Why Nurses Leave Nursing - page 2

health affairs-the policy journal of the health sphere n a r r a t i v e m a t t e r s january/february 2002 3/12/02 note: acrobat reader required to view articles as they are now archived.... Read More

  1. by   Jenny P
    NavyRN, are you kidding? They won't even INTERVIEW you unless you agree to work full time nights? No wonder California has such a nursing shortage!
  2. by   Russ Dowling
    Excellent articles! I worked in a busy urban hospital on the oncology unit, and we did primary care. When the unit first opened, the ratio was 4-5 patients per nurse. By the time I left three years later, the ratio was 6-8 patients per nurse. What that meant was I would have 6-8 patients, and the RN covering me for chemo, transfusions, and IV push meds could have 6-8 patients. So, in actuality, the RN could be responsible for up to 16 patients! Needless to say, no one got the care they deserved. If we complained, we were told "Just do your best." The hospital had done away with the CNAs and the IV team, so we were responsible for all care, including blood draws and starting IVs. I got a LOT of practice starting IVs! In addition, the unit was no longer just oncology, but also the acute care stroke unit, the gyn surgery unit. While on that unit, I was chosen to be one of the nurses to meet with the JCAHO at their next visit. When they arrived, a meeting was held on our unit. Present were the JCAHO nurse reviewer, my clinical coordinator, myself, an administrator, and a few other nurses. During the discussion, I informed the nurse reviewer of our unit's combination of services, and she was flabbergasted. She strongly felt that oncology and neuro were two very complex specialties that should have been kept separate. Unfortunately nothing changed. After being displaced from that unit, I went to the geriatrics unit, where each nurse could have up to eleven patients! Eventually, my back couldn't take it anymore, and now I'm a compliance analyst. I still work PRN, because I love patient care, but I'd never go back to it full-time. I consider nursing the highest human calling, and am saddened at the conditions patients and nurses are subjected to.
  3. by   Sleepyeyes
    I read Ray Bingham's article,
    and now I'm crying.....for our patients....for our profession
  4. by   All41
    "If you are not a part of the solution, then you are part of the problem" - this is a healthy attitide I feel. In response to this I am going to attempt a contribution to the solution. We are hearing a lot these days about benchmarking. It is much more palitable to say than "change". That word tends to upset folks. I am developing a Nursing Benchmark Journal in an effort for nurses to have a forum to be heard. I know that I am always trying to set the mark a little higher at my work and I am frequently met with resistance. Hopefully, if there is a positive and active response we can be heard. This is a grassroots effort for nurses in the trenches. I would like to leave you with this last thought...."Don't complain about something unless you have a suggestion about how it can be fixed". I LOVE my profession and I am sick at the way we are heading. The God Almighty Dollar is always the bottom line, not patient care, not effecient practice and not the job satisfaction or safety of Nurses. Let's keep speaking up. I would like to recieve any ideas as to what you would like to see in the Nursing Benchmark Journal in an effort to address all concerns. Thank-you for your input!
  5. by   All41
    Sorry about my spelling
  6. by   -jt
    << No wonder California has such a nursing shortage!>>


    I worked at a major facility in LA thru an agency recently. I am an ICU RN - went in on a gorgeous Saturday - a sunny 92 degrees - confirmed for CV ICU. I had to fight with myself to stop from canceling the shift & going up the street to spend the day on the beach. But you know, Im a professional, they have a shortage, I gave my word on the confirmation, etc etc etc. So I get there & the nursing office tells me Im assigned to do private duty.

    I remind them that I confirmed for critical care and I dont do "private duty". They said "well its the private duty case or nothing". At that moment, the supervisor had just hung up the phone with another agency & said "OK so thats the 16th RN who canceled this shift". And here she was telling me do the private duty or go home??

    Since it didnt seem to matter to her that they had 16 new holes in their staffing for that shift and she could afford for to lose me too, I should have said "ok, see ya!" and went to the beach, but I thought it must be a very critical pt if he needs his own RN.

    So I go to the unit, take report, & find that its a wealthy 47 yr old post op pt - simple ENT procedure - who was discharged the day before but refused to leave. He was so demanding that the staff couldnt meet all his needs as quickly as he wanted, & were harrassed by him & his "people" all day. The staff RNs complained to the nursing dept that they didnt want to take care of him. So the hospital hired a private RN to be his maid. Guess who.

    The nursing office didnt want to hear any comments from me about this little trick they pulled on me. So I canceled my shift for the next day, told them exactly why, and that I wont work there again. Im sure it didnt faze them in the least.

    PS
    I suggested to the pt that instead of paying a hospital bill & for private RNs, he could leave & check into a hotel with his wife and relax at the pool with the hotel staff tending to his every need. And thats exactly what he did.
    Last edit by -jt on Mar 12, '02
  7. by   -jt
    for immediate release:

    <<<
    Nurses Link Working Conditions To Exodus of RNs From Patient Care

    Albany, NY - March 11, 2002 - Thousands of registered nurses are no longer working in patient care settings because of intolerable working conditions. That was the message delivered today by nurses attending the annual legislative workshop sponsored by the New York State Nurses Association (NYSNA).

    At a noontime news conference, NYSNA President Robert Piemonte warned that workplace conditions must be improved to reverse a disturbing trend - registered nurses leaving patient care for jobs that provide predictable working hours, less stress, and fewer physical risks.

