Why Do Nurses Quit?

[Nurse Beth]

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 remain employed. Christina returned to the Bay Area and Shelby is in an NP program. Lindsay went on LOA and never returned. Alex worked ICU for one year, then left to work in State Corrections for better benefits and pay.

Is this an exodus? A revolving door? Lynda, the nurse recruiter complains "I bring nurses in the front door, but they bleed out the back door"

Every year the hospital hires in two new cohorts of 25 nurses. Every year, at least 50 nurses leave the facility.

Just one of the downstream effects is that preceptors become burnt out on precepting new grads because of the turnover "You put your heart and soul into training them..then they leave!"

In the United States, nursing workforce projections indicate the registered nurse (RN) shortage may exceed 500,000 RNs by 2025.

It's estimated that 30%-50% of all new RNs elect either to change positions or leave nursing completely within the first 3 years of clinical practice.

Here's a few answers to commonly asked Why are nurses leaving? questions :

Why do nurses leave after transitioning from school to clinical bedside?

Reality Shock: Some new grads do not survive the shock. Nursing school is insufficient preparation for nursing. Often there is an overwhelming lack of support for nurses in their first year.

Passing meds on two patients with an instructor available does not prepare a new grad for passing meds on six patients with doctor and family interruptions, Lab calling with critical values, and ED calling report on a new patient.

Is stress a factor in nurses leaving?

Nursing school is exhausting, but working as a nurse is a different kind of exhaustion. Nursing demands constant vigilance. Nurses are always "on" - there is no cubicle to hide in, no office in which to decompress and escape. This proves more exhausting for some than for others.

The sheer intensity of nursing comes as a huge shock.

Is staffing levels a contributing factor in nurses leaving?

Caring for four ICU patients or eight high-acuity Med-Surg patients is simply unsafe and untenable. Across the nation, California is the only state with mandated nurse-patient ratios.

Is mandatory overtime a reason for nurses leaving?

New nurses either:

• Come in to work extra shifts. How does working three twelve hour shifts on, one day off, four on sound? (as relayed to me yesterday by a nurse with less than one year experience in ED)
• Learn to say "No", a boundary many struggle with

Is floating to other units a concern for nurses?

Floating to other units is a major stress. Care is not always taken to ensure competency-based assignments, or to support the newbie floater.

What do some non-nursing tasks push nurses away?

An inordinate amount of time is spent on tracking down supplies, ordering forms, screening calls, ordering diets ...all tasks that could be handled by non-licensed support staff.

Nurses need to focus their energy on critical thinking- how do I get the patient from Point A to Point B along the continuum of recovery/wellness during my shift?

How do new nurses react to the additional responsibilities?

Realization that the buck stops here. New grads experience the fear of making a mistake and possibly harming a patient. This can literally be paralyzing for the new nurse.

How does poor management lead to nurses leaving?

Nurse managers are strongly linked to job satisfaction. Managers who are not trained lack the necessary communication and leaderships skills. Favoritism abounds and poor performance is tolerated. Poor performers are not eliminated.

Poor management ultimately results in turnover.

What are some reason why new nurses struggle?

Lifting patients and other physical demands take their toll. Work hazards such as exposure to hazardous drugs are a safety concern.

Nurses are subject to physical assault/verbal abuse which causes job distress.

How challenging is the nursing work environment for new nurses?

I think what happened to me is what they call "nurses eating their young". Yesterday I couldn't get my patient's IV re-started before shift change. I tried but missed and the patient didn't have any meds due. It was so busy and I had SO many other things to do. During handoff, the other nurse loudly humiliated me in front of everyone. "You left the patient without IV access?" Everyone got quiet and I didn't know what to say. Even some family members heard. I thought it is a 24-hour job, that's what they said in orientation. Did I do something wrong?" As seen on social media

How can nursing turnover be reduced?

