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? 

[Rach1234567]

Isn’t this a good thing overall? If they are leaving then that means they found someplace else to go. 

[sergel02, BSN]

2 hours ago, toomuchbaloney said:

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

That makes me sad ?

I had a patient who worked in my hospital decades ago and retired in the 80s. Staffing was tight and I explained to her at the end of the shift that I didn’t see her as much because of that, and she said it was just like that back then. 40 years later and I guess things don’t change too much in regards to that.

[toomuchbaloney]

11 minutes ago, sergel02 said:

That makes me sad ?

I had a patient who worked in my hospital decades ago and retired in the 80s. Staffing was tight and I explained to her at the end of the shift that I didn’t see her as much because of that, and she said it was just like that back then. 40 years later and I guess things don’t change too much in regards to that.

That's because it's a business model.  RN'S are expensive. 

[guest1143647]

What is wrong with working or training  experienced nurses with no acute care experience to acute care?

I notice some on this site like to talk down on non acute care nurses as if we are "stupid".

 

 

[ClaraRedheart, BSN, RN]

On 8/7/2021 at 3:48 PM, turtlesRcool said:

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.

Thank you so much! I love this idea! I suspect our ED is already doing something similar as all of our patients are on non-select rather than allowed to order room-service. I don't see why we couldn't have set times for covid patients and still allow them to order what they want, just get their orders in early enough to have them all arrive at once. I'm going to bring it up. Thanks again!

[RobtheORNurse]

This is just a phase of the bigger issue of the on going shortage. We have worked short staffed for over a decade, everyone is burned out to some degree, and this just added fuel to the fire. Hospitals have had years to fix the issue and refused, instead worrying about the bottom line, building new buildings, bonuses for administrators etc. The refusal to hire new grads, all the while complaining that there are not enough nurses. I can go on, but this is not a new problem. Until administrators start truly listening to nurses, and fixing the issues related to poor treatment of nurses, it will continue.

I left bedside nursing after 30 years because I was tired of the constant on call e had to do, which was really mandatory overtime because we never left the hospital when on call, and worked right through the regular shift, call shift and following regular shift. Often being at work in excess of 24 hours at a time. Couple that with uncaring management and administration, as well as HR, who called us to ask why we were getting so many worked hours and pay. They never fixed the issue. The result, in a 6 month period of time, 70% of the nursing staff in my OR left. Then they were in a real shortage, causing cancellation of cases, closure of rooms etc. I now have a great job in the device industry, am valued for my expertise and knowledge. I have been hoe for every holiday and family event. Don't need to get approval for a vacation a year in advance and the pay is about 1/3 higher than working in a hospital. Why would a nurse stay in those conditions?

[Guest1176712]

Nurses, ancillary, and doctors hold the power because corps are profiting off our work, skills, and education. Corps are pushing us to the edge for profit. But really we can come together and tell them NO. what are they going to do without us? They're starting to see this with Covid. We should have caps on pay for admin and have the to be accountable to Drs and Nurses with total transparency. Admins should be made of Drs, Nurses and ancillary. I know this will not be easy but it's doable. 

[bitter_betsy, BSN]

My hospital just got their Magnet renewed. Our CEO just got some sort of bonus with a few zeros after it and on the same day - they gave day shift watermelons. Most of us night shifters weren't there the day before and didn't know we had to come in early to pick one up. Why take care of your night shift though? 

I work in the ED and the people coming in are so entitled.  They want blankets in the waiting room while waiting for their covid test.  We have started telling them we don't have enough blankets for that and we have to save them for the admitted patients. I wonder when we will stop just testing people. We can't actually save lives because we are too busy triaging people for tests who don't need to be there.

Even the people we need to take care of have a new attitude. They leave their family members (with dementia) who are sick and now they become our problem.  We have sicker patients, and now we have become a med-surg holding area because we don't have enough nurses for the beds upstairs. I can't blame them - I used to love my job and now I hate it.

I think I'm gonna trade in the big people for little ones.  At least when I have to change their diaper, I don't get punched in the face for trying to do so.

[Hoosier_RN, MSN]

On 8/7/2021 at 10:42 PM, Rach1234567 said:

Isn’t this a good thing overall? If they are leaving then that means they found someplace else to go. 

No, many quit and go to nonnursing things or they simply retire

[toomuchbaloney]

10 minutes ago, Hoosier_RN said:

No, many quit and go to nonnursing things or they simply retire

I retired early because I was just tired of the profit focused care. I'll turn 65 soon and I'm glad to have missed the covid pandemic as a working RN.

[summertx]

On 8/9/2021 at 4:52 PM, AtomicNurse said:

Nurses, ancillary, and doctors hold the power because corps are profiting off our work, skills, and education. Corps are pushing us to the edge for profit. But really we can come together and tell them NO. 

At first, I thought this was the answer to say no, but after  years of no change in staffing or respect,  I have decided not to deny shifts or amount of patients because they need the care, I am going to invoke Safe Harbor in my state before my shift (means management has to fill out a form to not report to nursing board any deficiencies). 

[Hoosier_RN, MSN]

13 hours ago, toomuchbaloney said:

I retired early because I was just tired of the profit focused care. I'll turn 65 soon and I'm glad to have missed the covid pandemic as a working RN.

I wish that I was at a place financially that I could do so. If I were, I'd join all of you!