Alberta Health system brutal

[pittman]

Originally Posted by brazeau

Where's the oversight on awarding contracts? As was pointed out elsewhere, you want to pay $2 for a meal, you get a $2 meal. The bidding process and the awarding of contracts is not based on price alone or at least shouldn't be. Delivery, quality, scope of menu, volume, patient expectations, value, etc should all come into play. Anyone who awards a contract based solely on price (unless specifically directed to do so) is derelict in their duty and are just plain incompetent. But unfortunately, we're talking about government involvement over any bidding process so we shouldn't be surprised at the lack of qualified direction and resource to perform this function.

The number one factor that the government considers when awarding contracts is price. Full stop.

Physicians push for endpoints that relate to quality and outcomes all day. All the government, AH and its administrators care about is price.

[pittman]

Originally Posted by Scott h

I remember when BC made the same change to private food services and cleaning (Sodexo). There were huge numbers of layoffs, and then nearly 100% of the jobs were filled with new immigrants that would work for the much lower wages. While the food quality was hit and miss prior, it got really unappealing after the change over. The cleanliness was definitely not improved either. There is currently a move back to rehiring back to hospital positions and getting rid the private supplier.

I think Sodexo won the contract here as well. It's a company from France that specializes in large scale food service. I forgot to add, that while the quality of the food went down, the price nearly doubled. I feel bad for families stuck at the hospital with no other option for a snack.

If things don't change here they'll be looking for another contract. Another round of bids, wasted time and wasted money.

Go over to the covenant health sites. Food service isn't privatized. The food is affordable and edible. Not exciting, but at least it's affordable.

[Scott h]

Originally Posted by pittman

I think Sodexo won the contract here as well. It's a company from France that specializes in large scale food service. I forgot to add, that while the quality of the food went down, the price nearly doubled. I feel bad for families stuck at the hospital with no other option for a snack.

If things don't change here they'll be looking for another contract. Another round of bids, wasted time and wasted money.

Go over to the covenant health sites. Food service isn't privatized. The food is affordable and edible. Not exciting, but at least it's affordable.

I just looked it up and it is Sodexo taking over in the Foothills. Too bad, I well remember eating many meals in that hospital that weren't half bad, and must of been cheap, if I could have afforded it back in the day. Looks like Alberta is following the exact playbook BC wrote.

[Scott h]

Originally Posted by Big Sky

Milk River ER shut down for a week. Rural doctor shortage.

https://calgary.ctvnews.ca/milk-rive...tage-1.6481056

That's too bad, but on a positive note I just had a physical from a new to BC family practice physician that just relocated her practice from central Alberta. Very pleasant lady with small hands

[1899b]

Originally Posted by does it ALL outdoors

I haven't read this whole thread but has anyone had to go to DynaLIFE for bloodwork or tests lately?

I had an appointment, and walked out an HOUR AND A HALF after my appointment time, she could care less about my appointment, what a DISASTER they are!

If your in Edmonton you have another choice for lab work.

There is a small lab in the north east emergency clinic that almost nobody knows about.

Had to get blood work recently and went there, they got me in 5 min EARLY and I was out of there before my appointment time, it was beautiful.

DynaLIFE is a train wreck and needs to go!

No complaints with the Dynalife lab here in Sherwood Park. Im in there on the regular due to self adminstering TRT which i get bloods done for 3 times a year. Was just there three months ago. In and out easy peasy.


As for ER wait times, i have a 20 year old and a 16 year old. When my kids were little, it was always at least a 3- 6 hour wait no matter what the issue was be it in Fort McMurray, Edson, Stony Plain or Sherwood Park. Didnt matter the town or what governing party was at the helm. It was always a long wait.

[flydude]

Originally Posted by does it ALL outdoors

I haven't read this whole thread but has anyone had to go to DynaLIFE for bloodwork or tests lately?

