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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."
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.
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!
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.
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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.
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.
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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.
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*
Okay... somebody doesn't know what triage is. When somebody shows up in the an emergency room, the first person they see is always the triage nurse. The process of triage is a simple concept that's hard to execute... putting people into one of three groups.
- Those who are in such extreme need they must be treated right away in order to save their life. These get treated first.
- Those who are in need of treatment, but aren't going to die or suffer much if their treatment is delayed a bit. Those are the people who have to wait until all of the people in the first category have been taken care of.
- Those who can't be treated. They're already beyond hope, and any effort spent on them would be wasted.
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.
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"
It's not as much an auction as much as it is a way to rank people when the schedules are being drawn up. If nobody goes under the max price, then the schedule is random-made... however, if somebody's willing to trade a little pay, they get the most-desirable prime slots. Those who are holding out for the highest pay will end up getting the overnight and holiday shifts.
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.
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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You could also argue that you would be helped by the nurse who cares least about money, and cares most about helping people.
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.
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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
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.)
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.
Here everyone wins, the hospital gets their hard to fill slots staffed, the nurses can command a higher rate for those premium shifts.
The healthcare industry has to be creative to cover those hard to fill shifts. my mom works at an RN at a nursing home, the home had a hard time getting weekends covered, people would call in sick etc, so they offered her a sweet deal. She contracts to work every weekend, no excuses, for 2 15 hours shifts, inexchange they pay her for 40 hours. This way she gets her whole week free, the home gets the shift filed, and the residents win because they have a consistent presences every weekend with a nurse who knows them and their history. If they used a agency nurse or rotated the schedule, the patients would have different nurses every weekend. As anyone who has worked with alzheimers patients can attest, a very structured, consistent environmnet can help immensely,
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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