Planning our future and outsourcing

Nurses General Nursing

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First it was manufacturing, then IT jobs and next it may be us, and so this post is my attempt to make us think about our futures and brainstorm and maybe think outside the box to come up with new ideas.

The US health care system is in shambles. We now lag behind 36 countries in overall health system performance ranging from infant mortality to adult mortality to life expectancy. The maternal death rate in NYC is over 20%. Smaller companies like Blue Ridge Paper Co in North Carolina that are essentially self insured for their 2000 employees is sending employees to India and Thailand for medical proceedures. Open Heart in New Delhi, India at the world class Apollo Hospital is $6500 plus airfare that can be found for as little as $700 if booked in advance. The cost in the US is an average of $60K. The patient/nurse ratio in India is 1 to 1 and they only employ RN's.

This is all new thinking, but what happens when a large company like General Motors or Citibank hops on this bandwagon? 350,000 Americans are now going out of the country for surgical proceedures. 44 million Americans are without healthcare insurance, and Congress has passed laws that you can no longer file bankruptcy to get rid of your medical expenses. 70% of medical expenses are incurred the last decade of life. The oldest of 77 million Babyboomers just turned 60.

So, if this trend continues, where does that leave us and what can we do to make ourselves more marketable? How do we redefine nursing employment? Obviously, there will still be a demand for emergency care and emergency surgery and chronic care to some extent. But what about caps on medicare spending for chronic care---then what will people do.

I wish I had a crystal ball, but alas I don't. I'm seeing more and more part-time and seasonal contract work in the paper. I'm seeing less and less "benefits" Will we first be outsourced to a nursing agency the way payroll services were outsourced----so we won't work for Healthy Hospital or Old Age Home, but rather ABC Nursing Agency. Will we all become contract labor? Will we bid jobs?

This will be a time of great turmoil and also great opportunities. I want to concentrate on the opportunities. What are your ideas??????

WOW is all I can say as a new nurse.--- I think it's unfair that jobs are outsourced (I think a certain percentage should have to stay in the USA) Ok- it may cost less to get procedures done in India but I know the cost of living is a lotttt cheaper. I would be fine with making $10 an hour as a nurse if a loaf of bread was 5 cents, gas was 20 cents a gallon and I could get a decent 2 bedroom apartment for less than $1,400 a month. I don't think it's merely greed on our parts as much as it is wanting to live a decent quality of life. I do believe; however, that our government is extremely corrupt & that the rich are getting richer and the middle class are getting poorer....... Our country is headed for destruction and it's starting with the HEAD and it is trickling down.

Specializes in Accepted...Master's Entry Program, 2008!.

Agreed, but what to DO about it? I feel we are mostly powerless. It's easy for people NOT in this country to say "Use your right to vote!" Yeah, but vote what? I've got choice A or B, I don't like either, so what am I to do? Pick the least corrupt one, correct?

If this country wasn't so disjointed and "every-man-for-himself", we could work together to fix this. But we can't, since we are all so disjointed.

You know, if no one bought gas because it was too expensive, guess what? Gas would be cheaper. But we, as a country, cannot manage that. "I don't care what you do, I HAVE TO GET TO WORK IN MY GAS GUZZLING CAR!!!!"

I think the responsibility falls on the common people to work together to fix this.

Specializes in sub acute, ALF. Currently in RN school.
For all the reasons in your post, this is why I've ruled out the ADN/BSN programs. I've decided to pursue only a Masters. If I don't get in, so be it. Anything less is asking for trouble in the near future. It happened in IT, I won't let it happen again.

Hmmm...well, if they start requiring MSN, I am sure there will be a lot less people going into nursing, and I my friend, unless someone else is willing to pay for it, will become a cop. If one is going to put so much money/time into school in order to practice as a nurse, why not just become an MD? I have nothing against education, but it does cost a lot of money and time. I think if under-educated nurses are the problem, then the government should start paying for us to go back to school.

Also...Things such as a 20% matenal mortality rate...is this due to medical errors, or other things such as pre-eclampsia? One of the reasons I think healthcare is so expensive has something to do with how poorly we as Americans take care of ourselves. Look at places such as India, or China. Are two-thirds of their population obese as well? I dont think so. Americans are lazy and too quick to put chips in their mouths than go for a run. Americans are fat and lazy. More sick, fat people with clogged arteries requires more money required by ins companies which equals higher insurance costs.

So my biggest concern is repeating this mess. Right now nursing is the hot job. But what happens in 10 or 15 years when this mass of baby boomers starts dying? When the boom is gone? Where are all the nurses going to go?

maybe im in the wrong area but i dont see trouble ahead with all the new grads coming in because as fast as they come in mmost leave as quick as they came. they arent aallowed to get experience and they fall on trouble and get fired or get frustrated and leave. as well i see many many experienced nurses getting out due to the crap - leaving a lot of new grads without the experienced nurse to help them.

As a side note, they are closing our VA hospital here. In Chicago. As you can imagine, it's an extremely busy hospital. They claim there is not enough funding from the Fed government to keep it open. Ridiculous and filled with lies. Perhaps a few less pork barrel projects and a few more dollars to the VA?

