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TX Bans Local Nurses from Quitting to Work FEMA Crisis Contracts in State (nurse.org)
88 points by SQL2219 6 days ago | hide | past | favorite | 82 comments





According to Indeed, the average wage for an RN in Texas is $35.82. The new contracts pay $100/hr and $150/hr for overtime.

According to the staffing agency you have to have not been employed by a hospital in Texas for the last 30 days. for an almost 3x wage bump I'd be shocked if some nurses didn't decide to sit on the sidelines for a month.


Austin based Texas travel RN here- flying out Friday for a 13 week contract in a tropical locale. Compensation is:

  -60 hours a week guaranteed (even if sent home because not needed, get paid)

  -Hourly (<40 hr): $95.00/hr

  -OT: $177.00/hr

  -Untaxed weekly stipends: $1,785

  -$500 relocation + $500 for doing some online training modules

  -All holidays at OT rate, callback at OT rate with minimum 2 hours

  -$9,125/wk minimum gross
I'm told that more overtime will almost certainly be available should I care to pick up (~$2100 per 12 hr shift). I have an associates in nursing and 2 years of work experience in the last 3 years.

Happy to answer any questions as I know this sector is pretty outside of the normal HN discourse and there's been some interesting employment trends since the pandemic began.


How much training do you need to qualify for this position? In Europe nurses typically study for 3 or 4 years, and then you are lucky to get much over minimum wage... In Western Europe, €30k/year would be a good salary for a nurse.

2.5 years or 5 semesters at a community college costing 0-10k is the fastest route from scratch and the one I took. If someone already has a bachelor's (4 year degree) they can take an accelerated nursing bachelor's program for 30-60k which can take as little as 12 months. 1 year of work experience post graduation is the minimum to travel.

EU salaries seem to generally be lower than those in the US, but with healthcare the difference is extreme with Switzerland being the only exception I'm personally aware of.


Or quit, work a traveling nurse contract out of state for a month, and then come back on contract.

A nurse friend quit the VA and is making $10k/week traveling.


My brother in law is a traveling nurse, he has shown me the 10k/week jobs in Alaska but the others seem to be 4-6k

Wages are increasing rapidly as everyone is outbidding each other for the very limited number of travel nurses in a labor market that suddenly has a large amount of new vacancies.

How is this sustainable? Is the shortage of nurses a temporary, short-term issue or are there structural problems in the market? If there is a longer-term problem, how will it affect healthcare costs and the quality of patient care?

While I generally understand the value of travel nurses and the role they have historically played in the market, if I was a healthcare consumer in the US, I'd be pretty disconcerted if I knew that the healthcare systems I relied on were so desperate for nurses that they were offering travel nurses $10,000/week.


Answer - it's NOT sustainable. But then again neither is US healthcare costs in general... They'll continue to march upwards and onwards until the entire country finally goes bankrupt and then (and ONLY THEN) will real change happen. Covid (and health care staff covid burnout) has just accelerated this issue... Welcome to American healthcare - most expensive healthcare in the world for the 18th best ranked system....

Yes, it seems like the US is heading to a breaking point.

That said, I think ranking healthcare is difficult. I'm an expat who has used health systems in a number of different countries. The country I'm in now for example (Taiwan) has a very well-regarded single payer system. On some ranking lists, it even tops the US.

I've found Taiwan's system works really well for most basic needs and is very cheap by American standards. Through the national healthcare system (NHI), I can see a specialist of my choosing at a hospital for around $20. That includes the appointment and any prescriptions or blood tests ordered. My monthly contribution to the system is high by local standards (it's in the hundreds of dollars a month) because I have a higher salary and am self-employed.

In terms of care, if you have a complex health issue, I haven't been able to match the specialist care available in the US. It's not even close. But yes, specialist care in the US is expensive and therefore not available to many people.


Texas has 9,000 surplus ICU patients due to COVID-19 [0] (not total patients, not cases, ICU patients). This is, predictably, causing a nursing shortage. In addition, nurses are resigning due to no effective public health measures to stop the spread -- half the state is unvaccinated, masks are not worn and the mandate is not enforced (by personal experience). As a bonus, some nurses are resigning because they themselves refuse the addition of the COVID-19 vaccination to the list of required nursing vaccinations.

