I don't remember the source, but I believe I listened to a podcast on an "uber for nurses" (not sure if it was this place), but they do all sorts of nasty things that really shaft the nurses. ISTR that the nurses when they get called in, have to be running a phone app that tracks them, and if they get stuck in traffic or lose cell signal, they get demerits. They pretty much do anything they can to give the nurses a demerit, and demerits cause your pay to go down.

So they're pretty much taking the existing terrible nursing environment in healthcare, and weaponizing it. Nurses already have too many patients and not enough CNAs, on top of 12 hour shifts, needing to do charting after those 12 hours. Healthcare squeezes nurses to the breaking point. Data point: my wife is a nurse.

Isn't this exactly what you'd expect from an Uber for (somethign)?

Garbage company, garbage culture, garbage business model.

Well yes, but more so it's how I expect a shitty and perversely structured industry that makes boatloads of money perpetuating a variety of huge barriers to entry to treat the employees who have the least barriers to entry protecting them.

Several of my family members were or have been nurses for decades and your wife’s experience mirrors the experiences I’ve seen from that distance.

And I’ve heard “it used to be so much worse”.

The American healthcare system is fairly well broken from virtually every angle.

I think I heard the same Podcast - not only do the Apps try and discover the minimum rate a Nurse might take, they’ll actively attempt to manipulate the circumstances of Nurses who were in a strong position so they too end up more dependent and exploitable.

this is the presentation that discusses this wage suppression for nurses.

https://pluralistic.net/2025/02/26/ursula-franklin/

Thanks. This is definitely the source I was referring to.

However, as it applies to my parent comment, the companies mentioned were: Shiftkey, Shiftmed and Carerev. I do not see ENSHYFT mentioned, so I stand corrected.

I’m interested, given the massive nursing shortages, why any nurses were using this service at all? Especially for higher levels, there’s no reason to mess with a shitty app that underpays you, when you should be able to walk into any provider’s office or facility and get hired almost immediately (and for Runs, you even have wide-ranging telehealth options).

This was my thought exactly. There is a giant nursing shortage. I know some nurses who are traveling nurses and they may bank, and they don't need any BS app. (Just want to emphasize, nursing is an incredibly difficult job at the moment, but there are also currently weird dynamics where traveling nurses can actually make a lot more than "stationary" nurses).

Thus, I'm led to believe that nurses using this app have to have some sort of difficulty finding jobs for other reasons, or they're just not informed about their options.

I imagine many of them are people who can't commit to full or even part-time jobs because of responsibilities like childcare or eldercare; their own physical or mental health issues; etc.

Or they have full time jobs already and aren’t generally interested in extra shifts, unless the price is right.

You can get paid more as a contractor than an employee.

Some may just want to pick up casual shifts without any obligation on top of their full-time work. This is kinda double dipping because your full time work is paying your benefits, so why work overtime at time and a half for them when you can get 2x+ somewhere else with + pay in lieu of benefits?

Big orgs don’t want to deal with 1000 different individual contractors (especially if it means taking potential misclassification of employee as a contractor) risk.

I think the bigger issue is the myth of nurse fungibility. A rando nurse unfamiliar with your setup/org is unlikely to be very productive.

This is abhorrent if true; truly evil behavior.

What's interesting is that broadly speaking, people acknowledge that negotiating with asymmetric information is immortal or wrong. Take the stock market for example, insider trading is illegal and you don't often hear calls to reverse these laws.

But when it comes to private markets and semi-private negotiations that same sentiment doesn't easily transfer. Does society benefit in some unique way for allowing asymmetries in labor negotiations, private markets like Uber, or B2C relations like Robinhood (1,2)?

1. https://www.sec.gov/newsroom/press-releases/2020-321 2. Note, Robinhood was fined not for front-runniny customers, just for falsely claiming customers received quality orders. I suspect theyve only stopped the latter behavior.

> broadly speaking, people acknowledge that negotiating with asymmetric information is immortal or wrong

I don't think that's true at all. Companies and individuals negotiate all the time with information the other party doesn't have. Insider trading is about fairness on public markets so every negotiating party of the same type has the same information, and is quite specific to that.

> What's interesting is that broadly speaking, people acknowledge that negotiating with asymmetric information is immortal or wrong. Take the stock market for example, insider trading is illegal and you don't often hear calls to reverse these laws.

Insider trading is not about fairness. It’s about theft. If you overhear someone in a public place talking about an upcoming merger, you can trade on it.

Yes... And why is theft bad?

> What's interesting is that broadly speaking, people acknowledge that negotiating with asymmetric information is immortal or wrong.

They do? I’m quite happy when I have more information than the party I am negotiating with.

Do you tell your customers all of the input costs of the product or service you sell? I doubt it.

Also, certain parties that trade in public markets have way more information than any retail investor could ever hope to have, hedge funds buy satellite imagery of parking lots, track oil tankers at sea, etc to gain an edge.

Insider trading rules are meant to prevent the public bagholding stocks from the management team having insider information that no other market participant could or should have, there are no rules against legally gathering or purchasing information on your own to gain an edge over other market participants.

Incentive wise you're probably a lot better off if your own broker is front running you than if a HFT desk at a liquidity provider firm is doing it since the broker is at least in a position to kick some of that back to you in the form of reduced fees or whatever.

Might as well get a pat on the head with your punch in the face if you're going to definitely get punched in the face either way.

I don't disagree with you, but wow that requires a bleak outlook.

That is why it should be mandatory for companies to publish the salary range for a role.

I agree with you. I'd go further and suggest that candidates should get anonymized information about applicants in the pool. Nothing like negotiating with yourself for a job...

