WEBVTT - The Million Nurse March 0:00:04.960 --> 0:00:07.800 Welcome back to it could happen here a podcast about 0:00:07.920 --> 0:00:11.200 things falling apart and occasionally even about how to put 0:00:11.320 --> 0:00:14.320 some other things back together. UM. Today we're gonna be 0:00:14.360 --> 0:00:18.520 talking about something that is increasingly a part of what 0:00:18.840 --> 0:00:21.200 we like to call the crumbles around here, which is 0:00:21.520 --> 0:00:24.599 the health care system in this country, in the hospital 0:00:24.600 --> 0:00:27.560 system in this country as it uh kind of gets 0:00:27.600 --> 0:00:31.160 crunched by COVID. UM. And we're gonna particularly talk about 0:00:31.160 --> 0:00:34.720 a really critical aspect of our entire medical infrastructure that 0:00:34.760 --> 0:00:37.919 a lot of people don't know about traveling nurses. Uh. 0:00:37.960 --> 0:00:41.040 And with me today is our guest and and you 0:00:41.080 --> 0:00:44.239 are a traveling nurse from New York to California, all 0:00:44.240 --> 0:00:46.760 around the country. UM, thanks for being on the show. 0:00:48.040 --> 0:00:50.960 Glad to be here. Yeah. So I live in Colorado, 0:00:51.159 --> 0:00:55.319 and I was a regular staff nurse UM until COVID hit. 0:00:56.040 --> 0:00:59.080 And you know, at that time, we expected it to 0:00:59.360 --> 0:01:04.280 crunch everywhere. UM, but my home hospital, like many places 0:01:04.319 --> 0:01:06.520 that worked on the coast, UM ended up being really 0:01:06.560 --> 0:01:09.479 empty when everybody locked down and stopped getting into car 0:01:09.520 --> 0:01:12.200 accidents and going to parties and all of the other 0:01:12.200 --> 0:01:14.000 things that bring people into the e R. And I 0:01:14.040 --> 0:01:16.960 see us UM, So at that time, I quit my 0:01:17.160 --> 0:01:19.280 full time job and went to New York as a 0:01:19.319 --> 0:01:22.720 travel nurse. UM. And then I've been dancing around hotspots 0:01:22.720 --> 0:01:28.040 since then. So New York, Texas, Ohio, rural New Mexico. UM, 0:01:28.080 --> 0:01:31.040 I just finished my third contract in California. I've been 0:01:31.120 --> 0:01:34.160 up to Oregon. So UM, I've seen the health care 0:01:34.200 --> 0:01:36.880 system working and not working in a lot of different places, 0:01:36.959 --> 0:01:41.600 and also like how much disparity there is different communities 0:01:41.680 --> 0:01:43.880 related to covid as in the health care that we 0:01:43.880 --> 0:01:47.120 can provide. Yeah, and I am kind of before we 0:01:47.160 --> 0:01:49.120 move on to some of the specific things going on 0:01:49.120 --> 0:01:52.360 the travel nurses, what is your sense of like how 0:01:52.400 --> 0:01:54.880 often are you in a place and feel like, well, 0:01:54.920 --> 0:01:58.440 this the hospital system here, this particular hospital, they're they're 0:01:58.520 --> 0:02:02.160 like right on the edge of a breaking point most 0:02:02.160 --> 0:02:09.480 of the time. Okay, that's good to know where your seatbelts, folks. Yeah, 0:02:09.639 --> 0:02:13.640 I mean, particularly since everyone was able to get vaccinated 0:02:13.760 --> 0:02:17.160 right Like to me, I really feel like that that 0:02:17.520 --> 0:02:19.440 that point of like the tipping point of like the 0:02:19.520 --> 0:02:23.400 quote unquote crumbles kind of like after everybody was was 0:02:23.440 --> 0:02:26.720 able to get their second vaccination, UM, and we had 0:02:26.840 --> 0:02:29.400 so much hope last May and June and things were 0:02:29.440 --> 0:02:31.760 reopening and it was kind of like, wow, things could 0:02:31.800 --> 0:02:36.160 go back to normal. Um, and then like, I don't 0:02:36.160 --> 0:02:39.720 believe that's going to happen. And since then, I've seen 0:02:39.880 --> 0:02:42.639 so much more despair in my coworkers, and I've heard 0:02:42.639 --> 0:02:48.079 about so many more healthcare suicides, um staff, nurses, travel nurses, arties, 0:02:48.120 --> 0:02:52.720 other ancillary people, and you know, the kind of running joke, 