This is a pretty ignorant suggestion. It's like saying that my company should dramatically increase its software output without hiring software engineers. These are people, not robots. You must hire more skilled labor if you wish to expand the capacity which requires that labor.
If you're saying we should fill that labor requirement with low-skill medical technicians, you're misunderstanding the needs of the hospital. If you are ending up in the ER or ICU with covid, or any other cause, you are beyond the help of an at-home med tech, which is why you're at the hospital in the first place.
We get more efficiency out of nearly every sector of the economy. We grow more food despite an ever decreasing number of farmers.
The problem is that the incentives aren't aligned with health care primarily due to third party payer system and onerous regulations.
You ever wonder why there is a line of people outside of urgent care every day to get tested for covid? Presumably, there are cheap tests that be administered at home without having to see a nurse or doctor. Or if you really can't do that you can train someone how to administer tests in a few hours and have that as a service. But in the US at least, it's nearly impossible to do these things. It took until April 2021 for the FDA to approve at home covid tests, and they're still not popular or available (at least I haven't seen them)
Medicine is a field notorious for its gatekeeping.
But a lot can be done. In Italy during the height of the pandemic, they "emergency graduated" 5th (or maybe 6th ... near the end) year medical students. I really wonder if there's any data whether they provided worse care after some on-the-job training than "fully educated" practitioners.
It's not gatekeeping when you're talking about life or death emergency medical care. Taking students out of school isn't a solution, it's an act of desperation.
If I have a private pilots license and the pilot of my commercial aircraft is incapacitated, sure I'm technically more qualified than the others on the aircraft to try to perform an emergency landing. But that doesn't mean American Airlines should be expanding their routes because I could land a plane.
duuuuuuuuude do you have any idea how labor intensive care for ICU patients is? ICU patients can't move. Requires staff to turn them so they don't get bed sores and to prone them stomach down for lung function.
If the ICU patient can't breathe on a vent and are able to secure ECMO, the ECMO specialist ratio is ideally 1:1. Under a crush of patients maybe 1:2 patients. A 1:3 ratio is risking all the patients under that specialist's care because the patients are all too tenuous. Let me reiterate and restate: 3 ECMO patients are too much for a single ES to support.
The ECMO specialist isn't the only person caring for the patient. There is the ICU nursing staff, the pulmonary therapist, plus the actual pulmonary doctors, the renal doctors, plus plus plus. You are talking decades if not a hundred+ years of study just to take care of a single ICU patient.
That's not an option. Hospitals in many were already understaffed before the pandemic. And the pandemic has caused such a severe worker shortage that traveling RNs are getting paid upwards of $200/hr in remote parts of the USA.
The only way to deal with this pandemic is to vaccinate as many people as possible. It's the best way that we know of to reduce spread of, and the effects of catching covid-19.
> Hospitals in many were already understaffed before the pandemic. And the pandemic has caused such a severe worker shortage that traveling RNs are getting paid upwards of $200/hr in remote parts of the USA.
This has always been a systemic problem of how hard medical education and license are to get. I'm pretty sure medical personnel can be trained to reasonable (mediocre but better than nothing) skill level much faster and for much cheaper than it normally is.
Yeah, if the problem is lack of staff in COVID wards, just start COVID-specific training programs and hire COVID-specific personnel, who are only allowed to work with COVID patients. That should reduce training time a lot.
This approach might sound like some completely out of the box, untested and extreme approach, yet it’s completely standard in industries that are not as heavily regulated as medicine is. Alas, healthcare has its Rules and Procedures and Best Practices, and as a result, everyone else must adjust and implement novel approaches, so that the healthcare industrial and regulatory complex doesn’t have to.
The vast majority of COVID patients aren't just "COVID patients". They're people with comorbidities that put them in a more serious position than a regular (otherwise healthy) individual with a respiratory illness. To "specialize" in COVID you likely need to have training on diabetes, neuro, renal, cardiac and other systems. To a certain point, you just need a fully trained nurse because you can't specialize too deeply on "COVID" without needing training on the comorbidties that come along with an ICU patient.
I guess I'm bias because my spouse is an ICU RN, but the ignorance of HN comments boggles my mind. Do all the hackers try to solve domain problems they have absolutely 0 experience in? I don't pretend to have solutions for the healthcare system because I don't work in the healthcare domain. I can assure you, the red tape that exists is there for very good reasons, because we've tried "unregulated" systems and they were a disaster. We've learned from our mistakes, and that means rigor that can't be replaced by some keyboard jockey writing webdev or embedded systems for unrelated fields.
And knowing they are going to get laid off when COVID dies down, do you expect people to be stampeding to be hired to a job with no transferable skills? Have you seen the Medicaid nursing home labor pool?
> That's not an option. Hospitals in many were already understaffed before the pandemic. And the pandemic has caused such a severe worker shortage that traveling RNs are getting paid upwards of $200/hr in remote parts of the USA.
How did this understaffing happen?
> More than 260 hospitals and health systems furloughed workers in the last year, and many others implemented layoffs.
As someone whose partner is a med-surg nurse, and whose extended friend circle contains a lot of current and (mostly)former nurses, that post is not really the case. That's like saying that the shortage of software engineers is down to InfoSys having a bunch of IT layoffs.
The big issues are: the job sucks, the patients suck, the insurance companies suck, the hospital administration sucks. It's a hard, thankless job, where you get shit on all day by everyone, figuratively and literally, and for not much pay. Pre-COVID, pay was maybe $30-35/hr for most floor jobs. Or you could get an hospital office job, making more than that working a basic 9-5, no shit, no working holidays, no lawsuits (due to bone-headed coworkers fucking up), no feeling like a waiter, or being groped by patients.
Hmm, who provides care at a hospital? Wow, RNs and MDs. Do you expect a janitor to intubate you? Increasing hospital capacity is hard, expensive and takes time.
I don't need a person with a doctorate degree to treat me. I just need a person who has a reasonable understanding of how does a human body work and a reasonable skill of doing particular medical procedures.
Doctors generally don't have doctorate degrees. That's a Ph.D which is a doctor of philosophy degree. A physician becomes a doctor by earning degrees as an M.D., doctor of medicine, or D.O., doctor of osteopathic medicine.
What you're describing is either an MD, a NP, or a traditional nurse/specialist.
I agree! But the issue is that where these processes exist they are not designed for the scale of the current pandemic, are too inconsistent when implemented, and rely on spare personnel that do not currently exist.