• Increasing staffing and limiting nurses' work hours. Flexible work schedules and job sharing help nurses with children stay in the workforce
• Creating a culture of safety
• Providing strong, supportive nursing leadership
• Creating a Just Culture
• Including nurses in decision-making related to patient care delivery and practice

It's honestly been so tough transitioning from a nursing student to new grad nurse. I have good preceptors, and coworkers, but I wonder if I'll ever be fast enough to keep up. The patients are very sick and I get worried about the protocols and everything I might be forgetting. But yesterday my patient's wife hugged me at the end of my shift and said how much she appreciated my care. I felt good and it reminded me why I wanted to be a nurse and that I can make a difference. I know I'm still learning and not up to speed yet. I totally needed that hug. As seen on social media

As a nurse, I love nursing and promote my chosen profession. At the same time, I'm well aware of the dissatisfiers that drive nurses away from nursing and the bedside.

What is driving nurses away from nursing?

References

Aiken, L. H., Sermeus, W., Van den Heede, K., Sloane, D. M., Busse, R., McKee, M., ... & Tishelman, C. (2012). Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. Bmj, 344, e1717.

ANA 2011. Health & Safety Survey Hazards of the RN Work Environment. Retrieved December 8, 2016. 

Jones, C. B. C. B., & Gates, M. (2007). The Costs and Benefits of Nurse Turnover: A Business Case for Nurse Retention. The Online Journal of Issues in Nursing, 12(3).

[nutella, MSN, RN]

What I tell high school students who are interested in nursing as a career is that :

If you are comfortable being uncomfortable - nursing is for you!

I do not agree with the idea that the younger generation, that is now coming out of the nursing school, is doing something "wrong" or is all about instant gratification or can't be uncomfortable.

But their behavior is a product of a constantly developing world with parents who seem to be very concerned to expose their kids to anything or , the other extreme, neglect them.

What I do see is that nursing and healthcare in general has changed. Nursing is very different from even 20 years ago. It is all about the "tasks" and completing the endless list of "to do" - which is often too long. This generation is better educated than any generation before us. They do not put up with something "just because" - which is actually something I admire. I am not saying one should quit right away with little problems. But I think that not putting up with too much balony is to the advantage of everybody in the end.

One of the reasons for young people to stay at home or to move back in are the high costs of education.

I think it is totally ok to place a high value on life-work balance and also to consider "happiness" and overall life. I feel that the generation graduating now is perhaps the first one that is not forced to "just suck it up" and who will also determine the "rules".

When I look at how med/surg has become for nurses - between intentionally understaffing (to save money) to forcing nurses to also work for the techs, to dealing with highly emotional patients and families, and the usual stress of working in a hospital it is no surprise that nurses run away. Why shouldn't they???? What else has to happen so that the people who make decisions and who are in control realize that patients only get care that adds value when nurses actually have the time to do so and the time to think and reflect. I do think that the baby boomers who were used to just slaving along in the name of "caring" and who would constantly jump in and "work extra" undermined change that is necessary. For sure it happened in different setting I worked in. Instead of all nurses pulling on one string, some would "work extra" and put pressure on everybody else. HR does not see a need to hire when there are always people jumping to the rescue who thrive in this environment and who get a lot of validation through "being needed".

I now work in a hospital that values nurses and is not punitive. Of course there is a normal turnover and there are also a lot of nurses back in school to become NPs or educators. But to me it seems less turnover as compared to other hospitals.

I like to work with the young generation - my perception is that they are motivated, want to do a good job and care. There needs to be mutual respect. Yes, I have more experience but I also learn from them. A different perspective sometimes, a different opinion.

[SeasonedOne, RN]

Reality check! Over the years we have negatively altered the supportive and progressive model affecting nursing in the following ways:

#1 Student Selection

Schools placing a high priority on "A" students who can memorize materials. In practice, I'll take a "C" student with good people skills and common sense any day of the week. Let's face it, having a higher level to pass the boards tends to be a driving force.

#3 Attempted Killing Off LPN/LVN Programs

With the "better care with all RNs" rhetoric we have decreased options for upward transition from CNA to LPN/LVN to AS-RN to BSN, etc. Over the years many RNs would have been better served as an LPN or an CNA than in a position of responsibility. Not everyone was meant to be an RN. CNAs, LPN/LVNs and AS-RNs really understand the basics of patient care where BSN focus is more admin. The transitional stair-step model of the past helped weed out those not suited for nursing early, rather than going 4 years and then quitting.

