Why Do Nurses Quit? - page 11

Jamie looked at the framed group photo on the wall of Cohort 22, the 24 new grad nurses who started a year ago in 2015. They all look so happy and eager. Where are they all now? Of the 24, 16... Read More

  1. by   Wuzzie
    Quote from AnnoyedNurse
    Wuzzie, you're right. I did come off abrasive. I'm sorry. On the day I wrote that post, my patient was re-intubated, had a large loose BM during the intubation which was leaking to the floor, and once the intubation was over, each nurse and CNA left my room. It took me another 35 minutes for help. I asked every nurse and nurses aide on the 32-bed ICU (large unit, plenty of nurses). Yesterday, I needed a hand to boost my patient. My "buddy" agreed to help, only if my patients didn't have a BM. She saw that he had a BM (a small one), laid my patient flat, restrained him, left the room while saying, "sorry I'm not on bathroom duty." It then took me another 20 minutes to find someone to help me. It's 32-bed ICU with only one nursing assistant, a Unit with very strict bowel and bladder protocols and a really high reputation for neurosurgery, but yet they don't provide the proper resources to provide proper nursing care. Last night, I quit my job. I refuse to keep my patients in their stool and urine because I don't have sometime to help me turn while I clean them (I've tried on my own, but it hurts like hell, and when the patient is intubated, sedated, and having DT's, it's not the safest.)

    I am fully aware that it wasn't "professional" to leave without notice. But I'd rather not work then put my license in danger. Luckily, my per diem job (which is a magnet hospital and provides awesome staffing) agreed to give me as many shifts as I want until I figure out my next step.
    Apology very happily accepted. I'm sorry you had such a horrible day and it sounds like your ex-coworkers are serious pieces of work. I don't blame you for feeling like you do. I promise you if I was there I would have totally helped you and without complaint. I really do understand. I have been in your shoes. Having nasty peers is the pits. One thing I'm sure of though is there ARE places where people work together as a team. I've experienced that as well. Don't get me wrong no place is perfect but your unit sounds like pure hell. I do hope you can find your place whether it's in the nursing field or not. And again, thank you for your service. I meant that sincerely the first time I said it too.
  2. by   AnnoyedNurse
    Thanks Wuzzie, it was honour to serve. I appreciate your support in my negative experience in my current job. I would like to add that I have an amazing team when I worked Trauma ICU in NJ. I learned a lot and everyone was always helping each other out- the acuity was so high, any type of crack in the team could mean a patient's life so teamwork was a life and death requirement.

    I am not sure what the future holds for me, especially in nursing. I know I am good at sales and I love real estate so I may do real estate. However, I am very happy that I have my PD job to lean on until I figure it all out. After explaining it to my manager, he completely understood how I was feeling. Who knows, I might go full time at my per diem job but of course I definitely have some soul searching to do!

    Thanks again for letting me rant and for your forgiveness. I guess we can say that nurses can leave nurses for a variety of reasons, but solid teamwork can keep nurses longer- the compassion we give to our patients, if we have to the nurses on our unit regardless of experience, then maybe 30-50% of new nurses would not leave nursing in their first 3-years as nurses.
  3. by   calivianya
    Quote from AnnoyedNurse
    My "buddy" agreed to help, only if my patients didn't have a BM. She saw that he had a BM (a small one), laid my patient flat, restrained him, left the room while saying, "sorry I'm not on bathroom duty."
    Off topic, but this is the problem with having CNAs in the ICU. Mine is 30 bed, also very high acuity, with zero CNAs. So, all of the nurses HAVE to help each other. Consequently, we have very good teamwork, even amongst people who really dislike each other. We have plenty of politics and lots of cliques, but even the most snobby people know you may be the only help they have one day, so they know better than to screw you over if you ask for help.

    Now, my PRN ICU job that I quit recently had CNAs, and some of the nurses would look at you like you had grown three heads if you asked them for help. Having CNAs makes some of the nurses feel like they never have to help you with anything unpleasant because "that's what CNAs are for." There is no accountability because they don't HAVE to have your help because they can call the CNA.

    I will never work anywhere that has CNAs ever again if I can help it. It destroys the teamwork between the nurses.
  4. by   Libby1987
    If these groups of clique-y nurses were brought together and asked why they're not supportive of and/or the cause of losing the new grads/hires, what would they say?
  5. by   sarah2416
    I believe the main reason newer nurses leave is because of the "moral distress" that comes from working in corporate healthcare. Hospitals are being run by rich people trying to squeeze huge CEO pay out of Medicaid and Medicare patients. You can't run a hospital like a Walmart and expect thing to go well. If a Walmart employee gets overworked and shelves don't get stocked, no one dies.

