Is the nursing profession causing its own RN shortage?

[RNDave]

With all the RN's going to NP school, is the profession significantly contributing to the RN shortage? Between retirement and RN's in line to become NP's it seems our unit is on a constant hunt for staff.

[fnp2b369]

I have no problem at all with RN's who see bedside nursing as a bridge to a better career. I've been an OR nurse for nearly 20 years now. During that time the work has steadily gotten so much harder and so much faster that I don't want to see myself rushing around when I'm in my 50's. I am almighty tired, physically and mentally, of running around like a chicken with its head cut off for unappreciative surgeons and managers.

I was was recently accepted into a prestigious NP program and am looking forward to doing and being more as a nurse than I've ever dreamed of. I've wanted this since I was 17 and I'm 49 now... I'm also very much looking forward to making a little bit more money for easier, more civilized work. Besides, I'd rather pay off exorbitant school loans till I die than get ordered around by the surgeons for the rest of my career. Surely you don't begrudge any nurse the right to steer his or her career in whatever directions they see fit, do you? Let those who want to be at the bedside stay at the bedside. Likewise, let those who are determined to move onward and upward do so, without judgement.

[Farawyn]

The NPs I know work their butts off. I don't know that it's easier or more civilized. Less lifting, less poo. LOTS of stress.

I don't want it. I have the utmost respect for those who do, and don't forget where they came from.

[toomuchbaloney]

I read several posts here that seem to use absolutist terminology: Units are understaffed due to management. Period. Low pay. period. Undue hardship/poor working conditions. Period. I don't find that language accurate or helpful. I think the etiology has a multitude of factors. Some jobs are just plain hard no matter how much support staff gets from their organizations. This is often patient population dependent. I am fortunate enough to work for a great hospital, but our market is tough. I leave my shift exhausted sometimes, and I don't blame any of it on my employer.

I think there is a significant fluctuation of unit staffing because RNs can make a variety of lateral transfers within the same organization. This allows them to try something new yet not change employers. This looks good on a resume.

Bottom line, our flexibility/portability can be both gift and curse.

Just my .02

If you don't believe that nursing units which experience high turnover rates on a chronic basis are not suffering the consequences of bad management, fine. You are entitled to your opinion.

Regardless, any nursing unit which enjoys a chronic exodus of unhappy RN staff is a poorly managed unit. No it is not the fault of the patients, it is the fault of the employer.

The two primary reasons that nursing units experience chronic and high nursing turnover are "relationships" and "staffing", both management driven.

3 Biggest Causes of Nurse Turnover

[LadybirdRN]

I'm on a Med Surg Tele floor. We are almost always short staffed. Short CNA's, short nurses, which means our clinical lead has patients. It's stressful, tiring, and no one has time to have anyone's "back". I never get my 2 allotted breaks. I often have no time for lunch and just cram crackers and pudding down my throat to stave off hunger. If I take a lunch I go to the cafeteria, eat on my way back and get back to work. God forbid someone falls or anything happens that sucks up my time; it's a disaster and utterly destroys my day. As everything is so difficult, nobody wants to work extra. I doubt I would pick up an extra shift even if I got double-time. It's nothing but working my *** off 14 hours straight and I go home feeling bad half the time because I didn't give the type of patient care I'd like to give. I'm pretty well organized and rarely, maybe five times, stay after report to chart. It's just the way our floor is. I've been there five years and am trying desperately to get out but feel like a new grad; no experience doing utilization review etc. etc. I think I'm "burned out". I got my BSN so I'd have more options but it doesn't seem to do anything for me; it just put me $32,000 in debt.

[Dranger]

If you don't believe that nursing units which experience high turnover rates on a chronic basis are not suffering the consequences of bad management, fine. You are entitled to your opinion.

Regardless, any nursing unit which enjoys a chronic exodus of unhappy RN staff is a poorly managed unit. No it is not the fault of the patients, it is the fault of the employer.

The two primary reasons that nursing units experience chronic and high nursing turnover are "relationships" and "staffing", both management driven.

3 Biggest Causes of Nurse Turnover

False, my job would be a lot more enjoyable if not for the patient population. I have worked at multiple places and this is by far the worse.

Is the management great? No, but neither is the patient population. I have seen both sides of the coin and those that say it's NEVER the patients fault have never worked in a garbage area. I have been per diem for a while now which makes it tolerable at least.

As an ICU nurse this is what I see:

DKA with often infested diabetic wounds

Heroin or any other type of overdose

Respiratory failure secondary to smoking meth and cigarettes for years

Hepatic Encephalopathy sedondary to drugs, Hep C, alchohol

GI bleeds secondary to alcohol and liver failure (mostly Hep C and alcohol again)

Alcohol Withdrawals

Acute Psychosis secondary to everything listed and more

Sepsis secondary to everything above

Yep, great patients to have. Almost none are grateful or actually civil when they start feeling better. Many come back again.