While there are absolutely structural issues, there were the same structural issues two years ago -- this is an acute crisis due to the amount of new "healthcare consumers".

0. https://www.texastribune.org/2021/08/10/coronavirus-texas-ho...


I'll gladly take $4k per week.

> I'd be shocked if some nurses didn't decide to sit on the sidelines for a month.

Texas residents are banned from the new contracts.

Sitting on the side sounds like roulette... presumably those who are mobile will leave the state for other lucrative contracts, and the rest will work "within the system" (probably wishing for a stronger union while they campaign for a slice of the pie).


I'm no healthcare forecaster, but if the pay for new work is currently 3x and the state isn't doing much to improve conditions, in 30 days there's likely to still be a lot of demand for new work.

If I were a nurse, I think I'd have a hard time with sense of duty and sitting out, so a one month traveling job in another state (if possible, one that's doing better at vaccination) for a few weeks would feel better than sitting around, but at the same time, when the government incentives say to sit around for 30 days if you want to get paid more, who am I to not follow incentives.


Some context… due to nursing shortages, many places are giving great bonuses and pay rates to new people and temporary help. Those who stay aren’t being compensated the same. This is leading to a lot of people changing jobs. Sometimes to work down the street. There is far more demand for nurses than there is supply.

Isn't it how free markets work ?

It’s funny how selective free market thinkers can be on these things.

In general that's how free markets work, but medicine is definitely not a free market and FEMA isn't a customer.

As long as “free” means you can’t partake because you already work in the state.

Not in Texas!

Not a free market. Regulatory capture allows the nursing industry to ensure that there will always be a shortage, to allow their members to line their pockets.

Sounds like software developer markets (and others) right now.

nursing wage arbitrage.

I thought Texas was all about individual choice / responsibility. /s.

Now government overreach, apparently.

[flagged]


Last I checked, Texas gets back about 92 cents for every dollar it sends to the Federal level, so even if the state "is about getting as much federal money as possible", Texas loses money to the Federal government.

I say that as someone that generally finds the state reprehensible, but facts are facts.


The majority of Red States don’t.

The majority of red states are welfare states. The majority of blue states are too. There are only 11 states that pay for All federal expenditures. What is even more interesting is that internal to the red states, their blue areas pay almost all the state income taxes, and while having a higher population get less votes for state officials. Because once those people are in power, they commit election fraud in every election from that point on. looking at pictures of the district lines in red states is hilarious.

Cant believe unsubstantial lies on election fraud are now in HN also. I demand sources.

https://en.wikipedia.org/wiki/Gerrymandering_in_the_United_S...

texas makes the top 5 twice. but don't take my word for it. take a look at a picture. https://cdn.statcdn.com/Infographic/images/normal/21313.jpeg


Gerrymandering is obviously reprehensible and should be abolished (as should the system by which politicians get a say in drawing districts). That being said, it is a stretch to say politicians are committing "election fraud" because of gerrymandering. The process by which districts are drawn is sadly legal.

The supreme court cast of Davis v. Bandemer, while establishing that partisan gerrymandering violates the Equal Protection Clause and is a justiciable matter, it failed to agree on a clear standard for the judicial review of the class of claims of a political nature to which such cases belong. Thus, that supreme court case effectively has no teeth and the partisan system by which we draw districts currently is sadly illegal.

Thus, it is incorrect to say politicians are committing election fraud through gerrymandering.


miller v johnson would be a case you should look up, from 1995, which made gerrymandering illegal. so it is absolutely correct to state they are committing election fraud, if they are using a federally illegal action to get elected.

cases of suspected gerrymandering are taken to court, often lost by the election fraudsters, and districts are then more fairly withdrawn. this does not stop the gop, and to a smaller extent the libs, from continually doing it. the only penalty for doing it, is they lose the election they would have lost without the fraud. there is no downside to trying.

the process by which districts are drawn is absolutely not legal if gerrymandering is used.

here's the issue with places like texas: no one is suing to redraw the lines, because the population is of low iq, of high anger, and easily manipulated to actually support this illegal action.

