The Dysfunctional-Palooza Obnoxious Masshole BS Thread

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TheDudeLebowski said:
Hey who won the scrap pile heap this year?
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F U. I did.
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paulthenurse said:
They’re busy checking out some dude who copped a feel forty years ago.
Trippr is in SO much trouble.
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Only if they missed something in the previous background checks.
Job stuff. Pita, frankly. But they never came up with a "No!", so I think I'm ok.
Now, the guy with the rumoured hooker graveyard? Whole 'nuther range of possibilities right there ;)
 
Fuq! I hate getting asked this question. The problem is that both sides are so entrenched in their distrust of each other that they’ve lost sight of the big picture.

It’s a labor/management argument. The hospitals spend a fortune on personnel. An ‘average’ nurse in the city of Boston makes well over 100K/year. Before shift and weekend differentials or overtime. I believe top step in the city is at the Brigham and is around $70/hr.). That’s a sh!tload of money. Management would can that nurse in a nanosecond if they could and replace him/her with three new grads and they’d still save money. Do you want your mother being taken care of by a nurse who barely knows where the best bathrooms are in the hospital? Or who doesn’t know that “The Doctor” just graduated med school herself and is relying on experienced nurses to keep her from killing somebody?

It’s all about money. I believe that if it passed nurses will end up shooting them selves in the foot and end up getting replaced by non licensed personnel with lesser education and experience. Not good for the patients. Not good for the nurses.

OTOH, I’ve had my share of unsafe assignments. I’ve been scared sh!tless that I’m going to kill somebody because I have somebody over here who’s trying real hard to die and I’ve got the supervisor up my ass to take another critically ill patient who’s on the way down from the OR ‘NOW!’ Oh and I’ve got five ‘easy’ patients who all need attention, and the idiot intern is asking me to do spectacularly stupid and pointless things. And I haven’t visited my favorite bathroom in 11 hours.

This will eliminate flexibility. It will not allow me to say “Hey Dland, I’m doing ok here right now. I’ll take the admission and medicate your others. I’ll let you know if there are any problems and I’ll square it with the supervisor. You’re buying the beer after work”.

It will prevent us working together to do the reason we are all there, to take care of sick people. Even today, working as an NP, if I see a patient in my clinic and decide they need to be admitted I’ll tell the nurse, “You go do X, Y and Z. I’ll do ABC and we’ll get him upstairs.” I’m still a nurse even if I’m a super fancy-pants nurse and I wear a tie to work every day. I’m going to help my nurses take care of my patient. Teamwork is critical. This law will worsen the divide between labor and management because of inflexible quotas.

I honestly wasn’t sure how I was going to vote on this before I started answering this. (BTW, I SHOULD be watching the Wild Card Game right now and drinking instead to getting pissed off typing on my iPhone. Tomorrow is my day off.) But I think I convinced myself to vote against it. I hope none of my former union sisters find out, I’ll be a pariah. FWIW, SWMBO (Also an NP) is voting for it.

All I want to do is take care of sick little old ladies. They’re the only people I really like. The politics of it pisses me off. Leave me out of the argument. Even though I’m no longer a bedside ICU or ER nurse I’ll always take the next metaphorical admission. That next admission could be your mother.

A pox on both their houses.
 
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Don't know what this is. But Thank you for being honest and not just taking the union position.
 
Thanks for posting that, Paul. I've been having an internal battle over this, wanting to go with "Yes" but realizing it's probably too big a hammer and going with "No". And as there was a SWAG published today on the cost adder ($1B over five years, I think it was) that might help push me more towards "No".

For non-Massholes, the issue to which Paul is referring is a proposal to set state-wide minimum nurse-to-patient ratios in hospitals. Each department would have to meet or exceed the minimum prescribed for that practice or face $25K per diem fines per offense. And that metric is measured in real time - be under the threshold for five minutes and it's a technical violation.

It was inspired by a similar law passed in CA, which in turn was inspired by the largely unmentioned problem with nurse burn-out. But it turns out the MA bill is even more strict than the CA bill. One of my DILs is a wicked smaht ER doctor (at Bay State in Springfield - pretty much a war zone so she gets lots of cool stuff to work on ;)) and she's hard-set a "No".

btw, there are apparently numerous nurses unions, and here one group is firmly "Yes" and the other "No"...

Cheers!
 
Thanks for the insight, and I apologize for introducing serious content to this otherwise frivolous conversation.

Speaking of serious, I did finally solve beer infection problem, two good batches in a row, four more to go before my big coffin has no room for this canned stuff.
 
It's a big cost and it's a massively quick implementation. FWIW, the local hospital is saying they'd need to hire about 125 additional nurses, and there just aren't that many around (the local community college trains most of BMC's staff, they usually graduate about 35-40 per year).

And as I remind my wife... the nurses' union doesn't represent patients. But adding 125 new members to their ranks....

I worry a lot that the finances will drive BMC to close the little satellite operation they have in the old North Adams hospital. That facility closed a couple years back, just because the economics of small rural hospitals are garbage. It was reopened as a satellite facility so we have an emergency room and a place to get blood drawn, but I can't imagine it's actually profitable as a standalone operation.

And yeah, I'm going to agree that a lot of the blame goes back to administrative bloat (just like in higher education)... but there's nothing in this bill that's going to change this at all.
 
Far and away the largest union is the MNA, a local statewide union. It belongs to/associates with countrywide organizations like the ANA. For a while we had to pay extra dues to the ANA, I think they opted out of that a while ago. I think my dues were about $1000/year +/-

Health care is so f’ed up right now. Huge hospital groups like Partners dictate to insurance companies what they will be paid for procedure XYZ because they have the clout to do so. That kills smaller community hospitals who aren’t the big academic centers and can’t bill at near that rate. As an example, I work for Mass DPH in the state’s ‘safety net’ hospital. My patients are the most difficult patients around; homeless, schizophrenic, HIV, Hep C, drug abuse, and prisoners. (Now that I think about it, being at work is a lot like hanging out here) I simply cannot see one of my patients in fifteen minutes. They’re too complicated. We get paid about $30/visit. Partners gets around $200/visit for a ‘regular’ patient and won’t take my MassHealth patient because of the poor reimbursement.

Damn you Dland. I went to bed mad and now I’m starting my day off mad. And the f’ing Yankees won. I think I’ll go by Cape’s later on today and slap him around for a bit. That always brightens my day.
 
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My wife is a Labor and Delivery, Union Nurse here in Massachusetts. Her contract already lays out these patient limits and they are impossible to enforce. The hospital where she works is always hiring nurses, even traveling nurses, and they’re still understaffed. So passing a law isn’t going to all of a sudden make thousands of nurses ready for the job. And if hospitals have to enforce a law that is unenforceable, patient care will undoubtedly suffer. This is why she(we) will be voting No on Question 1.
 
paulthenurse said:
Damn you Dland. I went to bed mad and now I’m starting my day off mad. And the f’ing Yankees won. I think I’ll go by Cape’s later on today and slap him around for a bit. That always brightens my day.
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Just be happy your job isn't something important, like taking care of yards for peoples' 2nd houses.
 
paulthenurse said:
I couldn’t take that kind of stress
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Sounds like you've met some of my customers, haha, actually, I've dropped most of the aholes and ones that want more than they want to pay for, but that's only after over 30 years at this..your customers can only fire you by dying, I guess, but you'll still get paid, (probably not enough)
 
InkBird 300

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