CONTINUED IN WHAT IS THE MAJOR REASON Why are they all leaving? - page 9
What conditions would cause so many nurses to leave? Our ER has been losing friends fast. Why is there such a large turnover in nursing? I'm going to school, yet I talk to many RN's who are looking... Read More
Nov 16, '06Quote from mariedoreenwe have lost quite a few new grads quit due to lack of orientationand slammed with what we put up with - thats in the last month - after we lost many of our "old time" nurses who got out just for these resaons.I have had people tell me this too and it sounds nice in theory... you know, the patient's not dying... take a break.
Yeah okay, last night I had no patients on the verge of death BUT I had two who were getting blood transfusions, two who needed extensive dressing changes, several who were painful, lots of scheduled meds to give, orders to note off and other tasks to attend to. I did not stop and sit down until the final hour of my shift and then only to chart quickly for 15 minutes before hitting the floor again. There literally was no time. Telling me to take time doesn't solve the problem. We're too loaded down. Period. And a person can only take so much of that before they start questioning "Is this the kind of job I want for the rest of my life?" Funny, I just started another thread (before seeing this one) about being a new grad and wanting out of hospital nursing...
Nov 16, '06why are so many leaving? well, i love nursing. does that make me crazy, probably. it is hard, long hours, mandatory overtime, mandatory holidays, weekends, call time, stress: you could potentially kill some one, and tell me why we are expected to never get sick, hello we work with sick people. yes, i'd like to think i'm wonderwoman, but alas i am not. many people just cant hang. many people thought there'd be more money or maybe more gratitude, either way they were wrong. nursing is what it is, it alway has been. no, it's not for everyone. maybe they just need to find their niche, there are so many opportunities in nursing. before you give up try something elese, so you hate floor nursing? (me too) try research, teaching, fertility clinics, plastic surgery clinics, peds, ob, case management, legal consulting, forensics, there are so many things to try.
i dont know why there is such a mass exit? there always has been there always will be. it's not new and not likely to change unless the pay, working conditions and benefits suddenly change.
Nov 16, '06Quote from augigifor one thing - in america - at least most places - do not have nurse patient ratios- they do not go by aquity of resident care but only the number of residents there- so a 90 bed facility that they say nneeds 3 nurses and 7 cnas really needs at least 4 nurses if not more and 9 cnas if notmore can get away with the low staffing..I don't understand this at all. Perhaps we are lucky in Australia, but having breaks is mandated by law. People cover your breaks. You get a 10 minute teabreak and 30 min lunchbreak you HAVE to take. I don't understand how people can do an 8 or 10 hour shift without getting to the bathroom! Then again, we have mandated nurse-patient ratios, including med-surg wards, so perhaps as I said we are just lucky. There is no way I'd work in that situation.
Nov 16, '06Quote from mamasonHAHAHAHAH phew - sorry had to laugh - nextshift doing it? yeah - i can go away for 2 days and still have to finish the paperwpork from admit i started 2 days ago - all the shifts are as bad as the next on staffing and even though days have powers that be there all day that are rns do you think any of thoise powers that be will chip in and help? NO. nursing is like chasing your tail an never being able to catch it.Hummm......I always took my breaks. Guess I was lucky and other staff would cover my pts for the time being. Of course, we ate on the floor in the breakroom should an emergancy arise we would all be there to help. There were some times that I didn't get a lunch and I charged the hospital for it. Manager didn't like it and I explained to her that if I was expected to take report on new admissions and get them into bed while on my lunch break, then, they will pay me for my time. It was mandated that we were allowed an uninterupted 30 minute lunch. I pointed that one out to her in the employee handbook. She never brought the subject up with me again and I DID get paid for working through my lunch. I realize that sometimes the units can be crazy and we may have to eat on the run, but, take the time to pee, and to grab a bite to eat. It's important not to run yourself into the ground. Nursing is a 24 hour job. What can't get done on your shift, can possibly be finished on the shift that follows.