I had an appointment, and walked out an HOUR AND A HALF after my appointment time, she could care less about my appointment, what a DISASTER they are!

If your in Edmonton you have another choice for lab work.

There is a small lab in the north east emergency clinic that almost nobody knows about.

Had to get blood work recently and went there, they got me in 5 min EARLY and I was out of there before my appointment time, it was beautiful.

DynaLIFE is a train wreck and needs to go!

That's interesting you've had that issue when having an appointment. I am a Dynalife regular, about 10-15 time per year, and have never waited more than 20 minutes past an appointment time. Which location was it at?

[roper1]

Originally Posted by pittman

The reasons that health care is designed the way it is in Canada is outlined in the Canada Health Act. There are 5 big tenants in this act. The first being that it is publicly administered, and the third being that all insured people can receive the same quality of health care.

While I don't deny that a tiered system can improve access for some people, this generally comes to the detriment of others - specifically those who cannot pay. The other factor in this decision is that when looking at other health care systems, the most affordable systems tend to be ones with a single payer (the government). As the numbers of payers increase, so does the money spent on administration. Generally health care systems are best when administrative costs are lowest.

Another factor to consider is staffing shortages. Right now in Canada we really don't have many doctors or nurses to spare. Making parallel systems with this staffing issue in mind really does come at the expense of the public system. Generally the private systems pay employees more, and select for healthier patients so you can see why folks prefer that kind of employment. This leaves the public system understaffed with sicker patients.

There is plenty of room for improvement in the Canadian system for sure, but my argument would be to focus on improving what we already have in place.

Respectfully, this has been tried for so long, what would your solution be? Thanks

[britman101]

In BC the hospitals are bringing their housekeeping and food services back in house:

https://news.gov.bc.ca/releases/2021HLTH0157-001703

Privatization of those services obviously did not work.

[pittman]

Originally Posted by roper1

[/B]

Respectfully, this has been tried for so long, what would your solution be? Thanks

I would disagree. The last UCP government did nothing but fracture relationships with health care providers in the province. We're still reeling from the ramifications. Many folks left to neighbouring provinces or retired early.

The problem is that the government feels the need to continually meddle with something they don't understand. Take for example, Danielle's new plan to restructure AH. The last time AH was restructured (recall the amalgamation) it took years for the problems to get worked out. Depending on what she has in mind, this will likely be the same.

The list of work to do is endless. For example, primary care needs to be supported. Family physicians need to be recruited in droves, and their fee structure needs to be adjusted so that they can spend time with complicated patients. As it sits right now they have to churn through dozens of people per day just to pay their overhead and make a decent wage. Think quality not quantity. Better primary care keeps people out of the hospital. The hospital is expensive.

The big hospitals need work too. Everyone is working in silos with different budget constraints. This lends itself to departments losing sight of the bigger picture when patients have complex care needs. Sometimes a bit of overtime saves money in the long term. Additionally, the staff we have need to be taken care of. As it sits we're so short that most vacation requests are denied. How long would you work at one place if you couldn't get time off?

Looking at management, again there is room for improvement. Management isn't patient care so this is a good place to look to save money. That said, to say something this complex doesn't need management is absolutely nonsense. AHS is one of the largest organizations in Canada. Something like this needs to be run by people who know what they are doing. Why not recruit folks with extensive financial and business backgrounds to steer the ship? Yes these folks are expensive, but they certainly know more than the managers that we have now. Look up the folks sitting in managerial positions. They are generally physicians or nurses who have taken on these roles later in their career. While they might know something about how medicine works, their managerial backgrounds are all lacking.

Just a start.

Anyhow, the data for public vs private healthcare in terms of cost savings is not even a debate. The money spent on administration in a private system is at least 3x that of a publicly administered system. Measurable health outcomes are also better. You'd be surprised how much things cost. Families go bankrupt if an individual gets cancer, others can't afford their medications etc etc. Heck, even having a baby is expensive. One day most everyone finds out that it is truly a privilege to live in a country with publicly funded health care.

