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Would You Bid for a Job?
Roland Piquepaille writes "Several U.S. hospitals have found an innovative way to deal with nursing shortage. They post shift openings and the highest hourly rate they're willing to pay on their internal networks. Then, the nurses bid online for these extra shifts. The lowest bidders get the shifts and are notified by e-mail. This bidding process is almost certainly a good thing for the hospitals, but is it good for the nurses? Or safe for you? And what will happen if other industries also adopt auction systems? Imagine a company telling you, "Hey, you want to make some extra dollars by building this car or writing this piece of software? Name your price, and you'll make some more cash." What do you think of this bidding process? Read more before posting your comments."
Scam! Yeah like I'm going to pay you to hire me or provide me with extra work if I'm employed with you. That is exactly what low-bid hiring amounts to -- corporate kickbacks. This is the most disgusting thing I have ever heard of and I hope all the companies involved get exactly what they have coming to them -- loads and loads of malpractice suits. That's about as much as they'll get from hiring low-bidders. The job market is tough enough on job hunters to have to undercut your own salary in order to have an advantage in job hunting. Many employees take back from the company in order to offset low enough salaries! If the rest of the job market decides to follow suit, this could be a catastrophe.
Why don't they have online queues for hospital waiting rooms? That's because they *want* you to bleed out in the Emergency room so that the hospital can help ensure they get better funding, or at least that's the way it is in Canada. They spend all kinds of money on eShift to get it running and all the nurses buy into it because they are either too tired to realize they're being screwed by the system, or they have no choice. *sigh*
This reminds me of some shady business practices in the petroleum industry. Once a project I was bidding on went to the competition because we refused to kickback a large diamond to the guy in charge of purchasing for this huge company. Yes, he wanted a diamond. Not sure why but I'm guessing he was going to tie a fob to it and use it for office-oriented bling-bling. Either that or he wanted to cut a safe open...
eShift == eShit
The dangers of knowledge trigger emotional distress in human beings.
are the bids silent/undisclosed, so that noone knows what the current bid is?
Nurses are unique creatures in that they require a four year education and above-average intelligence, but are managed like factory workers. It won't take long for peers to figure out who the low bidders are and to educate them as to the protocol to be followed, i.e. a minimum bid.
I too have felt the cold finger of injustice.
The "nurse workers-unions" (whichever they are) should be really upset about this - it surley must go against their collective agreement?
This most certainly is an innovative solution for determining the "fair value" of work... but it seems quite dangerous for a hospital to be trying it out. What happens if a shift gets left on the board with nobody willing to bid under the max posted?
This kind of system is great to use when there's more labor supply than demand, but seems dangerously close to a colapse should the staff decide they want to cause a problem... no need to give two weeks notice or even to quit, just refuse to bid on the designated day and therefore nobody will be assigned to work that day.
Having an unmanned checkout at Wal-Mart is one thing, having not enough nurses to cover all of the patients in a hospital is quite another.
not sure if this would be a proper comparison, but contractors in all industries do this all the time. Defense, construction, etc.
Nurses would obviously charge more for less desirable shifts, ie, grave yard shifts, and less for more the desireable daytime shifts. It's almost like market economics and determining how much you're worth. Of course, this could create trouble if nursing unions suddenly decide to raise their bids all at once.
If the nurses don't want to be exploited even more they better make sure there will be no bids.
This is totally off-topic and your attempt at being funny failed!
This is almost like slavery -
Back then, people were made slaves without any choice in the matter. Now it's almost like being forced into one, because of economics.
This is so wrong.
Who did 9/11, then?
I highly doubt that a union would find a bidding process like this acceptable - which means that nurses, pilots, car assembly workers, etc. wouldn't ever get to use the system, even if its clever. And its not like such a process would work in the IT field -- heck, get PAID to work more than 8 hours a day??? :)
We keep playing the game like it's an open system, and it never was, and now we are quickly discovering the end stops.
Designing an economic model which awards wealth to those who grow, is doomed when a company, any company reaches market saturation.
The American economy no longer exists, American business is multinational, global, and not limited to our borders. It finds cheap labor and brings the saving in production back to the U.S. where American consumers rejoice at the low cost of service and goods. Sadly it's all a sham. It's as unsustainable as a constant diet of junk food. It tastes good while you're eating it, but it's slowly killing you. It's all take and no give, the dollars fly out of the country faster and faster, until the nations fundamental wealth is gone, and the citizens of the nation notice they are now the collective bag holders.
* Money that leaves never supports U.S. economy and infrastructure. * Money that leaves undermines U.S. labor, costing jobs and quality of living. * The growing gap between haves and have nots in the U.S. suggest a growing economic instability. Loss of jobs starting with manufacturing, but now quickly moving up through intellectual "white collar" professions, points to a growing joblessness with no end in sight. As the government services fail (and if you haven't been reading the paper or watching the news at 11:00, local government everywhere in this country is on the verge of collapse), the means to manage and provide basic life needs to the growing disenfranchised evaporates. The middle class vanishes. We are all reduced to the same level of living enjoyed by billions of starving people all over the world. Already 3% of our population owns 75% of the wealth, this is the greatest desparity in wealth in our history. And still the insanity accelerates. This is just the beginning ladies and gentlemen. What will you do, when your kids fresh out of college, with hundred thousand dollar college loans to pay, can't find work. What will you do, when you haven't received a raise in 4 years, and the boss says "Sorry, the work is heading to China."
I've personally spent the last 6 months looking for work, I've had my resume tuned, I have 25 years of technical experience, and I've made it clear I'll do almost anything, and I have not had a single interview. I'm not alone, I have a couple hundred friends and acquaintances who've been unemployed for between 2 and 3.5 years.
I keep hearing neocons mouthing the lines of Scrooge from a Christmas Carol... "the surplus population shold just get on with the business of dying...", or some variation of that. It's not bad yet. It may well get there. If it does, our government, is going to have a very bad time. Our society is going to have a very bad time. We need to begin addressing sustainable business practice from an economic, environmental, and ethics based context. To simply let the train go where it will is to insure a crash none of us will walk away from.
bw
Welcome to our hospital, where you'll be looked after by the lowest bidder - guarenteed!
Wouldn't this cause mass-unionization? I mean, if it required bidding by the employees, a unionized workforce could easily keep the rates high or all-out force the employer to stop this outrageous practice
Excuse me, I don't mean to impose, but I am the ocean
Especially for the health care industry. What's stopping the nurses from giving poor quality service? In fact, in all areas in life, you usually get what you pay for.
This is like going to the cheapest doctor in town, or buying the cheapest car you can find, or eating the cheapest quality meat and vegatable. Whatever happened to a balance between quality and price???
This sucks. This is not what I need to have in order to provide myself and my family with a living. In the end, that's all I care about - providing for myself and my family.
:(
I hope this kind of practice is made illegal.
I liked it better when union-busting took the form of large men with baseball bats. At least that was more obvious.
pooptruck
It doesn't seem that the nurses are "paying" for the extra hours, but more like bidding a lower price for their labours - I suppose in the same vain that contractors bid for government contracts*. A little difference, but a difference nontheless.
*Of course, this only isolates the lowest bidder, not the person/entity best suited for the job, a major flaw in this system that I see. Of course, all of the bidding nurses are employees already, and this shouldn't affect the quality of care.
if(!toilet_paper) roll.replace(new roll);
Just think how the quality of porn would slip if they adopted this bidding process!
Isn't that basically market forces at work?
IMHO probably; doesn't make it right or wrong- it may well work better than a fixed price though. But it's going to be vulnerable to all the normal market problems.
-WolfWithoutAClause
"Gravity is only a theory, not a fact!"Anyone who knows his/her quality of work will seldom undersell. If I charge more, it's probably because my quality of work speaks for it.
By making people bid, they are literally making them demean themselves - and those that offer their services low are probably not going to be the better ones.
Ofcourse, this will make others bring down their rates too, and everyone loses -- well, everyone except the top management who make a shitload of money at the expense of their employees.
This is just wrong and absolutely disgusting. I'm a PERSON - not a thing. My services will be charged what I feel are appropriate, and not being forced to BID like a slave. Sheesh.
But I think we all know the danger of going with the lowest bidder. Other than that, basically all big jobs are bid upon, why not the small ones? Automatically picking the lowest bidder is nothing short of retarded...
"You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
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it is something like this that will push workers to form a union. who would want to work for a pay rate that could change so easily because someone else decides they will undercut everyone else?
many times, you get what you pay for. higher wages attract better people. i would not want to be in a hospital when the "best bid" was on duty.
Come and say hi. http://forum.penpals.com/index.php
well done
props 2 gnaa
For those in the Technology sector, lets all collectively agree right now to not allow this to become a common practice for IT jobs. If quality people do not participate, then the companies that host this kind of charade will get the unskilled, questionable people that they deserve.
You're new here, aren't you?
I don't need a signature.
I especially don't see how this is a problem as it appears to be a "who wants to work overtime for the lowest amount of money" contest. How bad do you want the extra money? Maybe applicant number 1 needs a new car and will do it for 30 bucks an hour but applicant number 2 has 4 kids at home and his wife just got laid off so he will do it for 25.
Next thing you know companies will just ask, "Ok, before we hire you we need your salary requirements and the salary requirements of 4 of your peers."...Just like Progressive car insurance.
http://jayceecorder.blogspot.com
I dare to stand against the prevailing mythos of anti-corporatism and say that this is an economically efficient solution for nurses who want overtime and hospitals who are often in financial distress, not to mention keeping all of our health care costs lower.
I invoke Godwin's Law. So, you lose.
PS - do you know that the actual Aryan race is now in India? So much for white supremacy, eh.
Dumb fucks.
If you are in the unskilled-labor market, imagine trying to bid for a job against an illegal alien or Mexican willing to work for 50 cents per hour.
Combining job bidding and on-line web surfing is a disaster for the American labor market. To destroy the American labor, the Chinese needs only to get online and bid for your job.
I don't have a problem with this. The hospital and the winning nurse are entering into a voluntary agreement. Who am I, as an outsider, to stand in the way.
Abuse by the hospital and incompetent nursing will be prevented by the negative feedback loop of malpractice lawsuits.
Why not? Is this a country "for the people, by the people", or is it a country "for the corporation, by the corporation"?
We can make it happen, people, if only we want to make it happen, and believe in ourselves.
Create laws so that the citizens are the owners, and that our time is valuable. Pay a basic minimum income to all citizens. Slow down immigration. Offer tax-funded national healtcare. Build public subsidized housing. And make all these govt programs transparent and effective. Government is just a machines. Machines can be improved.
THEN you will have a situation where busineses have to bid for employees.
Of course, it may not be in our best interests to have certain vital industries/businesses hurting for labor. Hospitals, as part of nationalized healthcare, might be due for special consideration.
eat shiat and bark at the moon
I think this is disgusting and I propose DOS / DDOS attacks to take out these bidding sites. Nurses SAVE LIVES and they are being forced to bid each other down?? Just how CHEAP is this?. I am appalled to the point of being perfectly willing to go against the law to stop this.
Do you really think that is my real name? I am really Micheael Moore!
*COUGH*UNION*COUGH*
I know not everyone would join, but have you ever tried to work in the auto industry w/o being in a union!? Your co-workers go ape-nuts. This is just encouraging (better?) nurse unions, and if it catches on other unions as well.
md5sum
d41d8cd98f00b204e9800998ecf8427e
Another example of what happens when the primary corporate philosophy is predatory and parasite friendly.
it is a result of black and white accounting values, instead of seeing a full spectrum color photo of the situation, which means acknowledging more than personal selfish goals as important.
Survival is a multidimensional activity. Otherwise you sacrifice everyone else's quality of life for your selfish ends. Do that too often and you end up living inside a toliet bowl with the only rope out tied off to the toilet handle.
"It is a greater offense to steal men's labor, than their clothes"
Come now, nursing is regulated by the government, do you not trust the government to ensure that nurses have appropriate skills & training?
It is, after all, merely a much more accurate and timely version of what happens normally, which is that if demand for staff is high, pay rises, and if demand for staff is low, pay drops.
An issue I see with current system is that it seems to have no mechanism by which hospitals can specify more or less experienced nurses; all nurses are percieved by the system, as equal, which they are not.
I note in the comments there is considerable comment on the fact that "the lowest bidder will win the auction." This is a red herring, an improper way of thinking of the mechanism at work.
The work offered has a certain value, which derives from how unpleasent the work is and how skilled the work is. This system should accurately determine the correct market value for work offered, and it is *this* value which is being offered and accepted, *as it should be*.
By properly pricing nursing work, nurses will either be paid more (if they are currently underpaid) or the paid less (if they are currently overpaid). In both cases, the market is more efficient, and so the overall production of wealth in the economy improves, which is the key to improving the long term wealth of all.