    Every time the hospital that I work at has gone through low staffing times, staff have been required to do more than is really safe for the patients. But all of these low staffing times have been their own fault. A few years ago, we had a massive lay-off because we had one summer of low patient census. Things picked right back up again (duh), and suddenly everyone is supposed to handle a full patient census with way less staff. They eventually started mass hiring, but the staffing ratios never actually went back to what they were. Once the big wigs see that nurses can handle stupid patient assignments, they keep it that way. Nothing ever gets any better.

    So everyone with experience continues to leave. A 12 hour shift shouldn't feel like a 12 hour Crossfit workout. You should be able to walk without limping when you clock out. You shouldn't have to clean incontinent bed-bound patients by yourself all the time because everyone else is also so busy running around like a chicken with their head cut off that if you waited for someone to be free to help you, the patient would have already lost the first several layers of skin.

    The hospital is evidently content to just keep bringing in the new grads. I personally suspect it's because they're cheaper than the experienced nurses anyway. I have worked for one hospital in the little over 2 years since I became a nurse. I started on a progressive care unit and then moved to an ICU (both day shift positions). On both units, I was made a preceptor within 6-8 months of being off orientation. Think about it - with less than a year of experience being an RN, I was teaching new grads how to be nurses. In a cardiac surgical ICU, a new grad gets 8 weeks of orientation on the unit. They're being trained to take CRRT patients and VAD patients before they've been there 6 months total. They're receiving fresh open heart surgery patients within their first few weeks off orientation. I can distinctly remember times of trying desperately to keep a fresh open heart patient alive in the midst of significant hemodynamic instability and looking around for anyone to help, only to realize everyone around me was newer than I was. Add in the fact that in a teaching hospital, the residents don't know much either and it's terrifying.

    I've been to ortho docs and physical therapy for issues that I believe are directly related to lifting too much and putting an average of 18-20K steps on my poor tired feet every shift. I dread going in to work most days. I hate that I don't have the time to do what I have started to consider the "fluffy nursing stuff" like patient mobility, patient education or making a human connection with patients or their loved ones. Things that should be standard nursing stuff, not "extras" that I rarely have time or energy for.

    I personally have a very high level of self-confidence and am assertive by nature. I'm no wilting flower type. I was flat-out bullied by my preceptor on my first unit. Directly confronting her about, and directly reporting it to my educator and manager accomplished nothing. I have witnessed bullying of other nurses by the few experienced ones that are still around. I've stood up to the bullies, I've comforted the victims. I have brought these things to the attention of management over and over and seen NOTHING done about it. I have seen shift coordinators (who function like assistant managers) do some of the bullying. It keeps happening. I've seen patients suffer because of bullies refusing to help newer nurses. In this female-dominated profession, there is a lot of back-stabbing, bullying, favoritism, and general meanness that reminds me of junior high and high school. Only back then such problems didn't adversely affect the health and well-being of innocent by-standers like they do our patients. It's sickening. And anyone who wants to deny that this happens is delusional.

