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? 

[keward01, MSN]

 I have been blessed. We have been supported as much as we possibly can with the resources that are available inside and outside of our organization. We have received numerous bonuses during this time: 2 retention bonuses, extra shift bonuses, free PTO days. There have been times during the pandemic when all the non-clinical employees (even corporate) were assigned to units and provided whatever help they could instead of working from home (transport, crowd control, runners, etc.). I have personally seen my CNO pushing patients. We have been hiring agency staff for months on end (without any red tape) to ensure that we get as many nurses in as possible. We have 15k sign-on and retention bonuses for all of our positions posted. 

I feel proud to work in a place that isn't afraid to aggressively invest in the workforce in normal times and double down during hard times. Unfortunately, for many of us, even financial incentives can't repair the mental and physical exhaustion that we are all suffering from. Even with open access to bring in extra help, there still aren't enough available resources out there. People are fleeing from healthcare, not running toward it.

Each surge I know we all think....can I do this again? Can my family handle this again? Can I put off my own healthcare needs a little longer? Can I find a better way to cope?

I've heard some stories from others that have had it much worse than me based on the environment in which they are working. I have spoken to agency nurses that have come from emergency departments where there are no permanent staff, no department leadership, no presence of senior leadership where the beds are full of boarders and patient just wait in the waiting room until they finally leave. 

OK, enough running on and on. I have done emergency room nursing for 20 years and there are some things that stay the same, pandemic or not.

Front-line leaders have to be able to paint the picture for those that are in charge and not in the trenches (executives).

If the leaders aren't listening and advocating for you then you'll never get what you need.

Rephrasing what you need is important. Everything that you are asking for is essentially to be able to take better care of patients. Make sure you phrase it like that. Sometimes using phrases like "we need" or "I wish we had" are easy to dismiss. Change your language "the safest way to care for our patients is" or "our patients deserve". Since we are all in it for patients, it is hard for leaders to rationalize that it's not best for patients to have the resources you need. 

Nurses already give so much and giving more, and more, and more with every surge will definitely leave us with an empty tank. My hope is for each and every one of us to get through this with our minds, health, and families intact. 

PS you don't have to stay in an organization were you feel hopeless. You may have heard that "the grass isn't greener"...... that's simply not true. The grass is watered by the culture of the organization you choose to share your loyalty with. 

[she244]

   I worked in the ER for 11 years before they decided my ADN degree meant I was no longer educated enough to work there as a they became a Magnet Hospital.    So most of us who where unable to go back to school or agree to were told to find other jobs.  I did.  Worked 14 years at my last job.  Gained a lot of skills, took classes to keep my skills up to date and current.  Now I see the Hospital I worked for is even asking for LPN's to apply. They called me to come to work.   I don't trust them enough to go back to work for them.  When the pandemic is over we would be told again to find other jobs.  No Thanks.  I recently retired and have been looking for something part time or supplemental.  Good Luck and Best Wishes to all working on the front lines.  Hope they can find additional staff to take ease the load all of you are facing.  Prayers for all.  

[Justcultureisjustcrap]

I am nearing the end of my career (thank God). I'm 60 years old. I always loved nursing- but I don't now. I hate it. I have anxiety before I go in. I'm on a med-surg floor taking 6 patients- I have to pass meds, do "task lists", draw labs, give baths, clean, turn, strip rooms, pass and pick up trays, start ivs, etc- 12 hours, 6 patients. That's approx 2 hours per pt. What a joke. And usually half or more have COVID. I don't know how much longer I can do it. I am so tired of feeling like I am treading water, so tired of apologizing. We have techs but they are not like techs back in the day. They must constantly be reminded or begged to assist. I admit I am only doing this for the benefits, that's it. I have even considered retiring early , living on dog food and taking my chances with no insurance. 

Seems like these hospitals always have enough money for another paper pusher, or another layer of eyes, another clipboard or someone inan office, another award to pay for or another million dollar CEO or administrator.  I got a 1% increase... I'm sick of it.

[Starz_stuffs, BSN]

I worked in a state ran psychiatric hospital in Texas. Staffing was a HUGE problem. The abysmal low pay for nurses and PNA's was unreal. We also dealt with  consistently broken or scarce  equipment/supplies, disregard for effective infection control measures, and general lack of care for patients and staff. Psych care can be dangerous and when you don't have enough staff to restrain aggressive patients, no supplies to protect yourself or patients, and administrators indifferent attitudes; it proves to be too much. They had a "huge" hiring event last month and didn't have one taker for nurses or aides. Why you ask? Because they pay new techs 10$/hour. You can go to McDonald's and make that much. All the while administrators smile and say "thank you for your service", "you're our hero", "thanks team!".  I never want to hear those words again. We had patients and employees die from covid and I blame the money grubbing hospital administration for their gross negligence. It's shameful and heartbreaking. 

[toomuchbaloney]

1 hour ago, Starz_stuffs said:

I worked in a state ran psychiatric hospital in Texas.