--
Toby
This is a great idea. To counter the band-aid argument, nurses are already in short supply and have to work extra shifts and very long hours anyway. Perhaps the union can get overtime out of the extra shifts, but if the hospital is paying some kind of max rate, that must be taken into account with this scheme (otherwise, nurses simply wouldn't bid and they would collect their overtime). If this is a band aid solution, forced overtime (whether well paid or not) is a two centuries ago barber surgeon. Presumably somebody who bids on the work will be more fresh and more inclined to work well in their hours than somebody who had to stay on the job due to having nobody to relieve them.
The real fix is to train more nurses (and doctors for that matter). Union's (along with almost all fo the medical profession) do not like that idea since their wages would go down with supply going up. Get more accredited medical schools for doctors and nurses, and a lot of these problems will fix themselves.
I'm pretty sure they aren't accepting bids from just any loser out there, only people are qualified to be nurses. If they turn out to be bad at it, I'm sure they won't be hired back (as malpractice costs are too high to risk it).
I like the idea, but only if the bidder ends up with a solid contract for, say, 6 months of work at that rate, and gets first crack at new contracts.
Suggestion: get skilled
...RentACoder (http://www.rentacoder.com) - you can get low quality software from Indians there. and now you can get low quality nursing too. lol fuck scams like this. maybe of they get more prevalent for meatspace jobs, people will wake up and realize how crappy it is.
...how this is any different from the way things work now:
"Imagine a company telling you, 'Hey, you want to make some extra dollars by building this car or writing this piece of software? Name your price, and you'll make some more cash.'"
I live in a state with at-will employment. In EVERY single interview I've ever had, the interviewing company has asked me what salary I wanted. They know how much they're willing to pay, and my answer to that question will pretty much always be a bid - if I name too high of a price, I generally don't get a call back. If it's low, they're more interested (or suspicious if it's too low).
Of course, this bidding process exactly how it works with a contract company; the client asks me to do something and wants to know how much it costs.
As I understand, this nurse bidding process is for extra shifts; you're already getting paid for a normal job and they have an extra shift. The person willing to work it for the least is going to get it.
And the media tells people what to do, one way or another. In reality, most people don't really think much about such things, because the media doesn't pay much attention to such things. So, you may thingk you are in some sort of vanguard, pushing the envelope here with this "outspoken" view of yours. But in reality, you are just going along with what TeeVee tells you to do.
Sorry to put it that way, but that is my honest opinion....
eat shiat and bark at the moon
There is a minimum rate that if you opt for, you are guaranteed the shift. The variance seems to be about 10% from the top rate. So I really don't see a problem when the minimum you can be paid is 90% of what the max is. This won't lead to constantly lowered pay until you are basically working for free, it means you will work the shift for always a minimum of 90% of the market rate. I would venture to guess that the 90% rate is probably more than the standard hour rate. I see it as a win-win both for the nurses and for the hospital.
You will also likely see no decline in care quality, maybe even an increase as it is mostly people who are bored or have nothing better to do on that shift because they CHOOSE to be.
You asshat's didn't read that this is only for picking up extras.
Want to see every step I took to start my company? http://www.rowdylabs.com/blogs/pitchtothegods
Grow up.
-- Not a
There are too many complexities to introduce this into other industries, such as software programming.
For example, a low bidder can easily write the code in such a way to ensure no one else can modify it. You know...like most code written in PERL.
No, Vern. They just let him in.
If you really look at it, it is not very different from what most IT people are used to in freelance negotiations.
If a company needs an amount of manpower, they usually collect some offers from various freelancers, and then pick the ones with the best prices (or quality/price ratio).
In this case, it would be even more efficient, since the education of licensed nurses must be quite similar.
To me, it sounds like free market taken to a new level!
Phhbt! Isn't this Slashdot? If we started reading more about the article subject (let alone the article), wouldn't it detract from the great quality of postings you see here?
You'll never find a really really good programmer (unless he's like 16) who is also the lowest bidder. Instead, your lowest bidder will be the person who is the most desperate (or most stupid), and while there are good engineers who are desperate (bad luck, etc.), usually the good engineers have found good jobs already.
I think this is a "shoot yourself in the foot" situation, really. You get the cheapest programmer, you're going to get the cheapest code, and this is guaranteed to cost you more down the line, because the code's not going to work, and then you'll have to pay someone a hell of a lot more to fix it.
This is painful just thinking about. We think of Microsoft products as being pretty lousy, but the truth is that they have some very good programmers. Why there stuff sucks, I'm really not sure. Maybe a cultural thing. Anyhow, any company with the culture that even CONSIDERS bidding for programmers has to have a pretty stupid culture -- just imagine what kinds of horrible stuff would come out of such a company. I shudder at the thought.
Now, if someone could come up with a way to bid for programmers based on SKILL, then that would be very productive. It seems that Google is trying to do that. Maybe some programming competitions.
At the company I work for, the interview process involves lots of complex technical questions. Not so much "what do you know" as "what can you figure out". Logic puzzles, tricky code examples, etc. We have some very clever people as a result. Sure, we've had some bad apples, but the recession took care of them. (Too bad the recession took care of some of the good ones too.)
Reply: The poster is speaking about skilled jobs as well as unskilled.
Note that a system already exists like this - nurses and other 24/7/365 workers already trade shifts in a barter system. My father was a firefighter and my mother a nurse - they routinely assigned values to the days they were trading with someone. Christmas day was not traded for a single shift, I can assure you.
As long as the nurses do not go over a certain amount of hours / week, I think that it is great.
I prefer the "u" in honour as it seems to be missing these days.
The IT job openings I see in the local (Albuquerque, NM) paper almost universally specify "wage requirements".
I've had a couple replies that said, essentially, "we hired someone cheaper than you bid".
The nursing field has travelling nurses and temps and part timers. In larger hospitals most of the nurses don't know each other.
This is the greatest threat that US labor has ever seen.
How could we ever hope to become anything more than minimum labor slaves by this? Since when did employeers give a shit about their employees without being named Paul Newmann?
I don't know how many of us read Cheaper by the Dozen, the charming book about the twelve-child family of Frank and Lillian Gilbreth, as kids, but I certainly did, and there's actually a surprisingly pertinent example of the failings of this kind of system in that book.
The family utilized this bidding system to decide who would do incidental chores. In one case, there was a fence that needed to be painted, and one of the girls (who was saving up for, IIRC, a new pair of roller skates) underbid the rest of her siblings by a lot of money because she really wanted the job although it absolutely was worth more than she was asking for it. She worked herself nearly into sickness but knew she had to finish the job, and eventually, bitter and tired, she got it done.
The difference is that in the book, her father was employing her, which meant that when she finally did get the fence painted, he took mercy on her and she found a new pair of skates on her pillow the night she finished. How many major employers give that much of a crap about their people?
In all seriousness though, how is this different from outsourcing tech jobs across the oceans? In either situation, the person willing to work for the lowest wage gets the job.
Jobs should be given according to the prospective's knowledge, experience, and willingness to put him/herself into the job. Ability to survive on a meager salary should have nothing to do with it.
Wages should be the reward for accepting a certain job. A job should never be the reward for accepting certain wages.
How long until we see ebayjobs.com? Hell a few years ago people would never have bought cars off the internet, let alone at auction, i ended up buying two!
If you want to make more money, you can be a gigolo.
This just lets the poor lady who works nights get a little more compensation relative to her peers...why not?
As for you being a "person"...well, don't get too involved in being very sick in the US, you will find out quickly it is a business, and yes they basically will let you die in favor of a better funded or insured patient. If you have HMO, they must clear every procedure. This means your treatment is waiting on a claims agent who dropped out of high school in Alabama. Don't think people haven't died while waiting on treatment clearance.
The system's for sale.
Stick Men
This is a perfect example of how the free market system fails the working class.
If there is a shortage of nursing staff the solution should be to raise the incentive to be a nurse. That incentive is pay and benefits. If the industry needs more nurses it either needs to fragment the job description so that the qualified nurses can concentrate on skilled tasks while orderlies and candy stripers handle lesser tasks OR it needs to make nursing a more attractive profession.
Instead, somehow, they have managed to convince the employees to sign on to this overtime for less plan that deprives the working class of its free time and in fact devalues it. Eventually these people will ahev to pick between overtime at the hospital or part time work at Taco Bell.
Just to review...in a free market economy a scarce commodity should be worth more. This is an example of the system breaking where a scarce commodity is being devalued, thereby reducing anyone's desire to be a nurse.
"Which side are you on boys?
Which side are you on?
Which side are you on boys?
Which side are you on?
Oh workers can you stand it?
Oh tell me how you can
Will you be a lousy scab
or will you be a man?
Which side are you on boys?
Which side are you on?
Which side are you on boys?
Which side are you on?
Don't scab for the bosses
Don't listen to their lies
Us poor folks haven't got a chance
unless we organize.
Which side are you on boys?
Which side are you on?
Which side are you on boys?
Which side are you on?"
If you were going to stay a hospital for a few days for a surgery or illness, Would you rather have a nurse that values her skills at $10/hour or one that thinks she is worth $50/hour. Also, a nurse that works for less will put in longer hours to maintain the same standard of living. She is more likely to be tired and overworked.
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The bottom line is that this job pays poorly and hence attracts poor candidates in many job markets. But to pay nurses more you have to take it out of hospital exec pay or doctor pay. Probably won't happen. But you may see a JetBlue vs. United situation take hold - a hospital that charges lower rates for basic care but won't accept high doctor pay or unions of any kind. Doctors, like airline pilots, believe they are above wage concessions...almost as if they are entitled to wealth. This will change. The healthcare company execs will simply outsource to foreign doctors the same way tech has been outsourced.
Since there is a shortage of nurses, why wouldn't hospitals be bidding for nurses, thus offering them higher pay? (instead of having nurses bid for jobs as they seem to be doing)
This sort of thing would work in bidding for software engineers where there are plenty of available workers but not as many jobs (have you seen some of the rates on Rent-a-coder - sometimes they're not getting much over minimum wage).
But if there are plenty of jobs, why would any nurse in their right mind under-bid for a job?
Maybe a good adjunct to this practice would be an online list of hospitals, etc. that are using this practice so potential patients are informed. I'm guessing they'd want to know this just like they'd like to know that the airliner they might be flying on is built with the cheapest possible parts and labor and maintained by the cheapest possible engineers.
I wonder what the local nurses union has to say about this.
With a minimum wage, a company decides how many people they want to hire. More people apply for a job, so a number remain unemployed. Work that is considered too costly, is outsourced to low-wage countries. The people hired are pushed to maximise productivity (to compensate for the high wages), and of the money they earn, a large chunk is paid in taxes. A lot of that tax money is then used to support people that can't get a job, even if they'd like to work.
Abandon minimum wages, and what happens? Companies would decide how many people they want to hire, at what price. A sheme like the above might help determine it. You decide if you think it's worth it, and if not, you go work elsewhere. With any hourly wage possible, there's always a job opening somewhere, or of the type of work that you like to do. Instead of seeing your job go overseas, you can compete directly with Indian workers. But the kicker: because there's less people that really can't get a job, there's less money needed to support them. So, you can lower income taxes, and all the working folks get to keep a larger portion of what they earn. That also makes low-wage jobs more attractive.
I for one, would rather have a low-pay job, with low income taxes, and pay my own bills, then not have a job, and need support from high-pay workers through a high income tax system.
Hi, RTFC he and I are saying:
skilled task + no warm body required + bidding for job
= US worker fucked
unskilled task + warm body required + bidding for job + illegal aliens allowed to bid
= US worker fucked
skilled task + warm body required + bidding for job + degree required
= US worker still fucked when localized supply of monkeys even slightly exceeds demand for monkeys
Maybe that system would work more fairly if we had open real-time bidding for every good and/or service offered by corporations. I can bet that the hospitals using this system for their nurses won't offer the same system to insurance companies to bid how much to pay for services and if it was suggested to the C level execs they would find the suggestion patently unfair and unworkable.
...not many of you fsckwits here at ./ actually are ill and need to vistit hospitals often, are you ?? /MD
Well in certain areas a anoligous system like this may help. The reason is the Internal _ Services that have seen 50000 canidates wouldn't have a face, but they would have numbers, this may help for places like NorCal California due to the very unique education division.
"Hey, you want to make some extra dollars by building this car or writing this piece of software?
Hate to break it to you, but there's a ton of software that gets written this way in the real world. Easily 50% of the gigs that my company's landed in the last 15 years have been as the result of competitive bidding. (And a much higher percentage of gigs for new clients.) Donno what I think about using a bid system for nursing care, but for Roland Piquepaille to imply in the parent (and his blog) that this doesn't happen in the software world is simply fantasy.
I think this method would be great, if it was implemented in conjunction with a contractor/employee rating system. And actually, now that I think about it, that would be BENEFICIAL to the customers/patients.