0:02:52.800 --> 0:02:55.160 and a lot of workplaces is like, well, I hope 0:02:55.200 --> 0:02:57.160 I test positive for COVID because that would be better 0:02:57.160 --> 0:02:59.720 than coming into work another day. Yeah, all right, I 0:02:59.720 --> 0:03:01.200 hope I get hit by a car so I don't 0:03:01.200 --> 0:03:04.000 have to come in your job, I think, is what 0:03:04.160 --> 0:03:07.320 a lot of people would the people who you know 0:03:07.440 --> 0:03:11.600 are reasonable human beings and see what you're doing is 0:03:11.639 --> 0:03:14.800 incredibly necessary, find that would find the work to be 0:03:14.919 --> 0:03:17.359 something of a nightmare. I mean, it sounds like horrific 0:03:17.560 --> 0:03:19.600 um to have to to deal with this. I mean, 0:03:19.639 --> 0:03:22.440 it's it's it's not an easy job in the best 0:03:22.440 --> 0:03:25.720 of times, being a nurse, but like with COVID and stuff, 0:03:25.760 --> 0:03:29.880 it's it's just there's so much else on y'all's plates. Um. 0:03:29.960 --> 0:03:31.840 And one of the things that has happened over the 0:03:31.840 --> 0:03:35.760 course of the last year or well almost two years now, UM, 0:03:35.880 --> 0:03:39.800 is that from January the advertised pay rates for travel 0:03:39.920 --> 0:03:44.280 nurses around the country have gone up by about sixty UM, 0:03:44.400 --> 0:03:47.160 which in staffing firms of you know, increase their building 0:03:47.160 --> 0:03:50.560 of hospitals by like so like this huge rays in 0:03:50.680 --> 0:03:54.040 what um travel nurses are demanding and what is getting 0:03:54.040 --> 0:04:00.000 paid out. And I think a reasonable person would go, well, yeah, 0:04:00.160 --> 0:04:04.360 of course, UM, And yeah, I think anybody would go 0:04:04.640 --> 0:04:07.840 any reasonable person would go, well, yeah, of course, you 0:04:07.880 --> 0:04:10.400 guys deserve much more money than that for what you're 0:04:10.400 --> 0:04:13.320 dealing with right now. UM. I have no problem with this, 0:04:13.440 --> 0:04:15.520 But people who do have problems with this are the 0:04:15.520 --> 0:04:20.599 American Hospital Association UM, among other folks generally the folks 0:04:20.640 --> 0:04:22.560 who are seeing this primarily as a well, now we're 0:04:22.560 --> 0:04:25.640 spending more money issue, as opposed to a, hey maybe 0:04:25.720 --> 0:04:30.000 we don't have enough nurses, which right, yeah, so I 0:04:30.000 --> 0:04:32.880 guess I have maybe a couple of comments on that. 0:04:32.960 --> 0:04:36.000 So one of the things about trafical nurses, so if 0:04:36.200 --> 0:04:38.600 if you're not in the travel field and you say 0:04:38.640 --> 0:04:41.839 I want to change hospitals, even if you're an experienced nurse, 0:04:42.000 --> 0:04:44.359 they will take between a month and six months to 0:04:44.360 --> 0:04:47.240 go through their hiring process, and then they will give 0:04:47.279 --> 0:04:50.159 you a week, two weeks, maybe four weeks of orientation. 0:04:51.240 --> 0:04:54.120 So that's a long process to hire a nurse normally YEA. 0:04:54.360 --> 0:04:57.039 For me as a travel nurse, I will talk to 0:04:57.040 --> 0:04:59.640 a recruiter, I will say yes, I will be on 0:04:59.680 --> 0:05:03.960 the road somewhere between four hours to twenty four hours later, 0:05:05.400 --> 0:05:07.240 I will get to the hospital. I will do a 0:05:07.240 --> 0:05:09.400 bunch of paperwork that is for compliance and makes no 0:05:09.440 --> 0:05:12.839 difference at all. I will get between two and six 0:05:12.880 --> 0:05:16.359 hours of orientation, which is basically, here's the bathroom, here's 0:05:16.360 --> 0:05:18.080 the store room, this is what we're going to audit 0:05:18.160 --> 0:05:21.839 in the charts, and then I'm expected to take care 0:05:22.000 --> 0:05:28.760 of complex actively dying patients. So so you know, people 0:05:28.760 --> 0:05:31.200 complain about how much we're getting paid, but if you 0:05:31.279 --> 0:05:33.800 only have two hours of like where's the bathroom, and 0:05:33.800 --> 