>failed to agree on a clear standard for the judicial review

which has nothing to do with making something legal or not. gerrymandering is illegal. the standard for judicial review is left open, and up to the judge in each case

>the partisan system by which we draw districts currently is sadly illegal. >it is a stretch to say politicians are committing "election fraud" because of gerrymandering

it's a stretch to say people getting elected using an illegal process are committing election fraud. gotcha. you're very good at stretching. mental gymnast?


I think the government with their gerrymandering redistricting are the one committing the most obvious of election frauds. However, the reporting on gerrymandering depnds on the source of information on if it exists or not. Just a quick look at a map of the Texas districts should be evidence enough.

It's been getting diluted by the Californian diaspora. Also, I wouldn't put it passed the People running things who brought us the ERCOT disaster to also have managed to make a time bomb out of this. The medical infra down here is garbage compared to the rest of the country.

Interestingly though, it'd be Texan as hell to make the most of them Fedbux. Tell you what.


> The medical infra down here is garbage compared to the rest of the country.

My experience in this extremely large state is limited, but I know that the medical infrastructure in Houston is the best in the world.

> Houston’s Texas Medical Center is the world’s largest medical complex by several measures: number of hospitals, number of physicians, square footage and patient volume.

> Scientists at TMC-affiliated institutions, most notably Baylor College of Medicine, Houston Methodist, and MD Anderson are advancing life science breakthroughs across dozens of research centers and more than 300 research laboratories.

And that's just the Texas Medical Center.

https://www.houston.org/houston-data/health-care-houston


Are you high? This is all Abbott. California immigration has nothing to do with the BS we're going through. Governor death only cares about free enterprise when it's in support of religious right wing ideologies and will gladly stifle businesses that don't follow his perverted version of conservatism. He's a trump thumper with eyes on the white house and thinks personal choice is not something to afforded to the left, the center or the moderate right.

You know, I expect we’re both going to get downvoted in this thread, but I love that you called him “Governor Death.” What he’s doing is mind-boggling.

I gladly accept the -1. I've been in Texas for a while. I don't plan to stay. It isn't safe or sane here. Between gerrymandering away people of color, preventing businesses from mandating masks to promote public safety and taking away women's rights, that pice of sh*t seems intent on making this place incompatible with non god testing white men and the women who blindly accept their station in that life.

(I can't take credit for the nickname. I think I picked it up from some ATX native DevOps folks.)


>>“This surge is nothing like anything we’ve ever seen,” the THA said. “Hospitals are doing everything in their power to figure this out. Staffing is a critical issue and this spike is unsustainable without help. Many hospitals have already idled non-essential services and are offering bonuses and incentive pay just to keep staff.”

THA is Texas Hospital Association. It is kind of absurd reading this because the nation as a whole has been short on nurses for years and its been well forecasted as a problem for some time. Add on top of it a pandemic that is treated as a political problem, at this point a very clear problem with burnout and working conditions, and this little piece of fluff just becomes absurd.


Why would you bother planning ahead when you can just have the government change the rules of the game after you sit on your ass and pocket the savings for a year.

Isn't the government supposed to be the one preventing anticompetitive behavior?

“Small government”

Like not allowing Tesla to sell cars without going through a money grubbing annoying dealership.

Or legal marijuana.

Or selling alcohol on Sundays until afternoon.

Or terminating a pregnancy due to rape.

Small federal government. For some reason (1), small State government seems to be a entirely different concept.

(1)I'm guessing the bribe money is better that way


As a person who has lived in many red states, this is generally how it is for some reason. Many people here actually get mad when I point it out, but after giving half a dozen good examples it's hard for them to deny it.

FTR I'm not taking a position on small vs. big government, I'm just sensitive to and OCD about pointing out hypocrisy when I see it.


Or people simply prefer government that's closer to them.

While I think that is definitely true, states like Florida have forced local school districts on certain issues recently.

So it is not even consistent on that level.


Given how little Texas legislators get paid, I don't think you can make a living as one without supplementing your income with them. The cashier at Chick-Fil-A takes home more than you do.

I was thinking "Liberty." With vaccine mandates banned, I don't expect out-of-state nurses to clamor for this opportunity...

Lot of fired nurses around the country looking for work…

>99% of nursing jobs survived, though

And by lots, you mean 'lots' of nurses that complained about mandates, stalled until the last minute before turning their papers in, but when push came to shove, got vaccinated.