If the contractors were rated by the employers, then the employers could say they require a minimum level rating in order to accept your bid. This is good for the customer, in that you can see what the hospital/company accepts as a "minimum rating".
How is this any different than what many people do --- which is to work at companies who are awarded contracts based on the lowest bidder. This is just on a smaller scale, that's all. Do you honestly believe that the planes you ride on were built in any other way than by the lowest bidder? We put our safety in the hands of the lowest bidder every day, and so far, it hasn't killed us.
Personally, I think this hospital is welcome to do as it pleases. If this ends up impacting safety, than people won't choose the hospital. If it doesn't, people will choose it for the cost savings. Give people a choice --- isn't that the Slashdot motto?
A deep unwavering belief is a sure sign you're missing something...
imagine trying to bid for a job against an illegal alien or Mexican willing to work for 50 cents per hour
Is 50 cents/hour really that attractive for Mexicans? It would be really low pay here in Poland.
"Long run is a misleading guide to current affairs. In the long run we are all dead." (John Maynard Keynes)
It's not that different from taking bids for contract work, just on a micro scale.
For me, it's acceptable for nurses and similar occupations because nurses are government certified to meet certain standards (your average IT job isn't certified at all, and the ones that are aren't by the state).
Except for the fact that it could be a single 8-hour shift, this isn't any different than requesting bids for building a building (architects and engineers are also government certified).
And if the starting bid is too low? Nobody takes the job, and the free market forces them to move their bar up. If a nurse bids too high? You don't work. That's not likely to happen, given the number of nursing vacancies out there and the limited pool to fill them.
Now a clever app would act as a neutral broker for what shift-jobbers are willing to work for and the available openings, so that as many people as possible get the maximum value for their time. It gets more complicated when you factor in favorable shifts, locations and specialties (e.g., a warn nurse isn't going to bid high on an ER triage on graveyard shift on a Saturday in an inner-city hospital 100 miles away).
But the problem really goes back to hospitals not wanting to pay enough for nurses, while loading more responsibilities (and potential liabilities) upon them.
The result is that fewer students get Bachelors of Nursing degrees, schools close, and the cycle deepens.
Design for Use, not Construction!
this reminds me of the stable marriage algorithm. In that system the men are not guaranteed their best choice, but the women are. Interestingly, the stable marriage algorithm was also developed for hospitals (and interns).
In this system, the hospital is guaranteed of the best (lowest priced) labor, but the worker is not guaranteed of the highest pay.
Does this answer the poster's question of whether this system is fair for the nurses? On one hand they are not getting the best deal possible, on the other hand, without this system they might not get the extra work and pay at all. I don't know, I'm just enjoying the comparison to CS451
This is not new really.
Check out consultingdirect.com. A people auction.
-- A cat is no trade for integrity!
There are serious attempts to do just that. Now nurses don't earn all _that_ much money-about $29/hour for a large hospital in the Seattle area-and that is for a high stress job that requires 3-4 years of college-but of course is is cheaper to pay nurses with a shot at a green card than use cash.
What are you? A fucking idiot? If you won't bid your labor at an acceptable price then someone else WILL, and you will lose out and starve until you fall off your high horse and get some goddamn sense in your head.
Bidding isn't slavery. Its free market capitalism.
Mac OS X and Windows XP working side by side to fight back the night.
How do you choose a car? You look for the seller who has what you want and for the lowest market price. The same thing applies to business contracts and now it applies to nurses as well. Big deal....
I am more troubled by the fact that these for-profit hospitals provide worse service than not-for-profit ones; that is fucking scary. I lost the link somewhere, but an extensive study done in Boston area provided very interesting information: for profit hospitals had more deaths per number of patients and more complains per number of patients than not-for-profit hospitals.
No. This kind of system has a complete disregard for a person's skills. That's not how society works - you are required to have a minimum knowledge of what you're working on. Otherwise, the business collapses.
In this specific case of nurses in a hospital, it could get to the point where it's not viable, simply because too many patient's complaint will arise due to errors and misconduct from cheap nurses.
If this "cheap'o system" could work, it would have been adopted by our society much earlier.
I can just see HMO's putting my bypass out for bid. The lowest common denominitor is that the consumer/employee will be smashed and that's what will happen if companys are allowed to pit them against each other.
"It's so convenient to have a system where everyone is a criminal" - A. Hitler
The waiting in the emergency room isn't due to lack of funding... it's a random thing based on whether a higher-priority case is in your way at the moment.
I think it would be more accurate to say that the wainting time is partly to do with higher-priority cases and funding.
Like all pain, suffering is a signal that something isn't right
Loss of jobs starting with manufacturing, but now quickly moving up through intellectual "white collar" professions, points to a growing joblessness with no end in sight.
The Navy is always hiring.
Over the long term, the demand for workers WILL equal the supply for workers, the only variable being the market clearing price (i.e. the price a which the supply of workers willing to work for said price is equal to the price at which all employers are willing to hire said number of workers).
There is a shortage of nurses right now.
Therefore, over the long term, the market clearing price is increasing. This bass-ackwards way of trying to circumvent the system is doomed to failure.
The only caveat I'd throw in on this little explanation is that the preceding scenario assumes a free market. Unfortunately, (libbies, close your ears here) we've got the government artificially setting the price of health care beneath its value (two very different concepts).
I'm curious to see how this one works out for the hospitals... nurses are a notoriously feisty bunch when mistreated...
Talk about bidding on a piece of software, a friend of my introduced me to Rent-a-coder. At first I thought the idea was novel, and even though I haven't tried it out yet, I know from her experience that the cash really sucks. But it's relative. It also depends on what region of the world you live and the exchange rate between the bidder and the customer. I'm in North America. Sometimes my friend gets a job for $20 that lasts for 3 days. If she lived in ... (just off the top of my head -- no flames please) ... Cuba for example then that $20 US adds up to a lot more. However my friend is in an odd situation -- which I won't go into the details of here -- that prevents her from working and she needs the cash. Of course she also has a high sense of personal integrity so she always gives the project 100% effort despite the low return.
Where did these people go to business school? I thought it was standard practice to bribe congress to declare a health industry emergency, and get them to work for unpaid overtime.
That's what you do for the middle to high end of the middle class. You only auction off low-paying jobs (after lobbying congress to loophole away minimum wage for auctioned wages, of course).
I think competition is, no, can be a good think, but i want professional people taking care of me, not desperate people (willing to work for $5/h)
Or is the next step that the patients can set the minimum salary they want the nurses to have and they cough up the difference?
Well, rather shoot me.
Privacy is terrorism.
Shortage? A bidding system be for the case where land-lubbing nurse wenches be in great supply. This is logic that walks the plank. No man but those in Davey Jones locker understand this cabin swill! Arrrr.
(It be the 19th o' sept this hearty day in Japan!)
It must have been the proximity of the letter 'B' to Job in the article topic, because I first misread the article as "Would You Bid for a Blow Job?"...
Something is clearly on my mind tonight...
Oolite: Elite-like game. For Mac, Linux and Windows
Who did WTC, then?
I work at a Level 1 ER in St. Louis as a paramedic, were we work side by side with the RN's. Honestly, if we only had to treat the life threatening illness we would only need 3 or four 4 rooms and not 32. That is right, most of what we see should be treated by their personal doctor and not by us. I could go on and on about the abuse of system. But there is no cure for the problem. If your a medicaid patient, or no insurance you will wait at least a month to get seen at a clinic. So people stall as long as possible, but often fill up waiting rooms. Now you do get the same treatment as anyone else, but we are sure to ask you if wish to further treatment and test. CT scan alone will run you over 2g, VQ scan will run you over 5g. Alot of those test are unneseccary for a diagnose, but are need to cover the doctors butt. Hnce unneeded expense, but our society is sue happy.
http://www.freeiPods.com/default.aspx?referer=112
I remember a story about an irate worker who broke into HR and took a balance sheet with everyone's salary.
They made a few dozen copies and posted them in conspicuous place about the office.
Supposedly, two weeks later the company went out of business.
While I think that's an urban legend, I'm certain I've never worked at a company that disclosed how much they were paying anybody to anybody else unless it was absolutely necessary. (In some cases, not even then.)
I predict this will either quickly turn into a secret auction, or die altogether.
-- should you question authority?
Hey There,
... or is it?
...
... I for one am willing to put in a percentage of reasonable over time. One of the main reasons is that my employer is reasonable when it comes to letting me take care personal issues. But this arrangement has it's limits ... in both directions.
... but I don't "have" to work it either ... and if you're willing to throw down your trumph card ... IE. fireing me ... we're all better off.
This is totally off topic
Anyway, my two cents
Seems a bit silly to me that corporations can put together schemes by which employees are expected to bid for work, (Allthough completely in line with the notion of a free economy.), while at the same time, they can lobby the government to outlaw certain employees from qualifying for overtime (Specifically the tech industry)!
I for one would be willing to bid for a job. This way my employer and I would see eye to eye on the effort it would take to complete a project successfully. No need to start quibbleing about over time if I win a bid on either fixed cost or time and materials.
As far as the rant about over time goes
You may not "have" to pay overtime
Cheers,
--The Dude
one part of me wants to say: why not? isn't this how all workers should be paid? at some point, the bidder will reach a price which is no longer worth it 'to them' and so they will go do something else. theoretically, lower worker wages should result in lower prices for everybody.
but the other part of me realizes: that (1) if business owner A can pay his workers less money, that usually means more profit for business owner A, not lower prices, especially in "non-competitive" fields for reasons of monopoly or necessity, and (2) most workers in the US at least are required to get specialized degrees, usually a 4-year degree, so it's not so easy to stop under-bidding and go find other work.
MORTAR COMBAT!
Like most HR issues (think the overtime law changes) people dont understand them and jump to wild conclusions when they hear about them.
The problem with nursing is that in most regions there are significant *shortages*. Staffing at many hospitals is a problem, recruiting nurses is a problem.
This is a way for the nurses to in essence set their own schedules (as opposed to the hospitals mandating certain hours) and to make their own tradeoffs on $$$ vs shift etc.
From what I have heard (Ive got lots of family in the medical field) most nurses *love* this system vs the previous systems.
lol jews did wtc
You can see that there are multiple definitions of Aryan. So, are you sure he was talking about some filthy, unwashed Indians?
Get a clue, turd.
You could also argue that you would be helped by the nurse who cares least about money, and cares most about helping people.
I agree, in order for our current system to heal itself from this problem, it must become an all-encompasing mess. Only then will it be fixed. In the meantime, some of us have to scrape by, and create stuff on our own.
Zhrodague.net - I do projects and stuff too.
Would you rather be cared for by a nurse who was considered good enough to have a steady job at the hospital and just wanted to pick up a extra shift here or there? Or perhaps you'd rather be cared for by someone from a temp agency, who has never before been vetted by the hospital, and doesn't care all that much because they may never work there again.
I think it has already happened. I can't remember the names of the sites; but there are some sites where consultants bid on IT jobs.
It's a joke. These guys are bidding down to $5 an hour.
"This bidding process is almost certainly a good thing for the hospitals, but is it good for the nurses?"
Unless you do more than wave hands, yes. They get extra income for doing what they're trained for.
"Or safe for you?"
Why not. It's not like a nurse will be doing a job for which they're untrained.
"And what will happen if other industries also adopt auction systems?"
Software already does. It's called asking for hourly rate. Same for plumbers, carpenters, lawyers, accountants, etc. Pretty pandemic, if you ask me.
"Imagine a company telling you, 'Hey, you want to make some extra dollars by building this car or writing this piece of software? Name your price, and you'll make some more cash.'"
I don't have to, because that doesn't make sense. Nurses aren't being asked to do something they aren't trained for, why pretend that's the case?
"What do you think of this bidding process?"
Reasonable, what rational reasons would you have against it?
If there's a nursing shortage, why would the nurses, who obviously are in demand, be the ones doing the bidding? Shouldn't it be the other way around? Are we dealing with the bizarro world here?
Hey, why not use the same system for fill-in physicians? Then you could potentially be treated by the lowest bidding doctor and nurse.
I'm not sure I want to be treated by someone thinking that if they would've just walked away from the craps table they wouldn't have to take low bid shifts.
That's our life, the big wheel of shit. - The Fat Man, Blue Tango Salvage
If you have been to the emergency room three separate times for a "busted open arm/leg", perhaps you need to avoid doing whatever it is that's causing that.
10 PRINT CHR$(205.5+RND(1)); : GOTO 10
I don't trust the government to regulate telephone service, or the sale of electricity - why would I trust them with my health?
"You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
How about simply not breaking the damn law? That ought to make using the internet much more pleasant don't you think?
Why do folks who live in free western democracies decide to revolt against the system because of one tiny annoying law or another?