Nov 16, '06Quote from ItsyBitsySpidergreat in thery but not practical inmany places - when one doesnt ahve the staff to cover each other the residents just gtet left alone- i soooo wish state made unnannounced visits any time of yr so places staffed like the window week of state. and when your facility uses lot of GN and med techs ( who requiuire an rn in building at all times) it is annoying to not get OUT of there for a few and breath...... if i take a break its not in house- im off to get a burger and smoke - if not they can dang well pay me for staying in house - everyone else has the right to leave when i am NOT allowed ( due to med techs and gn in house) i am not punching out. if i chose to stay in house that would be different ( which when its cold i will sometimes do so to lazy to goi in cold for cig and burger - but it shoud be MY choice not thiers)You know, whether she's a nurse or not, her advice is great. Nurses should take their breaks and lunch DAILY. I know there are times when it's just not possible but those days should be few and far between. The reason why nurses continue to work in these absurd conditions is because WE ALLOW IT! Never have I seen such complacency as you see in this profession. I know we need to pay our bills and eat but that doesn't give the hospitals, nursing homes, etc. to treat you like garbage.
On my floor, whether it's a madhouse or not, we go one at a time to take breaks, get lunch, etc. We cover for each other while the one is out and it works out great. I would suggest trying to get a system going where everyone can get a break. Even if it's only for 10 minutes, we need it!
Nov 16, '06Quote from porcelina22just one thing wrong with this view i see- yeah ok we have 2 min to go get our food to eat while we chart - that isnt taking care of US cause if you get busted doing it you can get a heafty fine - i do believe its mandated NO food and drink at the desk and its also illegal to take the chart off floor say to lunch room to chart - so either way your in a pickle and an deven more srious problem then not eating at all ( not that we ALL dont do it - i am sure many many of us do just that - eat where we arent supposed to .....................I sense some bitterness on these boards, yes?
I also am not a nurse yet. BUT, I do work as a nurse extern in EVERY unit in the hospital with the sole exception of the OR. I work on understaffed days, severely understaffed days, overstaffed days, severely overstaffed days, and once in a blue moon, I work a day that is appropriately staffed. I have NEVER not taken a lunch. I have taken them late, I have taken them WAY early, I have run to the cafeteria for 5 minutes to get myself lunch that I can eat intermittently, I have taken short lunches, and I have stayed late afterwards to finish all my work. But I WILL NOT deny myself food or a bathroom break in order to get non-urgent patient care done right away.
If you have to deny yourself those basic needs, you need to leave. It isn't appropriate and it isn't safe. If there is no one to cover your patients so you can run down and get something to eat, or run to the fridge to grab your food to eat while you chart, then there is something seriously wrong with the picture.
Now you can blast me for not having appropriate experince to back up my position.
Chrissy (nurse extern)
Nov 16, '06Quote from mamasonwe can pray - i know i wont stand up for it alone again ( though i tought i was fully backed ALL my coworkers turned on me when state actually came in sigh) id stand beside anyone but my mouth wont open till the end is seen and others have done it - im already blacklisted and lucky tobe working where i am bacause of it.I would love to work in CA. But, that's not feesable and won't be anytime soon. Sounds like heaven to me. I wish the government would get off their butts and make the pt/ratio laws federal. Who knows, it might just happen one day.
Nov 16, '06Quote from NREMT-P/RNi left nursing for 4-5 yrs and now am back and often wish i hadn't come back- luckily for me the place i work for were so desperate they hired me ( i am blacklisted due to calling state ) and i only work part time - if i had to work full time to survive it wouldnt be in nursing. i work enough t pay bills and care for kids- more to the story but the way we ar treated is mostly the reason i dont work more.Speaking from a purely personal experience.
I just can't keep any self respect and continue nursing! I refuse to allow myself to be treated in the manner that is customary toward NURSES!
Brutal, but true.
Nov 16, '06Quote from schooldaysi wold have had to tell your instructor she doenst know diddly about where i work - there is NOONE to take my place when i go to work - and the higher up know all about it cause they do the scheduling and they staff us short on purpose ( so we swear it seems)Amen! Let's allow Epona to speak and not jump down his/her throat!