0:05:35.680 like this is how most of the time when you're 0:05:35.680 --> 0:05:39.040 spending with I t being like, hey I need computer access, buddy, 0:05:39.279 --> 0:05:41.480 and then there you are and you're in the thick 0:05:41.520 --> 0:05:44.360 of it with no backup. You know, so you already 0:05:44.360 --> 0:05:46.200 have to be an expert in your field, and you 0:05:46.200 --> 0:05:48.400 have to be able to walk into an unfamiliar chaotic 0:05:48.440 --> 0:05:52.479 situation and hit the ground running immediately. So, yes, making 0:05:52.480 --> 0:05:55.360 a hundred twenty bucks an hour is a lot of money, 0:05:55.400 --> 0:05:58.080 But I don't know that that's so super unreasonable for 0:05:58.160 --> 0:06:02.520 two hours of like, yeah, it's now to take care 0:06:02.520 --> 0:06:04.800 of people who are actively dying, and don't screw it up. 0:06:05.320 --> 0:06:08.599 It's the way we're told the system is supposed to work, right, Like, 0:06:08.640 --> 0:06:11.039 this is how capitalism is supposed to function. The demand 0:06:11.200 --> 0:06:13.479 for something goes up, and the demand for nursing his 0:06:13.520 --> 0:06:16.240 way the hell up, so the price goes up. Um, 0:06:16.279 --> 0:06:20.320 if you believe in capitalism, like one assumes these people 0:06:20.720 --> 0:06:23.520 who are responsible for you know, paying you and are 0:06:23.520 --> 0:06:25.640 currently lobbying. So what's happening. I should go back because 0:06:25.640 --> 0:06:28.680 we didn't note this. But the American Hospital Association and 0:06:28.680 --> 0:06:31.240 a number of other folks are lobbying Congress right now 0:06:31.320 --> 0:06:33.840 to put a cap on the amount of money that 0:06:33.920 --> 0:06:39.040 traveling nurses UM can uh can can receive, and a 0:06:39.160 --> 0:06:42.840 number of UM congress people have said that they're going 0:06:42.839 --> 0:06:47.480 to be looking into the issue. Several states, Oregon, Illinois, Pennsylvania, Kansas, 0:06:47.520 --> 0:06:51.719 and Kentucky have introduced legislation that's attempting to cap nurse 0:06:51.760 --> 0:06:55.800 pay rates. So there's like this huge backlash attempting to 0:06:56.360 --> 0:06:59.560 lock down the amount of money y'all can continue to 0:06:59.600 --> 0:07:02.520 get pay aid UM because of all of the things. 0:07:02.600 --> 0:07:05.679 This country I guess has money for the people dealing 0:07:05.760 --> 0:07:08.520 with the I don't know what. I don't know how 0:07:08.520 --> 0:07:11.720 many millions of additional sick and dying people UM are 0:07:11.760 --> 0:07:14.320 are are kind of beyond what these folks are willing 0:07:14.360 --> 0:07:18.040 to shell out for UM. Have I got the size 0:07:18.040 --> 0:07:22.160 of that? And I mean to clarify so in a 0:07:22.160 --> 0:07:25.080 FEMA contract, so what a lot of the contracts I 0:07:25.160 --> 0:07:27.440 take are. So the nurse is making between a hundred 0:07:27.440 --> 0:07:31.200 and hundred and maybe you also have a tax free 0:07:31.200 --> 0:07:33.320 stipend or you don't kind of depending on how you 0:07:33.320 --> 0:07:36.040 are in that. And then but the bill rate to 0:07:36.080 --> 0:07:40.720 the hospital is usually like tot. So the legislation is 0:07:40.760 --> 0:07:44.960 against the agencies. The agencies are making between forty six. 0:07:45.480 --> 0:07:47.480 Of course, the agency is then going to say, hey, 0:07:47.560 --> 0:07:49.120 well we aren't going to pay you as much because 0:07:49.120 --> 0:07:52.960 we still want the same cut. Yeah, my understanding, so 0:07:53.720 --> 0:07:56.280 the trickle down effect is likely going to be travel 0:07:56.360 --> 0:08:00.920 nurse wages. But my understanding is it's setting the FTC 0:08:01.120 --> 0:08:06.320 to take enforcement against the travel nurse agencies because the agencies, 0:08:06.360 --> 0:08:08.040 they're the ones that say they have the person on 0:08:08.040 --> 0:08:10.720 the phone that says, hey, you have these credentials, we 0:08:10.720 --> 0:08:12.840 want to send you to this hospital yes, or