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Comment by Spooky23 | Hacker News Reader

My sister was an RN at a hospital whose parent company gobbled up some area hospitals.

In her case, they cut her pay 25%, because it would be unfair to pay the other people less. This was right before COVID, and everyone basically quit - like a whole department of nurses en masse.

She came back as a contractor when they were hard up, at one point making $350/hr. All of the normal staff left and it became a contractor mill. When contract people didn’t show, she got $2000-3000 shift bonuses for a 4 hour work commitment to allow the ER to stay open.

I certainly hope the Slack folks do something similar.

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Yep. My good friend is an RN who worked for a hospital bought up by some conglomerate and the perks slowly went away and burned a ton of loyalty/good-will. He left to do travel nursing and made a ton more.

It’s so shortsighted and ultimately defeating/self-destructive when companies act like this.

It just doesn't seem to harm the corporation enough. The requests for subsidies, the limitations of available support that put the public at risk should be negatively impacting leadership of these organizations drastically.

The people who make the cuts see a small immediate gain. The losses of the company as a whole as people leave take at least some months.

In the case of a hospital and emergency room, they will usually have a monopoly in a given arena, so the losses will be felt by taxpayers and insurance premium payers. And the patients who end up getting lower quality are due to turbulence in operations. And the workers who cannot afford to or decide not to quit who have to deal with lower quality of life at work.

This is my frustration.

How is it when I fuck up at work, I get fired but when these definitely reversible decisions are made and allowed to run their course for years we dont see a mass exodus at the SVP level?

Maybe not enough people know what's really happening with those companies.

Nobody is really evaluated all that effectively on an individual level. I can't figure out the difference in my performance reviews between advocating, coming up with new ideas, and taking initiative vs just working on tickets and not saying a word in meetings.

Just wanted to say I love this. Happy for your sis and also thankful for her and all the other medical staff for going through what they went through

As great as it is for her... This dumb shit ended up being $$$ on a bunch of people's medical bills.

Absolutely, and hospitals are to blame for that, not RNs.

When I hear of something like that scenario, I can't logically see how the executive team making those initial decisions can spin it as a victory, but I can readily imagine them doing it.

"Hooray, we've reduced headcount and improved productivity!!" "Yeah, but your wages bill is now stacked with contractors and is 10x what it was before." "OK,OK, but how about that next exec bonus?"

Interesting math for the Hospitals. My understanding is that if they don't have enough nurses on shift, they pay high penalties to medicare. Not sure I know the details but that's my understanding.

https://www.law.cornell.edu/cfr/text/42/482.23

The benefit of being a nurse is that it is a monopoly, and the hospital is also a monopoly, and neither the hospital nor the nurse pay the cost of that mishandling, but you the taxpayer do.

Aren’t most nurses unionized though? This sounds like a union problem or at least something a union should prevent.

Outliers being paid more than their peers is the exact thing that unions fight against. I wouldn't be surprised if this originated as a union demand.

My friends Union recently fought against work from home for desk jobs because the field workers could not enjoy the same benefit.

Corporate leadership negotiated against the Union, but the union prevailes so there is no work from home

Unions also fight to have everybody paid more. The company dropping everybody to the lowest bar instead of increasing benefits for the worst off is absolutely not something the union demanded.

As for outliers in general, sure. The whole union thing is based on collective bargaining after all. If Bob is making more than everybody else in the same position, that means there's more room for everybody else doing that job to make more.

If something like this did originate from a union complaint, it sucks now for the best-off, but it's also going to be a real strong point for all the workers to use when the contract is renegotiated.

I work in a place with a union and sometimes have a minor role in negotiation with them.

100% WFH put them between a rock and a hard place. Ultimately the power of bargaining is dependent on being able to strike. Remote weakens that as people can be anywhere. The control lost by management is also felt by labor.

The circumstances vary - if your union and circumstances get hybrid and remote work in the CBA, you’re much better as we’ve already seen “return to the office” used as a stealth layoff technique that denys unemployment and severance.

I'm curious how it is used as a stealth layoff. If your role location requirement changes, you should be eligible for layoff UI.

Inequality in pay is what unions typically fight against unless it is based on seniority. Many union shops have underemployment problems solved by bringing in contractors - or non-union organizations that exist in states with strong labor laws, where businesses only hire a small number of FTEs and hire contractors for the majority of the rank and file work to get around strong labor laws.

Really depends on the state. My hospital in Arizona sat me through a presentation urging me to not sign a union petition, like a lot of other companies.

No, most nurses aren’t unionized.

There is no legitimate SWE shortage though. Most software can run in maintenance mode with minimal staff and no feature growth. A hospital is dead without nurses.

I work at a large public tech company with a bland product and sure you could lay off 90% of engineering and coast with no feature development for a good while (probably). The problem is when you want to staff back up, getting that 90% back won’t happen overnight and it’ll take years to get that efficiency back up. We paused hiring for just a couple months in my org once, we had something like 5% attrition during that time and it took 3x as long to get the hiring pipeline back up and it’ll take at least a year to get those people to be useful. Always Be Hiring.

> Most software can run in maintenance mode with minimal staff and no feature growth.

If it is well built, sure. At one of my jobs, one of the firehoses requires a messy restart every few days as it was left to decay and now everything is out of date.

Yea but an intern could keep that going for a few months if they had to, you don’t need senior engineers.

The point is that stagnation/KTLO is way easier than expansion and needs way less talent.

Typically, not really. If a software is badly built, it isn't as simple as following a set of well-described instructions. Random stuff breaks all the time due to hidden dependencies to other servicea, and debugging it is definitely not a job to be entrusted to an intern. If it was easy to restart, you could write a cron job for it.

> A hospital is dead without nurses.

So are the patients :p

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