CONTINUED IN WHAT IS THE MAJOR REASON Why are they all leaving?

pagandeva2000, LPN · Nov 5, 2006

Hi, I departed this site almost 4 years ago under the user name Glad2behere, and this is a wonderful site. I will be leaving nursing again soon, my second departure. I am 52 yeats old, and it is really quite easy to explain why. Where else could I find the wonderful employment to work a Christmas evening and many weekends with staggered shifts, awesome responsibilities, vague legal guidlines, disease exposure of the nth degree, pathetic insurance, physically demanding, emotionally draining pseudoprofession that has become nothing but a temporary nesting job until something better is found that promotes some quality of life. I have worked my job 4 years in critcal care CCU, and have seen for a hired staff of 50 turn over 4 times. Yes, I am very senior now, Level II RN, (could be Level III easily if I wanted to play the goofy games to be one), do housesupervisor in a 478 bed trauma center prn, and could probably be the nurse manager of my unit if I cared about it. Reading truckdriver ads in the newspaper for a salary $15K> somewhat dissimenates the urge for the glory of a NM position. It's simple, the job doesn't pay enough for the exertion. What is really infuriating is the doublework of charting. Physicians don't really do it, bricklayers don't chart every brick they lay, architects write their thoughts when using CAD, plumbers don't say "applied plastic cement to x joint exactly 8 cm beneath expected concrete slab". Overall, having been in business, seen other industries, nursing is the most wasteful of available talent that has created a monster watchdog in charting that has become so important that it totally destroys the mission of nursing. Those of us who attempt to prioritize the patient as first do so at the risk of professional jeopardy in the charting arena. We are all guilty of getting slammed, not being able to chart until it's time to clock out or two hours later, then humans we are, the relevancy of it really rings and we succumb to drawing from memory tainted subjective comments that mean nothing. So there, wasn't that easy?

I can understand what you are saying. Charting is repetitive, redundant, and seems dumb to me. Where did the days go where nursing was really nursing, and they welcomed newcomers into the fold more easily than now? I am a new LPN and am working in a clinic at a hospital that paid my way to go through school. At first, I wanted to work in med-surg, and they did have me work there for about two months when I first started as a formality, but after all that I saw on the floors, I was so happy when I had to go back to my clinic. While it is still busy, it was safer than what I saw, and my heart went out to the patients as well as the nurses there. But, at this point, I don't care if I ever get any more floor experience. It was a nightmare.

Sandi0302 · Nov 6, 2006

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....

Amen. I worked in a Level 1 Trauma center ER for four yrs (Not as a nurse, but as a tech), and EVERYTHING you said is true. I think we all had a love/hate relationship with it...loved the challenge, different things everyday, but high burn-out rate. One time this guy was complaining about how long it was taking for his wife to get her TOE xrayed. "Sorry sir, there are 7...yes 7 trauma pts on the other side right now, so it's gonna be awhile"

Personally, I think we should have Nurses Tell It Like It Is Day during nurses week..."Hey buddy...@#$% &%$!" :)

Racin_Rick · Nov 6, 2006

I can understand what you are saying. Charting is repetitive, redundant, and seems dumb to me. Where did the days go where nursing was really nursing, and they welcomed newcomers into the fold more easily than now? I am a new LPN and am working in a clinic at a hospital that paid my way to go through school. At first, I wanted to work in med-surg, and they did have me work there for about two months when I first started as a formality, but after all that I saw on the floors, I was so happy when I had to go back to my clinic. While it is still busy, it was safer than what I saw, and my heart went out to the patients as well as the nurses there. But, at this point, I don't care if I ever get any more floor experience. It was a nightmare.

I'm happy for you, congratulations! I guess I am so bored with nursing really, perhaps clinic nursing will shield you from the cynical immersion. Having steady hours is a really good feature. You Go!

aberrn · Nov 6, 2006

Where I work at the moment,nurses are leaving from the ER in droves.

Management accepts resignations without batting an eye.No one is asked what can we do to make you stay?.

I am personally not interested in listening to management personel who may have RN after their name but have no bedside experience outside of school.