#3 Primary Care Model

The less than brilliant idea of changing from the supportive team nursing model to the more isolating primary care model may have looked good on paper but in practice patients are getting poorer care now. It is an expensive choice and had decrease the continuity of care.

#4 Not Starting At Med/Surg

If you don't give nurses a basis for making decisions on the big four: COPD/CHF/DM/Renal diseases, how do you know they can recognize a problem? Developing self confidence by sheer repetition is a good thing. The basics can be scary as heck by themselves and then you throw someone into a critical situation...many run like hell.

#5 Nursing Aptitude

Part of nursing is to weed out those without the aptitude for nursing. It is more than showing up for work and collecting a paycheck or assuming you will be the boss. It is emotional, or should be at the gut level. It is service with a smile, or it should be. It is staying that extra 5 minutes holding a hand even if you aren't getting paid for it or it should be. Nurses have to have inner strength to act calm on the outside even though being scared within. It is being a teacher, a confidant, a cleric to all religious need PRN, or it should be. It is learning to listen to your gut instinct and be willing to act even if you are proven wrong, cause one time you might be right. It is learning to face your fears of not knowing and trying anyway. There are times you will second guess your decisions and hope you made the right one - yes you will be uncomfortable and you should be...for to be overly confident has even more risks. Nursing is not always hearts and flowers. It is sometimes emotionally painful as well as rewarding. Nursing is not for the faint of heart. I would say that many nurses who leave have difficulty acting in one or more of these roles or instances.

#6 Is It A Profession?

When I started on the first day our instructors advised us were were nurses 24/7. We had a standard to uphold while at work and off hours in the community. Dress appropriately, act the part. BE a professional. Today, I'm amazed how nurses want to demand others respect them, when they have little respect for themselves shown by their actions and appearance. Is nursing these days still a profession or just a job?

#7 Life Is Unfair

If you work in this profession long enough you will have an issue with staffing, poor supervisors, overtime, and a hundred other injustices nurses face. In reality, we make a good living, are respected by our community, do good things in service to others, and hopefully when we lay our heads down at night, are happy.

Yes, there are probably some things we as nurses can do to keep people in nursing but the question really is, do we want to? If you are not cut out for our profession, isn't it better to leave and change your path sooner rather than the potential harm of doing it later? And for those with unrealistic expectations, the 'school of hard knocks' is an unrelenting teacher.

[johsonmichelle]

I see some interesting and valid points on this thread but there are some misconceptions . Nursing students have evolved, the new graduating nurses today tends to be older, may have a previous degree and work experience. Cost of living has risen but the not the pay which has caused some people to live longer at home then they should. If a new nurse is still living at home, I highly recommend that he/she save money and work at the job for a while before moving out. I have also seen a lot of people quit who have children and mortgage to pay so its just not those who are living at home. At one of my previous jobs, the older nurses were leaving because they could not cope with the hospital new charting system. At my current job, they have the highest turnover I have even seen in my life. A lot people have told me that they will not work at my facility even if its the last nursing job on earth and thats coming from both new and experienced nurses. We are in desperate need of nurses , they don't get a lot of applicants, the ones they do get, they don't show up to orientation or they quit after a few days of work.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

I wrestled with responding to this thread for quite some time. In just the mere reading of the title, I was like "is this a trick question?", "this is a joke, right?", "she can't be serious!", and finally, "you know what, I don't have time for this today; I have to go to work". Yes, that one question 'why do nurses quit' sent me through a myriad of expressions. Now that I've had time to let my flames die down, I will toss in my two cents.

Why do nurses quit? I think another way of finding out the answer to that question is to ask seasoned nurses why we stay. The short answer to that question for me is because I have what it takes to stay, and my pay comes closer to reflecting appreciation for my presence than it does for the new(er) nurses. Over the years, I've learned a few tricks of the trade that helps make life a little bit easier for me and my patients. New(er) nurses don't have the experiences of the nursing olden days to fall back on that would take some of the edge off. A lot of them don't even have olden days of any kind to reflect on.