Mac OS X and Windows XP working side by side to fight back the night.
I totally disagree, nurses get loads of TV and press coverage.
:)
E.g. "Holby city, Casualty, ER, ANY soap operas, etc". When have you EVER seen a proper engineer on TV? CAROL VORDERMAN!!!?
It should be:
s/covertOP/engineers/
As we are so damn secret
It appears that cost is the only factor when choosing nurses. The bidding system does not take any other factor for choosing nurses (besided a minimum standard of being a nurse).
Nurses don't have to be smart, just careful, very reliable, and willing to do extraordinarily unpleasant things. I mean, the definition of a nurse is basically, "non-expert medical assistant."
I think the intelligence requirement would only disqualify the bottom 10-20%, and lack of imagination is probably a positive thing for a nurse.
Where the median wait for radiation therapy is 6 weeks and people regularly give up waiting years for replacement hips or other major care and so fly to the USA to pay for it themselves?
That sort of health care?
Clear, Dark Skies
I think that the poster (maybe subconciously) wants us to greatly reduce global trade. To do that, we would have to levy huge taxes on any imports into our country. Which would devestate our high tech companies. Since most of us work for high tech companies, it would lower our salary and probably result in many of us being layed off.
My company sells its products primarily to countries outside of the US. Global trade benefits high tech companies more than any other industry. In the old economy, such as oil, automobiles, and clothing, we import more. I think eliminating global trade would be great for Detroit & Texas, and horrible for the biotech, hardware, and software companies across the United States.
Wanting to be working 365 days yearly, 18 hours per day. Daily rate is 200 rupees (about USD4) negotiable. Your patients are being safe in my capable hands as I am being educated in Bangalor Technical Nurse and Healer Institute, and am having much experience with relatives. (Those who survive to this day will be my humble referees).
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The above is a SLIGHT exaggeration of the quality of care you can expect out of this no holds barred free market mentality. When will "captialists" learn. Minimum working conditions exist for a reason. Its not good for every business on the planet to put profit above everything else. In the long run it screws us all. I would suggest that for a society to work smoothly there are certain minimum standards of service that need to be guaranteed for its citizens but I'm sure I'll be labelled as a socialist in saying that.
These posts express my own personal views, not those of my employer
A college student like me would do a grunt job for hours just so he or she could afford pizza for the next couple nights... At least, I would! >:-D
-----
Make Love not [Browser] War!
The article says the unions are irate and doing everything they can to stop it. Giving Nurses the ability to set their own wages totally destroys the union power base. Even if the bidding resulted in a substantial improvement in the quality of life of the nurses, the union would oppose it.
Direct employee/employer negotiations destroys the illusion that the manna comes from the union.
BTW, why is there an automatic assumption that bidding mechanisms will lower wages? This product is being released in a nursing shortage. As such, I would think a bidding mechanism would dramatically increase wages.
IMHO, one of the biggest problems with the employment arrangement is that workers only get to negotiate their wage once...at hiring time when they are least in the position to negotiate. A bidding process creates a continuous feedback mechanism that will keep wages better in line with market forces.
The wages in both countries for nurses are crap...many just conveniently forget to report income accrued while "on vacation" in the US.
My mother, sister, and several cousins are nurses (all from Toronto, Halifax, and Newfoundland). The brain drain (for nurses) is way overblown. Their colleagues who've gone south usually (no, not often - USUALLY) return with broken fantasies of high wages and good working conditions. Know why? Because the wages vs cost of living in the U.S. cities *sucks* and the working conditions in hospitals are no better than the ones they left. True, there is a significant difference in wages/conditions for public health Canuck nurses and those in American private clinics but they're competing with American nurses for those jobs. Canada, U.S., U.K., all are facing nursing shortages but they don't have much success in permanently poaching each others.
That's entirely true, the best deal would be choosing the better quality/cost ratio, unfortunately assessing the quality of a nurse's work might prove a little difficult (and seeing how many slashdotters crying "this is enslavement!", I can't even start to imagine what they'd say about that).
Maybe we deserve this world ?
"I don't think so. I do think the Hospital will be forced to set the max hourly pay rather high."
I can see that as a possibility. But I can also see the hospital exploiting local economic conditions to get nurses to work lots of cheap overtime.
Unfortunately, the article didn't provide enough information to determine what the situation actually is.
"One concern I have is that if large parts of the work market use this kind of system, it may possibly amplify boom/bust cycles, because in boom times everyone can ask whatever the market would bear and spend the money, and in bust cycles salaries are decreasing significantly, spending also, deepening the bust cycle."
Yup. Not to mention that the business can push the cycles faster by not hiring enough workers and bidding out the extra hours.
So we COULD see higher peaks and lower valley and a lot more of them in any given period.
Or it could be a wonderful solution.
I want to see how LOW the lowest bids are and how many hours are being worked.
I would feel much better about this program IF the lowest bid is higher than the time-and-a-half standard for overtime and that there are a few nurses working the most hours (exploiting someone's economic situation).
Now, before anyone gets on me about "allowing" someone to work as many hours as they "want" as cheaply as they "want", I'll point out now that businesses (and hospitas are businesses) will tend towards the cheapest labour they can get. If this method allows them to exploit people's economic situations, they will. And then they'll look for more of that same type of worker to exploit.
Bidding is fine except for one thing: it shifts power to the employer. You can always find some desperate yet competent person to do a job. A good example of people in these categories are newly graduated students, immigrants with huge debts/penalties to pay or people with lower cost of living (eg. in rural areas in other states/provinces). These people will always undercut others (of course, I am assuming the job can be done by them--which is true for the vast majority of tech jobs (only a small percentage are senior, architect/designer/etc jobs requiring experience). Now, if you enter a bidding proces and are undercut then that will make you look badly to the employer. The employer might at some point ask 'why shouldn't I do everything through the bidding process?'.
The root problem is that the employer is a large aggregate body while the employee is just a small ant. This is the key reason for having unions in the first place. You don't have unions in the tech industry because the salaries are high enough that employees aren't being marginalized (i.e. employees actually have a lot of power, relative to most jobs).
Having said this, bidding for jobs in already here and will simply spread. It is inevitable! Business contracts (not talking about job contracts) are generally won through some bidding process. Therefore, it wouldn't be unusual to have job contracts also won through bidding. Already employees in certain industries work by bidding all the time (an example is artists and the art industry in general).
I think the key change that will occur as bidding gains prominence is that salary will matter more than "skill" in the future. Right now, "skills" are what get you hired but I imagine salary will start to play a major role under bidding (since modern capitalist bidding is all based on price; no way to quantify skills). This is not to say that someone who can't do the job will be hired but that the difference between getting hte job and not getting it will depend far more on the salary than now...
Sivaram Velauthapillai
Seeking the meaning of life... @slashdot of all places
Isn't this patented somewhere by someone already?
Really, auctions are already the current system for most jobs. Just because we don't think in terms of auctions doesn't mean we're not doing it. It's just not an auction with instant feedback.
There may not be an auctioneer but it's still the same market mechanism at work. You might not think you're competing against other workers, but you really are.
But don't look so glum! Price isn't the only thing labor consumers (employers) care about. If all other things are equal, then the person willing to work for the lowest wage will get hired. Fortunately for us all other things are NOT equal.
Don't blame me, I didn't vote for either of them!
Just three or four fake IDs, register for a shift at "competive prices", fail to show up and *poof* hospital in crisis mode.
My wife is an RN, and let me say this is a great idea. In one of her previous jobs, they were perpetually short-staffed. Many Saturdays, the manager would call, sometimes twice, begging each RN to come work.
I would tell my wife "name your price". Seriously. The manager doesn't want to waste literally hours trying to get someone to come in. Tell her you'll work for an extra $10/hour, and she would likely jump on it.
In the hospital, it's worse. If they can't get staff, they have to go to an "agency" and pay $50-$60/hour, about twice what a staff nurse costs. It just makes sense to meet your own staff half way- pay them $40/hour and both end off better.
It's economics 101. If you have trouble getting enough staff members to work for you, then by definition you aren't paying enough. Period. The stark reality for a hospital is that they can either raise pay a little and actually get the staff that they need, or they can pay out the ass for agency nurses. The solution is obvious.
An auction system makes good sense.
Do you have ESP?
One thing I like about this system is that you can trade off money for ensuring a spot during popular hours. Alternatively you can go for more money on less popular jobs/shifts.
Hopefully this will turn out to be a win-win system - less manpower to figure out schedules, and people getting the combination of money or schedule flexibility that they desire.
Owen still fucked your aryan champions in the ass, back in Berlin, so there must be something really really wrong with your beliefs.
I'm trying to help, really.
I think a fake name that shows up without a proper intro in a 50 user environment usually stands out as a red-flag situation.
Several polls have been taken asking canadians which system they prefer. They are familiar with our system.
Yet about 92% of Canadians prefer their healthcare system to ours.
Q.E.D.
eat shiat and bark at the moon
But what if you use real names of existing nurses?
Here's a view from the other side of the world.
In Australia and many European countries holding this kind of reverse auction for pay rates is illegal. The reason is quite simple - in occupations like nursing where there's an oversupply of willing workers the employers are able to use a reverse auction to bid wages right down to the breadline. Employees will be desperate enough to bid themselves into poverty just to get their next meal. This makes employers happy but results in a lot of employees suffering greatly.
The alternative is a "minimum wage" system which we've traditionally used here in Australia. This more egalitarian approach reduces the incidence of poverty in the country but also reduces the chance for employers to get incredibly rich.
We used to have an oversupply of doctors and nurses here and (cutting a long story short) we now have shortages of doctors and nurses due to many leaving the profession. This in turn is starting to drive their wages back up again. Most importantly due to our minimum wage policies, unemployment benefits and the unions they didn't all starve during this adjustment.
Having said all that stuff about minimum wage, Australia is gradually trending towards an individual employment contract model more like the US - and as a result the social divide here is increasing. Thirty years ago true poverty and homelessness were rather rare here - a very different situation to the US. Trailer parks were almost unknown here compared to the US. Homelessness was also comparatively rare back then. The visible rate of homelessness here is now maybe ten times what it was back then. It's still a small fraction of the US rate though - I was shocked to see the number of homeless people when I visited San Francisco. This change in Australia is partially due to changes in employment policies and partially due to reduction of benefits. Government policies have reduced unemployment benefits and tossed people out of mental institutions as well as allowing individual pay negotiation in some cases.
So I guess whether you allow employment policies like reverse auctions is a matter of "What kind of society do I want?" If you want a comfortable country where no-one suffers too much then you need more left-wing policies like minimum wages and strong welfare. If you want to encourage the profit making possibilities of a free market economy then you should allow policies like reverse actions and reduced welfare.
As a point of comparison the US spends about half its tax on the military. Australia spends about half its tax on welfare instead. The US allows employers to get people to bid themselves into poverty. Australia doesn't. As a result it should surprise no-one that Australia has a vastly lower rate of poverty than the US and much fewer incredibly rich people. The cost of some of these policies is pretty high taxes compared to the US. People here seem to be willing to pay that price to have a relatively egalitarian society.
I am an EMT, and I have to correct the parent's explanation of the triage system. He is correct that there are four different triage categories, green, yellow, red, and black. However, he is incorrect regarding the disposition of patients between the categories and how patients within the various categories are treated.
Triage begins by pointing, and asking all people who can walk to go over to where we are pointing. This will correspond to the area we've decided to establish as the green triage area. Any patient who can follow directions and walk to a location we indicated is presumably relatively okay, and treatment of them can wait till last. Therefore, anybody who walks over there is automatically classified as green, or "walking wounded." This step is critical, as it saves a lot of assessment time, often clearing out 90% of potential patients, and allowing us to locate and evaluate the 10% of patients who need care urgently much faster.
Next, a triage crew goes around evaluating all remaining patients, classifying them as either black, red, or yellow.
This determination begins by checking if they have a pulse and are breathing. If they are not breathing, we will reposition the head once to open the airway, hoping that restarts their breathing. Here is the big difference in treatment between a triage (mass casualty, number of patients overwhelming the system) and a normal setting. Normally, if a patient is not breathing, we would attempt to resuscitate them using CPR, etc. However, in a triage situation, CPR is not viable, as devoting several EMT's to extended treatment of one individual who most likely will not survive will almost definitely result in the death of several other patients. So, in a triage situation, patients are declared dead and ignored who we would normally attempt to save. However, a key difference from what the parent claimed is that we would black tag these individuals, officially declaring them dead/unsalveagable.