    "Nurses are leaving patient care because they're burned out, fed up, and just plain tired," he said. "They're tired of trying to deliver patient care without enough staff. They're tired of not knowing whether they're going to be mandated to work overtime. They're tired of running the risk of back injuries, exposure to infection, and even physical attacks."

    Piemonte and nurses at the news conference urged the State Legislature to enact legislation that would prohibit employers from forcing nurses to work overtime, except in the case of a declared emergency. Nurses who work excessive hours are more likely to make medical mistakes, are prone to injury, and experience high levels of job stress.

    "Nurses face a Catch-22 situation. According to their professional standards, they should not work if they are too tired to practice safely. But if they refuse to work overtime, under state law they can be charged with patient abandonment," Piemonte said.

    Mandatory overtime is one reason a growing number of nurses are leaving patient care.

    A national survey of nurses conducted by the U.S. Department of Health and Human Services showed that the number of RNs employed in nursing in the U.S. increased by only 4 percent between 1996 and 2000. During the same period, the number of licensed RNs not employed in nursing increased by more than 11 percent.

    In New York State, the survey estimated that the percentage of RNs not employed in nursing increased from 15.2 percent in 1996 to 19.0 percent in 2000, higher than the national rate of 18.3 percent.

    Piemonte said the expected passage of a state healthcare whistleblower protection bill is an important foundation for NYSNA's legislative proposals to improve working conditions for nurses. "Legislation to set staffing levels or ban mandatory overtime can work only if nurses feel that the law protects them when they report violations," he said. "Nurses must be empowered to exercise their professional judgment and speak up on behalf of patients."

    NYSNA's solutions to the nursing care crisis also include these measures:

    Ensuring Safe Staffing: Legislation that would require the state to establish and enforce guidelines for safe staffing in all healthcare settings.

    Disclosure of Quality Indicators: Legislation that would require healthcare facilities to disclose information related to the quality of nursing care, such as nurse-to-patient ratios, staffing levels, and patient outcomes.

    Violence Prevention: Incidents of violence against nurses have been on the rise in hospitals, psychiatric facilities, and other settings. This legislation would require employers with 50 or more employees to develop and implement plans to protect employees against violence.

    Ban Mandatory Overtime: except in declared emergencies. Zero tolerance of forced overtime for nurses.

    NYSNA is the professional association for registered nurses in New York with more than 33,000 members statewide. A multipurpose organization, it fosters high standards of nursing education and practice, working to advance the profession through legislative activity and collective bargaining.
    http://www.NYSNA.org
  8. by   susanmary
    Originally posted by -jt
    << No wonder California has such a nursing shortage!>>


    I worked at a major facility in LA thru an agency recently. I am an ICU RN - went in on a gorgeous Saturday - a sunny 92 degrees - confirmed for CV ICU. I had to fight with myself to stop from canceling the shift & going up the street to spend the day on the beach. But you know, Im a professional, they have a shortage, I gave my word on the confirmation, etc etc etc. So I get there & the nursing office tells me Im assigned to do private duty.

    I remind them that I confirmed for critical care and I dont do "private duty". They said "well its the private duty case or nothing". At that moment, the supervisor had just hung up the phone with another agency & said "OK so thats the 16th RN who canceled this shift". And here she was telling me do the private duty or go home??

    Since it didnt seem to matter to her that they had 16 new holes in their staffing for that shift and she could afford for to lose me too, I should have said "ok, see ya!" and went to the beach, but I thought it must be a very critical pt if he needs his own RN.

    So I go to the unit, take report, & find that its a wealthy 47 yr old post op pt - simple ENT procedure - who was discharged the day before but refused to leave. He was so demanding that the staff couldnt meet all his needs as quickly as he wanted, & were harrassed by him & his "people" all day. The staff RNs complained to the nursing dept that they didnt want to take care of him. So the hospital hired a private RN to be his maid. Guess who.

    The nursing office didnt want to hear any comments from me about this little trick they pulled on me. So I canceled my shift for the next day, told them exactly why, and that I wont work there again. Im sure it didnt faze them in the least.

    PS
    I suggested to the pt that instead of paying a hospital bill & for private RNs, he could leave & check into a hotel with his wife and relax at the pool with the hotel staff tending to his every need. And thats exactly what he did.
    Last edit by susanmary on Mar 12, '02
  9. by   susanmary
    Are you suggesting that we don't work in hotels?
  10. by   hisblueskies
    Am I missing something? The first thread to click on was titled Navigating the Uncharted Territory of Industry Sponsored Research. The second thread was on the The benefits and risks of a pack of M&M's. I thought the two reference threads were supposed to be on why nurses are leaving - Obviously, some of you were able to read the correct thread because you thank the person for bringing the articles to your attention.
  11. by   NRSKarenRN
    hisblueskys:

    Articles archived---re-edited links, try again. Karen
  12. by   -jt
    Uncharted Territory & M&Ms...thats what I got too! LOL
  13. by   NRSKarenRN
    try again with edited links:
    health affairs-the policy journal of the health sphere
    n a r r a t i v e m a t t e r s
    january/february 2002

    3/12/02 note: acrobat reader required to view articles as they are now archived. karen

    leaving nursing
    by ray bingham

    hospital staffing cuts have created conditions under which this dedicated nurse can no longer work.

    http://130.94.25.113/readeragent.php.../v21n1/s29.pdf
    ----------------------

    accountable but powerless
    by barry adams rn

    unable to deliver high-quality care, a nurse calls it quits, but not before blowing the whistle.

    http://130.94.25.113/readeragent.php.../v21n1/s30.pdf

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