now 0:08:13.320 --> 0:08:15.760 we've got this hotel arranged or we don't or you 0:08:15.760 --> 0:08:17.280 know those types of and we're going to do this 0:08:17.320 --> 0:08:19.440 type of on boarding. So they have their own kind 0:08:19.440 --> 0:08:23.640 of infrastructure and they take you know, half of the cut. 0:08:24.640 --> 0:08:26.400 And so some of those people are making a lot 0:08:26.440 --> 0:08:29.280 of money too. Yeah, And it seems like it's kind 0:08:29.280 --> 0:08:32.040 of the situation where the way this is being framed, 0:08:32.040 --> 0:08:33.880 they're trying to crack down on these people who are 0:08:33.960 --> 0:08:36.439 kind of profiteering or could be argued to be profiteering 0:08:36.480 --> 0:08:39.679 off the situation, um, rather than trying to cap the 0:08:39.720 --> 0:08:42.240 amount that that the nurses can make, so to speak, 0:08:42.960 --> 0:08:45.960 or at least not by as much. But the overall 0:08:46.000 --> 0:08:48.760 effect will be that because of the way these companies work, 0:08:48.840 --> 0:08:52.760 y'all will still wind up making less money. Um. Yeah, 0:08:53.240 --> 0:08:57.080 how um within the traveling nurse community, what is kind 0:08:57.120 --> 0:09:00.200 of where are people right now with this? Like, what 0:09:00.200 --> 0:09:03.319 what is kind of the mood? Um? So I think 0:09:03.360 --> 0:09:05.760 there's a couple of things to note. So in the 0:09:05.760 --> 0:09:10.080 FEMA contracts, they're usually sixty to seventy two contracts, so 0:09:10.120 --> 0:09:12.120 you're working back to back to back to back. So 0:09:12.960 --> 0:09:15.920 I'll do a d our weeks sometimes. And most people 0:09:16.160 --> 0:09:19.400 are not white women like me. This is mostly first 0:09:19.400 --> 0:09:23.480 and second generation immigrants and generally people of color. Um So, 0:09:23.559 --> 0:09:26.440 these are not people that are saving for Lamborghinis. These 0:09:26.440 --> 0:09:28.560 are people that are paying off their student loans because 0:09:28.600 --> 0:09:30.959 a lot of them went to private nursing schools because 0:09:31.000 --> 0:09:33.319 that was kind of what was accessible to them because 0:09:33.559 --> 0:09:37.480 all of the disparity and education and opportunities. These are 0:09:37.480 --> 0:09:39.960 people that are trying to pay off their mortgages. These 0:09:40.000 --> 0:09:43.600 are people who are paying off their parents houses. Um So, 0:09:43.640 --> 0:09:47.120 this kind of idea that like nurses are greedy is 0:09:47.880 --> 0:09:50.600 I think really unfair because most of us are just 0:09:50.640 --> 0:09:53.960 trying to like, you know, make a life that works. 0:09:54.000 --> 0:09:57.200 And also, you can't do a d our contracts fifty 0:09:57.200 --> 0:09:59.880 two weeks out of the year, No, I mean doing 0:10:00.000 --> 0:10:03.360 it for any extended period of time. I've I've worked 0:10:03.400 --> 0:10:10.360 those kind of hours in a generally less stressful working environment. 0:10:11.040 --> 0:10:14.920 Um and it like it breaks you down. Um. Over time, 0:10:14.960 --> 0:10:17.760 like you you can't do that and at any time 0:10:17.800 --> 0:10:20.520 in your life for one thing like um, and you 0:10:20.600 --> 0:10:22.599 can't do that forever. And it sounds like this is 0:10:22.679 --> 0:10:24.800 kind of a lot of people are taking it as 0:10:24.880 --> 0:10:27.760 like this is an opportunity. I can get my parents 0:10:27.760 --> 0:10:30.280 out of debt, I can I can get a house, Um, 0:10:30.320 --> 0:10:31.920 I can say for my kids to I can pay 0:10:31.920 --> 0:10:34.600 off my own college. Like it's a chance for a 0:10:34.600 --> 0:10:38.480 lot of these people by putting in an unbelievable amount 0:10:38.480 --> 0:10:42.800 of effort to get ahead. Uh. And I can't can't 0:10:42.840 --> 0:10:46.560 even imagine the frustration at seeing so many people be like, 0:10:46.720 --> 0:10:49.760 well no, not so fast. And I mean one of 0:10:49.800 --> 0:10:51.920 the things that people are bringing up is right like 