I've read some of the threads on this forum in which some nursing students and new nurses are asking for advice. But then they go on to say that they are only looking for responses from those who have 'recently had this experience', or they want to guide or dictate the responses to them. Oh, the ignorance! Is it possible that some of us have not 'recently had this experience' because we learned many years ago what not to do to have this experience again? Oh well, your loss. I simply scroll on by. By the way, these threads that begin with "Help!" always crack me up before I read them because my first thought is that a new grad got exactly what he/she asked for. (I've said repeatedly to be careful what you ask for).

Another point is that some new(er) nurses enter the field believing that they know everything. They think that everything we seasoned nurses were taught is now outdated and as such is rendered useless. They are simply oblivious to the fact that we receive regular inservices, obtain CEUs, and actually advance ourselves in this profession in mandatory and optional ways. Although I will always intervene before I stand by and let a new(er) nurse harm a patient, I have no problems whatsoever allowing the arrogant nurse to fall flat on his/her face or be knocked down on his/her a**. Sometimes, that's the only way nurses with attitudes will become humbled enough to pay attention and learn, I.e. sit down and shut up. Although one cannot become a nurse by receiving all or any F's in school, while on the clock, nobody gives a squat that about the A's received either.

When asked about my time in nursing and I respond with 30 years, that doesn't mean that I have not learned anything new about nursing practice in 30 years. I've heard from some new(er) nurses in regards to my years, "oh, a lot has changed since you went through school". Wow, really? Then I break it down to them: LPN for 24 years, RN for 6 years, and BSN for 2 years. Do the math and it equates to a combination of 30 years of continuous hands-on nursing experience and education because I could not afford to stop working while I returned to school. Seems to me I'm more than one up on the new(er) nurse. I smile and strut as I go about my job because they haven't a clue what they have gotten themselves into.

As an old hag of a nurse, I've had time to adjust to the changing world of nursing. I have a great deal of their new school:bookworm: to add to ALL of my old school. This is why I stay. Some of them don't have so much as a basic work ethic that would keep them in the position long enough to build any much-needed confidence.

Now, just a word in defense of the vacating stampede. If I were a new nurse just entering the field and being thrown into the WOUND (World Of Unbelievable Nursing Discord)...I just made that up, by the way.....I'd leave nursing today, too. The ones that leave don't tough it out long enough to grow a set. And since I grew my set long ago and had them bronzed and engraved, I'm here to stay. I don't like it, but I am here to stay....until something or someone (one who prefers a housewife) better comes along...

FYI: I went back and inserted the smileys to make reading this novel a little more bearable.

[Libby1987]

BSNbeDONE said:

I wrestled with responding to this thread for quite some time. In just the mere reading of the title, I was like "is this a trick question?", "this is a joke, right?", "she can't be serious!", and finally, "you know what, I don't have time for this today; I have to go to work". Yes, that one question 'why do nurses quit' sent me through a myriad of expressions. Now that I've had time to let my flames die down, I will toss in my two cents.

Why do nurses quit? I think another way of finding out the answer to that question is to ask seasoned nurses why we stay. The short answer to that question for me is because I have what it takes to stay, and my pay comes closer to reflecting appreciation for my presence than it does for the new(er) nurses. Over the years, I've learned a few tricks of the trade that helps make life a little bit easier for me and my patients. New(er) nurses don't have the experiences of the nursing olden days to fall back on that would take some of the edge off. A lot of them don't even have olden days of any kind to reflect on.

I've read some of the threads on this forum in which some nursing students and new nurses are asking for advice. But then they go on to say that they are only looking for responses from those who have 'recently had this experience', or they want to guide or dictate the responses to them. Oh, the ignorance! Is it possible that some of us have not 'recently had this experience' because we learned many years ago what not to do to have this experience again? Oh well, your loss. I simply scroll on by. By the way, these threads that begin with "Help!" always crack me up before I read them because my first thought is that a new grad got exactly what he/she asked for. (I've said repeatedly to be careful what you ask for).

Another point is that some new(er) nurses enter the field believing that they know everything. They think that everything we seasoned nurses were taught is now outdated and as such is rendered useless. They are simply oblivious to the fact that we receive regular inservices, obtain CEUs, and actually advance ourselves in this profession in mandatory and optional ways. Although I will always intervene before I stand by and let a new(er) nurse harm a patient, I have no problems whatsoever allowing the arrogant nurse to fall flat on his/her face or be knocked down on his/her a**. Sometimes, that's the only way nurses with attitudes will become humbled enough to pay attention and learn, I.e. sit down and shut up. Although one cannot become a nurse by receiving all or any F's in school, while on the clock, nobody gives a squat that about the A's received either.