People who sit behind a desk 9-5 M-F also have no business telling us weekend Baylor people how to do our jobs..I know how to do my job,get me what I need to do it without walking all over to find supplies.

Docs who get involved in the NURSING process are doing us no favours.You get your docs to see pt's in a timely fashion,we'll take care of the nursing side.

Plus the usual suspects,ER's filled with non sick,non compliant pt's

Verbal abuse,no back up from management."No staff,sorry,you'll just have to deal with it".."

But that being said.the little old lady who grabs your hand and says "Thankyou" after relieving her bad CHF make it all worthwhile.

DeLana_RN, BSN, RN · Nov 6, 2006

Just curious, can you use a patient's bathoom for a bathroom break if you ae on your way in there to check on them, or is that considered bad "nurse etiquette"/prohibitted?

When I worked med-surg/PCU as a new grad with impossible ratios (1:8 on day shift!) I did this all the time; I can use the BR very quickly - you don't have to actually sit on it! - but use it I would. And I also always made it a point to take my 30 min lunch break - off the floor, pager given to a coworker who would later give me hers - because otherwise I would have never made it through a 12-hour shift.

Never mind that it was never a 12-hour shift - on a good day, I would finish my charting after only 13-14 hours (total of course), on a bad day 15-17 (!) hours :uhoh3: . But what are you gonna do as a new grad, basically thrown to the wolves, with 12 pts to chart on?! Yes, up to 12. 8 beds, 4 discharges, 4 admits :angryfire *

I had to get out of there and went to outpatient dialysis; however, it's a different kind of grinder, and what made that job so hard was (1) horrible early morning hours, (2) UAPs with bad attitudes, probably because many are doing tasks that only nurses should do such as accessing central lines and giving meds, and (3) similar to hospital nursing, impossibly high ratios and expectations.

So where do I go from here? Well, unlike many, I do have the calling... so I'm not about to leave nursing, and I'm even going back to the hospital! But this time to inpatient dialysis with the incredible nurse/pt ratio of 1:1! It sounds like the best of both worlds... I'll let you know how it goes

DeLana

P.S. I've been in nursing long enough now ('98 grad) that I won't hesitate to leave a bad situation - fast.

* I forgot to add that I made

anne74 · Nov 6, 2006

Previous Post: "I can say that during my 3 years working as a tech in PACU in Arizona I have never seen a nurse miss out on lunch. They all also find time to use the restroom."

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You can't compare the PACU to typical floor or ED nursing. The PACU is different - the pace includes natural downtimes, so it's a lot easier to eat lunch, go to the bathroom. But the floor is a different story. I used to be in Med/Surg and there were many times I didn't eat, etc. On the floor, you don't have the luxury of taking care of a patient for a few hours and then sending them on their way. In Med/surg, you are constantly at the beck and call of your patients for 12+ hours. And the poor ED nurses - I've never worked there, but I know you guys have to deal with frequent flyer, non-compliant patients that never let up.

I now work in the PACU, and it's much less stressful. Not that it's stress free, but at least you get a break now and then. It's delightful! If you're burned out from the floor or ED, consider the PACU before quitting nursing all together. It kept me in the profession.

Hats off to those who can stay in Med/Surg. I don't know how you do it. It killed me - physically and spiritually. Thank you for all your hard work, floor nurses! And ED nurses too!

DeLana_RN, BSN, RN · Nov 6, 2006

Hats off to those who can stay in Med/Surg. I don't know how you do it. It killed me - physically and spiritually. Thank you for all your hard work, floor nurses! And ED nurses too!

Amen.

DeLana :thankya:

marybethm · Nov 6, 2006

Hospital nursing, like many labor-intensive jobs, is a young nurse's job in my opinion. And nursing is one career that offers so many opportunities for the different stages in a nurse's life that a person would be a fool not to take advantage of them all. It's the greatest job in the world, I think. I have worked as an float in all dept. of the hospital when I was a student, overseas as a young single nurse, in the ER and CCU for ten years, then part time nights as a young mother. I took a few years off and went back as a school nurse so I have summers and holidays off. I also worked as a camp nurse so I could take my kids for free. It's a great life, but hospital nursing is still the hardest job I've ever had. You can only do it for so long.

alien-warrior · Nov 6, 2006

After all these years, I'd like to have a job where I didn't have to worry about anyone's urine, bm, cardiac, or pulmonary history - plain and simple.

