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jeastridge jeastridge (Member) Writer Expert Nurse

Gonna Quit: When Nursing Is Rough...

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The author presents some of the current issues in today's nursing profession including nurse/patient ratio, living wages, bureaucracy, positive mentoring, and discusses possible ways to address them.

Gonna Quit: When Nursing Is Rough...

My friend texted me a short note that spoke volumes, “Gonna quit. Just can’t handle this anymore. Work here is too hard. Help!” I read her note with sadness and tried to respond with a word of encouragement that might last longer than the appearance of the emoticon on her screen. Getting discouraged in our work as nurses happens to all of us from time to time.

Studies show that nurses change jobs more than other professionals. In fact, the latest trends show nurses leaving the profession in greater numbers often for other lines of work but sometimes to pursue advanced degrees that will move them beyond the bedside and into higher paying positions. This trend, evolving over the past decade, has led to a large number of nurses with advanced degrees and many fewer who see their calling as staying the course in the arena of bedside nursing.

Recently, a friend went to the local ER where she was to be admitted for an appendectomy. The ER was full and there were physical beds upstairs, but the lack of staffing by nurses kept patients on gurneys in the overcrowded spaces downstairs. This problem did not develop overnight but administrators scratched their heads, perplexed as to why they couldn’t attract and retain enough nurses to keep their hospital fully functional. “The RN Work Project reports an average of 33.5% of new RNs leave the bedside within the first two years” (https://minoritynurse.com/why-good-nurses-leave-the-profession/). Staffing levels in emergency departments and intensive care units in some places are better, with less critical shortages. Some have theorized that this is because those areas are seen as stepping stones to leaving the profession to pursue higher education. In other words, nurses apply for ED and ICU jobs more often, stay with them longer, in hopes of going to nurse anesthetist school or getting a nurse practitioner degree. At one hospital, administration is considering requiring nurses to work medical/surgical floors prior to having an ICU or ED job. While this may take care of the problem in the short term, what are some longer-term concerns we need to discuss?

While the problem is widely acknowledged, and the proposed solutions are myriad, it seems that at times the remedies are knee-jerk reactions, running around with band-aids to address gaping wounds. While stop gap measures may be required in the short term, is it possible that a longer term vision might serve us all better? What can we do, as nurses, to help influence the conversation? Do we have a place at the table? Are we invited to give our input?

What would you tell administration if you could sit down and have an honest conversation?

A living wage is important 

While money is not the main motivator for most nurses, we all have to pay rent/mortgages and car payments. Having a living wage helps to take that off the table. Most nurses don’t go into the profession with the hopes of becoming fabulously wealthy, but all would like to be able to live decently and retire with dignity.

Patient ratios matter 

Administration can ask nurses to do extraordinary duty from time to time but not on a routine basis. Taking care of more patients than you are physically able to is not only dangerous but demoralizing. It sends the message that “what you are doing isn’t all that critical.” By slowly eroding professional pride excessive demands on nurses in the forms of unreasonable staff/patient ratios takes the wind out of the sails of good nurses who thrive on doing a good job, not on cutting corners and making do with less than the best. [There have been a number of articles on this website related to this important issue.] 

Keep bureaucracy at bay 

Fears, especially fears of litigation, can lead administrators down the dark and dangerous road of micromanaging and over-control. It is a given that mistakes are bad, perfection is good but the road to excellence is not covered in more forms—it is instead, oddly and perversely opposite to trends, in the freedom to pursue excellence as individual professionals. The fear of mistakes and lawsuits keeps us at times in the straight jackets of compliance, endlessly clicking our computers while the patient suffers the consequences of our inattention, at times resulting in units where nurses spend their time congregated around computer screens and less often doing hands on care.

Mentoring matters 

New nurses need connection, encouragement, supervision, training. When professionals long to flee their field after a few short months, something is very wrong. Part of the answer lies in what we expect from our new grads. Longer term preceptorships, lower expectations of independent function can work together to promote safety, collegiality and well-supported co-workers who want to stay and find reward in their work. While long term preceptorships cost money, they are an investment in the long term health of our institutions. A nurse who feels the brightness of a the future in his or her job will stay with it and be an asset to the profession as a whole.

It’s complicated…

It is important for all of us to work together to find solutions that fit our situations. With increasing pressures from within and without, hospital administrators daily find themselves in lose-lose situations, working furiously to simply put in place the “less bad” alternative. The answers to our current problems are many are far-reaching, extending from voting to informing our legislators, to speaking with kindness and courtesy to listening carefully. As H. L. Mencken said, “For every complex problem there is an answer that is clear, simple, and wrong.”

For my friend who found herself upset and angry, a word of encouragement was just what she needed to get through the day and face a new tomorrow. When the going gets rough, we can all be that voice of hope for our co-workers in need.

Joy Eastridge, BSN, RN

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Joy currently works as a Faith Community Nurse. She enjoys cooking for her family, taking long walks with her dog, reading good books to her grandkids, and hiking in the mountains.

74 Likes, 5 Followers, 87 Articles, 145,145 Visitors, and 376 Posts.

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Thanks, Joy, for this article highlighting some of the many issues nurses are facing today. 

57 minutes ago, jeastridge said:

When the going gets rough, we can all be that voice of hope for our co-workers in need.