I am a student nurse, and I had one clinical instructor who worked straight med-surg many years and she went on and on about this. Yes, you can take breaks. Yes, you can almost always go to lunch. It's about time management and, more importantly, setting boundaries. Now I KNOW you have someone who is assigned to cover you. You have to go to the trouble of giving report and getting report again from them before and after your breaks, but it can be done. If they don't do their job, you have to speak to them about it and then follow the appropriate channels to get them spoken to by someone higher up if they don't cover you properly. That is not easy and won't necessarily make you popular, but it will slowly affect a change on your unit.
Also, I work as a student RN and I'd say most nurses on the med-surg floor I'm on take lunch every day-an a full 1/2 hour at least. Those who don't are 1) the new grad who is gonna burn herself out fast and just can't seem to get it all done and 2) the woman who cannot delegate and has trouble prioritizing. I'm not at the level of either one of them (!), but from the comfortable position of a student I can see where they are going wrong.
Nov 16, '06I have not read all 11 pages of this thread, because I am tired and have to get up at 0500 for another 12 hour shift. Today was my off day, and I got a call at 0700, 0930 and 1100 to see if I could work all or part of today. I could not. I am 52 years old and have been an RN since 1973 when I was 19 years old.
I stay because I don't know what else to do, I have done this all my life. I stay for the money, the "security" of always having a job and because I enjoy living indoors.
Why are nurses leaving? Why have I considered goat herding in Tibet? There are all of the reasons listed above with a few others. I currently work in the ER as a traveler, and have for the past 6 years. That is the only reason I am still relatively sane.
Nursing has become increasingly dangerous. I have worked in 2 ERs where a doctor has been shot. I worked in another ER where patient blew his brains out with a shotgun just outside the ambulance bay doors. He apparently could not get in the locked doors. There was a triage nurse shot and killed by an irate family member in a nearby hospital a few years ago. I am routinely cussed at, bled on, swung at, threatened, etc. by drunks, druggies and even family members. Where else do these things happen? One of our paramedics was shot in the chest while trying to help a patient out of a chair and onto their cot. Fortunately, she survived.
Yes, there are other options in nursing, but I do choose to stay in the ER for my own reasons. In many cases, we deal with life and death (our own), but the customer is always right? Where are our administrators when we are in the heat of battle? Home sipping tea?
In what other job do you run the risk of getting sued and losing everything you have worked for if you make a mistake? I don't mean neglegence, I mean a mental mistake when you are beaten down, tired, short staffed, working with outdated, absent or faulty equipment?
The longer I do this job, the more concerned I become about those things. When I was in my 20's and 30's and was supermom and invincable, I didn't think about it too much, but now that I am older, wiser and more vulnerable, I do.
Even though I am still healthy and have many years of employment ahead of me, I think my remaining days as a bedside nurse are few. I will stop traveling, find a nice computer job with an insurance company and live to be a ripe old age. But, maybe that is the way it is supposed to be.
Nov 16, '06Quote from pjsleepyagree with you its all about money - when i first started this job i thought about my administrator she is great - she cares - she sees i am a good nurse and will be an asset - since 1 1/2 yrs has gone by i have seen a dark side to her - have been threatened in such a way to make me think i cold loose my job if i chart or dont chart certain things ( which i charted anyhow as it was a dementia resident hot another - and even though no injury it should be charted) well she wanted me to NOT chart it after all they aren't "with it like you and me so it doesnt count as an altercation - which needs to be reported to state - hmmm not my idea but maybe I'm wrong....) she has told me to call for more meds on residents who need one on one - and literally told me she cant afford to staff for one on ones - well i cant afford to chemically restrain my resident when one on one is effective - i am sure state would frown highly on that one - but ya know - unless we have recorders in our pockets ( which is also illegal in most states ) and get them to say this stuff on tape ( if they know they are being taped they ain't gonna say it ) we could close down half the facilities in this country i can almost bet.I can tell you why I am looking to leave ER nursing:
*Gross misuse of the emergency room by the general population for problems that are no where close to being classified as an emergency situation because: a.) they either have no doctor or b.) they know that they must be treated by us and that they don't have to pay
* Primary care doctors that refuse to attempt to practice medicine for non-emergent symptoms and instead say "go to the ER"
* Rude patients and family members who:
a.) are so egocentric that they can't recognize that the person who is blue and barely breathing is going to be seen before your hang nail you have had for 30 minutes
b.) yell and scream at you, call you every naughty name in the book, name drop supposed "big-wigs" of the hospital (who supposedly exist but I wouldn't know any of them because I've never seen one make it down to my ER to check out the working conditions), and threaten lawsuits, etc.