Know what you mean:uhoh21::uhoh21::uhoh21::uhoh21::uhoh21: and don't forget their bowels!!!!

And having pander to demanding and ungrateful patients, and relatives, while listening to their abuse and grittng teeth and biting your tongue!!!.

Mary Austin · Nov 6, 2006

Ah yes, the million dollar question that employers will find the answer to later when there are not enough of us to do the work on the floors. It will be then and only then they might start to listen (maybe)

A Nurse spends 8-12 hours per shift attending to patients When you have co-workers who sleep on the job, take extra long breaks, and then do not cover your lights when you go on break then who does the patient direct their anger towards? and how do you explain that you needed a break and another nurse was suppose to answer your call lights for you? Patients are self-focused and they care about getting the help they need now. Patients do not understand that you are one person caring for six or seven patients by yourself. They do not realize that you may walk three to six miles per shift. Many older patients see the nurse as their handmaiden and she/he is there to follow the doctors orders. The general population has a very interesting view of nurses and it has not changed for the most part. I interviewed people who were not tied to the medical profession (the average patient) and they would tell me that nurses follow doctor's orders and that the doctor is the boss! I see and hear how patients praise doctors up and down for their work when they come into see the patient. I have been a nurse 27 years on Med Surg units in various hospitals and nothing has changed in the general public's mind on what nurses do and are suppose to do. :uhoh3:

For me, I am looking for a way out and off of the med surg floor. I am watching RN's that are 4 years into their job and want to get out because the job is "killing" them. They cite their reasons as "not enough help", "demanding patients and families", "no breaks", "arguements and disrespect from doctors", "lifting heavier patients kills my back," etc. Hospitals, Nursing homes, doctor offices are working short staffed and work ethics have changed. This profession is in trouble. The baby boomers are aging and are dropping out of the workforce. There are not enough people to fill their job positions and nursing is one of them. There are nearly 77 million baby boomers. Wait until they all need medical care in the next 10-20 years.

The nursing profession is going to be in for a very rough ride when the boomers leave the nursing profession which they are currently doing. I have some years left and will go back for that Master's degree so I can get away from floor nursing. So why are nurses leaving? Multiple reasons but the bottom line is that PROFIT comes before people in ALL medical professions. Thus the reason the doctor's office nurse has been replaced by the medical assistant. (I recently spoke with a MA who was doing complex dressing changes in an office with no experience in wound care and no, the doctor did not show her how to do it she just did it!.) If it goes on behind closed doors and no one knows then what is the difference. The general public does not know who treats them except it was that "nice nurse" at the doctors office who did it. MA's cost less to hire than an experienced nurse. Interesting to note that a number of doctors at our facility think that nurses make too much money! These doctors are usually older and established surgeons who have made their millions already. Bottom line......MONEY;)

futurecnm · Nov 6, 2006

Wow, what a discussion. Sometimes these type of posts discourage me as a nursing student but I'm going to keep at it because I truly feel like I'm meant to be a nurse. I am a student doing clinicals on a med-surg floor. The nurses are required to take breaks and lunch. For the most part, they seem happy with their job. this is my first exposure to hospital nursing so I don't have a lot to base my opinion on. Maybe it depends where you live, because here it seems like job satisfaction is pretty good.

jabiru · Nov 6, 2006

The nursing profession is going to be in for a very rough ride when the boomers leave the nursing profession which they are currently doing.

This is so very true. I don't know what's happening where you are but in Australia, there is very much a head-in-the-sand approach to the looming nurse shortage. They can't go on importing nurses forever and not enough new nurses are being trained to replace those who retire. Almost half the nurses in this country are aged 45+ (me included) and it's predicted that 100,000 nurses will retire in the next 15 to 20 years. Nowhere near that number are being trained.

I guess they'll do what they always do and wait until the drama unfolds and then say, "but no one told me".