How to Stop the Mass Nursing Exodus?

[ClaraRedheart]

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? 

[BSN-to-MSN, ADN, BSN, RN]

11 hours ago, sleepwalker said:

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.

Agree, our facility received Magnet last year, and so much talk about it, but clinical advancement program (and incentive) was cancelled. It means nothing to me, it felt like things were forced on nurses to become Magnet.

[JKL33]

https://www.nursingworld.org/organizational-programs/magnet/

And I quote:

Quote

The Magnet Recognition Program provides a roadmap to nursing excellence, which benefits the whole of an organization. To nurses, Magnet Recognition means education and development through every career stage [...]

Or maybe

2 hours ago, RN-to- BSN said:

clinical advancement program (and incentive) was cancelled.

?

 

[Guest1176712]

This is fitting as a way to stop the exodus. ? 

Federal Nurse Patient Ratios Bill currently under review in Congress.

HR 3165 just got more cosponsors!
Come on Nurses keep calling and filling petitions & Friends and Family can sign it too! Help Us Keep America Safe!:

https://www.nursestakedc.com/legislative-information

The related bill for the Senate side is S1567.  

I am only one person so please share this. We have to push until it's passed. Let's make it sooner than later. Don't think your signature doesn't matter! 

[OUxPhys, BSN, RN]

On 7/31/2021 at 10:26 PM, RN-to- BSN said:

Agree, our facility received Magnet last year, and so much talk about it, but clinical advancement program (and incentive) was cancelled. It means nothing to me, it felt like things were forced on nurses to become Magnet.

That's usually what happened. My hospital got Pathways to Excellence (they will never get Magnet). No one who worked my unit wanted it or filled out the survey. Unfortunately the people who don't work the floors pretty much got the designation. Im curious to see what bonuses and raises those who were heavily involved got. But yeah, it's a gimmick that benefits senior leadership. 

[Leader25, ASN, BSN, RN]

You can not respect and recognize nurses just when things get rough and ignore, humiliate, mistreat, subject to horrid working conditions the rest of the time.

[Kerivara]

Unpopular take:  There are a certain percentage of nurses now that didn't really want to be nurses in the first place.  They did it because they could make good money, because their first choice didn't work out, because they needed it as a stepping stone to another advanced healthcare career, because ________ (insert non-nursing reason here).  These folks probably won't stick it out.  On the other side of the coin are people that only ever wanted to be nurses.  They felt it in their blood at some point.  That is what life presented them as their vocation and they always knew that is what their destiny was.  They are nurses, not because a licensing agency told them they met the requirements, but because they were called to serve by a stronger pull of some kind.  Some of these folks are done too now, but many will still be there doing the job.

[turtlesRcool]

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

*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. 

On my hospital's COVID unit, the meals come at predictable times.  The aides work in pairs to deliver them.  "Clean" aide gets the tray from the trolly, and hands it to "dirty" aide who goes into the room and delivers it. Because it's not necessary to don/doff between patients who all have COVID, the "dirty" aide just charges outer gloves and does hand hygiene between rooms. The pair goes down the hall, with "clean" handing off to "dirty" over and over. It's way more efficient than having to be clean to get a tray, don clean PPE, go into a room to deliver a tray, come out, doff dirty PPE, and repeat.

In many facilities, the kitchen staff is not employed by the hospital, but by outside contractors like Morrison or Sodexo.  This adds issues with fit-testing for N-95s, plus training and liability issues for non-employees.  Given that some nurses and aides are afraid to go into COVID rooms, I imagine many food service workers would nope right out of the job if someone told them they had to start delivering to COVID rooms. It's a high-risk, low-reward situation.

[Guest1176712]

On 8/5/2021 at 2:31 AM, Kerivara said:

Unpopular take:  There are a certain percentage of nurses now that didn't really want to be nurses in the first place.  They did it because they could make good money, because their first choice didn't work out, because they needed it as a stepping stone to another advanced healthcare career, because ________ (insert non-nursing reason here).  These folks probably won't stick it out.  On the other side of the coin are people that only ever wanted to be nurses.  They felt it in their blood at some point.  That is what life presented them as their vocation and they always knew that is what their destiny was.  They are nurses, not because a licensing agency told them they met the requirements, but because they were called to serve by a stronger pull of some kind.  Some of these folks are done too now, but many will still be there doing the job.

I'm a nurse through and through but if it takes breaking down my body or mentality because of the work environment and lean policies, I'd rather not. I'm not a nurse martyr. I don't encourage that. I dream of a supportive enviro and all the problem solving support availability. It's so much fun and fulfilling. Then I wake up and remember what I've been through. I'm not a SuperNurse or a SuperWoman. This is not war time, I'm not on a battle field, and I don't like working in ratios that suggest it is. I just want to practice nursing and help folks without the bull^%$#. I expect to be paid and respected which is a lot less for all nurses now than it should be in light that hospital systems are profiting in the millions and billions. 

[sergel02, BSN]

I think the ratios are essential but as a RN in California where we do have mandated ratios we are still bleeding staff. I’ve been thinking of leaving bedside all together.

 

Staffing would be great. I know travelers are pricey but many have stayed on full time once their contract ended. Better staffing would help in general, nurses would get breaks, and there would be resources to help.

 

Smaller things staff can maybe do is not overload one nurse with the critical patients. Our facility tries to not give nurses 4 Covid patients anymore, and they try only 1-2 at a time and spread them out, and hopefully one is somewhat stable since many are on hi flow again. It’s not perfect but helps.

[MarleyGrace, MSN, APRN, NP]

On 7/30/2021 at 10:20 AM, JKL33 said:

 

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.

How true this is. Management is now using the phrase "there is a national shortage of nurses" to justify the even worse working conditions to the staff that does remain at our local hospital. I know there are more nurses/non-nursing staff planning to leave. Management is making no attempt at better treatment, just increased bullying and making excuses for the heavier and unsafe workloads.

[sergel02, BSN]

34 minutes ago, MarleyGrace said:

How true this is. Management is now using the phrase "there is a national shortage of nurses" to justify the even worse working conditions to the staff that does remain at our local hospital. I know there are more nurses/non-nursing staff planning to leave. Management is making no attempt at better treatment, just increased bullying and making excuses for the heavier and unsafe workloads.

I remember years ago during nursing school there was lots of talk about the nursing shortage. Went to apply to a bunch of hospitals and we learned there wasn’t a shortage of nurses, hospitals just didn’t want to hire and pay for them. 

[toomuchbaloney]

1 hour ago, sergel02 said:

I remember years ago during nursing school there was lots of talk about the nursing shortage. Went to apply to a bunch of hospitals and we learned there wasn’t a shortage of nurses, hospitals just didn’t want to hire and pay for them. 

We were told in nursing school in the 70s that there was a nursing shortage.