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Comment by chiefalchemist | Hacker News Reader

I heard a report on (I believe) an NPR station a couple of days ago about the nursing profession being in a very similar position. That is, excessive stress, people leaving the profession, not enough new hires coming in, etc.

Another day another (preventable) crisis in "the greatest country in the world."

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If during a staffing shortage a nurse said "I'm willing to work 30 hours a week, take it or leave it", I'm guessing the company would leave it. So much for negotiating in a free market. Quality of patient care would drop, but patient bills would not, nor would CEO pay.

Our free market is moving away from the proverbial town square full of food carts and merchants peddling their wares and haggling over prices. It's more like a bunch of tired people waiting in line for a single automated computer terminal.

That's not a failure of the market - it's not worth their overhead to deal with someone working 30 hours a week. Quality dropoff and more people quitting takes time to have an effect, and then it takes time to for that effect to be noticed and corrected. Medicine has an additional quirk in that the government strictly limits who can practice and where they can practice.

> it's not worth their overhead to deal with someone working 30 hours a week.

How do you know this?

"not worth their overhead to deal with someone working 30 hours a week"

What a ridiculous thought process. An overworked and stressed-out employee is going to make mistakes and they will always ultimately quit the job. The employer will then have to start a hiring and training process for a replacement. Creating significantly more overhead for the employer.

A happy employee, working a reasonable 30 hours a week is going to be less stressed, less likely to make mistakes, and be overall more pleasant. A happy employee is more likely to stay working for that employer for a long time. Meaning the employer will not have to hire and train new employees, lowering overhead costs.

Yes. To clarify, it's completely reasonable to pay someone working 30 hours a week less, it's even okay to pay them less per hour. Make an offer!

A problem is that almost nobody will offer any salary at all to a nurse willing to work 30 hours per week. It's a testament to the flexibility of our market, or the lack thereof.

If a nurse is willing to perform 30 hours of skilled labor and our economy cannot extract any value from that, what does that say about our economy?

And they get paid way less than a Pharmacist does. Some of the nurses that I have met who helped me take care of my father, and the ones who help take care of my grandmother now are some of the most patient, amazing people I have ever met in my life. I don't know how they do it, dealing with cranky-ass people all the time, working long shifts... and here I sit on a computer all day, in my own house, drinking coffee, listening to music, making way more than them. It's kinda fucked up.

I've seen and felt similar. It's pretty much a thankless job, especially when dealing with the elderly (i.e., most are not going to get healthier, they're mostly trying to mitigate the pain of old age and dying). I couldn't do it, not with the consistency and grace I've witnessed.

While I don't believe money is the cure for everything, a donation here and there to efforts in that field helps to pause the guilt.

Nursing is a different problem altogether. A vast majority of healthcare staff in USA is immigrants. Nurses from Phillipines, India etc. Doctors primarily from India, Pakistan, Iran etc.

Trump's war on immigration definitely hurt these groups massively followed by the green card backlog for Indians. Thousands of Indian doctors and nurses left their jobs and went back to India creating a major stress on the healthcare sector and especially the rural areas. H1B visa is oversubscribed by 8x these days and Doctors and Nurses get pushed out by tech companies. No one wants to hire a doctor with only 1/8 probability of joining due to visa issues.

As more people age and we have young people moving out of smaller towns, this problem is going to become even bigger.

> Nursing is a different problem altogether. A vast majority of healthcare staff in USA is immigrants. Nurses from Phillipines, India etc. Doctors primarily from India, Pakistan, Iran etc.

Citation? I can’t find information on immigration/citizenship status specifically, but the racial demographics of doctors[0] and RNs[1] do not reflect your claims.

[0]: https://www.aamc.org/data-reports/workforce/data/figure-18-p...

[1]: https://www.aacnnursing.org/news-data/fact-sheets/nursing-wo....

Good point. Nonetheless, there's no back filling of the openings. Those who could aren't interested. In addition, Uncle Sam is too busy chasing his tail (e.g., the quarterly or so debt ceiling / budget crisis).

I’m not sure you have any basis for your argument. There are certainly a lot of immigrants in those fields, but absolutely not a vast majority.

> Trump's war on immigration definitely hurt these groups massively

Sorry what? What policies were implemented that hurt legal immigrant doctors and nurses?

There aren't many illegal alien doctors.

Not in official hospitals, but there are absolutely neighborhood places that aren't licensed, where they work as doctors.

Yeah, there's a lot of unlicensed pharmacists coming over the border as well.

> What policies were implemented that hurt legal immigrant doctors and nurses?

Trump's war on immigrants did not differentiate between legal vs illegal. One common problem I have seen for example is asking (via RFE) a MD as to why his profession is considered "speciality" and asking to prove this job needed a special degree.

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