Be the Coral

Nurses know better than anyone that we function in a flawed system. Though we exist within and are affected by systemic issues, many factors in our environment are beyond our control. Sometimes we may feel as powerless as specks in the sea tossed about by the waves. There is, however, a special kind of speck worth imitating. Coral larvae attach themselves to rock, on which they grow together to build a coral reef. Reefs block the impact of the ocean’s waves and provide a safe haven for many bright and beautiful species to live and flourish, buffered from the blow of external forces. When nurses are grounded in their values and priorities, we are on the “rock” from which collaboration with others is most effective. Nurses can build a safe haven where our voices are heard, our priorities honored, and our patients are cared for in a healing environment.

Powerlessness

Recent events within the nursing profession have created large and foreboding waves, impacting nurses across the nation. 1 in 5 nurses has left the workforce since 2020 and hospital nurse turnover is at an all-time high. RaDonda Vaught’s case has highlighted deficits in organizational responsibility. COVID trauma continues to affect nurses. Bedside nurses are left without the option to work remotely as droves of modern professionals transition to video conferencing from their couches. There are many reasons to leave nursing, and they all point to a singular problem: nurses are powerless against the global and national events that plague the profession.

The Cost of Nursing

At its best, nursing is a meaningful and fulfilling vocation. Nurses have been considered the most trusted professionals for twenty years in a row. I’m lucky to have worked with many nurses who revere and cherish that trust. Through life’s most heart-wrenching and heartwarming moments nurses bring meaning to the sterile protocols, standards, and flowsheets of the hospital system. It could be the moment when a tense and shivering patient melts under the comfort of a fresh warm blanket. It may be a furrowed brow coming unwrinkled as pain has been relieved. It could be the silent mourning of dressing a newly amputated limb. These are moments that give me purpose in my nursing career.

These moments come at a price. There’s the risk of back injury from transferring patients several times a day. There are the fumes of incontinence, the terror of a medication error, the exhaustion of mandatory overtime. Worst of all is the guilt of knowing a patient did not receive the care they deserved because circumstances beyond our control did not permit it.

Life is full of ups and downs, and for years nurses have been moving on and getting over the difficult shifts. I’ve sat down with several veteran nurses who have told me, “Back then, our ratios were much worse,” or “Try calculating drip rates for every infusion.” Nurse turnover in hospitals used to be a steady rise and fall, but this year has seen record-setting numbers in turnover. Nurses have faced wave after wave of the pandemic and staffing shortages. Nurses are human and can sustain only so much impact before walking away.

Building a Reef

We need a real solution. Washington state’s nurse’s union asked for regulations on nurse-patient ratios and a ban on mandatory overtime. The bill gained some traction before a disheartening failure. In Indiana, lawmakers have proposed lowering standards for nursing education to produce more nurses faster. The quickest fix yet has likely arrived at a hospital near you: Travelers. This bandaid solution rewards external hires with flexible time off and two to three times the compensation of regular staff. Though lucrative, constant relocation and re-orientations lead one to question travel nursing as a long-term career option.

We need nurse-driven solutions. It starts with nurses asking the question: What would it take for me to be happy at work? Identify the priority, and we are the coral larva that has found its rock and is ready to build a reef. Through collaborative growth, we can create a work environment that buffers us from the impact of the next COVID variant or staffing crisis.

Collaborate with managers

With hospitals losing an average of $46,000 for every nurse turnover, open communication of our values and priorities is a win-win:

• Advocate and/or initiate creating a calm room. Cedars-Sinai has a great example.
• Propose a nursing wellness retreat.
• Take time off frequently and consistently. You deserve the room to breathe.

Collaborate with coworkers/unit

Shape your unit and your practice through involvement in committees, nurse quality groups, and shared leadership boards available to you. Your voice matters.

Collaborate with the nursing union

Follow action steps recommended by your union to create systemic change.

Collaborate with the nursing world beyond

Networking with nurses in different specialties and backgrounds can broaden our understanding of the nursing experience. Diversity helps us grow resilient.

Nurses give the best care when we are valued, respected, and free from fear of being swept away by the next wave of unprecedented events. We must not settle for less.

References

How Do Coral Reefs Form?

Benefits of coral reefs

2022 NSI National Health Care Retention & RN Staffing Report

‘The nurses are not okay’

Military Brass, Judges Among Professions at New Image Lows

Nurse Safe Staffing Bill Fails in Washington Senate

Indiana Lawmakers Consider Easing of Nursing School Rules

Nurse Salary Research Report 2022