I've been a nurse for 6 years. Just in what seems to me to be a short amount of time, I feel like the work load in the ER has tripled. We used to have some downtimes. After midnight was usually a cake walk with maybe 1-2 pts a piece. Now I come in and the lobby is packed from the time I get there until the time I leave. I got tired of hospital politics and started traveling a little over 2 years ago. It was better for awhile, now I only see it getting worse (and I'm a glass is half full kind of girl!) I hate that we have to hold patients in the ER because the floor is not ready. Nothing against the floors---I know they are dealing with their own problems. I bow down to the med-surg nurses because you do a job I could never do. There are just no easy answers. Hospital administrators only see $$$$ as the bottom line when suggestions are made about hospital improvements. And adding to my fury is JCAHO- an organization whose heart (I'd like to think) is in the right place, but it's recommendations and guidlines are so out of touch with reality that a hospita's JCAHO accreditation means zero in my book. I think one doctor I worked with said it best---"They are just making it impossible to do our jobs." Sorry to vent so long. It's part letting off frustration and part mourning a emergency medical system I used to love....
Nov 16, '06Quote from chigapbummer- i had serously thought of going there as i think its one of teh state my license carries over to - but sad to hear it isnt much different - and i know having relatives there and visited there several times yes the cost of living is wayyyy hogher than where i am and the higher wage wouldnt ,make upo for the change- to bad- i like your weather in the areas i have been - i can actually breath and sleep witout all the humidityI had an epiphany the other day and it wasn't good. Basically, I have been in a very unhealthy relationship and haven't left because I keep waiting for things to change. It hasn't changed in 10 years and it probably not going to... I am so tired of hoping and waiting and I ain't getting any younger.
In the last 10 years, I have worked in 3 different countries and it is basically all the same: there must be some benefit to high turnover and a skill mix that is heavily skewed toward the younger and less experience side. Hmmm, I bet it has something to do with money. In the US, you are paid well (relative to other countries), but worked to death. In Australia and New Zealand conditions are a bit better and you get more time off, but you get paid crap and have absolutely no voice or input (extremely top-down management styles) and change is almost imperceptible. Turnover is also very high and staff very inexperienced. In all 3 countries there is a high percentage of imported nurses.
I left Illinois to work in California and before any of you buy into the hype about how wonderful the CNA and their national branch are, the fine print is that the AB 394 ratio/staffing laws are pretty much unenforceable and routinely and widely ignored. You can make money in California, but you work like a dog for it (just like anywhere else) and the cost of living is high.
Nov 16, '06Quote from BSNtobe2009nope- had one wayyy back when i was a young woman going to getout of being a cna to go to school to be a nurse- havent had one since- and all the nurses we havelost in last month ( nealry a dozen including ones who com ein for a few weeks and get out from what they see ) i know the 8 i still have contact with were basically told dont let the door hit you in the ass - never asked why or offered any counter offer ( have lost several who never even got there after commiting as thier workplace valued them and counteroffewred so they stayed there and never even came to us....) and big ads all over for last month have brought little in way of staff - few cnas thats it....... word gets around i hear......................What amazes me, is why are nurses leaving hospitals (at ANY hospital) and Administration isn't scrambling doing exit interviews to see why.
From reading these boards, orientation is a huge expense to the hospital, so I don't see how to keep training new hire after new hire is going to benefit them in any way.
Has anyone that has quit a hospital had an exit interview? Are these typical or rare for the industry?
Some might find that it's a particular DON, a supervisor, a certain doctor, etc. To me it would be easier to get rid of the source of the problem than to go through a bunch of staff members.
Not everything can be corrected, but it's hard to be sympathetic to hospital administrations that keep saying, "We need good, quality nurses!" Because my first question to them would be, "What are you doing to keep the ones you have?"