When asked about my time in nursing and I respond with 30 years, that doesn't mean that I have not learned anything new about nursing practice in 30 years. I've heard from some new(er) nurses in regards to my years, "oh, a lot has changed since you went through school". Wow, really? Then I break it down to them: LPN for 24 years, RN for 6 years, and BSN for 2 years. Do the math and it equates to a combination of 30 years of continuous hands-on nursing experience and education because I could not afford to stop working while I returned to school. Seems to me I'm more than one up on the new(er) nurse. I smile and strut as I go about my job because they haven't a clue what they have gotten themselves into.

As an old hag of a nurse, I've had time to adjust to the changing world of nursing. I have a great deal of their new school to add to ALL of my old school. This is why I stay. Some of them don't have so much as a basic work ethic that would keep them in the position long enough to build any much-needed confidence.

Now, just a word in defense of the vacating stampede. If I were a new nurse just entering the field and being thrown into the WOUND (World Of Unbelievable Nursing Discord)...I just made that up, by the way.....I'd leave nursing today, too. The ones that leave don't tough it out long enough to grow a set. And since I grew my set long ago and had them bronzed and engraved, I'm here to stay. I don't like it, but I am here to stay....until something or someone (one who prefers a housewife) better comes along...

FYI: I went back and inserted the smileys to make reading this novel a little more bearable.

These two statements hold so much of the truth, they should be a thread, a stickie.

Pre nursing students should be seeking answers to how successful satisfied seasoned nurses stay, what does it take? Not the why examples like making a difference in people's lives, but the how it was possible.

[37changes, ASN, RN]

There is so much good here.

I want to personally THANK each and every one of you for sharing your experience.

I am maybe the newest newbie here... Just getting ready to do my pre-req classes, starting in January ~ for a 2-year fall ASN program I have to apply for in May.

I signed up for classes before I found this site.

I have one RN friend who has been very supportive and happy for me! She works in the NICU, and has been a nurse for 25 years.

I have another RN friend who has tried every which way to talk me out of it ~ because she is miserable. She is a new(er) nurse who has finally landed her "dream job" in L&D and she hates it. But she says she's worked in pretty much every other area, and she just. plain. hates. nursing.

I was very surprised and honestly a little hurt (at first) by her lack of support. But that is because I had no idea what she was going through on a daily basis. After I found this site -- and have spent a lot of time here, reading -- I do understand now.

Maybe a certain amount of time spent on allnurses.com should be a requirement before you can apply for a nursing program. It has been a great benefit for me... And I feel I have a much clearer picture of just exactly what I'm signing myself up for.

How could anyone read through seven pages of this, and still want to do it?

Well... I think it takes a very certain/special sort of person to not just become a nurse -- but to stick with it. Year after year after year. And the reality is that we don't truly know if we have What It Takes until we are living it.

I think it should somehow be required to shadow nurses for quite awhile before getting too far into a program. Seasoned nurses, brand new nurses -- and everything in-between. In as many areas as possible.

...Not get in the way, not do any hands-on stuff... Just OBSERVE. Shadow. See all of the emotions and work that nurse goes through in a 12+ hour shift. Multiple 12+ hour shifts. Back-to-back 12+ hour shifts. Because that is not something we can just imagine. We can find places like this and read about it all day long... But I think you have to see it to believe it.

And I think that is probably the bottom line of Why Nurses Quit. It seems to me that it is just very sink or swim.

[guest52816]

Ruby Vee said:

There are bullies in nursing -- I've seen two in 40 years. But failing to say "good morning" is not bullying, nor is not wanting to share personal histories with the orientee you met yesterday. Negative feedback is not bullying, even if it isn't delivered in your preferred manner. Too much of the complaints of "bullying" we see these days is nothing of the sort. And that devalues the REAL bullying it that is out there, although rare.

