunately many of these hospitals are using government FEMA nurses who are getting paid by the government not directly by the hospitals by my understanding. But those nurses are typically deployed to the populated areas like NY,CA, TX. Not to smaller places that also have a need. These hospitals are fighting each other for nurses.
I don’t blame the nurses for leaving one bit. I would too. But that ends up creating holes.

All I am saying is this whole thing is a giant swap game when nurses leave one hospital only to be replaced by travelers.
As hard as we are hit now, there aren’t enough. Unless all these midlevels get demoted, then we may possibly have enough. Many would be making more money actually but they are too good. Lol
 
Where do travel nurses come from?

1) PACU nurses which staff 6 nurses to watch 8 patients - 4 are perma on instagram
2) Pre-op nurses which staff 5 nurses for 10 bays - 2 are perma updating their facebook status
3) Floor nurses that decide they would rather earn 4x their weekly wages and take an assignment to NYC or LA
4) Not every part of the US is hit equally. Plenty of "less" overhelmed hospital systems that have nursing to spare.

If I were a young nurses with no significant other limitations, I would perma travel in this covid climate. The demand is there. Use that to your advantage like any other field would do and make bank. I've even seen nurses quit their perm employment to be rehired as travel nurses 2 weeks later at 2-3x the rate in my institution. Money talks.

Don't even get me started on ob where the nurses have a meltdown if you try to give them two patients
 
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How do you know this for a fact? Where do you think all these travel nurses come from? Are they sitting at home twiddling their thumbs or something?

When hospitals are used to operating under capacity, and now are bursting at the seams and putting tents outside, where do they find these RNs just waiting for a payday?

Try and think practically here instead of imagining some magical extra pool of nurses that don’t exist.

And the whole point of traveling is to make more money as you explore the world. That’s how the travel nursing industry works. So unless you live and work in CA which has some of the best salaries in the US, you are going to make more money when you travel.
For somebody who states "There aren’t enough travel nurses period." as fact, it is quite funny to see you fact-check somebody else.

Your institution being unable to hire more travel nurses =/= the absence of travel nurses. Many hospitals have an overflow of nurses on staff. If other hospitals offer enough money, they will have access to those nurses. Most nursing unions make it quite easy for nurses to go work elsewhere, unlike physicians.
 
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My wife is a nurse who now works from home doing something else. If she got offered enough money, she would at least seriously consider it. So yeah, some of them.

Similar deal here. A lot of people don't think it's worth the stress and ridiculous patient burdens as well as the risk of getting infected. This is as a travel nurse who was getting paid 2x+ during the pandemic.
 
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For somebody who states "There aren’t enough travel nurses period." as fact, it is quite funny to see you fact-check somebody else.

Your institution being unable to hire more travel nurses =/= the absence of travel nurses. Many hospitals have an overflow of nurses on staff. If other hospitals offer enough money, they will have access to those nurses. Most nursing unions make it quite easy for nurses to go work elsewhere, unlike physicians.
I don’t have an institution. I go to multiple institutions and am seeing problems in more than one institution.
It’s common sense quite frankly. Read and hear what these agencies are saying about not having enough nurses to dole out the past couple of months.

But yeah, they are all sitting at home waiting for a better payday because no one is paying them a fair wage. Right.
 
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I don’t have an institution. I go to multiple institutions and am seeing problems in more than one institution.
It’s common sense quite frankly. Read and hear what these agencies are saying about not having enough nurses to dole out the past couple of months.

But yeah, they are all sitting at home waiting for a better payday because no one is paying them a fair wage. Right.
You have stated your opinion. Others have given examples to the contrary, yet you double down on your stance as it is a fact. It is not and things are different throughout the country. There are many motivations to work and things that may be sufficient for some, may be lacking for others. No need to beleaguer this topic. Agree to disagree.
 
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