Red is used exclusively for those patients who are most critical, such as altered mental status, difficulty breathing (but breathing), etc., that will die without immediate medical care. The odds of survival of a patient who is not breathing are too low to justify spending time treating them, because for every one that you could save, you'd most likely lose several additional red tagged individuals on average. If you remember, I mentioned we try repositioning the airway once for all individuals who aren't breathing before we black tag them as dead. Repositioning the airway takes neglible time, and if doing so restores their breathing, then they are red tagged, because their odds of survival are sufficient to justify spending time on them. Red tagged patients are the only patients treated until there are no more red tagged patients. We do have to make tough choices (following protocol... We don't make decisions about who lives or dies, we follow protocol of how to choose who to treat to save the most lives.). Nor do we conceal that we are doing so, we clearly label as dead (black tag) individuals who we have negligible hope of saving when the attempt would cost others their lives.
If you are breathing (and hence not black tagged), but will live if you do no receive immediate treatment, then you are tagged yellow, or "delayed", as the only remaining option. (Remember, "walking wounded" or green, have already been cleared out, so the only options are black, red, or yellow.)
I have first-hand experience with this - I'm a developer involved with software that enables this and is being used nationwide.
Here's three things I know to be fact about this practice:
1. In our case - the nurses in question are all RN's and are all contract nurses. These hospitals are being billed $60+/hr and the nurses paid $30+/hr. On the low end, $30/hr is $57,600 per year. That's way more than most occupations pay so for the people that said nurses are underpaid - you're way wrong. On the flip side, the hospital is paying $115,200/yr for that same nurse. That's a big bill to pay.
2. Since these nurses are all contract nurses, there aren't very many that actually work 40 straight hours in a week - there are a few that do and there are a few that work more than that but they are a very small percentage.
3. The reason for this practice in the first place is due to the national nursing shortage. If you think there is an over-abundance of nurses in the U.S., you're wrong. Nursing shortages are approaching a crisis level in many parts of the country. Nurses are being offered big time incentives such as apartments, cars, per-diem, and good wages to travel to different hospitals within certain regions. If there weren't such a disparity in supply and demand, this wouldn't even be an option or sustainable for that matter.
Also, since they are contract and part of a pool, most of them get to demand what hours they work, what department they work, and what days they work. How would you like to say, I'll work MWF, 6a-3p in the dept of my choice and that's all I'll work - perfect for mom's and dad's or anyone else that needs a flexible schedule.
At first glance, it sounds like a terrible, capitalist, predatory practice. In reality, it's a necessity for these hospitals to be able to staff their departments to the minimum standards. It allows nurses that are more flexible and willing to work the chance to pick up the hours when they want them and the hospitals to keep staffing levels adequate. I'm not saying there aren't nurses that pick up their 50th hour (or more) this way but the actual times that happens is extremely low - I have payroll figures to back me up.
I wouldn't get overly concerned about it or start comparing it to IT or trying to draw any other conclusions other than the obvious supply and demand conclusion.
I invite you to google for variations "Nursing Pool", "Contract Nursing Pool", "Traveling Nurses", etc. and read up on how this works.
If you do what you always did, you get what you always got.
Once companies begin changing the bids to lower costs slightly (we've got 20 people bidding, looks like it's stopped at 13.50, lets see if we could impersonate someone and, say, make that 13.45...).
Secondly, companies will engauge in price fixing. "We see these jobs being payed for at 13 an hour, lets all start our bids at 12 an hour".
Finally, and most importantly, they won't be honest. They won't put up ther max they'll pay, but lower.
Candy-Coated Knowledge
Is the program in question the listed on the site Flexestaff.com. You'd a thought the /. submitter would have looked up and linked to the web site that makes the product...this being a web site about technology and all.
The article sounds like the primary purpose of the program is to give nurses greater flexibility over their schedule and not just bid down wages. The primary cost control is that the program is giving internal nurses a shot at the shifts hospitals were outsourcing.
This is fine for union workers, as if it's not acceptable it will be stopped.
However, if this process becomes commonplace in other industries, you'll see more and more people join unions and unions regain the power of old.
Until it's back to normal.
Nursing is a co-operative profession, and if the nurses are all at each others throats over who got which shift that is counter productive.
Time to stop taking the "human resources" thing too far and to remember that they are employees - either that or put on more supervisors and security which will cost more and piss everyone off.
while going for a position you effectively put together a bid in a lot of professional jobs - but bidding on a shift by shift basis sounds a lot like a HR person trying to justify their existance or get more control.
What if you use fake names to bid at Sotheby's?
What if you use fake names to bid on wheat futures?
What if you use fake names anywhere?
Duh.
Infuriate left and right
If I'm laid out bleeding to death, I'll take the quick.
In all other cases, I'll take quality.
In no circumstance will I ever want my healthcare to be delivered as cheap'n'nasty as possible.
--
Don't like it? Respond with words, not karma.
Normally you would get a raise when you get older. So there's a difference in the wages nurses get.
In this system the lowest bidder wins.
Will the nurses agree on a (informal) minimum-wage, and what will happen when none of the nurses really needs the cash and decides to go under it ?
This is not ebay where venders and buyers are 'anonymous' , I would expect a lot of competition between staff members would come from this.
--> Insert Funny Sig Here
Wage slavery is a term expressing disapproval of a condition where a person feels compelled to work in return for payment of a wage. ... In terms used by critics of capitalism, wage slavery is the condition where a person must sell his labor-power, submitting to the authority of an employer, in order to survive.
Not precisely what the grandparent was talking about, but you get the idea.
Everyone is ripping against this like it's the worse thing since moldy sliced bread. Sounds like they have a small number of extra shifts and a large number of nurses who want to work them.
They could give out the extra shifts randomly or to the nurse who a manager thinks is particularly cute in that uniform. They could queue everyone up and let everyone have a turn.
Instead, they get the people who need the work the most actually working and those who are just looking for bigger money to spend at the mall will likely drop out at high wage levels. In a sense, this is a very fair way to sort out who needs the work. It's unfortunate that the nurses earn less this way, but they aren't having their wages forcibly cut, they are bidding.
Further, last I checked there was generally a shortage of nurses, rather than a surplus. I figure the hardships this introduces would less than tragic for most.
What would I think about this for my profession? Hmm... extra pay for overtime would sure be a nice thing. Oh, the overtime is optional? That's nice too. I'm not really jealous of the nurses here, and I think this is moderately slimy behavior, but there really have been worse developments in the course of human history.
I put an add on various job boards, and (x) number of people reply with résumés and Salary Requirements listed.
Hi!
I'm Joe Blow and I am a great fit for your job. I am willing to start at $85K. Résumé follows.
Best regards,
Joe Blow
and then I get a Resume of equal value and qualification from Jane Jones, but she's only asking for $60k. And I get another cover letter from Mickey Mushka, fresh off the boat from Freedonia, with a similar resume as Jones and Blow and he's more than happy to work for $35k.
If Mushka's English is up to par, and his work is good, I'll take him on and reward him with $40k.
We do these kinds of "auctions" all the time. It's called labour under capital.
RS
Shoes for Industry. Shoes for the Dead.
This is a furious worldwide competition between freelancers and agencies which is being won by those who have the lowest costs and get most from the dollar - offshorers, thirdworlders, expats, homeworkers, sweatshoppers.
I have seen rates shift from 10-15 cents a word to 2-5 cents a word. Nurses have a physical location that moderates how low things can go. The world is bigger than a hospital catchment area and there is still room for cuts.
DK
Rabbits Don't Hunt Tigers
Loss of jobs starting with manufacturing, but now quickly moving up through intellectual "white collar" professions, points to a growing joblessness with no end in sight.
The loss of US manufacturing jobs essentially started in the '70's and finished in the '80's. You might as well be wringing your hands about the "loss of jobs" in agriculture in the 1940's. Guess what: those manufacturing workers haven't just been sitting around unemployed for 20 years. They have gotten into different careers, relocating if need be.
To put things in perspective, the recent tech downturn is MUCH smaller in its impact on employment than were the end of manufacturing and agriculture. Both of those fields shed 10's of percentages of the country's total population in employees in just a few short decades, and yet the 20th century in America was hardly one of starvation and rampant joblessness. The move from agriculture to manufacturing, and from manufacturing to services, were profound shifts in the nation's output. What has happened in tech, on the other hand, is kind of a sidenote. It's comparable in scope to what happened on Wall Street in the '80's. In both '90's tech and '80's Wall Street, a media-propelled hoard of prospectors crowded into a field that was perceived as "lucrative", creating a glut of workers for relatively specialized fields. This glut, coupled with an eventual market down-cycle, made the field less lucrative than many had hoped, and lots of people lost their jobs. But guess what: both the computer industry and finance have carried on, and just as the world isn't crowded with unemployed bond traders who lost their jobs in 1988, I strongly doubt 2020 will see us with a surfeit of unemployed web developers who just never found anything else to do.
Smart bidders worked. Better the worker, more offers to work.
Project managers got as much as $2500/day. Senior Techs $1500/day.
The only thing new in this world is the history that you don't know.[Harry Truman]
But you can send your resume to as many firms as you wish. Is the hospital going to allow its nurses to bid for shifts at other hosptials as well... hmm? I doubt it.
Chances are the real nurse will pretty quickly report that bids they didn't place were showing up in the system.
Polls show that 60-70% of Americans would prefer a universal healthcare system, which is what Canadians have, and what Brits have, and French have etc etc etc
eat shiat and bark at the moon
My mother is a nurse, who was on strike. The skinny of it is that they already rotate nurses around, out of their specility and normal duties. For example..do you want a pediatrics nurse taking care of you in the emergency room?
To top matters off many hospitals do not limit patiant to nurse ratio. Many nurses get 7-10 beds a night, meaning that *if* everything is running smoothly and there are no problems you get a whole 4.5 minutes of their time each hour.
This is just another way for hostpital administration to squeeze the *life* blood out of their customers. Pushing the limits on how cheaply they can provide health care without getting sued.
-eakop-
I think that most skilled and/or experienced workers especially IT people would benefit overall if they were all contractors. Companies no longer value employees or return their loyalty. A full time employee is probably more vulnerable to a layoff than a contracted employee is at this point. Companies are also dropping most of the health and pension/401k benefits that go to employees because they are expensive and the price break most small to medium companies get on bulk plans are very small now.
Contract work is the only way to go. I don't even want a regular job. I want a contract.
Which is what michael used in the tagline, genius.
My wife and sister are both nurses. They both think this is a scam to decrease the amount of nurses taking the extra shifts so temps can be used more and more. If the full time nurses are unwilling to work for less money temps can be brought in as needed and turned away when they are not. This keeps the fixed cost of running the hospitals nurse lower.
This makes since if you can't fill the jobs at full pay how are you going to fill them at a reduced rate?
Adam smith, in his On The Division of Labor, said this would happen. He also admitted that it would lead to the "perfect" economic condition in which people work for "as little as economically possible". This comes one chapter away from where he claims that the best economy would be one in which ONE person would emplor the world, manufactoring everything that those people need (and build). The rest of the people would be working for the perfectly low wage, that is, the minimum wage set by Laisse Faire economics.
Scary stuff to me.
Vote NADER!
"And this is your helmet. What is it for?"
Acceptable answers are 'easy cleanup' and 'open casket'.
Computers are useless. They can only give you answers.
-- Pablo Picasso
I guess you learned to spell from the lowest bidder. Your opinion doesn't matter, because YOU ARE A MORON. GO AWAY.
> you'll be looked after by the lowest bidder
as opposed to being looked after by the non-lowest bidder, as in the rest of the capitalist system?
http://milkshake.dexy.org
Who did WTC and 9/11?
You know, this method could be useful in an on-call situation that traditionally has rotating shifts (like systems administration).
I personally detest being on call and would much rather avoid it. If instead of having everyone participate and having it (supposedly) built into your salary, having the people who don't mind (or even like) being on-call, or need the extra money, can bid for it. Those who don't want to be on-call can just not bid, or bid really high.
Of course, unless a max bid is set, companies wouldn't go for this, because it virtually guarantees they would have to pay more than in the current system.
This system is better for all concerned.
The standard way to fill shifts is to find someone willing to work (at regular pay) or go to an outside source known as a nursing registry. The hospital pays the nursing registry between $60-$80/hour and the registry pays the nurses from $30-$45.
In this system, the hospitals are paying less for than they would going out to the registry. The nurses are getting paid more than they would be paid if they got their extra work through the registry. The patients get care from someone who acutally works for the hospital and this usually means better care as most registry nurses just do their time and go home.
Personally, this assumes employees are a commodity item. I personally will not work in that environment.
I am not 200 pounds of programmer meat.
The problem with quotes on the internet, is that nobody bothers to check their veracity. -- Abraham Lincoln
For sure....gimme the slacker who bid minimum wage, to give me my meds. In fact give me the volunteer off the street.
This bidding process is bad for nurses because it sets a maximum rate and the rate goes down from there. Nursing work is standardized therefore they are interchangeable. In theory, you only need a license to be a nurse. As a nurse, you do not need to create or invent anything.