I have no idea what these poor soldiers, who were promised a lifetime of care, are going to do. It's obscene....

you are kidding - there arent many as it is - if my son who is a vet gets sick we already have to drive at least an hour and half or more to get to the va clinic let alone a hospital................... i am in wisconsin. this si disturbing.......................

Interesting that you talked about medical supplies and products. I kept ordering IBU the other day from the pharmacy and couldn't get any and we were out. I called and the Pharmacist told me they were having trouble getting it. So what's up???? Drugs like Tylenol and Advil are no longer made in the good old USA. Outsourced because it is cheaper. I don't know how true this is as I have not looked into it further, but don't have reason to believe he would lie.

maybe they are getting it cheaper but it boilsdown to so they can make more money - thats why they throw a fit if one gets meds from say cananda where its much cheaper - they loose money -

anyone that has a pet can attest - go get the SAME antibiotics or xray or etc - for your dog that you would your kid and see the price difference- ive often half joked with my vet that hey my kids are animals cant i bring em here lol. they dont get the HUGE price difference either excpet that its all about the money....................

Some more thought. Went on the Bureau of Labor Statistics that the Govt puts out. For RN's the number of nurses leaving the occupation from ages 60-64 is nearly 60% of the number of nurses working in the 55-59 age bracket. Not surprising that after age 59, we find the work too physically demanding.

But, what if there is no Social Security, no retirement benefits, no way to quit working for many of us? I could not live on the proposed Social Security wage of $800 that I might get at age 62 and my full retirement age is now 67.

Some more info.

There are approx 2,500,000 RN's. Avg pay is $27.35 hr. 1,400,000 approx work in hospitals.

States with the highest concentration and largest percent of state employment are: Mass. (avg $32), S. Dakota (avg $23), MS (avg $23), W. Virg. (avg $23), and Maine (avg $25)

Top paying states: CA(avg $34), Maryland (avg $32), Mass (avg $32), Hawaii (avg $32), N. Jersey (avg $30)

There are approx 725,000 LPN/LVN's Avg pay is $17.41. The number employed in Nursing Hms and Hospitals is about even.

States with the highest concentration and largest percent of state employment are: Arkansas, LA, W. Virg, OK, MS (salaries avg $13.50)

Top paying states: Conn, D. C., N Jersey, Mass, RI (sal avg $22)

APN/NP. There are approx 58,000. Avg wage $42.13 hr. Most all work in Hospitals and Dr Offices.

States with highest concentration: MO (avg $43) RI (avg $38) IL (avg $18) AZ (avg $63) ID (avg $27)

Highest paying states: MT (avg $85) AR (avg $78) NV (avg $76) SC (avg $70) W. Virg (avg $67)

In the avg's above I have rounded to the nearest $$ for simplicity.

Best Metro area to work for an RN: San-Jose/Sunnyvale/Santa Clara, CA with avg of $42.28 hr.

Best Metro area for LPN/LVN: San Francisco/San Mateo/Redwood City, CA with avg of $25.05

Best place for NP/APN: Clarksville, TN/KY with an avg of $94 hr. Close behind is Kingsport/Bristol TN/VA and Prescott, AZ with $93 hr.

In doing all this, I have to admit that living in the Hot Springs, AR area and it being one of the worst places for LPN's, this probably gives me a different paradigm of the future. But, a lot of the nursing "shortage" has to do with older nurses leaving the profession in their 50's and baby boomers getting socialized medicine called Medicare. I don't think the boomers can afford to retire. They will work till they drop and there won't be much money for medical care for them. Lots of people will be hoping they drop soon.

damn!! i am in the wrong area- i am not making much more than an "average" LPN - i am an RN................. wonder where they get their averages from - lol i know its not in my area hahhaa

I'm not really sure what this means. You mean to say with all this disillusion, the population (of German) found a strong leader (in Hitler) and blindly followed him, despite the horrors for which he was responsible?

So are you saying a horrible person could come along to lead the country (George W.) and we would blindly follow him into a disastrous reign of terror?

I don't think George W. is the same as Hitler, but I'd like to know why there is a war in Iraq that the majority of the country DOES NOT SUPPORT. How does this happen, in a democracy?

i guess its where you live that you get your opinions on wether the majority supports or doesnt - in my area - we are mostly supportive of this war and feel the majority of teh country does support it ( from what we hear from relatives in others areas of the US )- as for bush - well - he is out in a few anyhow- and i dont think its him we need to worry about - its the ones who will come in after raising the taxes back up and screwing americans of their monies.

People complain about spending money on the war in Iraq, but have no problem w/ the millions if not billions of dollars spent on the useless 'war on drugs' that has cost countless lives. It hasn't worked, it will never work, and it's costing a fortune to keep trying to treat something as a crime that should be treated as an addiction problem or a vice. If we must spend a huge fortune on fighting drug abuse, find a method that works and quit wasting money. That's dollars that could have gone to treatment programs or healthcare, for sure.

I'm wondering also about infant mortality rate. Are they including high risk mothers? Do we in the US have a higher percentage of women who are high risk to begin with trying to have babies when maybe they shouldn't? Do we have a higher rate of fertility treatments resulting in multiple births? I'd be interested to know.

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