How to Stop the Mass Nursing Exodus?

[ClaraRedheart, BSN, RN]

Hi. My hospital is currently up for magnet renewal,  but we're losing staff constantly. I've even said myself that I can't do another COVID round, but it's here, and I'm still there while my co-workers are leaving and we're having to train staff that have never worked in acute care, because that's all we're getting. I've heard it's the same in many places. I'd like to gather some ideas on what it would take for you to stay, if you left.

Here are some things that pushed me over the top during our last covid surge, and some ideas on how the hospital might could help. 

* Having to transport an extremely sick covid patient to radiology because they were on over four units of oxygen while leaving four extremely sick patients on the unit that would not be looked in on or get their medication on time during the 40 minutes that we would be off the unit.

IDEA: I don't know how else to fix this one but more nursing or RT staff. We're already working short though. A resource nurse to help those that are drowning, or to transport when a nurse is required would help. 

*Trays left outside of covid rooms for 45 minutes when the nurses and techs are in other rooms and our covid patients who are already isolated and sad getting cold meals. 

IDEA: Hire more kitchen staff and TRAIN one of them to don and doff and deliver covid meals. 

*Full trashcans everywhere with isolation gear, in the hall, in the rooms, etc.. I try to empty them when I can but I've always got due and overdue medications and really don't have time to slow down. 

IDEA: Hire more ancillary staff to clean

If you left your nursing job, what would it have took for you to stay? 

[toomuchbaloney]

The coronavirus is devastating U.S. hospitals, which will lose $200 billion in revenue by the end of June

My guess is that hospitals aren't going to hire more staff to make life easier for nurses.  Bedside and support staff have always been expensive necessities and cost centers  (rather than profit centers) for our capitalism based health system. People are hospitalized to receive nursing care but nursing care is generally provided on the cheap and isn't actually how hospitals make bank.

[ClaraRedheart, BSN, RN]

1 hour ago, toomuchbaloney said:

The coronavirus is devastating U.S. hospitals, which will lose $200 billion in revenue by the end of June

My guess is that hospitals aren't going to hire more staff to make life easier for nurses.  Bedside and support staff have always been expensive necessities and cost centers  (rather than profit centers) for our capitalism based health system. People are hospitalized to receive nursing care but nursing care is generally provided on the cheap and isn't actually how hospitals make bank.

You’re probably right, but it would be in their best interest and save money in the long run if it means they’re not having to train new staff or hire expensive travel nurses because the experienced nurses are leaving. 

[toomuchbaloney]

15 minutes ago, ClaraRedheart said:

You’re probably right, but it would be in their best interest and save money in the long run if it means they’re not having to train new staff or hire expensive travel nurses because the experienced nurses are leaving. 

For decades hospitals have ignored the data that reflects better patient outcomes occurring as they spend more time in the care of RN'S...that is not going to change because of covid.  Nurses are expensive and are not viewed as profit generators by the capitalist health system in this country. 

[mmc51264, BSN, MSN, RN]

Staffing staffing staffing. We are so short in every dept. RNs, NCAs, Dietary, transport, EVS. Can't hire fast enough. I am not sure what other places the non-nursing people are going, but the nurses and assistants are going to clinics, home health, etc. 

I have a friend that has gone into home hospice (from working inpatient nights and having up to 8 pts, some Covid, per shift). She is on her second HH job because everyone is overworked. 

I am desperately trying to ride it out and hope we can recover. My unit has hired upwards of 17 new grads that are suppose to start in the next 6-8 weeks. Some new grads are going straight into travel nursing, which I feel is not safe. 

Our hospital has built some new towers and we had the highest census ever last week (of all pts, not Covid). We had gotten to less than 5 Covid pts one week, but the numbers are going up again ?

We just got the notice that Covid vax is now mandatory to work. 

God help us all. 

[SmilingBluEyes]

Magnet? Sorry but what a joke.

And your ideas are right on, but not gonna happen, sorry.