[pittman]

Originally Posted by britman101

In BC the hospitals are bringing their housekeeping and food services back in house:

https://news.gov.bc.ca/releases/2021HLTH0157-001703

Privatization of those services obviously did not work.

Yup - my guess is that'll happen here too.

While privatization is a motivator for competition, it also relies on profit. Somewhere in the equation someone is taking over the service to make money. So this profit comes from somewhere.

The other way to look at it is that it is just an expense. Strive for quality and efficiency with a publicly administered service, and save the taxpayers from having to shell out more for a companies profit.

[Sundancefisher]

Originally Posted by pittman

Yup - my guess is that'll happen here too.

While privatization is a motivator for competition, it also relies on profit. Somewhere in the equation someone is taking over the service to make money. So this profit comes from somewhere.

The other way to look at it is that it is just an expense. Strive for quality and efficiency with a publicly administered service, and save the taxpayers from having to shell out more for a companies profit.

I believe the question comes down to private business healthcare providers within our public healthcare system.

What is the best value for the tax payers.

Currently but likely not an exact list of private companies providing services within the public healthcare system includes…

Doctors
Radiology
Cleaning services
Food services
Contractors likely hired in the system
Private surgical clinics

What the average person doesn’t see is a complete breakdown of costs and benefits. If a private service costs the public system less… then it says there is a lot of wasted money in the public system.

How does this wasted money get cleaned up? Someone is benefiting from the waste so there is a lot of hidden road blocks and gate keepers.

Do the majority of doctors want to be government employees on a salary versus as a private business? Which system would be most efficient? I don’t have those answers.

[pittman]

Originally Posted by Sundancefisher

I believe the question comes down to private business healthcare providers within our public healthcare system.

What is the best value for the tax payers.

Currently but likely not an exact list of private companies providing services within the public healthcare system includes…

Doctors
Radiology
Cleaning services
Food services
Contractors likely hired in the system
Private surgical clinics

What the average person doesn’t see is a complete breakdown of costs and benefits. If a private service costs the public system less… then it says there is a lot of wasted money in the public system.

How does this wasted money get cleaned up? Someone is benefiting from the waste so there is a lot of hidden road blocks and gate keepers.

Do the majority of doctors want to be government employees on a salary versus as a private business? Which system would be most efficient? I don’t have those answers.

There are two models for physician payment in Alberta - salary or fee for service. While fee for service is most popular here though the salary model is gaining momentum with younger physicians. Generally, salaried physicians work fewer days in a year.

Generally the fee for service model is pretty good value for the taxpayer - you only pay the physician for work completed. It motivates physicians to get work done, though the structure has to be carefully thought out to motivate the right things. Every salary model I have seen has resulted in few patients being seen per unit time. I'm not sure if that leads to higher quality or not.

[roper1]

Originally Posted by pittman

I would disagree. The last UCP government did nothing but fracture relationships with health care providers in the province. We're still reeling from the ramifications. Many folks left to neighbouring provinces or retired early.

The problem is that the government feels the need to continually meddle with something they don't understand. Take for example, Danielle's new plan to restructure AH. The last time AH was restructured (recall the amalgamation) it took years for the problems to get worked out. Depending on what she has in mind, this will likely be the same.

The list of work to do is endless. For example, primary care needs to be supported. Family physicians need to be recruited in droves, and their fee structure needs to be adjusted so that they can spend time with complicated patients. As it sits right now they have to churn through dozens of people per day just to pay their overhead and make a decent wage. Think quality not quantity. Better primary care keeps people out of the hospital. The hospital is expensive.

The big hospitals need work too. Everyone is working in silos with different budget constraints. This lends itself to departments losing sight of the bigger picture when patients have complex care needs. Sometimes a bit of overtime saves money in the long term. Additionally, the staff we have need to be taken care of. As it sits we're so short that most vacation requests are denied. How long would you work at one place if you couldn't get time off?