The police here are doing the same. I was hoping that, as reported frequently and loudly in the news, ~1/3rd of the department would get fired over the mandate, but as the deadline looms, it doesn't look like more than a handful will be.

... Also, because they'd be working for the federal government, they wouldn't be allowed to work those FEMA jobs without proof of vaccination.


I would point out that this article is from August 2021, which is not that long ago, but in the realm of COVID news, is actually significant.

Where is it the government's purview to say that a person can or cannot work somewhere? If the employer says they have the skills required to fulfill the position, where does the gov't come into play?

Well Reagan breaking the air traffic controllers union in 1981 because it was “a peril to safety” is a famous example of the government saying when and where you have to work

https://en.m.wikipedia.org/wiki/Professional_Air_Traffic_Con...


It was just as moronic then as it is now. Also, I don't believe these are even close to being the same. ATC works for FAA which is a gov't organization. Healthcare, as we all know in the US, is not a gov't organization. Gov't telling private citizens which private companies they can/cannot work for is asinine.

Incredible how quickly legislation can be enacted when it involves limiting workers options and opportunities.

My girlfriend got an associates degree last year in the hope of going to nursing school. However, she was actively dissuaded from even applying. It seems that competition for spots is so fierce that students with straight A’s may not get into the programs in the area. Some students retake critical classes three or four times to get enough “points” to compete.

So the shortage is entirely caused by academia and industry. Thank you, regulatory capture. They don’t want more nurses.


Awful title.

They're saying stimulus money must be used to secure out of state hires because they don't have enough nurses in state.

Hiring from the existing pool doesn't create a net improvement on the total nurses in state so they're saying you can't be hired with this money if you currently or recently worked for hospitals in state.

Nothing to do with banning quitting.


The article does mention that. Also mentions that nurses are significantly underpaid and quitting in droves. Raising pay to compensate the existing nurses would reduce this churn, but they'd rather keep local wages down and let non-resident nurses get the federal funding.

> Nothing to do with banning quitting.

You're not supposed to cut the sentence in half!

You can quit in general, but not to move to these jobs. The full action of "quit X to get job Y" is banned.


It might be reasonable to say the state stimulus money must be used to import nurses, but using the federal stimulus money to raid nurses from the other states seems morally dubious.

For the "live free" state they sure do take away a lot of freedoms.

That's New Hampshire. Common mistake.

Texas' state motto is "Friendship".

In Texas, Friends are people there when you need them, and politely distant, minding their own business when you don't.

Whom "you need" is referring to there is a perennial topic of conversation, and is generally a reliable seed of spirited dialectic.


Can you provide sources that support your position?

Texas keeps trying to ban abortion every which way it can. It is also trying to make voting more difficult instead of more convenient. This has been all over the news in the past year; sources aren't needed to support well-known facts.

I'm sorry, but I'm going to need more than anecdata.

a search engine is your friend especially for something as easy to find like this. save your requests for someone to provide links for the much more difficult to locate (much more supsect).


I'm so confused, I really thought Texas had at-will employment?

A lot of this "shortage" can be attributed to the firing of nurses who refuse the vaccine, which will probably only increase in the next few months.

>99% of nursing jobs survived the mandates, though

Can you provide sources that support your position?

1,400 workers cut loose from Northwell Health https://www.msn.com/en-us/news/us/northwell-health-cuts-2-25...

How exactly do you ban someone from quitting their job? Like, if they don't want to do it anymore, how do you prevent them from just not showing up, or showing up and sitting around and refusing to do anything work related?

Also, isn't a job you're not allowed to quit basically a form of slave labor?


If you read the article, what's banned is working FEMA contracts if you recently (in the last 30 days) quit from a Texas hospital, or are a Texas resident. Nobody is literally banned from quitting.

In defense of the person you replied to, it's so littered with acronyms and things I've never heard of (I'm not from the US) I was only 80% sure I understood it correctly.

It's clearly about banning them from taking up specific new jobs if they already work(ed) in Texas, so they don't have a motivation to quit an existing to job to switch to those, not literally banning them from quitting.

That's the "libertarian"-influenced Republican government in Texas at work. Small government... small enough to fit into your bedroom, your doctor's office, and your workplace.



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