OTOH, software development involves creativity. Should software companies adopt such pay method the balance would likely tip in favor of software developers. For instance, assume the software has critical bug that jeopardizes the product and millions of dollars of revenue. If I have an immediate solution the problem this gives me a lot of leverage at the negotiating table. I could now bargain with the company and keep them hostage until they decided to pay up. This system would also give employees incentive to purposely create 'emergencies'.
This is one of the reason companies need people on payroll. It builds loyalty. Contractors are mercenaries who could care less whether or not the company makes money.
Walter? Are you the same walter from the yahoo SCO board?
That's our life, the big wheel of shit. - The Fat Man, Blue Tango Salvage
If there truly is a nursing shortage, then shouldn't the nurses be putting themselves up for bid? If there are more positions available than there are qualified persons to fill those positions, then the nurses should be posting a *minimum* rate for which they'd work, and the competing hospitals could bid up from there.
Either the nursing shortage doesn't exist, which goes against what I've been reading in the news for at least several years, or this is some scam to bring in more less-qualified nurses and push out the more experienced (and therefore more expensive) ones.
Boards of Directors being what they are, I'm guessing the latter. These are two hospitals I would not want to wind up at after an accident.
09 F9 11 02 9D 74 E3 5B D8 41 56 C5 63 56 88 C0
Just moved to Houston. Looked for 3 weeks. Got a good offer. Accepted. If they've been looking 3.5 years they must be doing something wrong.
It's no good where you don't have a rigid, fixed target to aim for. That's pure research and you had better be on a time-based contract rather than a fixed-price one. Doing R&D for a fixed price will lead to disaster if you have to do that for a living. But if you can correctly estimate how much time you need and price the job accordingly you could do this and possibly even make a decent living although it would be difficult. (Working for yourself is always difficult.) But for picking up extra cash for working spare time it's easy to do. In fact, people already are doing this.
I did one myself, made a few hundred dollars for a job I worked part-time on as I felt like it and as I got the inspiration on how to solve the problem over a three month period. I had a lot of fun solving the problem and learned a hell of a lot. It also improved my ability to better estimate how much a job is worth. Had it been something I had to make a living at I couldn't, but for something that was extra money for doing a work-for-hire job on my spare time, it wasn't too bad.
The lessons of history teach us - if they teach us anything - that nobody learns the lessons that history teaches us.
$300 to $600 per month for health insurance alone takes a large bite out of 50k/year. Then there are pensions/401k/paid vacation, etc.
What they are doing is offering you a minimum. They are saying "If you will work for this amount, we will hire you right now with no further negoiation." They aren't telling you that you have to accept the job, just offering it to you. Also, if you are truly qualified, in most cases you can negotiate for more. You tell them that it's not enough and you want X. They then decide to either give it to you, counter with a lower offer, or say no thanks and send you on your way.
This particular bidding isn't even for a new job, it's for overtime. Basically the hospital says "Ok, we don't have enough nurses. We either need to hire temps or you guys need to work overtime." They then set a price at right under what it costs to being in temps (maybe even a bit above since your own peopel are more efficient). Employees then bid on slots for overtime.
Now in a traditonal system, it was either first come-first served or lottery for who got what. Well that meant you had a problem of where to set the pay. Much easier to get somone to work an extra two hours after normal shift than on Christmas morning at 3am.
So this allows employees to instead decide how much it's worth. You decide that sure, you'll work the 5-7 shift for just $2/hour more than your normal pay, no big deal. However for the graveyard, you want $10/hour more. Thus employees bid to what is reasonable. If you don't want the overtime, you just don't bid.
I think that's a much better system than setting overtime at a single rate and, worse yet, forcing people to work when they don't want to.
The nurses just need to get together and all agree to bid the maximum.
Better yet, the nurses could distribute the labor among themselves and then have just one person bid the maximum for each shift.
Jonathan
This approach sounds like it was derived from some theoretical model you worked up in your head. Not to totally discount it, because certainly some of what you said is true. But the one that really tripped me up: "Instead of seeing your job go overseas, you can compete directly with Indian workers."
As if the minimum wage is why Indian workers are taking tech jobs! I hate to break it to you, man, but I know of *no one* in software (my industry) that is even close to flirting with minimum wage. In most cases the Indians working that same job are still clearing American minimum wage themselves after a wage reduction of 75%. The fact is, American workers could compete directly with Indians as it currently stands as far as minimum wage law is concerned...there are other reasons this competition can't happen, though.
Here's the real scoop. It costs the average US citizen more money to survive than the average Indian. We have more material things of a higher quality than they do, and the same goes for services. You like to be able to walk down the hall (apt) or upstairs (condo/house) and do your laundry in a machine that is reliable and won't break down. Indian families either use machines that break down constantly, do it by hand, and dryers don't exist in most families--everything is air-dried.
We have gone through an economic evolutionary cycle here in America that India will soon experience too. We realized in the 50s that certain purchases were no-brainers (washing machines), because they freed up enough of our time to do other things that actually paid for the cost of the item and then some. It's basic econ--everyone wins, and now there are new jobs for people that know how to make those items. If you look back at pre-Industrial Revolution homes in America, it took a lot of hours of manual labor every day to keep a house running, from looming your own material to preparing meals to washing clothes, etc. Now these are things we devote a fraction of our time to.
The problem at the moment is that India is positioned such that they'll enjoy maximal benefits of this swing and we're positioned so that we'll take maximum pain. It's just the way things work out sometimes.
But don't kid yourself into believing that Americans can compete with Indians any more than we can compete with illegal Mexican day workers that work for less than minimum wage. We're not about the give back the washing machines because the logic is still sound--they still save us more than they cost us in the long run. It's the short run that's causing the problems.
but have you considered the following argument: shut up.
'Cause see, when something goes wrong, the patient's family sues whoever has the most money. And it's not Joe/Jhane Schmoe, it's the hospital that has the most cash. Usually several million. Now, if they lose the suit against the hospital, they'll go after Joe/Jhane. And they might even go after Joe/Jhane, even if they win. It's just that they'll go after the hospital, first.
And then everyone involved in the case, including the surgeon and the orderly.
BWHAHAHAHA!
But the hospitals will be the first ones to figure this little "issue" out. Oh, yeah, they'll get it figured out. This plan will totally fly.
I give it a month before FlexEstaff gets a C&D letter from priceline. AFAIK, priceline has just about every form of reverse bidding patented, and I'm willing to bet that the eShift software could be construed as violating their IP. Just another example of how AFU the IP laws are...
Yes, my only tool is a hammer. And you're starting to look like a nail.
Under this system, the hospital posts shift openings and the highest hourly rate it is willing to pay. Nurses willing to work at least four shifts a month then may bid on the work and pay, as long as their bids do not exceed the maximum pay offered. [emphasis]
The problem I have with this is that it isn't a free auction. The nurses can bid lower, but not higher. If no one is willing to work for even the max bid amount, the shift goes unstaffed. This is a deliberate restriction of free trade, and entirely incompatible with the American way. Placing an upper limit on the price a person may charge for their labor is eerily reminiscent of the same kind of socialism that stunted the economic growth of the USSR throughout the Cold War.
Basically, this is a classic capitalist oppression of workers; workers who work the hardest and least-desirable shifts end up earning the least amount of money. At best it is immoral; at worst, it will further exacerbate the shortage of nurses.
The society for a thought-free internet welcomes you.
That would be great ... except that income taxes will never, ever, EVER be lowered. Taxes have been increasing steadily in the US since they were introduced (at a rate of about 2%). Just because there are fewer people drawing unemployment doesn't mean the government will let us keep our money.
RS
Shoes for Industry. Shoes for the Dead.
Here's what the problem is with tech jobs, and I was able to foresee this clearly, as a teen, 15 years ago; I was born in the mid-1970s, my dad got me my first computer in the early-1980s, and in the early 1990s I had just finished highschool, having had the conviction throughout my childhood that computing was going to be my future career and having spent most of my schooling preparing for this path, and lo and behold, what did I notice? I noticed that the vast majority of my cohort wanted a career in computing, virtually everyone I knew. In the early 1990s there was an IT job at a bank to which 139 applicants applied, and the one who got the job was a relative of one of the managers. It was clear to me back then that there was likely to be an oversupply of IT workers as my cohort finished their education. Not only that, but the dotcom boom even made the problem worse by enticing the cohort after them oversubscribe to IT too, compounding the situation further. It was clear to me that if I wanted a career in computing then being a worker is *not* going to be a safe and secure option, and coming from a family that did not have much capital or easy access to capital and business networks, I knew that going into it with the mentality that I would start my own business after I graduate and succeed was something of a gamble. Needless to say, I did not pursue IT.
Or did I just give away a patentable idea? Dang.
DT
Is this thing on? Hello?
I wonder if they're willing to do the same for doctors. Nurses do a lot for far less pay. In fact, they often do what you would expect the doctor to do. Doctor's are like lawyers, everyone suckes except mine.
That argument is crazy, if you don't mind my sayin'. An opportunistic hospital that charged emergency patients an exorbitant amount would find that, aside from those very emergency patients, it had no business. If I had been charged like that during a time when I was helpless, I know I'd go well out of my way to avoid ever paying them for anything in the future. And thus, the "invisible hand" of the market would force them out of business, leaving only the hospitals who don't use such shady practices. See? Nothing beyond free market necessary.
Doing the opposite and scrapping the minimum wage would just have the effect of allowing companies to exploit their workers. It wouldn't have the effect of lowering unemployment that you think it would.
Huh. I was an independent consultant/contractor for about twenty years: I did software and systems development for heavy industry. When I wasn't actually working on a project I was ... bidding for a job. The next one, whatever it might be.
The only thing that will make this kind of system work for all parties is if some accountability is maintained. Yes, you may always be the low bidder but if you're always doing schlock work you should lose out to the next highest bidder. We've all seen the benefits of always hiring the lowest bidder: pretty much every government job that runs into major cost overruns (which is pretty much every government job) is an example of that principle in operation.
My father is a licenced contractor. He tells me horor stories about what the lowest bidder will do to a building. For instance... He works at an undisclosed University here in South Carolina. Well.. they elected to allow the lowest bidder to install the duct work into the HUGE PE Center they built. Now that it's over, come to find out, there are 50 less returns for the air than there should have been. So the Air circulation is horrible... Great for sweating College Students!
My name is a variety of floral rose, and no, it's not blue
It's why there's a shortage in the first place.
.She was often asigned 3 patients that require a 1/1 staff ratio (intensive care) plus a few more with standard needs. Literally, everyone involved suffers.
.au recruiting nurses with signing bonuses, travel expenses, higher pay and more flexible schedules than the local nurses. Like all her smart nurse friends - they left the field and no longer work as nurses in hospitals. The pay isn't even close to the value of the work required. Nurses find that out quickly, and those who can find other work, do.
The problem with this is hospitals can force nurses to work extra shifts because there's abandonment laws. Example: My 7 month pregnant wife was told she'd have to work another 10 hour shift after her current 10 hour because a temp didn't want to work that night. When she told them she physically could not do this she was told she'd be arrested for abandoning her patients if she left. The first shift was only 3/5 staffed and they had "total care" overflows from intensive care. Her shifts were 10 hours of triage, with absolutely no breaks
The staff is so overworked that no-one ever gets reviewed. Nurses right out of school often make more than the 10 year vets. No professional growth, no pay difference between slackers and hard workers. After 3 years at one hospital, she was offered a 5 cent/hr "merit" raise! Meanwhile, hospital admin is off in
When no nurse bids the artifically low max rate - the hospital can force staff to work. They can't strike either, a judge will prevent this as their jobs are "safety critical". Their only option is to quit. Nursing shortage - my ass. It's a pay and being treated like a human being shortage.
There's no shortage of nurses. There's a shortage of nurses at the NICE PRICE. Similarly, there's no shortage of gasoline but there is a shortage of gasoline at a price of $1 per gallon.
This bidding is apt to result in a race to the bottom.
Wansu, th' chinese sailor
Given an original salary of $35, how much less is $0.01 ... $34.99. Let this process go on long enough and people will drive the salary to the minimum the market will tolerate. This is just bad! This is union busting.
I'm tempted to create a web site, let the nurses create logins and bid as they would on this punk's sw, run the list and send an e-mail to all the subscribers with the winning bid and the winning people. The winning nurse(s) could then bid the max amount on the company's sw and take (all or a portion of) the difference and buy the other nurses dinner / pizza delivery / Thai carry-out / whatever!
If this takes off, it will invevitably lead to collusion among workers in setting the minimum bid price, eg unionization and a new form of collective bargaining that fits within the eShift framework. Any company would be absolutely shortsighted to adapt such a scheme. But then again, these are American companies we're talking about.