I get it, lots of places have inept management, but you are delusional if you don't think the actual job makes people want to leave.

[dec2007]

My hospital is chronically short staffed in ALL the departments. I work ER and if we get a patient that becomes ICU or DOU then be ready to sit on that patient all day as there are no beds (actually there's plenty of beds, just no nurses to take care of those beds).

Were hiring new grads constantly none stop but nurses quit faster than they can be replaced. And therein lies part of the problem.

Most hospitals that are horribly short staffed all the time either simply don't pay their staff enough money to retain them or don't make the work environment practical to work in.

Yes! This! Do we work at the same place?

[ZEBRA57]

It is amazing how many nurses working in acute care hospitals feel like this. There was a time that nurses were taught the immeasurable value of their place at the bedside of the patient. The bath was seen as an opportunity to develop rapport & trust with your patient & do a multi-systems evaluation through observation and questions. The registered Nurse had the necessary education to assess the patient: body/mind/spirit – a holistic approach that goes as far back as Florence” & the origins of nursing. Today the academically inclined professors demean bedside nursing & the TAB” role of the professional nurse. Administrators focused on budget see the nursing force as the rat in the python” – the largest cost factor in patient care. Nurses are their own worst enemy: failing to report overtime; missing coffee break & sometimes sacrificing all or part of their lunch time in order to complete the ever mounting demands of paperwork & charting records. Nurses are experts at coping with stressful situations and doing their best to meet patient needs. However, the better you cope the more the institution demands. Someone calls sick & they are not replaced……you manage somehow. I am an older nurse. When I comment on this situation & encourage a colleague to report her time & needs, my counsel goes unheeded. I see nurse after nurse either on the verge of burnout, already burned out, or working their way out of bedside nursing into administration or leaving the profession altogether. I am in Canada (Montreal) – my acute care hospital had recently frozen new hires. They are not replacing retiring nurses. They are cutting back wherever possible & treating nurses like interchangeable entities; denying the need for expertise in specialized disciplines from ENT to Plastics to Cardiology to Ophthalmology to Endocrinology, etc. The list goes on. As for myself after a decade in ICU/Emergency units (where nurses do seem to be valued), including time in nursing management, I left to study alternative/holistic studies, eventually opening a private practice in Holistic Health Nursing for over 11 years. Closing the practice to marry & move to the USA. I am back in nursing after a bad divorce & am grateful I had a career to fall back on in hard times. There are nurses out there. The hospitals refuse to maintain a reasonable nurse to patient ratio. Can't wait to retire.

[Farawyn]

Dranger, those are called patients. We all have them. What, do you think you have the market on the sickest people ever? A good manager will get you through that. As unbearable as the population is, a good manager is the one who sets the tone and the morale flows from there.

[NanikRN]

[quote=Dranger;8771677

As an ICU nurse this is what I see:

DKA with often infested diabetic wounds.

[quote=Dranger;8771677

As an ICU nurse this is what I see:

DKA with often infested diabetic wounds.[

Infested...as with critter-like things? I am so hoping that was a typo😰

[Farawyn]

Infested...as with critter-like things? I am so hoping that was a typo[emoji27]

What is? To what post are you referring?

ETA: Okay, I see your edit.

Yes, critters are sometimes in wounds. I'm thinking he meant "infected", but hey, in this crazy world, who knows, right?

[VANurse2010]

I think it is terrible that hospitals have gone to 12 hour shifts! Not safe for the patient or the staff! When this happened, I knew I would never work in a hospital setting again.

I would never work in a hospital that *didn't* use 12 hour shifts. 5 days a week of this bull? No thanks.

[homecaresurvivor]

Spending just a year or so in college and then pushing drug cart around for 35 years may be a good life for someone but it is definitely not an example of good career.

First, what RN only has one year of college education? More than that was required when I became an RN over 30 years ago, and it's certainly true today. But more to the point, your comments about floor nurses were condescending and insulting. I left floor nursing for home health over 20 years ago, but I have nothing but respect for those nurses who remain at the bedside. It's tough work filled with immense responsibilities. You don't sound like you respect what bedside nurses do. It may not be your idea of a career, but for that particular nurse, it is. It also doesn't necessarily indicate that the nurse who spends her entire career in one setting isn't ambitious, either. Ambitions don't necessarily place one on a management track, or on to advanced practice. Her ambitions may be to provide the best care possible in a professional way. Why isn't that important enough? I'm truly wondering what you might think about my parents, who taught the same classes in the same high school for 35 years. Do you think they didn't have teaching careers?