The nurse who shoved her orientee across the room and into the furniture because she "wasn't moving fast enough" may have been a bully. If she also scheduled that same orientee to work every Sunday for six months, threatened to fire her every week and nitpicked her charting until the manager called the orientee into the office daily for weeks, it is more likely that the nurse was a bully. If she called the orientee at home on her day off and threatened to fire her if she didn't come to work "right now", stuck her hand down the orienteers boyfriend's pants at the unit Christmas party and then said "I could (bad word) him right now if I wanted to" to the orientee, that might be bullying. If she told the orientee "I'm going to ride you until you quit," that might be bullying. But that sort of thing is rare.

This idea that "bullying is anything that makes me uncomfortable" is a crock we're selling to new nurses who then fail to learn about workplace relationships because they're so sure that everyone around them is a bully. THAT is more harmful to new nurses than letting them learn to deal with negative feedback and workplace relationships.

I think what you wrote in the third paragraph is actually considered sexual assault, not bullying. Sorry that you refuse to believe that bullying does go on among nurses. I've seen it and I've experienced it. Nurse bullies are very real.

Most likely, it stems from nurses being overworked, stressed-out and emotionally ill-equipped to handl these stressors.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

Lil Nel said:

I think what you wrote in the third paragraph is actually considered sexual assault, not bullying. Sorry that you refuse to believe that bullying does go on among nurses. I've seen it and I've experienced it. Nurse bullies are very real.

Most likely, it stems from nurses being overworked, stressed-out and emotionally ill-equipped to handl these stressors.

I'll speak for myself here and may be actually speaking inadvertently for some others. When I hear the term 'bully', I have this image of a kid taking another kid's toy or lunch money. In the working world, when I encounter people who act like that on an adult level, I never considered them to be bullies. I referred to them as b******....both seven-letter words, both start with the letter B. So, in that sense, there are loads b****** who fall under the more verbally-acceptable category of bullies.

So, if we stop for a moment to think of all the colleagues we work with whom we've said at one time or another, "that nurse is being a real b****", we may actually see that that nurse fits the definition of a bully as it is being lime-lighted in today's news.

[medic1969]

I'm nearly finished with my first year as a nurse. I've seen a revolving door in my ICU. People leave for different reasons, school, better jobs, etc. Me personally, I can't stand my nurse manager. She's a sneaky weasel who plays favorites big time. I've worked every weekend, random shifts, no consistency. I'll sign up for shifts only to have them changed with no notice. I just get an email saying that I have a shift tomorrow. I'll work a 8 night shifts in a 10-day stretch. Then I'll get called off 2x in the same week, while the favorites work overtime. I see very, very poor leadership at our hospital. My manager is an outstanding nurse who knows everything about the particulars of our unit, but her social skills suck. She berates people publically without naming names. I'm not a highly skilled cardiac ICU nurse whose a valuable member of the team. I'm a little donkey tied to a cart. My job is to pull as much load as possible while being clubbed and whipped for not doing more.

[SolosGirl1812]

Ruby Vee said:

There are bullies in nursing -- I've seen two in 40 years. But failing to say "good morning" is not bullying, nor is not wanting to share personal histories with the orientee you met yesterday. Negative feedback is not bullying, even if it isn't delivered in your preferred manner. Too much of the complaints of "bullying" we see these days is nothing of the sort. And that devalues the REAL bullying it that is out there, although rare.

Can I reframe something that you said RubyVee?

Let's say that your description of one RN "shoving" another RN across a room "maybe a bully" and "more likely might be" a bully?

Let's put that into another context, shall we? How about if that RN shoved a PATIENT into a piece of furniture because they weren't moving fast enough. Are they a bully now? Or is that ASSAULT and BATTERY and the RN should lose her license and be sued civilly.

Perhaps you may like to look up the rate of suicides of medical professions due to bullying, harassment and other lateral violence. Rare? No.

The brutality of what would have to happen to someone in your opinion, is obscene. Lateral violence can be as subtle and nuanced as giving the worst assignments consistently to an RN you "want gone" but have absolutely nothing to back up your desire to see them leave---to withholding information and outright sabotage on shifts, maybe a patient didn't DIE because of it, but the effect is the same.