Flying is easy, just throw yourself at the ground and miss. -Douglas Adams
Unions replace one asymmetry with another. That is why they tend to great a very short term boost in the the conditions of the workers followed by a long term stagnation. Plus I think you are wrong about all businessmen hating unions. The process of unionization generally gives one or two firms a competitive advantage and the politicos in charge of the unions and the companies use that competitive advantage to clean out all of the small competing firms.
As for the people who hate unions...I think that is mainly due to the thugs that get in power in unionized shops.
from my experience, most programmers are either under 150 pounds of programmer meat or over 250 pounds of programmer meat. 200 pounds of programmer meat sounds far too healthy. Are you sure you aren't a manager that accidentally fell into the wrong cubicle?
Do they accept unemployed IT professionals ? After all, humans are like machines, except for the reset button!
I recognize that most of the thread is about normal ER operation, however, the system of colors which the parent comment was referring to is the system used by EMT's in mass casualty settings. EMT's only really triage when we are in a mass casualty setting (triage being by defintion prioritizing patients, and if we have only one patient, there is no need to prioritize.) I probably could have made it slightly clearer in my post that my comment was a response to the parent, and only relevant in mass casualty settings, but the following line indicated I was not referring to a normal setting:
Here is the big difference in treatment between a triage (mass casualty, number of patients overwhelming the system) and a normal setting.
since everywhere else I was clearly referring to triage, and here I indicated that triage was not the normal setting.
but I think I'd request a transfer to a hospital that is not staffed by the lowest bidders for Nursing positions. The IV stick would be very painful as Nurse Allthumbs tries to find a vein to stick the IV in and ends up butchering both my arms, and I end up looking like a Heroin junkie or something. Or perhaps they forget to give me my medication and my high blood pressure causes a stroke or heart attack?
Thanks, but no thanks!
Remember, Slashdot does not have a -1 disagree moderation, and no, troll, flamebait, and overrated are not substitutes.
Start telling your church that you'll tithe 10% of your after tax income.
Well, since the main reason I'm getting a job is to get paid.. I don't think I'm going to have the cash to bid for a job -- unless it was just some under the table bid with the managers. The way companies look at jobs is getting more ignorant by the day... high grades? Money to spend on the position? What kind of a world is this coming to? Why can't we just hire people based on skill anymore? Now just what we can show off? Blah..
"Instant gratification takes too long." - Carrie Fisher
My mom is a nurse ad I know how the field works. This bidding process doesn't take into account the quality of care such as if the nurse has already worked 60 hours that week. Would you want her giving you medication? There are a lot of foreign nurses right now that fight tooth and nail for those overtime hours and will dig the eyes out of one of their own to get them even if the other person hasn't worked any overtime. You wind up with sleepwalking zombies on the floor. Fix the problem don't path it. This is done with cmopetative salaries. And paying temp staff twice as much to cover the shortage doesn't fic the problem either. It just makes health care more expensive and the quality of care lower.
This seems like an astonishingly bad idea. Companies should have to bid against each other to hire workers, thus driving wages up; workers should not have to bid against each other to get hired, thus driving wages down.
Keep in mind he purchased the two-digit account on eBay for over $100, which is really quite pathetic.
Desired extra hours should be awarded to people based on hard work, skill, and merit. This kind of shit is just degrading to the hard working nurses all across the country.
I like the system of bidding to resolve which nurses get which shifts but I think that there are good points about lower quality of service.
A slight change to the system should help improve quality.
Instead of using hourly rate as the bidding unit use number of hours work. So the shift might be 8 hours but you bid 16 equivalent hours (so each hour counts double). Nurses can be paid an hourly wage based on their quality, experience, etc but compete with each other based on how many hours the work counts as. Since the system is for "over-time" and other less wanted shifts this only makes sense.
Then high quality nurses can compete just as effectively as low quality nurses.
Hospitals will save less money but if you cap the max equivalent hours such that it is less than what it would cost to bring in a temp compared to your highest paid (or perhaps average nurse) at max bid then everyone wins.
A little thought to the goals of the system and how to maximize everyones profit is all it takes.
Complexity Happens
Is it possible that you're unaware of the distinction between Registered Nurses and other nursing-like occupations? RNs aren't the ones changing sheets, putting pills on trays, or doing lower-level jobs. RNs act more like managers or educators and need a depth and breadth of knowledge. However, there are other occupations (nurse aides, care assistants, orderlies, etc) that do not require the same degree of knowledge, planning, education, etc. Those are the people who have to do the "extraordinarily unpleasant things". From your comments, it sounds like these are the people you meant to address.
These kinda things only work when there are people willing to undercut the rest and think they can make a living that way. In a world where you gotta work with the people you undercut that might not be to enjoyable. Especially if you consider that there always is someone willing to work for less.
I also see another problem. The old army joke tells you to remember that your weapon was made by the lowest bidder. Now your life is in the hands of the lowest bidder far more directly.
Nurses have a lot of power and responsibilty. Why do you think we keep hearing these stories about a nurse getting away for years killing 20+ patients?
All that the nurses need to do is to make sure no-one undercuts the organized bid. Good job america, you just invited the mafia into your hospitals.
MMO Quests are like orgasms:
You may solo them, I prefer them in a group.
Suppose you bid a few cents lower within seconds of the job offer closing. Or on the other hand somebody starts bidding down so low it causes people to work for much less than what they are worth.
I agree, this is odd, as bidding down to the lowest wage that the nurses will take is not a good strategy if you have a shortage of nurses, but rather when you have a glut and are trying to save on staffing costs.
Actually this is great system for nurses. The supply/demand sets a price range within which the market is in equilibrium. So either:
- the hospital sets the price, and guesses correctly the price range. In this case the nurse may or may not get the highest possible wage in this price range
- the hospital sets the price too low - they will not have enough nurses
- the hospital sets the price too high - they will tend to lower the price ASAP as not to waste money
- the hospital asks the nurses to bid - in this case it seems that the nurses get the price in the higher part of the price range.
The market force(hospital manager) in the end tend to set the price range, so that the market is in equilibrium. This system works for nurses advantage as it is more probable that they receive higher wage in this price range.
Well, I had a look, but didn't find any comment about the hospital using this as an advertising feature.
This happens all the time, at least in the UK, but with any major contract.
Say a council (local government) wants a road building, they will put out a request for tenders, and then companies will put in tenders.
Council: We want 200yds of road from A to B
Builder 1: We'll do it for £10,000
Builder 2: We'll do it for £5,000
Builder 3: We'll do it for £7,000
Council: Tenders closed. Builder 2 gets it.
And thats where it ends! Most of the UK was built on this kinda principle, and it's worked for years. There's no danger to patients, as the nurses involved are already working for the hospital, so they must be sufficiently qualified anyway. The only danger lies in nurses becoming too tired to work.
As for other industries, and those without professional qualifications, it could work fine just so long as checks can be made, eg interviews in order to be able to use the site.
I knew that guarenteed didn't look right! I should have checked. Generally my spelling is not too bad. Oh well...
I'm watching the same thing happen in the IT field where I currently work. In fact, we get the pleasure of re-interviewing for our own jobs every 6 months. And if someone can do the same thing for less, hey, that's capitalism.
Corporations seem to think that this idea of lowest bidder is new. But, since information is power, I'm not about to disabuse them of this notion. So, using this amazing idea of communication, all of my peers get together and decide where we want to go. That way the managers only get one applicant, and we get whatever jobs we feel might be fun that 6 months. Sure there are arguments, but they're easy enough to resolve. It took a bit of convincing to get everyone on board with the idea of this mini-union, but like everything else, it only took a bit of organization to turn the situation back into our favor.
I like these new commercials of "Don't just take a stand, act". I think it sums this situation up nicely.
Never trust anyone who has to quote a song to prove his or her point.
A LOOOONG time ago, we used to hire people based on skills and experience.
A LOOOONG time ago, we didn't hire 14 year olds at McDonalds, and we didn't need to triple check our orders with the "manager" every frickin' time.
A LOOOONG time ago, companies were glad to offer reasonable compensation for a job well done.
I say let them have their funky hiring scheme. I think it's going to bite them in the ass in no time when the lawsuits start flying over crappy service. Cut-rate medical service ? Umm NO! It's already retarded enough as it is.
Spend less time inventing new ways to postalize the workforce, and more time updating these ancient medical practices. I treat my clanky little hatchback better than these people treat living people.
-Billco, Fnarg.com
More Evidence of the decline of the US.
How are nurses supposed to feed their families, or even raise their children, while working 12 to 16 hour shifts and bringing home less pay?
Nurses in this situation need to organize, only by creating a strong union can nurses defend themselves from outright exploitation.
I mentioned this to my wife, who is a Matron for a number of wards in a hospital in the UK. Staffing is a perennial problem, and even if you have all your job openings filled, you will always need cover now and then. When extra staff are needed, they use nurses from an internal agency which employs only internal staff who want to earn extra, and only in an absolute emergency are external agency staff used since they cost a huge amount - the whole reason is that there are minimum staffing levels that must be adhered to for legal reasons and if you are short-staffed, people become overstressed and thats when mistakes happen.
She thought it was an interesting idea, although she wasn't too sure about the lowest bidder concept. Then again, no-one is being forced to take these rates [the staff are normally employed anyway] and it would probably work in your favour if you took unsociable hours or very-last minute shifts.
What do you mean "imagine other companies..."? What do you think the likes of Accenture do? Mind you, I'm extremely happy with work by Accenture, unlike some lower-bidders who replaced them for some contracts...
(8-DCS)
> What do you think of this bidding process?
I think, as long as Veejey from India, Joze from Mexico or ChinLee from China (ad infinitum) isn't allowed to compete in the bidding process, everything will be fine.
Another reason for the shrinking tech market here.
Those with the gold makes the rules.....
If you work more than 40 hours during the week, if you are an hourly worker, you get time and a half. If you are a salaried worker, you are entitled to comp time.
If you're poor, you use the public health system.
If you're well off, you use the private health system.
If you're Kerry Packer (really well off) you treat the public health system as your own private health system.
The story goes he had a heart attack or something and an ambulance saved his life. He found out that most amubulances didn't have that piece of equipment (i.e. he was lucky) so he paid for all the ambulances in the country to be upgraded to have that equipment, in case he needed it again :-) [or paid 50% of the cost to be matched by the govt.]
..is that a very very very nice hus, with two cats in the yard?
If X is the new Y, and Y is "X is the new Y", solve for X.
Given that I'm unemployed, I'd bid for a job. It'd piss me off, but until I can pay my bills and also put a little money into savings/investment I'll do what I have to for more income. I think it's a bad way to conduct business (it'll hurt morale, if nothing else), but I'd bid.
-Rich
An extremely well-known carribean based consultancy picked up the job and promptly started making serious mistakes and the project ended up being canned.
Moral of the story is that a sensible way to treat bids is to look at cost, quality level and timeliness of delivery. The construction industry uses standards compliance and penalties for not meeting them or deadlines.
See my journal, I write things there
Confucius say, "Find worm in apple - bad. Find half a worm - worse."
I think this is an excellent idea....but lets implement it from the top down, starting with Hospital executives and politicians first.
The US Navy has been doing this with hard to fill billets for about 6 months. Interested parties log on to JASS (BUPERS's Job Availability Selection System) and bid up to $500/month extra for taking selected billets (such as Sigonella Sicily and NSA Bahrain).
r/dcviper
Ummm, err, say what, now?
This is a really interesting question, and one that we should all be asking ourselves. Why the hell is the dollar so strong? Our increasing trade deficit, skills deficit, and now labor deficit are all symptoms of a too-strong dollar: if the dollar weren't too strong, then it wouldn't make sense to export all of our production and some of our service to a foreign land.
In Adam Smith's ideal economic world, the invisible hand of the market would lower the value of the dollar until the deficits disappeared.
The latest round of outsourcing, the ubiquity of chinese doodads, and the sickness of our manufacturing sectors are all symptoms of that invisible hand trying to restore the market: because of the strong dollar, it makes sense to export as much production as possible. This is mercantilism
in reverse.
Something is holding up the dollar artificially. One may certainly argue about what that thing is.
Some say that it is foreign confidence in our eternally booming economy, which may be -- but our economy has been booming because we've been steadily exporting most of it! Astute observers will note that petroleum is traded in U.S. dollars, so anyone wanting energy has to get some dollars first. The world energy economy is large enough that it could prop up the dollar.
It hasn't been big in the press, but the UN/Iraq oil-for-food program traded oil in Euros, making Iraq the only middle-eastern country that didn't use dollars.
Its OK aslong as people stick together in their unions. Its all about 2 parties - the customer and the server, the employee and the employer etc etc and its vital that both have a fair footing - look at consumers, we very rarely have any kind of fair footing and thats why we get ripped the fuck off! Its an interesting way to do things on an employee level but in the end its very easy for things to slip into just being about money and doing as little work as you can get away with for it. Obviously to be fair this system is gonna have to be used on CEOs, presidents etc..
