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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."
But remember that nursing is a regulated field. That is to say, this system is only open to RNs, Registered Nurses, who the hostpital deals with on a regular basis. Anybody of sub-standard quality should be ejected from the system and not be allowed to bid.
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.
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.
You can't be serious? Bidding for a job means that you are a thing and not a person? Better stay out of the Freelance/Consulting business. And please tell me that you never ask for a quote when you take your car in to be worked on or when you ask for insurance.
I, for one, think this is a great idea. People work for what they're willing to work for, and the hospital is able to man the shifts.
Consider the daffodil. And while you're doing that, I'll be over here, looking through your stuff.
*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
Well, in the area I work in (Heavy Civil construction - roads, bridges, tunnels, etc.) contractors are usually required to be prequalified. In fact, the more technical the work, the stricter the prequals get. Tunnel prequals and cable stay / suspension bridge prequals are quite intimidating.
Things like: contractor shall have performed similar work in the past five years, still employ key personnel (cable stay engineer, TMB superintendent) and make them available for the job.
You are required to submit these with the bid, or your number gets thrown out and it goes to the second lowest guy.
Now, most jurisdictions do this, but it's a state-by-state kind of thing so YMMV.
I think I need a new sig here.
Are you aware that there are actual slaves in the world who aren't paid anything for what is often incredibly demeaning and demanding work, and are subject to whatever ridiculous demands and punishments their owner thinks up? That's not a joke, it's not made up to get a reaction out of our television audience, & it's incredibly inappropriate to compare this situation to slavery.
Can I mod something +1 Scary if it's true but I wish it weren't?
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.
This is actually how the free market SHOULD work! There is a need for a service and you have an ability and so do others... so the boss hires the person that will do it for the best quality/price ratio. However now with the minimum wage laws it doesn't work that way. The government now tells employers how much a job is worth.
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.
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.
Thank you, and I must say I am disgusted by the comment disparaging Canadian health care. Someone also has no concept of how our health care system works.
First off, claiming that Canadian hospitals will leave you in the emergency room to secure funding is complete bull. Individual hospitals are not even funded in such a manner, they are not entitled to more money if people have to wait. In fact, Canadian doctors are paid by how many people they treat, which has major flaws but if doctors want more funding they do not treat fewer patients!
In addition, he seemingly has no concept of the fact that our hospitals ARE overworked and underfunded, which is one reason a new deal was reached just days ago to provide billions more to the system. Personally, I know an ICU nurse who works at a Winnipeg hospital, and in addition my own mother is an x-ray technologist. These people do not, as you put it, *want* you to bleed out in the Emergency room. They are working to save lives, and in doing so they are overworked and underfunded to be able to deal with our population.
I think this fellow needs to learn respect and reality before spouting off with that s***.
This is not a sig.
This is the catastrophe triage system (think 9/11). During normal conditions everybody gets treated until they die, even the hopeless cases.
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.
Oil is priced in dollars. Without this golden arrangement the US dollar printer becomes an ordinary printer.
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.
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