Looking at management, again there is room for improvement. Management isn't patient care so this is a good place to look to save money. That said, to say something this complex doesn't need management is absolutely nonsense. AHS is one of the largest organizations in Canada. Something like this needs to be run by people who know what they are doing. Why not recruit folks with extensive financial and business backgrounds to steer the ship? Yes these folks are expensive, but they certainly know more than the managers that we have now. Look up the folks sitting in managerial positions. They are generally physicians or nurses who have taken on these roles later in their career. While they might know something about how medicine works, their managerial backgrounds are all lacking.

Just a start.

Anyhow, the data for public vs private healthcare in terms of cost savings is not even a debate. The money spent on administration in a private system is at least 3x that of a publicly administered system. Measurable health outcomes are also better. You'd be surprised how much things cost. Families go bankrupt if an individual gets cancer, others can't afford their medications etc etc. Heck, even having a baby is expensive. One day most everyone finds out that it is truly a privilege to live in a country with publicly funded health care.

Seems like almost every province in Canada has an issue. As far as cost goes, Coiloil in this very thread will will challenge your cost/return reward. You seem to be well-informed on Healthcare delivery, specifics would be appreciated. The Feds just committed an additional $46 billion. What are your thought on the .6 nurses shift ?

[Faststeel]

Originally Posted by Scott N

Canadians have been duped into believing how great our "free" healthcare system is, to the point that any discussion of privatizing / partially privatizing healthcare is sacrilegious. Unless it's changed recently, and one would assume that would be for the worse, Canada ranks #30 on the World Health Organization's list of health care systems. #30. You'd think that there would be some room for improvement, but Canadians are oblivious to the fact that our system is unsustainable, and health care services are already rationed. Importing a million new citizens every year is not going to help that, unless most of them are doctors and nurses. I would expect things to continue to decline, based on the financial geniuses that run the country / voters that continue to support said geniuses, for the foreseeable future.

I hope the original poster's mother received the help that she needed. The system does indeed suck, but this is not just an Alberta thing, it is a Canada wide issue.

Actually in most G7 countries poor health care is worldwide issue, England is especially pathetic

[densa44]

I can help a bit. The gov't cut the number of places for traing physicians in Alberta at both medical schools, I' think nursing schools too. By reducing supply you get higher costs and/or worse service.
The two main factors are: Aging baby boomers, my generation, and vastly improved medical treatments.
Thus more of my generation is living longer and more are requireing health care.
There is another issue close to my heart; lack of barrier free housing. Did you know if you can't climb 2 stairs in Alberta you are headed to an institution? These poor souls are now stuck in General hospitals, sometimes called, bed blockers, mom and dad, you get the idea. If there were houses these people could purchase experience has shown that they will leave the hospital and move to "self funded seniors housing" I couldn't find any in Calgary.
Ms Smith is hoping to attarct anethetists to Brooks, a 40 mbed hospital so surgery can be done there. Take your chances with that.

[barsik]

meanwhile, the government of Kanada pays 40 billion in interest every year to the bank of canada due to the debt that has reached almost 2.5 trillion dollars, most of that in less than the last 7 years. I wonder where that 40 billion dollars ends up.

[Mr Flyguy]

I don't know what everybody is bellyaching about. Yesterday got back from the Misericordia after a surgical procedure and overnight stay. All staff from the docs to the bed porters were friendly and helpful. Follow at home this morning with local nurse was similar.

It did appear however that some of the nursing staff at the Mis were putting in some pretty long shifts so yes, need more nurses.

[riden]

Originally Posted by densa44

I can help a bit. The gov't cut the number of places for traing physicians in Alberta at both medical schools, I' think nursing schools too. By reducing supply you get higher costs and/or worse service.
The two main factors are: Aging baby boomers, my generation, and vastly improved medical treatments.
.