We all need to remember this statement, carrying it out in our face-to-face encounters as well as here on allnurses.

 

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I've been a nurse for 26 years now - its my second career. I hope to work until I'm 70. What worked for me was getting more education. I can honestly say I don't think I could have kept up the pace in a very busy level 1 trauma center ED until I was 70 - lol. However, my current job, though mentally challenging is not as physical as the ED

Thanks for some thought-provoking ideas. 

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While I still pay every year for my nursing license, I no longer ever want to practice again. I should say that I was bullied from day one in nursing school despite being a great student. The bullying continued throughout my tries at nursing jobs so I finally just stopped trying. I was bullied so badly at one job that the company paid me to not sue them. I am trying to get into Nurse Informatics so I can deal with data and have some peace in my life. When I got out of nursing school, with no "ins" to a job in a hospital and a glut of nurses, I was forced into community health nursing. While I enjoyed my patients, I took the only job I could find, in a dysfunctional workplace. Nurses told me horror stories before I started and I became part of the roadkill from this job.  I am convinced that I have no future in nursing and will never apply or work in the field again. I spent a lot of money to get a job (not a career) that made me so stressed that I attempted suicide. You are damned if you do- I worked 16 hour days, won praise from the state Health department, but was daily (sometimes several times a day) reemed out by my Nurse supervisor. I tried to work in a rehab facility. The CNAs told me I wouldn't survive- and after bullying by fellow nurses, I was out the door. Even though I worked with nursing educators who said my technique was perfect, I was told everything I did was wrong and I was happy to leave.  No more Nursing for me!!!!

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Nursing is just too much, period.High stress level,too many clients,too much politics,heavy work load,and drama.Ill keep up my nursing license but I plan to work elsewhere. Nursing is not worth my peace and sanity when there are plenty of other jobs in the medical field 

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In addition to staffing ratios, the continual requests to work over or  work a double, come in on a day off, with the implication that you need to support coworkers is mentally taxing. And having vacation time denied because of shortages. 

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2 hours ago, LPNTORN704 said:

Nursing is just too much, period.High stress level,too many clients,too much politics,heavy work load,and drama.Ill keep up my nursing license but I plan to work elsewhere. Nursing is not worth my peace and sanity when there are plenty of other jobs in the medical field 

There are also many nursing jobs away from the bedside and the hospital that are much less stressful.  That is one of the benefits of nursing - you are not restricted to bedside nursing.

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It is all a matter of making this career work for you. Try out all the different options that the nursing field offers. Bullies are everywhere and in every field. Back them down. I have never let anyone run me off from a job. I leave when I am ready. I cover my tush, lol. There are times when you can't help stuff but there are a lot of times that you can.

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14 hours ago, tnbutterfly said:

There are also many nursing jobs away from the bedside and the hospital that are much less stressful.  That is one of the benefits of nursing - you are not restricted to bedside nursing.

Can you list those jobs please?

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On 1/23/2019 at 11:27 AM, greytRNtobe said:

While I still pay every year for my nursing license, I no longer ever want to practice again. I should say that I was bullied from day one in nursing school despite being a great student. The bullying continued throughout my tries at nursing jobs so I finally just stopped trying. I was bullied so badly at one job that the company paid me to not sue them. I am trying to get into Nurse Informatics so I can deal with data and have some peace in my life. When I got out of nursing school, with no "ins" to a job in a hospital and a glut of nurses, I was forced into community health nursing. While I enjoyed my patients, I took the only job I could find, in a dysfunctional workplace. Nurses told me horror stories before I started and I became part of the roadkill from this job.  I am convinced that I have no future in nursing and will never apply or work in the field again. I spent a lot of money to get a job (not a career) that made me so stressed that I attempted suicide. You are damned if you do- I worked 16 hour days, won praise from the state Health department, but was daily (sometimes several times a day) reemed out by my Nurse supervisor. I tried to work in a rehab facility. The CNAs told me I wouldn't survive- and after bullying by fellow nurses, I was out the door. Even though I worked with nursing educators who said my technique was perfect, I was told everything I did was wrong and I was happy to leave.  No more Nursing for me!!!!

Dear friend, I was so sorry to hear about your bad experiences, especially the reports of bullying. I hope that you go on to find something that is satisfying and rewarding and can put all these negative experiences in the past. All the best! Joy

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17 hours ago, LPNTORN704 said:

Nursing is just too much, period.High stress level,too many clients,too much politics,heavy work load,and drama.Ill keep up my nursing license but I plan to work elsewhere. Nursing is not worth my peace and sanity when there are plenty of other jobs in the medical field 

I hear you. It is hard. In the right place it can be very rewarding but that is not the case with every nursing job. I hope that you find something that is just the right fit for you. Joy

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16 hours ago, nursej22 said:

In addition to staffing ratios, the continual requests to work over or  work a double, come in on a day off, with the implication that you need to support coworkers is mentally taxing. And having vacation time denied because of shortages. 

You list some serious problems and these that you listed often go unmentioned because they are more subtle--but the pressure is there. Maybe some other nurses can chime in on their strategies for maintaining healthy boundaries in a demanding profession? For me, part of it is simply acknowledging that they have a problem but I can't always be the answer...but it is hard. For sure. Joy

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