“Not what we signed up for”: Nurse shortages, physician scarcity, and time for collective bargaining?

The amount of distress and disengagement among many nurses and physicians has reached concerning levels in recent years. The result has been acute nurse shortages, significant increases in travel nursing, more physicians working fewer hours and retiring early, and urgent calls for change and reform. This analysis surveys many of the leading systemic contributors to nurse and physician demoralization. As the healthcare sector continues to experience more consolidation and increased investment by private equity and other corporate interests, physicians are increasingly becoming employees with similar forms of employment arrangements and pressures that nurses have had for decades. They are also becoming employees of the same larger health systems, hospitals, and corporate employers. These trends are leading to a convergence in the kind and intensity of pressures and problems that nurses and physicians face. As more medical residents and fellows increasingly turn to unionization and as growing numbers of nurses have gone on strike, both professions should consider the potential benefits of joining forces for the purposes of maintaining the autonomy they have left and to push for better conditions both for themselves and the patients for whom they care. 摘要 近年来，许多护士和医生的工作忧虑和脱离工作程度已达到令人担忧的水平。结果则是，护士严重短缺、旅行护理大幅增加、更多的医生将工作时间缩短并提前退休，这迫切需要变革和改革。以下分析调查了造成护士和医生士气低落的许多主要系统性因素。随着医疗保健行业继续经历更多的整合以及私募股权和其他企业利益对该行业增加投资，医生越来越多地成为雇员，其处境与护士几十年来面临的就业安排和压力相类似。他们也正在成为更大的卫生系统、医院和企业雇主的雇员。这些趋势导致护士和医生面临的压力和问题在种类和强度上趋于一致。随着越来越多的住院医师和研究员日益转向工会，以及越来越多的护士参与罢工，这两个职业都应该考量联合起来的价值，以维持其留下的自主权，并为自身及其所照顾的病人争取更好的条件。 Resumen La cantidad de angustia y desconexión entre muchas enfermeras y médicos ha alcanzado niveles preocupantes en los últimos años. El resultado ha sido una aguda escasez de enfermeras, aumentos significativos en la enfermería itinerante, más médicos trabajando menos horas y jubilándose anticipadamente, y llamadas urgentes de cambio y reforma. El siguiente análisis examina muchos de los principales contribuyentes sistémicos a la desmoralización de enfermeras y médicos. A medida que el sector de la atención de la salud continúa experimentando una mayor consolidación y una mayor inversión por parte de capital privado y otros intereses corporativos, los médicos se convierten cada vez más en empleados con formas similares de arreglos laborales y presiones que las enfermeras han tenido durante décadas. También se están convirtiendo en empleados de los mismos sistemas de salud, hospitale