0:10:53.240 --> 0:10:56.520 it in the same way that you know, we struggle 0:10:56.640 --> 0:11:00.240 to want to pass minimum wage laws for the minute 0:11:00.240 --> 0:11:02.960 immigrants that pick our food and you know, support this 0:11:03.000 --> 0:11:06.400 infrastructure that is totally unseen now that we have, you 0:11:06.440 --> 0:11:09.680 know what is mostly for stance second generation immigrants that 0:11:09.679 --> 0:11:14.800 are working these FEMA contracts, Like you're targeting a section 0:11:14.840 --> 0:11:16.960 of the population that are not the people that have 0:11:17.040 --> 0:11:19.880 doubled tripled their wealth in the pandemic, right, Like, these 0:11:19.880 --> 0:11:22.320 are not all of the people that got the small 0:11:22.360 --> 0:11:26.160 business loans that didn't need them, and you know, and 0:11:26.200 --> 0:11:29.160 have are just putting all of that money into stock, right, 0:11:29.600 --> 0:11:32.440 is there not? These are people who just want a 0:11:32.440 --> 0:11:36.440 middle class American dream and we're working, will work really 0:11:36.480 --> 0:11:40.600 really hard for it. And I mean there these are 0:11:40.640 --> 0:11:43.000 people who are asking, can I have the thing we're 0:11:43.000 --> 0:11:47.320 all promised? If I spend eighty hours a week watching people, 0:11:47.480 --> 0:11:49.959 in a lot of cases choke out their last fucking breaths, 0:11:50.600 --> 0:11:53.960 is that okay? And a lot of people are saying, oh, 0:11:54.120 --> 0:11:57.559 of course, not right. And you know, so we're taking 0:11:57.600 --> 0:11:59.640 care of dyeing people while we're getting yelled at at 0:11:59.640 --> 0:12:02.320 the phone and of like, is cursing a lot on 0:12:02.320 --> 0:12:06.000 the show or yes, of course? Yeah. I mean I 0:12:06.040 --> 0:12:08.440 had a family member saying, you're fucking imprisoning her on 0:12:08.480 --> 0:12:10.680 a ventilator. I'm going to come for you. Where do 0:12:10.720 --> 0:12:15.720 you fucking live? You know we have to get security involved. Um, 0:12:15.760 --> 0:12:18.440 you know, we get death threats. I've had people like 0:12:18.520 --> 0:12:22.839 threatened to find where I live and raped me. And 0:12:22.920 --> 0:12:30.560 so I mean, yeah, taking care of your dying loved 0:12:30.559 --> 0:12:33.040 one who also probably would say those same things to 0:12:33.040 --> 0:12:34.920 me because I would say, hey, please be vaccinated and 0:12:34.920 --> 0:12:37.199 they would say fuck you. But I'm still going to 0:12:37.240 --> 0:12:39.000 do everything I can to take care of them, and 0:12:39.040 --> 0:12:41.520 I'm going to do this abuse and like, yeah, if 0:12:41.559 --> 0:12:43.560 I'm going to leave my home and the safety of 0:12:43.559 --> 0:12:46.200 a hospital that works and go into these total cluster 0:12:46.280 --> 0:12:50.000 fox of hospitals where the educator has left, the manager 0:12:50.040 --> 0:12:52.600 has left, the director has left, so there's no leadership. 0:12:53.120 --> 0:12:55.960 It's travelers, some of which are great, some of which 0:12:55.960 --> 0:12:58.360 are also hot messes, and trying to take care of 0:12:58.400 --> 0:13:00.240 these people. Then like, yes, I want to you paid 0:13:00.240 --> 0:13:05.040 accordingly for it. Now would I trade that for a 0:13:05.080 --> 0:13:09.320 social um, a social safety net of health insurance because 0:13:09.360 --> 0:13:13.319 I have to get private health insurance, which is shady. Um. 0:13:13.360 --> 0:13:16.040 I don't get any disability insurance. I have nostick leave 0:13:16.320 --> 0:13:18.440 right because you're you're you're a pinch hitter. You're not 0:13:18.520 --> 0:13:22.080 like salary anywhere. Yeah, But would I trade this high 0:13:22.120 --> 0:13:25.920 salary for a social safety net? Personally I would yes, 0:13:28.080 --> 0:13:30.320 But I mean nobody's going to say, like, yes, you 0:13:30.320 --> 0:13:32.400 will be able to retire with dignity if you play 0:13:32.440 --> 0:13:35.120 by all of these rules. They don't believe that I 