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Comment by neilv | Hacker News Reader

> We’re told, "You make good money. You chose this career. If you don’t like it, why don’t you just quit?" [...] My response to them was, "Do you REALLY want nurses to 'just quit' if they don’t like their jobs? Think that one through a little further."

Great response.

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I don't think it is, since it doesn't answer the question. What the person who asks the question thinks and why a nurse who doesn't like their job doesn't quit are not obviously connected. Such a response is for a hospital administrator, not for someone who has no power to do anything about their working situation.

If that question was in good faith, I think your response might be the right one. But I very much doubt that question was in good faith - it sounds more to me like "suck it up or get out, princess".

Regardless of the intent, the response is incongruous to the prompt.

A: This is the job; take it or leave it.

B: You don't really want me to leave it.

Maybe A does or doesn't want that, but how does that have any bearing on B's decision-making? Let's call a spade a spade. The nurses who are not quitting are doing so because (they think) the job is still good; it's just not as good as it was a few years ago. The nurses quit did so because (they thought) they could get a better deal doing something else.

> more to me like "suck it up or get out, princess".

Different wording, but same message though. It sounds like the two options are fundamentally the same, regardless of the wording.

It does not answer the surface level question, but I think it answers the implicit ask to stop whining.

It reads "I'm not exploited quite to the breaking point yet, there is room for more optimization, Mr. Corpo."

It's a great response within some filter bubbles but among the general public there's no shortage of people who think that nothing will change until there are bodies that need to be explained away and that getting it over with sooner rather than later will result in less bad things overall.

I have the same feelings about climate change. Nothing's going to change until shit gets much, much worse. Too bad to ignore.

The big issue with accelerationism like that is in a crisis like climate change by the time the issues are so bad they're non-ignorable resources will be so tied up addressing the symptoms there won't be slack left for addressing the underlying issues.

Also for climate change specifically there's a huge hangover effect from already emitted greenhouse gases and carbon extraction is extremely difficult.

"Bodies that need to be explained away" ? It's a hospital, that's literally one of their core functions. The death certificate reads "cardiac arrest" due to "$underlying_disease", not "nurse responded to call 30 minutes too late" due to "MBAs optimizing away every bit of margin and then some".

What happens is that the capitalists threaten or actually them to compel them to stay at work and to prevent them from taking other jobs, claiming they the unpaid nurse (but not the capitalist!) has a legal obligation to care for patients.

One of the threats frequently used against nurses is to report them to the state licensing agency for "patient abandonment". This threat is frequently made whenever a nurse tries to resign - even with 2 week's notice (even though state licensing agencies say that resignation is not patient abandonment). This threat is also made whenever a nurse is forced to work overtime.

https://www.nolo.com/legal-encyclopedia/what-patient-abandon...

Do not such threats amount to libel or slander?

Yes, yes i do.

Yeah, the system won't get fixed until it is broken. As far as hospital administration cares to understand, the hospital is still running, there's still money coming in the door. If nurses are really worried about losing their licenses from the corner cutting they need to do, then they absolutely should quit and let all the patient deaths that ensue be entirely the fault of admin.

That makes sense logically in our heads that such a course of action might save lives in the long run, a triage of sorts. But the nurses know the patients that would die if they quit, and they know the other nurses they would be heaping the work on, including watching those patients die. Nurses are taught triage, but when that takes the form of walking away from patients you could save to save more you have never met, I think that goes against what draws many to the profession in the first place.

> they absolutely should quit and let all the patient deaths that ensue be entirely the fault of admin.

Letting people die as a negotiation tactic with your bosses is horribly unethical. You can handwave and say it's the admin's fault, but that won't change the reality of those people being dead because of the way you chose to address a dispute with other people.

Putting nurses in situations where they feel like quitting a crappy job means people will die is even more unethical. Don't blame the nurse who's put in the trolley problem, blame the guy who's tied a bunch of people to the trolley tracks.

Take it to the extreme: if you were enslaved, forced to care for critically ill people, would you be acting wrongly to run away if you could? I don't think so. The difference is a matter of degree, not of kind.

More practically, not every nurse's threshold is in the same place; each nurse decides they've had enough at a different point. It's not as though — barring coordinated effort — every nurse is going to quit the same day. The problem will manifest itself as declining staffing, not a sudden depopulation of the hospital, and it will not go unaddressed.