[Rose_Queen, BSN, MSN, RN]

1 hour ago, mmc51264 said:

I am not sure what other places the non-nursing people are going

Sterile processing department in my facility. Yeah, we kinda clean out the other departments.

[ClaraRedheart, BSN, RN]

4 hours ago, SmilingBluEyes said:

Magnet? Sorry but what a joke.

And your ideas are right on, but not gonna happen, sorry.

Agreed. I don’t think any hospital losing staff like this deserves to be considered for magnet. I realize that this is a nation wide (likely international) problem but magnet and all of the extra hoops that we have to jump through (and I chair an extra hoop committee and usually like it, but lately, I would like that off my plate while I cope) need to actually do their job and actually find ways to retain nurses, or go away. The name means nothing if they do nothing. 

[caffeinatednurse, BSN, RN]

More staff is one part of the solution, but it won't fix the problem. In most hospitals, "more staff" just means more new grads and more travelers. And no offense to new grads, but when a floor is already overwhelmed with new grads that just finished orientation and are barely operating on their own, and then another round of new grads are brought in...it slows down the existing staff that are pulling most of the weight. Travelers are great, but they're only around for their contract and then they're gone, to be replaced by new travelers that need an orientation as well. It's a constantly revolving door of new staff who need training, and not enough existing staff to train them.

Let's say my hospital adequately staffed our units. That still wouldn't be enough to make me stay. The money-first attitude I saw during our first surge was unacceptable. Yes, there's some degree of this in all of healthcare, but our admin made us feel like our lives didn't matter at all.

Ex: Rationing PPE, even though there was plenty in stock to protect everyone. Locking all of the PPE up in a central location and forcing nurses to rationalize to their house supervisors why it is necessary to take care of their patients. Not allowing nurses to use their own respirators and enforcing paper masks that were not even intended for medical use (true story). Forcing older nurses and nurses with pre-existing conditions to take care of COVID patients, or else threatening them that they would lose their jobs. Forcing med-surg to house orthopedics and then PCU because the COVID unit kept being shifted from one floor to another and effectively spreading it all over the freaking hospital. Enforcing unsafe "crisis" ratios and then continuing to enforce these ratios AFTER the surge was over because why not? We had already proved that we could do it once, why not keep doing it?

Most of the nurses I worked with interpreted all of that ^ as admin not caring about the lives of the nurses and NAs working the frontline. So until hospitals can rein in their admin and start putting people in charge who actually care about the lives of the people they employ, it's going to be difficult to make anyone stay at the bedside.

[JKL33]

On 7/28/2021 at 10:31 AM, ClaraRedheart said:

My hospital is currently up for magnet renewal,  but we're losing staff constantly.

Magnet is going to become a designation, alright--denoting where not to work and where not to receive care. This was clear from Day 1 upon seeing the resources that could suddenly be expended to pursue and purchase an award, ranking or designation--but would never be used to do the obvious things to improve patient care.

This is harsh but I don't think hospitals deserve to have any of us worry about how to stop the exodus. They have had ample opportunity to do so and in fact they started it themselves, practically gleeful about not having to pay (or deal with) experienced RNs. I could not be more pleased that inexperienced nurses also won't tolerate their despicable behavior.

This is not about covid. Covid simply helped make their position clear and undeniable.

I do worry about patients, but patients haven't been being served well anyway. The amount of money spent on appearances has made that difficult for them to discern.

[Nurse Beth, MSN]

It's like the pot was simmering before Covid and now it's boiling over. There were warning signs but they were not heeded.

[sleepwalker, MSN, NP]

Why is this your problem? Not to be mean or snarky but let the administrators in this wonderful Magnet status facility do what they promised when then sought out and obtained/paid for/bought this designation...

The designation was and is a joke....meant to sucker in the masses that don't really understand how a facility is run or what make a quality facility and base their decisions solely on some meaningless award (just like with cars, tools, instruments, etc.). In other words...it's just a gimmick.