No expert, but I have read that there is a shortage of residency spots in hospitals. For several years now there has been a surplus of medical school grads, who can't land a residency to finish their training. AS a result, most medical schools in Canada have reduced their numbers.

[jstubbs]

Originally Posted by Mr Flyguy

I don't know what everybody is bellyaching about. Yesterday got back from the Misericordia after a surgical procedure and overnight stay. All staff from the docs to the bed porters were friendly and helpful. Follow at home this morning with local nurse was similar.

It did appear however that some of the nursing staff at the Mis were putting in some pretty long shifts so yes, need more nurses.

Glad you had a good experience. Should have seen the nursing conditions at the Cross Cancer inpatient when mom was there this winter. Think I spoke to maybe 3 nurses in the two months that I visited there everyday that had worked there (or been graduated from nursing) for longer than a month. Staff turnover was insane and in the past four years they’ve lost 90% of their senior nursing staff because of asinine budget cuts, line changes, clueless/borderline abusive management, and overall complete disregard for their nurses. Credit to all the nurses who were trying their best and working their asses off but there’s no substitute for proper experience in that field and you need senior staff to help train and mentor the junior nurses.

Imagine working your ass off through a pandemic while everyone else was sitting at home watching netflix and then the government decides to fight on your pay and even have the gall to ask for retroactive repayment. Then a bunch of blue collar guys that only pretend to work hard complain endlessly how nurses and overpaid and cheating the system all because they heard some out of context fifth hand info from suspect sources about some nurses who did some questionable things. As if every job and industry doesn’t have a portion of workers who are scamming the system in every way possible.

Not sure how many other jobs you can graduate a four year degree program and instantly get hired on to work as many hours as you want for a starting wage of $39/hr. Within 5 years you’re at $45+/hr. Yet they can’t keep people in the profession. If it’s such a well paid easy job I don’t know why some of you guys don’t go get on the gravy train too??

[pittman]

Originally Posted by riden

No expert, but I have read that there is a shortage of residency spots in hospitals. For several years now there has been a surplus of medical school grads, who can't land a residency to finish their training. AS a result, most medical schools in Canada have reduced their numbers.

Medical school spots and residency spots are both publicly funded - this means the number of spots is directly related to funding by the government. To increase spots, you have to convince the government.

Medical schools across Canada have been increasing enrolment (Alberta too). We graduate north of 300 medical students per year in Alberta. I think each of out two schools gets 10 or so more spots this year too.

Residency spots (the second phase of doctor training, and a large part of the doctor workforce) have not kept up to demand. This has lead to a very tight ratio between graduates, and residency spots. The way that medical grads get matched to these residency spots is complicated, but the bottom line is that as the number of residency spots gets tighter, more grads don't get matched - these unmathed grads often have to take a year off and try again.

This lack of residency spots is also a problem for foreign trained medical grads, as they are competing for these same spots (for which there are few).

So, long story short - the big hang up in Canada these days is the number of residency positions. The reason we're so short everywhere is lack of work force planning. It'll take a while before things catch up.

So, long story short,

[pittman]

Originally Posted by jstubbs

Glad you had a good experience. Should have seen the nursing conditions at the Cross Cancer inpatient when mom was there this winter. Think I spoke to maybe 3 nurses in the two months that I visited there everyday that had worked there (or been graduated from nursing) for longer than a month. Staff turnover was insane and in the past four years they’ve lost 90% of their senior nursing staff because of asinine budget cuts, line changes, clueless/borderline abusive management, and overall complete disregard for their nurses. Credit to all the nurses who were trying their best and working their asses off but there’s no substitute for proper experience in that field and you need senior staff to help train and mentor the junior nurses.

Imagine working your ass off through a pandemic while everyone else was sitting at home watching netflix and then the government decides to fight on your pay and even have the gall to ask for retroactive repayment. Then a bunch of blue collar guys that only pretend to work hard complain endlessly how nurses and overpaid and cheating the system all because they heard some out of context fifth hand info from suspect sources about some nurses who did some questionable things. As if every job and industry doesn’t have a portion of workers who are scamming the system in every way possible.