This comment does not represent the views or opinions of the user.
http://www.flagshipnews.com/archives_2003/oct02200 3_14.shtml
The U.S. Navy does this now for the enlisted ranks through a program called "Assignment Incentive Pay" which is part of the "Perform To Serve" program.
You basically bid for how much extra special pay you are willing to accept for a given duty station. So sailor A may want an extra $100 a month and sailor be may want an extra $200 per month to do the same job. The winner is supposedly a combination of lowest bidder with best skill set (although I'm sure lowest bidder is a little more weighted in the equation).
Personally I don't think these competitive models are a good idea. Like hospitals and schools, the Navy shouldn't be treated as a typical business. They have an essential service to supply first and foremost-- the cost should be secondary.
-Tony
I find most of the "outraged" comments here absolutely hilarious. The people showing the outrage are either a bunch of college students who don't have jobs or software developers who signed their rights to be paid an hourly rate a long time ago when they took exempt positions.
Both of my sisters are RNs. It is standard practice at their hospitals to work 36 hours a week and get paid for 40. Depending on when during the day they work, they get paid extra just for working a different shift. They get paid double time and a half to work during emergencies like Hurricane Ivan (they had a lock down and paid them while they slept for two nights as well) or during holidays like Thanksgiving and Christmas. They get free car detailing, free health care, free offsetting payments on their 401ks (IOW, upon request, they pay the normal tax free portion AND the matching amount), free gyms, free massages, and free vacations.
In short, you are whining about the "rights" of the most coddled group of hourly employees on the entire friggin planet. They already expect to get paid more for just about everything that isn't totally within the norm for them. All the hospitals are doing is making it a little easier to keep operating costs down.
There are some nurses with enough tenure at hospitals that they take advantage of the system and demand that they only work a nightly weekend shift. This means that the hospital still has to pay them the double shift differential AND give them full time benefits. Implementing the system has the benefit of almost eliminating this practice, since there will always be younger nurses making less who can benefit from the extra experience on some of the busiest nights of the week.
No actually the usage of the term "Aryan race" to refer to white Germans was origionally referring to Indians as well. Its use in white supremist literature is based on a misunderstanding of the word, as Nazi are (as a general rule) not that smart.
Mathematics is made of 50 percent formulas, 50 percent proofs, and 50 percent imagination.
The nursing shortage is due to the fact that a huge percentage of nurses leave the industry because the financial compensation isn't worth the demands of the job.
For instance most of the people I know who became registed nurses (either they did whay could be described as a apprenticeship as a nurse for 4 years to become a sister or they went to Uni for 4 years) or enrolled nurses (2 year mix of on the job training & college) don't work in fields remotely related to healthcare.
... from the law of supply and demand.
IANAL but write like a drunk one.
I *sincerely* hope the unions come down on this like a ton of bricks.
Oh, I know, we don't need unions, they may have been necessary once, but now we have all these wonderful benefits, and secure jobs, and they're all useless and only want dues from us....
mark "and to think, with the destruction of
the unions in the US, we have only the
government to defend us against the abuses
of big business...."
He's not talking about the procedure in an ER, he's talking about what happens when he's one of two ambulance crews first arriving at the site of a plane crash where there are 180 passengers, half apparently dead, and with 50 critically wounded.
You're damn right it's scary, but the scary part is the disaster that's already happened, not the cold calculus of triage. Spock would understand - the good of the many outweighs the good of the few, or the one.
If you're one of the walking wounded, go find some black-tagged person and give CPR if you are able.
My amazing wife - Artist, Author, Philosopher - Laurie M
One possibility of a bidding for shift structure is that people will bid for more leisure.
I've been reading literature on the nurse shortage. They are saying we have a dire problem developing and maintaining this valuable resource. A direct feedback mechanims between hospitals and staff will hurt unions but it is likely to result in better utilization of a scarce resource. After reading and thinking about bidding for intraoffice work. I am writing this up as a major innovation in employment and resource management.
I really would... except that I took lower pay in my job, just to have more hours and steady money, even though I consider myself worth at least 50% more.
But the difference is, I'm just a geek.... if I fall asleep at the switch, things go down for a few minutes and then the emergency plans kick in. If a nurse falls asleep at the switch, well, patients can't perform CPR on themselves. I find it funny that truckers (to pick an example out of the hat) have their hours severely restricted, in hours per day worked, hours per week, and contiguous hours, and yet the person who can kill me if they give me 50CCs instead of 15CCs is not only worked like a dog, but can even volunteer for more work.
The bottom line is that the power of money is seductive. Maybe you have a kid to support, a coke habit (either liquid or powder), or you just want a dual xeon system for home... working a few extra hours doesn't seem like much, until you kill someone.
If I knew the wedgies I gave you back in 6th grade would have resulted in this . . . I might have taken a moments pause.
You are not just an annoying troll, but an annoying neo-Nazi troll.
Oh well, sorry if that last post hurt your feelings. Wait..., no I'm not sorry. Truth hurts, deal with it.
Mathematics is made of 50 percent formulas, 50 percent proofs, and 50 percent imagination.
That explains all the headlines:
...
Doctor shortage cripples Canadas free health care
Broken health care system
Canadian health care deal adds $14 billion to ailing fund Pact
Just because people want something for free, doesn't mean they can actually get it.
Clear, Dark Skies
The question is where you draw the line. Apparently almost all people draw the line into where they stand. You feel that your case is where the bad situation begings. But why should other peopole feel same way? If you are not dying I don't care!
Ultimately everything revolves around world hunger. If you can solve that you can solve other problems too.
Dyslexics have more fnu.
Unfortunately, world hunger is more than likely a problem of politics within the country and not due to external factors. Often governments use this as a way to suppress and control. Intervention by "benefactors" (and I mean that term very loosly) is riddled with so many problems that to attempt acts of altruism is far more dangerous than watching people die of hunger.
IMHO, world hunger can only truly be solved by such fandamental changes in human naure that it is almost impossible to achieve. Governments in a way have the task to manipulate human nature to the benefit of many. Money, (and economics) unfortunately is a widely used tool to do these things and while I an frustrated by the waste that this creates, I can't think of any better way when human nature is taken into account.
The solution to world hunger is not about making more food, but of ways to compensate for human greed and I for one am not smart enough to figure that out.
So when it comes to my local environment and government, it is clear that keeping accomplished people unemployed is a bad thing. No doubt the tech bubble caused a huge unsustainable demand but now there is a huge unsustainable crater and history predicts that this is an unstable system that will over-correct itself many times. If you're unlucky to be caught in the crater and unemployed, it's usually not because you're less qualified, just less lucky and has nothing to do with world hunger other than a fallout of a fact of human greed.
The point is, ultimately everything revolves around human greed. It does not mean that we should eliminate the greed gene as I would be very concerned about what darwinian effects that would create, but it does mean that education is a primary factor to provide a more sensible system. Or what the heck, humans are so imperfect, should we just eliminate ourselves and replace ourselves with AI machines ?
So back to the very qualified unemployed citizens. These people are valuable assets to "society", the fact that the system is incapable of using them is certainly a fault of the system. There are plenty of useful things I can think of that these people could be working on that would benefit society as a whole, yet these people are being kept "unemployed" for 5-10% of their working life in their most productive time. That seems darn silly.
Ultimately everything revolves around world hunger.
Perhaps, but since I can't solve world hunger, does that mean we should stop solving the silly waste of human resource in our local society ? Telling these people to sell their computer to buy happy meals is probably not the way to solve this problem; just a guess.
I know this guy in "real life", he's very smart and I think your comment should be deleted with your account... I have never seen such a stupid comment in my life. You're #1, congratulations.
> This bidding process is almost certainly a good thing for the
> hospitals, but is it good for the nurses?
---
Is it? By encouraging nurses to work hours over their regular shift, they would likely be held responsible for encouraging nurses to work overtime which could expose the hospitals to liability for any accidents due to the nurses being tired during a shift going into 'no brain' mode...
There is likely some limit to hours worked/week. If the nurses are not exempt employees (like management and software engineers), I think they have to be paid overtime pay, no?
-l
In my mind, Automobile dealerships seem like a good example of "sunk to the same level of suckyness".
emt 377 emt 4
btw. I'm taking the "replace ourselves with AI machines?" path you suggested. Resistance is futile. See Manna example
There is also new intrest for the insights of Carl Marx (yes! the guy communist's worship) among economist circles. Instead of suggesting that workers should make revolution and use violence. Marx tought that communism is rational outcome from capitalism (surprise!). You can actually see it coming. Machines and robots automate physical labour, now self servise machines (web pages, teller machines etc.) take away service jobs. Eventually there comes limit where most of the human population is not smart enough to have any job that pays real money (real money means enough $$$ to keep you realatively happy). Rich people have to pay to the poor so that they stay calm and don't become terrorists/unhappy/troublemakers. It does not nesseserily mean that there is big coverment controlling this. It may be realized as kind of insurance against masses. If you give the masses enough money to buy tv, beer, pizza and painkillers, without too heavy work they will not take take the hard route (can you imagine fat american suburbanists heading to the hills fighting guerilla war after Patriot Act Plus Plus takes finally away all their rights to privacy) and can't threaten the rich and powerful. All remaing agression can be directed to easily managed violence (see soccer hooliganism) where poor people fight poor in small scale.
Dyslexics have more fnu.
ROFL. The best way I can help mankind is to do what I do well and whenever I can make a positive impact do so, no matter how small. If everyone did this we would get closer to solving world hunger. Unfortunately, often, people with the responsibity don't have that huge vision, they're short sighted by things like WW2 records and building a "nu-clear" arsenal to fight no-one.
If you have somthing better, spill the beans.
btw. I'm taking the "replace ourselves with AI machines?"
I wasn't thinking of that in particular, but it's not far off the mark.
There is also new intrest for the insights of Carl Marx ...
Scary. That's certainly one possible perspective. Unfortunately, it's far more complex than this and it's dangerous to divide the have's and have-nots. The successful approach will start with "we", not "them". If we are to succeed as a society, Muslims, Christians, Asians, Europeans, Jews etc (every creed), must embrace their differences.
The answer seems obvious now. Nobody wants to be a nurse anymore. This sort of hare-brained scheme is not going to help make the profession more appealing.
What people need now is stability. Give them a stable pay, predictable and reasonable hours of work -- stability. Being able to forecast your pay and work hours months in advance goes a long way in helping determine what you can afford (mortgage, car etc). As a bidding nurse, how can they decide on buying a house if they don't even know how many hours they'll be working next week never mind the next 3-5 years.
IANAEconomist, but seems to me that trend of contractual, work-today-laid-off-tomorrow is not helping the economy, as people under these regimes will not be spending on those big ticket items that help fuel the economic growth.
Sorry, but the world doesn't revolve around a US centric view of things. Not even a US way of doing health.
:-))
This is a whole fucking goddamn planet here.
When I was *literally* homeless two years ago I rescued a book about US healthcare and business admin
from the "recycling bin" (yeah: we are getting more
environmental even here in disordered delightful Athens).
I didn't like it. Hey, I ended up *understanding* ER (eat your heart out George
(plain description: The doctor is a *business* and
the hospital is a service).
Ouch. I'm from England and whatever crappiness we
have in our healthcare system doctors are people
who fix illnesses. We don't let them become businesses because many many years ago the charlatans of the world hurt many many people.
Our quiet Canadian friends could educate you naive
new world folks about this.
Not criticizing. Merely observing.
(The bad news is that never ever have a heart op in this part of the world - because unless everybody chips in your'e out of luck big time)
I wince when people put business and health into
the same arena. Don't you *care* if people get
well? I sure do. Maybe it's *why* I could never
be a doctor. At least my beta tests won't kill
anyone...
I've personally been a victim of this, sitting in the waiting room with a broken wrist for about 10.5 hours
Walk it off, you sorry little pussy-- Nobody cares about your wrist; it was probably limp anyway. If you weren't such a whining little cunt, you probably would have gotten your treatment sooner. Personally, I'd much rather drink coffee for hours than help some dainty little pansyfuck who thinks he's more important than an emergency room full of comatose geriatrics and cancer-kids.
Fuck you.
ok, so you want to start bidding. are foriegners bidding against us?
think about that for a second.
-- Betting on the survival of the media industry is a serious risk. I advise investing elsewhere.
Unless you're laid out bleeding to death, a quick and modern rescue arrives and you find yourself without money to pay for the service, and are left bleeding to death.
Cheap doesn't sound attractive as long as you can afford the quality. The moment you must face losing your beloved one because even selling all your property won't be enough to pay the bill, you start looking for cheaper options and complaining it's all too expensive. Usually, it's too late then, especially while many jackasses around opt for "faster and better, no matter the price".
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