0:13:35.160 --> 0:13:37.719 want to make the money. Yeah, it's I mean we're 0:13:37.760 --> 0:13:39.959 all always in this kind of like yes, soccer way 0:13:39.960 --> 0:13:42.640 as much as you can while it's coming situation, and 0:13:43.000 --> 0:13:46.079 she's especially if you're especially if you're doing something you're 0:13:46.080 --> 0:13:50.480 gonna need to recover from later, right, Like this is 0:13:51.000 --> 0:13:54.160 I I you know, I've I've done overseas work. I 0:13:54.240 --> 0:13:57.720 understand kind of the nature of like trauma. And while 0:13:57.800 --> 0:14:00.080 you're doing the job at the rate you're doing it, 0:14:00.160 --> 0:14:02.920 you're also like pushing off a day of reckoning mentally, 0:14:03.040 --> 0:14:08.480 and not having a cushion of savings helps with that. Yeah, 0:14:08.800 --> 0:14:10.640 Like in the middle of it, you're in it, and 0:14:10.679 --> 0:14:14.200 then you know, sometimes it's weeks, sometimes it's months. Um. 0:14:14.240 --> 0:14:16.960 I hiked the Colorado Trail for mental health, and half 0:14:17.000 --> 0:14:20.000 of those nights I had I See you nightmares. So 0:14:20.040 --> 0:14:22.800 I was in these beautiful, the middle of over places 0:14:22.840 --> 0:14:24.680 where everything was quiet. I would wake up with all 0:14:24.720 --> 0:14:26.920 of the beeps and people dying in my head night 0:14:26.960 --> 0:14:30.560 after night after night. You know. Yeah, I mean, yeah, 0:14:30.680 --> 0:14:32.760 I'm angry that they don't want to compensate me for that, 0:14:32.840 --> 0:14:35.120 because I mean, they're definitely not paying for my therapist. 0:14:35.440 --> 0:14:38.600 They definitely like aren't giving me access to disability if 0:14:38.640 --> 0:14:52.280 I need it. Right, Like, yeah, because obviously again you're 0:14:52.360 --> 0:14:55.920 you're a contractor. Effectively, Um, there's not like a union 0:14:56.000 --> 0:14:59.520 for traveling nurses, is there? Or Am I wrong about that? No? So, 0:15:00.000 --> 0:15:03.600 I mean the only thing you have each your negotiating power. Um. 0:15:03.640 --> 0:15:06.880 So I have eight years of experience between emergency and 0:15:06.920 --> 0:15:11.400 I see you, um and a lot of very um 0:15:11.640 --> 0:15:14.840 big and highly regarded hospitals. So I'm a hot commodity 0:15:14.880 --> 0:15:18.200 to them, so I can kind of pick and choose, um, 0:15:18.280 --> 0:15:20.200 who I want to work with compared to someone that 0:15:20.240 --> 0:15:24.320 has less desirable specialties. Not that those specialties don't also 0:15:24.360 --> 0:15:26.920 work as hard, but they're just harder. They're easier to staff, 0:15:26.960 --> 0:15:30.040 so therefore they're not It's a it's a market things. 0:15:30.120 --> 0:15:33.840 I definitely don't believe that my specialties are more like 0:15:33.880 --> 0:15:38.160 inherently valuable just in terms of the market. Um. So 0:15:39.280 --> 0:15:40.720 you know, so I get I can I have the 0:15:40.800 --> 0:15:44.360 luxury of turning down contracts that aren't what I want. 0:15:45.160 --> 0:15:47.680 But I mean, I have no idea what I'm walking into. 0:15:48.040 --> 0:15:51.960 So on Monday, I'll walk into somewhere. Um, they said, 0:15:52.000 --> 0:15:54.640 you'll do some paperwork, you'll get your orientation, you'll have 0:15:55.200 --> 0:15:56.800 it'll all be it'll be a busy day and then 0:15:56.800 --> 0:15:58.960 you'll be on your own and I have no idea. 0:15:59.640 --> 0:16:01.760 Sometimes you're oriented in one unit and you never see 0:16:01.760 --> 0:16:05.280 that unit again. So um, and I you know, you 0:16:05.320 --> 0:16:08.360 have no idea what you're walking into. And how how 0:16:08.400 --> 0:16:12.320 long are these contracts? Generally? For so, before COVID, the 0:16:12.360 --> 0:16:17.120 standard nursing contract was thirteen weeks UM. Since COVID, a 0:16:17.200 --> 0:16:19.040 lot of them are shorter. And I've only done in 0:16:19.080 --> 0:16:21.720 short contracts because if it's a decent place, then I 0:16:21.720 --> 0:16:24.840 