Not sure how many other jobs you can graduate a four year degree program and instantly get hired on to work as many hours as you want for a starting wage of $39/hr. Within 5 years you’re at $45+/hr. Yet they can’t keep people in the profession. If it’s such a well paid easy job I don’t know why some of you guys don’t go get on the gravy train too??

Nursing is a hard job. Think long hours, shift work, emotionally draining etc. Turnover has been incredibly high as nurses get worked even harder.

The nursing union is pretty powerful, and has negotiated well in the past. Recent cuts have made it less desirable however. The reason you hear about all the OT that nurses get is because of OT is determined by time worked over and above the time commitment they were hired for, not for time over a certain quantity per week.

For example, if a nurse signs up for a 0.5 FTE job, the nurse will get scheduled for 0.5FTE of work. If this nurse chooses to work more (and since we're so short, that option is readily available) then they get paid OT.

One can see how this fee structure motivates a person to sign up for a small FTE commitment, and then pick up extra.

[jstubbs]

Originally Posted by pittman

Nursing is a hard job. Think long hours, shift work, emotionally draining etc. Turnover has been incredibly high as nurses get worked even harder.

The nursing union is pretty powerful, and has negotiated well in the past. Recent cuts have made it less desirable however. The reason you hear about all the OT that nurses get is because of OT is determined by time worked over and above the time commitment they were hired for, not for time over a certain quantity per week.

For example, if a nurse signs up for a 0.5 FTE job, the nurse will get scheduled for 0.5FTE of work. If this nurse chooses to work more (and since we're so short, that option is readily available) then they get paid OT.

One can see how this fee structure motivates a person to sign up for a small FTE commitment, and then pick up extra.

I don’t know why this is such a grievance for so many—the system realistically works pretty fairly.

A nurse who picks up an additional shift outside of their scheduled line is not automatically receiving OT pay unless they’re on a line that has them working enough that the extra shift would be above 48 total hours worked that week or it’s a shift on their X day.

A nurse can “bid” on a shift at OT rate, but if another nurse bids on the shift at straight time, the shift will go to that other nurse and be paid at straight time. Obviously, the shorter the notice staffing has to post and find someone for the shift, the higher the likelihood the only people willing to take the shift will be at OT rates. But they’re accepting work outside of their contractually obligated work schedule, and are under no obligation to have to work an extra shift unless there is an incentive (i.e. overtime pay). Absolutely nothing unfair about that for either the nurse or joe taxpayer.

As you’ve noted, the real issue with this system is when there are widespread shortages of nurses that cause lots of open shifts to be available and for those looking to pickup holding the power to bid at OT rates with a high likelihood of getting the shift pickup. But that’s not a nurse issue, or a nursing union issue, but a systemic issue with majority the blame laid upon our government and AHS for their abhorrent treatment of their nursing staff that has created this shortage. Once again, even without a dime of OT pay, it’s a well paid job that comes with a great benefits package (including the highly coveted defined benefit pension) yet every year droves of nurses leave the profession to take work doing really anything other than bedside. I wonder why?

As for 0.5, 0.6, 0.7, etc lines - these were needed because burnout rates are so unbelievably high among those who work full time 1.0 lines that they needed to figure out a way to retain staff. Spending 40+ hours a week getting berated by patients and their families, being in multiple life or death situations, cleaning up ****/****/vomit/blood, being treated like pondscum by management, switching endlessly from days to nights, and overall being the backbone of our healthcare system is freaking draining. I wouldn’t do bedside nursing if you paid me $80/hr.

So yeah. I can certainly see why some would rather opt to choose a smaller FTE and pickup shifts at OT rates. I sure as hell would too. But if the healthcare system wasn’t churning and burning nursing staff at expedient rates, there would be droves of nurses all bidding on shifts and likely majority of the short shifts being covered at straight time so the issue is moot.