It's definitely shady, but it's par for the course. Uber charges you more if you have more gift cards loaded, or just spend more on average in general. You charge what the market will bear.

You charge what the market will bear, not the individual.

No, it just hasn’t been possible to differentiate as well before.

One example is biscuit manufacturing, where it’s a fairly open secret that supermarket own brand biscuits are the same product as name brand, because it’s better to capture that segment at a lower margin than to lose it to competition.

Tech now makes it possible to target individuals rather than demographics, but there’s nothing inherently against the status quo in doing so.

Nothing against the status quo. Yes, let’s perpetuate our dystopian nightmare. Good plan.

The post you’re replying is an ‘is’ post, not an ‘ought’ post.

Didn’t say it was a good plan, just that unless you’ve got some brilliant replacement for late-stage capitalism, it’s a logical progression.

I have a side business and virtually every customer pays a different price, what you’re saying is simply not true. Airlines do it, hotels do it, I have different rates for my customers at my day job, etc.

And even if they pay the same price, they’ll have different costs.

I’ll gladly take all the free alcohol an airline will give me, but other people don’t at all!

I sell some stuff on eBay. If you appear untrustworthy, I’ll spend more for tracking/better tracking on your order so you’ll actually get your stuff faster/more reliably.

Oh, I'm not denying this is the way things are done. I just don't think it should be legal.

Price segmentation was more palatable a few decades ago, but technology has enabled us to push it to this absurd (to me) extreme where individuals get different prices at different times of the day.

It feels wrong to size up your customer and pick the highest price you think they'll pay.

Burger chains have at least gotten a start on differentiating their pricing - by raising prices dramatically across the board, and telling anyone who’s frugal or just broke that they can only get discounts (to bring prices slightly lower than today’s pricing, but still a lot more than before) if they use the app. Upper-class people don’t bother with it and pay full price, frugal people take the time to figure out the cheapest way to use one of the current “offers” to assemble a meal.

Upper class people don't bother with it because we all know those discounts are temporary but they'll never let go of the data they extract from those apps and will try to spam you

One can always use a fake email and login account. Upper class people don't bother because they don't eat at fast food chains as often enough as lower class people to warrant needing an app for each one; 99.9% don't give a shit about data collection, only people on HN and other technical fora do.

>One can always use a fake email and login account.

When you're using that fake email be sure to have a burner phone or public internet so they can't link it to your IP, also don't use your computer or any computer you've logged in on so that browser fingerprinting doesn't tag you, also turn off your GPS so they can't geo correlate you.

Of course the rich person is in the same boat, their geolocation will log that they went to Burger King, or their credit card company will snitch on them. Okay, fine, pay with cash, cover your phone in a tin foil faraday cage. Now you also will need to drive a 30 year old car to said establishment since the car manufacturer put a cellular modem and GPS in your car and sells the fact that you went to Burger King to the highest bidder.

That's all I can think of off the top of my head, I'm sure there are dozens of other ways people are tagged. At some level may as well either use the app or just not go.

Yep, that's why it's usually not worth it trying to pretend one has online privacy.

The market ensure (mostly) there is another individual.

Aren’t they just creating a market of 1?

"just" is doing a lot of heavy lifting here

Aren’t they creating a market of 1?

Perfect!

Pieces of shit. And then they assign you a score for each travel, as if you are really "carpooling" when in reality is a shitty taxi replacement (not that taxis are on a moral high ground, but the point still stands).

It's amazing that, on a cursory look, only 11 states make this practice illegal. The "AI scriptown" is growing.

Game theory transcends basic humanity.

You might be surprised to learn that they're not the only company to do so.

Not of companies. Of the people who choose to work for them (or, rather, choose not to stop working for them after they build these "features").

We don't need names, we need legislature, and we need to vote for people who will write it, as opposed to grifters who only seek to pad the pockets of billionaires.

These predators aren't scared of name and shame. Any publicity is good publicity (And if it actually gets bad, they'll sue the pants off you.). They are scared shitless of laws censuring their behavior. It's why they fight like mad to ensure that they aren't subject to them.

> These predators aren't scared of name and shame.

There are exceptions. See the ongoing kerfuffle over "DOGE" employee lists.

That seems like a terrible way to estimate nurse wages.

People have spouses.

People’s parents pay credit cards.

People with bad credit sometimes don’t care.

People have family money.

People with low debt can be desperate for work.

Does it even work?

At scale, the corner cases don't really matter. In aggregate, if it's decently well correlated and readily available, it's probably going to be used.

I can't find it now, but I believe LexisNexis or another large similar reporting/data agency had a product catalog of dozens of products that spit out values for ability to pay, disposable income monthly, annual income, etc.

It makes you feel awful thinking about the direction things are headed. Corporations approaching omniscient regarding all facts of our lives that are reasonably of value to them.

But I’d argue they aren’t corner cases.

Most people I know with bad credit aren’t desperate for money. At least not educated, highly paid ones like nurses.

Most just ignore their financial problems in the hope they go away.

Not to mention nurse demand outstrips supply, so they have options and can certainly turn down bad offers.

> Corporations approaching omniscient regarding all facts of our lives

People happily give away lot of info voluntarily, for example by paying with a card instead of cash.

Agreed. And it's not just those -- if you need to pay off debt, you're extra-incentivized to take the highest-paying job, as opposed to one that pays less but is e.g. closer to home, or has a more predictable schedule, or whatever.

The idea that you'd offer less seems... counterproductive to say the least.

It might not be about high pay, it might be about increasing the odds of a nurse dropped into a dysfunctional environment staying there and not bouncing on day 2 or week 2.

Proper data privacy laws would make this sort of thing nearly impossible

In America you can get (buy) someone's credit report without their permission?