What Happens When Nurses Are Hired Like Ubers | Hacker News Reader

What Happens When Nurses Are Hired Like Ubers

themarkup.org

31 pointschapulin28 comments

It seems like the fundamental situation of having a very bad boss or an exploitative industry, coded into a procedure. Soon you’ll have to spend your salarycoin at the company storeapp, and there’s no recourse or anyone to blame.

It's the slow commodification of service industries through digital coordinators.

There's two sides to the coin of commodification: some people really like the leveling effect it has, "look, we're all being treated as equals!" On the other hand, it treats people as a means to an end, and being exploited equally is still exploitation.

It's concerning to see the potential for a situation where employees are locked into a system with little recourse or accountability. Yet ensuring a fair and ethical workplace is crucial... Maybe look into Sweden/Norway, they're known for having strong workers' rights and progressive policies, even if they too have started to lock their employees in..

Is there a registry somewhere of all of the "Uber for" businesses there are?

- Clipboard: Uber for nurses

- Taskrabbit: Uber for random tasks

- Door dash: Uber for food delivery

- Lyft: Uber for car rides

I'm sure there's more.

> - Lyft: Uber for car rides

Don’t forget:

- Uber: Uber for car rides

- Amazon (the store): Uber for non-food goods.

There are—or rather, were—lots: https://hn.algolia.com/?query=%22uber%20for%22

I can see merit in such a system. I can also see that it makes it much easier for companies to act badly.

I also think that if you're bringing in temps there needs to be a mandated standard for providing the information they need--something that's always going to be the same in any facility.

And I think we need to get serious about creating/enforcing staffing ratios and put in place work hour limitations like transportation workers have.

If my reading comprehension skills have not utterly failed me, the abstract says "people who buy a service frequently, find ways to cut out the middleman. This happens more if middleman fees are higher".

In about 25 times as many words. There is no hope for tech progress when this much time is being wasted.

Besides, transaction costs have been thoroughly explored in economics since 1970.

Abstract is not (only) the main finding of the study. It’s often a mini version of the article, with a background, methods, results and conclusion.

The length of the abstract in the linked article is well justified, in my opinion.

I understand that the point of an abstract is to tell a researcher in the field whether or not the paper is worth reading. I don't think the authors of this paper understand that, though. My reaction was "well, that's two minutes of my life I won't get back."

Just a hit piece on contractors because the publication doesn't like how they can't be part of a union.

> Contractors have more flexibility and in some circumstances higher pay, but generally, workers classified as employees have rights to sick leave, minimum wage pay, and other benefits that contractors aren’t automatically granted.

Yes, that's correct. If you're a contractor, you don't get paid if you don't work. Why is minimum wage even relevant here? Traveling nurses get paid a TON of money. Again, just a hit piece on nurses that choose not to be W2.

It works when all contracting nurses are high paid. It breaks down when companies decide to make everyone low paid contractors (aka Uber).

There are all sorts of contractors ... Low paid menial work like driving a car and highly specialized ones, like having expertise in an area of nursing (wound/burn care, surgery, maternity, etc).

IMHO contracting should always pay at least a competitive salary for the area of work plus a risk premium. ie. it does not make sense to talk about a low paid contractor.

The focus of the piece is the impact on delivery of care, relationship between patient and nurse, as well as the experience of the nurses. Hardly a hit piece, but keep simping for the gig economy.

Independent contractor ≠ gig worker

Independent contractors have been doing 1099 work way before the 'gig economy'

These companies (ShiftKey, Clipboard) are not acting as agents for long term 1099 contractors at a hospital or other health care facility. They are filling shifts for as little as a day at a time at a moment's notic. Quality of care is atrocious because you never know the quality of the health care worker and the health care worker may not have the necessary training to do the job required of them. Bottom line is the problem is not 1099 work or workers, it's that these garbage "gig economy" rent seeking companies are treating the health care profession as if they were picking up day laborers in a Home Depot parking lot.

If there's a hole or shortage in scheduling, these contractors can fill vital gaps. Are you saying that the hospitals, and patients, are better off with less nurses? Are the existing staff better off with higher patient to caretaker ratios? You have to have a license/certification/required education to take on these jobs, which are managed by state nursing boards (or whomever manages the licensure). Requirements for traveling/temp nursing staff are usually higher than FT (generally need experience within a hospital). Knowing the industry, any of these temps can get the FT jobs if they chose. Its a choice to them (make more $$ hourly, less/no benefits, no set work schedule, etc).

You seem to be missing the point. The problem isn't getting in temps to fill in during the odd shortage. It's replacing long-term staff with temps. This is bad for patients.

If your hospital is always understaffed on Friday nights, for example, you need to hire more nurses, not get temps.

Hospitals can't fill nursing positions. There's a big shortage atm. These services incentivize temps to fill the gap. It's in the hospitals interests to hire FT staff but they simply can't. They have to use staffing services or they'll have a bad time. The "just staff more on Friday nights" is a simplistic take. They would if they could. Every major hospital will have a traveler on any floor at anytime, don't make ShiftKey, Clipboard the bogeyman.

Generally, if there is a staffing shortage it’s because of a deeper issue (safety, pay, reputation, etc) temps are expensive and brought in by administrators kicking and screaming. Management will also perpetually mention how hard they are working to fill open positions but rely more on a “surprise “ pizza party on Fridays and Saturdays once there are enough grumblings and concern.

A $40 pizza party is about the worth of your safety. Anyone going into a hospital should be aware of these eternal games and runarounds. It’s not every hospital but it’s a lot of them. Hospitals are not focused on your well being but cash flow and they are run that way behind scenes.

Frankly, having an extra warm-body, even if not top quality but capable of basic nursing care might be helpful. I can see the administration now “we’ll Bill, floor 5 East is really building pressure we were pretty short last weekend and we gave them pizza but Rachelle says they are still pretty worked up, let’s do another pizza party and order a nurse for this weekend to placate them. We might need to consider a waffle party on Sunday if pizza isn’t enough. We predict next weekend will be calmer, historically.”

> Generally, if there is a staffing shortage it’s because of a deeper issue (safety, pay, reputation, etc) temps are expensive and brought in by administrators kicking and screaming.

There's a national shortage and the deeper issue is unclear (most likely to do with nurses taking care of increasingly sick and mentally unwell people, coupled with pay that's "not worth it"). These temps aren't brought in "kicking and screaming" either because they make the choice to be a contractor, and make a very good rate (its a good lifestyle if you don't need the benefits/job security , the cash pay can be 2-3x that of salaried staff).

It's enabling bad management and exploitation of nurses...making the problem worse in the long run.

Let the nurses decide that. I know several that love these temp arrangements. They get paid very well and get to pick/choose their schedule, w/o being tied to FT employment. And how is it bad management? The managers are plugging gaps in scheduling. Nobody can hire at the scale they want right now.

This. As a patient I'm terrified of this model. Big WTF?

No mention of the rates they are being paid.

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