But no, blame the nurses.

[AB2506]

Originally Posted by 3blade

Thank Ralph and the conservative old boys club. Doubled the population and cut healthcare. Worked out exactly as planned, make it all go to crap and sell it to the yanks.

The high rollers in boardrooms and the legislature don’t care about our families.

My pregnant wife had to sit in ER with a dangerous infection brewing for 7 hrs. Hope your mom pulls through. I hear ya, makes one angry as hell.

The system was screwed up before Ralph.

[AB2506]

Originally Posted by jstubbs

I don’t know why this is such a grievance for so many—the system realistically works pretty fairly.

A nurse who picks up an additional shift outside of their scheduled line is not automatically receiving OT pay unless they’re on a line that has them working enough that the extra shift would be above 48 total hours worked that week or it’s a shift on their X day.

A nurse can “bid” on a shift at OT rate, but if another nurse bids on the shift at straight time, the shift will go to that other nurse and be paid at straight time. Obviously, the shorter the notice staffing has to post and find someone for the shift, the higher the likelihood the only people willing to take the shift will be at OT rates. But they’re accepting work outside of their contractually obligated work schedule, and are under no obligation to have to work an extra shift unless there is an incentive (i.e. overtime pay). Absolutely nothing unfair about that for either the nurse or joe taxpayer.

As you’ve noted, the real issue with this system is when there are widespread shortages of nurses that cause lots of open shifts to be available and for those looking to pickup holding the power to bid at OT rates with a high likelihood of getting the shift pickup. But that’s not a nurse issue, or a nursing union issue, but a systemic issue with majority the blame laid upon our government and AHS for their abhorrent treatment of their nursing staff that has created this shortage. Once again, even without a dime of OT pay, it’s a well paid job that comes with a great benefits package (including the highly coveted defined benefit pension) yet every year droves of nurses leave the profession to take work doing really anything other than bedside. I wonder why?

As for 0.5, 0.6, 0.7, etc lines - these were needed because burnout rates are so unbelievably high among those who work full time 1.0 lines that they needed to figure out a way to retain staff. Spending 40+ hours a week getting berated by patients and their families, being in multiple life or death situations, cleaning up ****/****/vomit/blood, being treated like pondscum by management, switching endlessly from days to nights, and overall being the backbone of our healthcare system is freaking draining. I wouldn’t do bedside nursing if you paid me $80/hr.

So yeah. I can certainly see why some would rather opt to choose a smaller FTE and pickup shifts at OT rates. I sure as hell would too. But if the healthcare system wasn’t churning and burning nursing staff at expedient rates, there would be droves of nurses all bidding on shifts and likely majority of the short shifts being covered at straight time so the issue is moot.

But no, blame the nurses.

My daughter is a 0.8 (12hr shifts). Many of the extra shifts she picks up are at standard pay.

Staffing is a huge problem.

The province has tried to fix the system for 30 years with little or no success. It seems it is a Canada wide problem. We basically ration healthcare.

The ultimate solution is beyond me.

[pittman]

Originally Posted by jstubbs

I don’t know why this is such a grievance for so many—the system realistically works pretty fairly.

A nurse who picks up an additional shift outside of their scheduled line is not automatically receiving OT pay unless they’re on a line that has them working enough that the extra shift would be above 48 total hours worked that week or it’s a shift on their X day.

A nurse can “bid” on a shift at OT rate, but if another nurse bids on the shift at straight time, the shift will go to that other nurse and be paid at straight time. Obviously, the shorter the notice staffing has to post and find someone for the shift, the higher the likelihood the only people willing to take the shift will be at OT rates. But they’re accepting work outside of their contractually obligated work schedule, and are under no obligation to have to work an extra shift unless there is an incentive (i.e. overtime pay). Absolutely nothing unfair about that for either the nurse or joe taxpayer.