    I went into nursing as a second degree student in my 30s. Going back to that rather assertive personality of mine, I got all the experience I could during my nursing school clinicals. I had the experience of taking full med-surg patient assignments and full ICU patient assignments with my preceptors during school. I wasn't clueless when I walked into this field. I just sold my soul to the devil of corporate healthcare - I took a scholarship with a work requirement because I was broke. Thank god that's over now. I'm a damn good nurse and I've excelled under the ridiculously poor conditions that have comprised my first two years in this profession. I do all the stuff that makes the office-types happy - I've got a bunch of extra letters I can string after my name; I go to conferences; I sit on hospital wide committees and have unit-specific extra responsibilities. None of it actually matters down in the trenches. Now that I have that magical "2 years experience" under my belt, a lot more is available to me and I have a far more options in choosing my employer and my workplace. Never again will I work somewhere without a union. Never again will I work somewhere with high turnover rates. Never again will I work somewhere that hires almost entirely new grads. And just in case anyone is wondering, Magnet designation, Level I everything certification, and top rankings that are plastered all over town on billboards don't necessarily mean anything for nursing work conditions. I believe this is just the state of most of corporate healthcare nowadays. And anyone who sits around wondering why nurses are leaving in droves needs to get out of their ivory tower office and take a typical patient assignment for a shift or two. They're figure out the answer quite easily.
  6. by   AnnoyedNurse
    Sarah- best description of why nursing has gone to **** and exactly why nurses are leaving. I'love never work full time in nursing ever again!
    Last edit by Esme12 on Jan 1, '17 : Reason: TOS
  7. by   AvaRose
    This week was the lowest of the low. On Thursday I got a verbal "write-up" because night shift accused me of leaving things unfinished. Even when I later proved that I had finished the things they said I didn't do the write-up stood because admin also believed I was the reason their newest nurse quit during orientation which is total BS (she quit because the commute was too hard for her). Then later that day one of my patient's started to desat and it took me, the DON, and the doctor working with the patient for nearly 2 hours to get her back up to 90% (she was down to 80%). I finally got everything done at 830pm (2 hours late) Thursday night and then came back Friday morning with a splitting headache only to find out that the patient had died at 10 pm Thursday night. Despite that I started my Friday like normal and made it through morning med pass even though I felt like I was going to be sick any minute. I finally had to step outside to cool down and was ill in the parking lot. I told admin and they tried to find someone to cover my shift but couldn't find anyone so tried to coerce me into staying even though I was diaphoretic, nauseous, and had a headache so bad I could hear my pulse in my ears. They finally said I could go home but before I could leave the other day shift nurse told me I had to finish all the charting for my patients and turn off all the IVs I had started earlier. That took another hour. I got home just in time to get sick again and have spent all weekend so far either sleeping or in the bathroom. I have tomorrow off to hopefully feel better but then I have to go to work on Tuesday. I don't dare call off...I've already cost myself over $200 being sick plus my co-worker thinks I was faking the whole thing.
  8. by   AnnoyedNurse
    Honey, I'm so sorry you're dealing with this. That's not the best work environment. I think you need to focus on getting better and do not go to work until you are feeling better. You cannot provide excellent care unless you are 100% healthy and able to do everything your patients and coworkers need.

    Personally, I would have a one on one with my director of nursing. Explain to her how I am feeling and tell her I am willing to be a dedicated nurse, to stay thick and thin for the hospital, and I am willing to help support the change. If she is receptive, then great. If not, I'd look elsewhere- there are great nursing work environments despite the horror stories we do hear.

    Stay at strong and remember you health and wellbeing should also be an utmost priority to you and also to your employer. If they don't care about you, why you you work for them? There are many employers who love their employees and understand that life happens. You are not trapped nor are you alone.

    Best wishes!
  9. by   Jessy_RN
    This is part of the problem. People are running away from the bedside and the problem isn't being fixed. Imagine if everyone did just that (run away)? Eventually, there wouldn't be anyone one at the bedside and your job security probably would not exist.
  10. by   RegularNurse
    Reasons Nurses Leave:

    1. Most bedside nursing positions are horrible, and the good ones are taken by nurses who will never quit because they are great jobs.
    2. The only barrier to better jobs is a measly 40 credit grad degree
    3. Why fight the system when you can just change your place within it.
    4. Med surg/Tele/ICU jobs will always be a ton of physical work. Few young people want to endure that long term. No administrative measure will change the core of bedside nursing. This is why these jobs have high turnover, even when controlled for everything else.

    I love how all these professional bloggers etc. fail to acknowledge that nurses quit entry level bedside positions because there are simply better jobs available. Nursing is a legit 4 year degree now. Who the heck would want to spend the rest of their lives doing heavy labor with that level of education?
  11. by   KandidNurse
    well put!
  12. by   Jblanco
    "There are times when being friendly isn't in our patient's best interest."

    The issue is not one of friendliness vs unfriendliness, rather its a matter of respect. The nurse said she was "loudly humiliated" by the other nurse. There is no justification for disrespecting another nurse, even if you believe they were responsible for "poor patient care" as you mentioned. How does that correct the issue? If you truly believe the outgoing nurse made a mistake, use the opportunity to suggest how she could have handled the situation differently. Even after being a nurse for five years I find myself learning all the time, I would gladly welcome another nurse's suggestion/input. However, I wouldn't appreciate being yelled at for a perceived mistake. We should be kind and compassionate to one another, not only to our patients
  13. by   NuGuyNurse2b
    Quote from RegularNurse
    Reasons Nurses Leave:

    I love how all these professional bloggers etc. fail to acknowledge that nurses quit entry level bedside positions because there are simply better jobs available. Nursing is a legit 4 year degree now. Who the heck would want to spend the rest of their lives doing heavy labor with that level of education?
    Personally I would never leave if I got paid well. By "well" I mean anything beyond $40/hr. Right now I'm batting way below that magical number and it's simply not enough considering the rigorous education, physical labor, responsibility (everything falls on the RN...) and mental/emotional toll that the job requires. And my place loves those customer surveys so it doesn't matter what you did for the patient. I love it when family members who never visit are filling out those things and saying how bad we are.