I want to get out to my family just the same as anyone else. But I have had the experience of some "senior" "crusty" "entitled" RN coming in at exactly 12:30am to take report from me...and she is ASSUMING that I want to work my 12.5 instead of getting that .5 paid (i work noon-mid). I've explained to her that I would like to leave at midnight, when my shift "officially ends". She will deliberately sit in the lounge and not appear until 12:29:59 and then during report she'll harp on something irrelevant....

Me: "Pt was delivered via EMS at 1700 with c/o sob and cp x 4 hours."

NETY RN: "Why did that patient go to that ER? Why didn't they just go to the ER that was in X city closer??"

Me: "I don't know, NETY. Is this relevant to the handoff?"

NETY: "Why wasn't a specific en route bp charted by you on their handoff?"

Me: "Because, NETY, it is not our policy. We retake bp at handoff, no matter what. I noted VS stable en route and that is all I was given"

NETY: "WHY? Tell me why that EMT didn't tell you. Didn't you ask?"

This is how it goes. This is an off the cuff incident that I recall, but this is what she'd do until I was sitting there for a full half hour PAST when she decided to appear....giving her information that was completely irrelevant to the patient or their care.

Once, another "senior" who had "years of experience" (and would proceed to run down her list of places she worked and stuff she knew routinely, unprovoked...and if you have to do that routinely, who are you trying to convince...me or yourself...that you're a decent nurse?) WHo wanted me to falsify a note, saying that I had done something that I had not.

She used to work in a legal office, she said, and me not charting something that covered the hospital was placing the hospital in legal jeopardy.

Wasn't my shift, didn't see it happen, not gonna chart it as if I did. Huge fight ensued. She followed me into the med room, slammed the door....ran down her list of "qualifications" and then proceeded to harangue me as I attempted to get meds for a pt. She snapped at me to "sign off the Pyxis immediately" and pay attention to her.

I told her that i had pts to attend to. She left and proceeded to abandon her patients to me (without asking me to watch them), walk to another part of the hospital, and pulled a Charge RN out of a Red Trauma in order to "tell the NG to listen to her".

She was pulled from regular rotation after that incident. Not the first time, and I was approached MANY times afterwards....by others that had to precept with her and co-workers..."thank god you stood up for yourself. she's gotten away with this for years."

Take a look at the stats for suicide amongst healthcare workers, esp MDs and RNs. We have the highest rates of suicide, depression, alcoholism and drug abuse. And it's NOT "all" because of the stress of the job re: patients.

It's each other. The bullying, the nastiness...the back handedness, the gossip, the favoritism, the "well, i was trained like this and now it's my turn" garbage....i could go on.

It's rampant and it's well known. It's nonsense that you've only witnessed 2 incidents of bullying in 40 years, IMHO. Either you have no situational awareness, or you believe that the only way that someone can have been abused is when there are puncture marks, blood and a cop car sitting outside.

I would dissuade anyone from going into this profession at this point, but if you do....do your time in your "RN Residency" (another fancy term for legal abuse, just like with MDs)....and go traveling or do research or something that gives you autonomy and the opportunity to get away from the pack mentality.

[1056chris]

I can say that I had never even worked at all and was nervous about starting as a GN. It depends on the people working there, your preceptor, the condition of the unit or situation you are entering, staffing, and your ability to tolerate stress, admit when you don't know something, and learn to accept what you can't change. Your ability to work well with others on good days and bad. I always knew I wanted to work in the medical field, but my first day on the job the hospital was in the process of a big lay off of LVN's or LPN's and replacing them with an all RN staff. If I didn't feel nervous already, I was greeted by crying nurses and the staying nurses who were not so happy their co-workers were laid off.

Even the smartest students can't apply care plans , bloodwork, and procedures, all together to make sense at first. It can be a lot on anyone's plate and you need to see the process day after day to make sense of it all. I was glad that I was asked to work on the med-surg floor for at least 6 months before even thinking of transferring to a specialty unit. I learned so much that first year. Heck, I still learn something new just about every day.

Finally I think some people get in there and realize, this isn't for me, and maybe work elsewhere in a healthcare position.

By the way most of the nurses they laid off were hired back.

[SeasonedOne, RN]

You are so right, starting on Med-Surg is a blessing!