As you’ve noted, the real issue with this system is when there are widespread shortages of nurses that cause lots of open shifts to be available and for those looking to pickup holding the power to bid at OT rates with a high likelihood of getting the shift pickup. But that’s not a nurse issue, or a nursing union issue, but a systemic issue with majority the blame laid upon our government and AHS for their abhorrent treatment of their nursing staff that has created this shortage. Once again, even without a dime of OT pay, it’s a well paid job that comes with a great benefits package (including the highly coveted defined benefit pension) yet every year droves of nurses leave the profession to take work doing really anything other than bedside. I wonder why?

As for 0.5, 0.6, 0.7, etc lines - these were needed because burnout rates are so unbelievably high among those who work full time 1.0 lines that they needed to figure out a way to retain staff. Spending 40+ hours a week getting berated by patients and their families, being in multiple life or death situations, cleaning up ****/****/vomit/blood, being treated like pondscum by management, switching endlessly from days to nights, and overall being the backbone of our healthcare system is freaking draining. I wouldn’t do bedside nursing if you paid me $80/hr.

So yeah. I can certainly see why some would rather opt to choose a smaller FTE and pickup shifts at OT rates. I sure as hell would too. But if the healthcare system wasn’t churning and burning nursing staff at expedient rates, there would be droves of nurses all bidding on shifts and likely majority of the short shifts being covered at straight time so the issue is moot.

But no, blame the nurses.

The lower FTE also allows for more flexibility outside of work, or the opportunity to work in multiple different places if one is so inclined.

[FCLightning]

Originally Posted by AB2506

We basically ration healthcare.

The ultimate solution is beyond me.

The private system rations health care as well - but the rationing is based on ability to pay rather than immediacy of need.

Making a two-tier system in theory would remove some of the pressure from the publicly funded system and more people would receive the care they need sooner. However when the problem with the current system is not so much one of money, but rather a shortage of people to work, having a parallel private system will accomplish nothing - the same number of people can only do the same number of procedures regardless of who is paying for the work.

[elkhunter11]

I spent an hour in the Royal Alex Emergency waiting room today, and if you eliminated the drunks and drug addicts, you would eliminate at least half of the people waiting. These people certainly didn't make the staff's job any easier. And when a name is called, several people had left the waiting room to smoke. This all makes the long wait times a lot easier to understand.

[traderal]

Royal Alex in my experience is the worst. Getting bumped for surgery because someone got stabbed, long waits at triage, whole families showing up and having a loud gabfest for hours at said miscreants bedside, wrong meds being handed out, theft of clothing and personal items, nobody seemingly in charge on the floors, etc. We now specify to our doctors that we do not wish to have anything done there.

[elkhunter11]

Originally Posted by traderal

Royal Alex in my experience is the worst. Getting bumped for surgery because someone got stabbed, long waits at triage, whole families showing up and having a loud gabfest for hours at said miscreants bedside, wrong meds being handed out, theft of clothing and personal items, nobody seemingly in charge on the floors, etc. We now specify to our doctors that we do not wish to have anything done there.

If you have an eye emergency, the Royal Alex is the place to go,that is where the eye clinic is. The good thing, is that there is a separate waiting list for the eye room.

[Lefty-Canuck]

Originally Posted by elkhunter11

I spent an hour in the Royal Alex Emergency waiting room today, and if you eliminated the drunks and drug addicts, you would eliminate at least half of the people waiting. These people certainly didn't make the staff's job any easier. And when a name is called, several people had left the waiting room to smoke. This all makes the long wait times a lot easier to understand.

During covid they screened everyone who walked into the hospital, seeing as I work at various hospitals there was NO ONE LOITERING and no one there who did not need to be there, they need to have staff screening all entrants again as a new initiative. When Timmy stubs his toe he doesn’t need 8 family support members present.

LC