> The problem will manifest itself as declining staffing, not a sudden depopulation of the hospital, and it will not go unaddressed.

Note that "declining staffing" is exactly the complaint here, and evidently it has gone unaddressed.

People could die because nurses have to cut corners to keep up. It's better to not be involved in unethical behavior than to contribute to it continuing to limp along.

And to be clear, I don't think of this as a "negotiation tactic with the bosses". I see this as a tactic to get the bosses evicted completely.

That's a much easier thing to say as the person who's not the one who has to actually do it. Actively choosing to do identifiable harm now to prevent future diffuse harm is a more difficult version of the 'Trolley Problem' that already gives people trouble when the numbers are direct.

> Actively choosing to do identifiable harm

No, it's actively choosing to not do identifiable harm. Whatever harm comes to patients when you are not there, not even an employee anymore, can in no way be blamed on you.

Why does nursing licensing exist? Probably in no small part to ensure a minimum standard of care. Therefore staying and cutting corners in violation of your licensing terms is the active choice to do identifiable harm. To stay and cut corners is allowing management to shift the blame on you.

I've been on the difficult side of this problem, where safety and people's lives are at stake. Management never says "cut corners". It's always "you're expected to get through the work load." If you ask them if you're supposed to cut corners to make it happen, you get greeted with silence. They will stonewall you on every corner. You can tell them it's impossible and they will just ignore you and repeat their "expectations".

They'll hang your job over your head. They'll tell you they will just get someone else to do it. They'll tell you they'll blackball you. It's a bluff. Any place that is cutting corners is already in dire straights. They can't fire you because they'd be in an even worse position. They can't find anyone else to do the job because they wouldn't be in this situation if they paid enough to hire enough people to do the job. They can't blackball you if they themselves become persona non grata because they were at the helm when a hospital had to shut down because they refused to pay enough for nurses.

The only play, as a bottom rung worker, is to not play at all. It's War Games and WOPR.

Quit and the situation gets resolved very quickly. The org is on its last legs. It's only life support is the people who bend over backwards to keep it running. One hospital guess down, it's nightly news. Two and it's a national emergency.

GP said quitting, which is obviously not unethical (given some notice and not quitting at a time designed to cause maximum injury), even if people do die as a consequence.

Depends on how you quit. If a nurse or doctor gives appropriate notice before quitting or striking, so that innocent patients can be rerouted first, then there's no problem. But if they're walking out of an ER room and abandoning a patient on the table with their rib cage splayed open, that's basically murder.

In this case, the nurse who "called 911" was faced with a situation where the waiting room was packed with people who needed emergency care. For her to walk away from her job in that moment would be like leaving somebody on the ER table. At the very least, a nurse in that situation should persist through their shift and quit afterwards, not quit on the spot.

Rerouted to where? The bosses want the patients $$ but not to pay the staff.

Another hospital, or to scab nurses the administration has to scramble to call in. But to walk out without notice in the middle of a crisis because you want a stack of dead bodies to blame on your boss is basically murder.

Excuse me? Threatening to kill patients as a negotiating tactic with your employees is what is horribly unethical.

> You can handwave and say it's the admin's fault, but that won't change the reality of those people being dead because of the way you chose to address a dispute with other people.

You mean, the way the admin chose to address this dispute. The admin is the one cost-cutting.

Then quit when you're not on duty. Not when you're on duty and the situation is perilous. The first is eminently reasonable, but the second is tantamount to murder.

Easily said. Doing so puts your colleagues in much more stress, and in a time where there's more demand than supply for a profession it means people will suffer. And its a profession by people who try to lessen or end suffering, like many service jobs including teacher, police, etc. These professions will always lose because corporate psychopaths know their calling is to not leave society hanging.

And that thinking is exploited by the sociopaths who don't give a flying fuck who is suffering and dying because they insist on extracting a profit from every facet of society.

I'm kind of sick of looking at problems like this and having people like you saying that the only solution is to continue to let sociopaths ruin everything for the rest of us.

> there's still money coming in the door

And therein lies the problem with Hospitals.

Money for suffering, pay me to if you want to live.

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