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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.
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
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!"Actually, graveyard is prefered by many. My mom hates daytime shifts- she doesn't have to deal with doctors at night.
I still have more fans than freaks. WTF is wrong with you people?
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.
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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.
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"
...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.
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
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.
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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DON'T USE TUNAREZ!!!
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.
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).
You're right. I've been a contractor ever since graduating from the North Avenue Trade School with an honors degree in CS in 1991. For me, getting an engagement has always been a sort of auction, where a bunch of us stood up on the platform and Massa poked us in the abdomen and looked at our teeth and felt our muscles, then chose the optimal combination of strength, health, temperament, and price for his requirements. Completion of the analogy is left as an exercise for the student. It's nothing new friends, nor will it ever go away. Also at Tech, in my first week there, the founder of Samna Software (I think it was, a nice Indian gentleman) told us that we would never get rich working for somebody else, and encouraged us to go out and strive to make our own way. Since the bust I've been doing that, and in my experience building one's own business from scratch, without influential friends, is damned hard. I'm proud, but starving. Nevertheless I suggest with great respect that, if you decide to work for somebody else, you take what they are willing to give, and there is no use complaining that it is not what you think you deserve. If you don't like your current engagement, do something else. As somebody said, "Certainly the deck is stacked! But if you don't play you can't win, and there is only one game in town." Gut up y'all.
How do I know the way is like this? By means of this.
You view this as enslavement only because you can't think outside of the system, I guess. This guy, on the other hand, knows how to use some resources available out of the system. I agree that this standard of living might be inferior to the one you enjoy slaving away in a regular job, but only you can draw the line between what you absolutely need and what is purely comfort. It all depends on how much you value your freedom.
;)
But then, we're both posting comments on the Internet, shows where our priorities really are
Maybe we deserve this world ?
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.
You could also argue that you would be helped by the nurse who cares least about money, and cares most about helping people.
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.
"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 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
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
For those in the Technology sector, lets all collectively agree right now
Ha! Does the phrase "herding cats" mean anything to you?
Lost: Sig, white with black letters. No collar. Reward if found!
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
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!
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?
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.)
Radical U.S. protectionism would certainly do more to harm Texas than it would to help it.
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.
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.
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.
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.
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.
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.
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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.
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.
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.
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You may solo them, I prefer them in a group.
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.
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".
I believe this comment is obsolete in many places now. My mother used to be a nurse, and at her hospital there were no aides or orderlies. They laid them off to save money, and gave their jobs to the regular nurses. Somehow, they thought that lifting 300-lb patients was the nurses' job to do.
My mom's retired now, but she'd like to find some kind of part-time job to spend some time on and bring in some extra cash. However, she absolutely refuses to go back to nursing. There's a good reason there's a shortage of nurses in this country. They're treated like shit, worked to death, and paid terribly. Sort of like engineering, but worse. The only advantage nurses have is they won't be outsourced or have trouble finding a job (as long as they don't mind being treated like shit and paid poorly).
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.
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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.
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