can renew and stay longer usually, and if it's a 0:16:24.880 --> 0:16:27.400 bad place, then I'm pretty happy to get out early. UM. 0:16:27.600 --> 0:16:31.200 So I do between four and eight week contracts, and 0:16:31.280 --> 0:16:35.000 I usually do sixty plus hours a week. Is there 0:16:35.040 --> 0:16:39.080 any kind of like organization that you've seen come together 0:16:39.120 --> 0:16:42.120 a little more between people who are doing this this 0:16:42.200 --> 0:16:44.640 gig since you don't have kind of representation. Is that 0:16:44.760 --> 0:16:47.360 something that started to take form in the last two 0:16:47.440 --> 0:16:50.360 years since COVID. I mean, there's definitely a lot of 0:16:50.360 --> 0:16:56.120 talk about it. Um. I think like those of us 0:16:56.200 --> 0:16:59.960 that started traveling since the pandemic, you know, I would 0:17:00.000 --> 0:17:02.200 say that I've only done crisis contracts, like I've never 0:17:02.240 --> 0:17:05.640 done a normal thirteen week, thirty six hour a week, 0:17:06.400 --> 0:17:10.280 not crisis assignment. Like I've only gone into the ship 0:17:10.400 --> 0:17:14.000 show hot spots, um. And so therefore, like my needs 0:17:14.040 --> 0:17:17.240 and desires are different than somebody who likes that previous lifestyle. 0:17:17.760 --> 0:17:20.040 So in some ways it's a little bit hard for 0:17:20.119 --> 0:17:23.639 us to kind of agree on common goals because we 0:17:23.720 --> 0:17:25.960 have a lot of different you know, we're very diverse 0:17:26.000 --> 0:17:30.240 group of nurses. Um. Definitely, the Million Nurse March is 0:17:30.320 --> 0:17:32.760 kind of a step towards that. Tell me about that 0:17:32.800 --> 0:17:34.600 what what is this? Because I just learned about this 0:17:34.640 --> 0:17:38.280 pretty recently. Yeah, so I dropped off the grid for 0:17:38.320 --> 0:17:40.600 the last five days, which was fantastic for me, but 0:17:40.640 --> 0:17:44.320 it means I'm also just starting to figure it out. Um. 0:17:44.400 --> 0:17:47.439 So the kind of general idea is that you know, 0:17:47.600 --> 0:17:50.560 we have I think, uh, I'm gonna hopefully I don't 0:17:50.560 --> 0:17:52.760 get it wrong, four millions some nurses in the country, 0:17:52.800 --> 0:17:54.399 A huge number of nurses in the country, and a 0:17:54.480 --> 0:17:58.159 huge number of dropping out. Um, you know, hundreds of 0:17:58.160 --> 0:18:01.520 thousands quit last year. They think one estimate is five 0:18:01.920 --> 0:18:04.639 thousand make quit this year. And we were just so 0:18:04.760 --> 0:18:12.960 people know, tens of thousands of nurses understaffed, before COVID nation. Yes, right, right, um. 0:18:13.000 --> 0:18:14.560 And you know, I think one of the things to 0:18:14.720 --> 0:18:18.400 understand two is that like if you work, I don't 0:18:18.440 --> 0:18:21.440 know what's what's a normal type of job that people work. 0:18:21.480 --> 0:18:22.720 I don't know. If you work at the d m V, 0:18:23.040 --> 0:18:25.679 A bookman, Oh right. If you work at the d 0:18:25.760 --> 0:18:28.199 m V and the d m V is slow, you 0:18:28.240 --> 0:18:30.320 will still stay there eight hours and you just get 0:18:30.320 --> 0:18:32.680 paid for your eight hours. If you are a normal 0:18:32.760 --> 0:18:34.600 nurse and you work thirty six hours and the e 0:18:34.720 --> 0:18:37.240 R is running slow, they could say we're just canceling 0:18:37.240 --> 0:18:38.440 you for the rest of the day, go home. We 0:18:38.480 --> 0:18:41.239 won't pay you for those last six hours. And so 0:18:41.320 --> 0:18:45.840 like we've always had pretty like flexible like we've never 0:18:45.840 --> 0:18:47.879 had like most of the places I've worked, I've never 0:18:47.920 --> 0:18:50.639 had guaranteed hours. And so one of the reasons to 0:18:50.680 --> 0:18:52.560 go to travel contracts to is also so you can 0:18:52.600 --> 0:18:54.639 at least have guaranteed hours. So there's a lot of 0:18:54.720 --> 0:18:56.960 kind of protections that nurses have never really had, like 0:18:57.040 --> 0:19:02.240 guaranteed hours. UM like UH staff ratios, so some states 0:19:02.280 --> 0:19:05.280 California and organ or um two of them. If you 0:19:05.320 --> 0:19:07.000 go into the i c U, which is the highest 0:19:07.080 --> 0:19:10.639 level of care, so people are actively dying actively unstable. 