It seems that the state of Texas has a history of ignoring and underfunding mental health issues for the residents.  They recently voted to inject some money into their system but that usually involves more beds and facilities rather than increased pay for workers in the system. States which have long functioned under fiscally and socially conservative political leadership frequently under invest in public health (including mental health) and public education. 

[Starz_stuffs, BSN]

Yes, I totally agree. Most of my patients are (were) forensic clients coming from jail. The charges are occasionally serious but most are trespassing, failure to identify etc. That's the Texas way to get folks with mental illness off the streets. Of course then they have a record that makes it hard to receive services. They are usually sent to us on 60 to 90 day competency restoration commitments that actually turn into 90 to 180 days. So my acute care facility is actually long term. It's all about the money. You wouldn't believe tbe kickbacks and rackets they have running. I really miss my patients though and I hope I gave them a little comfort in what I'm sure is a really terrible spot to be in.

[B52, ADN, BSN, MSN, RN]

I left for several reasons, but mainly lack of communication from the nurse manager and assistant nurse manager, who were rarely visible. 

[Justcultureisjustcrap]

For years nurses have accepted "atta boys", pats on the back , worthless award certificates and pizza parties for a job well-done. I believe if we were a male-dominated profession, this would not have been the case.  Until we decide to start sticking together, nationally, and make them value us, this will never change. If I have to listen to one more privilege member of management complain about their "bonus" I'm going to puke. Bonuses that they get for sitting in an office and deciding that I   the nurse, can just do 3 or 4 peoples jobs. That will save the hospital $$ and make the administrator look good...I don't have so much compassion fatigue as b******t fatigue...

[ppfd, BSN, EMT-P]

Probably an unpopular opinion but, firing “heroes” for not taking the ‘vid shot or forcing it on employees is not going to fair will for retention.

And I agree, let that guy making 7 figures work it out. I go to work, do my work and go home. 

[Guest1176712]

On 8/18/2021 at 9:21 AM, maji2002 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."

 

While I love my job, and have been in nursing over 35 year, this martyr attitude is what keeps nursing from changing for the better.  It is short sighted to think that sticking it out "for the patients" will result in anything other than continued abuse &, less safety for patients and nurses.  When we really love something, we need to make the hard choices and get serious to fight for real change to happen.  The short term pain will be worth it if we can affect change for better staffing, pay and safety.  We need to get our heads out of the sand, get active politically, and refuse to accept the continued unsafe demands being placed on us. They count on that martyrdom, they use it against us, and cash those big executive bonus checks, while patients suffer, we suffer.  We are a force to be reckoned with if we get smart and use it against them.  They will use guilt and abandonment arguments as metaphorical chains to keep the status quo.

YES THIS! ^^  Remember, healthcare corps invest in other corps and buy realestate. Pts aren't their only cash stream. ex. https://www.natlawreview.com/article/understanding-pathways-hospitals-and-health-systems-to-invest-start-ups

On 8/18/2021 at 8:55 AM, GordonGekko said:

Nurses make great money.  What are you talking about?  My first nursing job paid $28/hour plus differentials in Florida.

Nurses should be making at least $50/hr in the lowest paid states higher in others. 6  figures/yr with our education, skill, hazzards, risks, etc.    PFFFF at 28/hr WTH?   Accepting that is martyrdom. We need to fight for higher. If the country goes 15/hr (which should be 20+/hr) we should be paid way higher for our positions. 

[GordonGekko, MSN]

1 minute ago, AtomicNurse said:

YES THIS! ^^  Remember, healthcare corps invest in other corps and buy realestate. Pts aren't their only cash stream. ex. https://www.natlawreview.com/article/understanding-pathways-hospitals-and-health-systems-to-invest-start-ups

Nurses should be making at least $50/hr in the lowest paid states higher in others. 6  figures/yr with our education, skill, hazzards, risks, etc.    PFFFF at 28/hr WTH?   Accepting that is martyrdom. We need to fight for higher. If the country goes 15/hr (which should be 20+/hr) we should be paid way higher for our positions. 

$50 an hour for an associates degree?  Ummmm I don't know about that.  The $15/hour fight is nonsense.  We need to eliminate minimum wage altogether and let the invisible hand of the market work.  Read up on Thomas Sowell.

Nursing is not a difficult job IMO and 50/hour is 100kish which is just outlandish for the level of work required.

 

$28 an hour was amazing at the time as my previous job as a Paramedic I was making like $13/hour.

[Justcultureisjustcrap]

$50 for a Bachelors Degree- and I don't know what kind of nursing you do, but it is a damn hard job- mentally and physically. I am not a Nun, I didn't feel a "calling" to be a martyr. I was interested in science, I could support myself decently. I have been a nurse for 38 years- I have received raises, awards, but I am about done. I want out. I am sick of this profit-driven crap. I am sick of the ridiculous surveys and their petty demands, I am sick of the attempt to turn our healthcare system into "mcdonalds" with customers. We all know that no one chooses to be hospitalized.  Also , don't customers know the price before they buy??!! I am sick of consulting firms like Deloitte becoming fat cats on $$ meant to care for people.