0:19:10.680 --> 0:19:14.280 Things can go bad within seconds. Usually it's a one 0:19:14.359 --> 0:19:17.800 nurse will have two patients UM, which is pretty much 0:19:17.800 --> 0:19:20.720 all you can handle because they're on multiple drips, multiple 0:19:20.760 --> 0:19:23.400 types of life's the part keeping them alive. So ventilators 0:19:24.200 --> 0:19:28.119 UM being the one that we see the most UM, 0:19:28.160 --> 0:19:30.600 and it's really your responsibility to know every inch of 0:19:30.600 --> 0:19:33.480 that person's body UM and everything going on with them, 0:19:33.480 --> 0:19:36.959 and you really direct a lot of their care UM. 0:19:37.000 --> 0:19:38.760 So two to one kind of makes a lot of sense. 0:19:39.520 --> 0:19:42.240 Since the pandemic and not having enough nurses, sometimes that 0:19:42.320 --> 0:19:45.000 slid to three to one or even in bad situations 0:19:45.040 --> 0:19:49.520 four to one. So one of the statistics that UM. 0:19:49.640 --> 0:19:53.760 One of the kind of nurse influencers and comedians Nurse 0:19:53.840 --> 0:19:58.200 Blake talks about UM is that for every additional patient 0:19:58.320 --> 0:20:00.240 that a nurse takes on, and I believe he's talking 0:20:00.240 --> 0:20:03.159 about med starch not I se you that that patients 0:20:03.400 --> 0:20:09.159 UM mortality increases by seven percent. So yeah, so asking 0:20:09.160 --> 0:20:12.280 a nurse to do more with less is not just 0:20:12.400 --> 0:20:15.080 like hey, just suck it up, be busier. This is 0:20:15.119 --> 0:20:20.200 actively contributing to people's disability and early deaths. So one 0:20:20.200 --> 0:20:23.359 of the things that the million Nurse march UM wants 0:20:23.359 --> 0:20:27.440 to talk about is man man dated staffing ratios. So, 0:20:27.600 --> 0:20:30.400 I see you would be two to one MED starch 0:20:30.520 --> 0:20:32.440 is usually four to one. I think you are. They're 0:20:32.440 --> 0:20:34.879 asking for three to one UM. So these have been 0:20:34.880 --> 0:20:38.960 studied by the American Nurses Association UM and other sort 0:20:39.000 --> 0:20:44.160 of UM nursing organizations UM. And not only do they 0:20:44.160 --> 0:20:46.480 make your job as a nurse so much better because 0:20:46.480 --> 0:20:48.359 we go into nursing because we want to fix things 0:20:48.359 --> 0:20:51.879 and take care of people. We want good outcomes, right Like, 0:20:51.960 --> 0:20:54.960 you don't go into nursing to just run around with 0:20:54.960 --> 0:20:57.240 your head cut off and watch everyone die, right Like, 0:20:57.320 --> 0:20:59.960 that's terrible. You go into nursing because you want the 0:21:00.000 --> 0:21:02.480 people to get better under your care and you want 0:21:02.520 --> 0:21:04.280 to be able to give them that. And so when 0:21:04.280 --> 0:21:06.480 you're asked to take care of more patients than you're 0:21:06.480 --> 0:21:09.400 able to, you're not able to do that and it's 0:21:09.840 --> 0:21:13.240 just crushes you. UM. So not only is it better 0:21:13.320 --> 0:21:17.280 for nurse satisfaction, it also saves patients lives and also 0:21:17.320 --> 0:21:21.680 prevents things that will give cause lasting disability like ventilator 0:21:21.720 --> 0:21:26.120 associated pneumonia or bed sores or delirium things like that. 0:21:26.240 --> 0:21:31.040 So you know, mandating UM patient ratios is one of 0:21:31.080 --> 0:21:33.760 the really big things that the million Nurse marks is 0:21:33.840 --> 0:21:36.199 for UM. There's a lot of talk about pay and 0:21:36.240 --> 0:21:40.600 living wages. You know, like every section. Housing prices and 0:21:40.680 --> 0:21:43.399 inflation have gone through the roof because you've got to 0:21:43.440 --> 0:21:45.800