We can all agree that in most areas of the nation, there is ample supply of nurses at the bedside, and in many areas, supply has well exceeded demand. Why they ask, are nurses always leaving the bedside? ANSWER: We didn't. The profession left us.
We can debate the why's, where's, how's, when's of the toxic culture in many hospitals and nursing homes.
More work, less support staff. More work, less pay. Too many patients. Higher acuity, more orders, fewer nurses being hired. My boss is dumb. My boss is toxic. Yes, its a BIG factor in a nurses decision to leave. We hate drama. We want to do our jobs in peace.
But those are just workplace semantics. There is drama in every workplace, wether in nursing, retail, law enforcement, food services, housekeeping, gaming, farming, hospitality, transportation, or basket weaving. Yes, its there now, and yes, it was there 50 years ago.
Truth be told, years ago, before corporate mergers/ takeovers/ acquisitions became as simple as buying pizza, we had hospitals and nursing homes. Today we have hospital systems and nursing home chains. With these corporate conglomerates at the helm, our profession was taken away. We lost our voices. We lost our sanity. We lost our zeal. Same thing happened to the banking system in the 1980s. Local stand alone banks were bought up, one by one, until we had 6 or 7 worldwide megabanks.
Corporate mentality stole the nursing profession and burned it at the stake. What used to be patient focus, is now billing focus. Today we do not have patients, we have inventory. Some generate substantial money, others are a drain. This is why, when and how "staffing to census" began rearing its ugly head. Back in the old days, there was no such thing as staffing to census. Nurses were hired on certain units, and that is where they stayed. Some days were super busy, others were not.
Staffing in hospitals and nursing homes today is soley based upon inventory (patients) and money (acuity). Not enough inventory in the burn unit? Float the nurse. Not enough inventory in L & D? Tell the nurse to stay home. Too many nurses on telemetry? Send 2 home, or let them work as techs on med-surg. And the list goes on.
What used to be paper documentation by exception, became EMR to generate maximum amounts of reimbursements from medicare, medicaid, and insurance. This is why we have box checkers (formerly known as nurses) spending 75% of their time at computer stations, and 25% of their time at the bedside. If you're lucky. So the next time your wife, husband, brother, sister, friend or companion starts mocking you for being a serial job hunter/ hopper, send them to this article.
Spread the word. Nurses didn't leave the bedside, the profession left us.
Nurses also leave because of entitled demands by patients that is backed up by managers, assault by patients, and the list goes on. Been at it over 20 years and it just gets worse. And yes, the many newbies who think this is a big money job, only to get in and find out that there's real work involved. They then do online programs to advance an education that has no experience. Administration can get them cheaper because they don't have experience or know the difference, nor having the footing to protect the group that they manage
From what I suspect the many reasons to be..I see a unison with the following points.
Documentation requirements increasing.
Patient to Nurse ratio not improving.
Pay rate remaining the same with pennies being given for raises.
And the attitude of "discharge and admit stat. (we (management) don't care you're at the end of your shift.)
Oh, and I must add.
-people who lack the common sense and think hospitals are hotels. "I want this, and that-rare please, and oh. Let me bother you in the midst of your medication passes to order me some salt & pepper. yes. That is more important. I don't care that you're pushing a EKG machine to another patient. Tell me what the thermostat is set at. Lower it a notch. Go grab me that cup of water. I know I can reach it but it's better for you to bring it to me. You're my servant attitude."
-the very beautiful family members of the patients, who decide to cope by just "bossing around healthcare professionals."
-people who lack the common sense and think hospitals are hotels. "I want this, and that-rare please, and oh. Let me bother you in the midst of your medication passes to order me some salt & pepper. yes. That is more important. I don't care that you're pushing a EKG machine to another patient. Tell me what the thermostat is set at. Lower it a notch. Go grab me that cup of water. I know I can reach it but it's better for you to bring it to me. You're my servant attitude."
Once had a call light flashing for 20 minutes not answered, and when I got to the room , patient wanted her water cup re-filled, as 3 family members sat in the room and looked at me. True story.
Is there evidence that nurses are "leaving bedside in droves?" I don't see this in my area at all, and there's no shortage.
When you look at some of the job boards on their websites, and see the job ads posted on indeed, monster, linkedin, etc, one would assume they lose about 20 per day, each
Or it could be that the job ads are left there for years unfilled
Or it could be that the hospital posts fake ads to run wage research and see how many unemployed nurses there really are
Or it could be that yes, they are leaving in droves
When you NEVER see a job ad posted for a large system, that could also mean they exhausted their pool of available nurses, hired every new grad they could find (then capsized them) and are now hiring from overseas visa applications.
Specializes in Mental health, substance abuse, geriatrics, PCU.
8 minutes ago, umbdude said:
Is there evidence that nurses are "leaving bedside in droves?" I don't see this in my area at all, and there's no shortage.
It's become overwhelmingly common place for nurses to get 1-2 years of experience before jumping ship and becoming an NP. Thus the reason the market for NP's is becoming saturated in areas. I've yet to talk to a recent nursing grad that didn't have this plan, I haven't spoken to any new grads in recent years that have stated they intend to be a bedside nurse long term. Anecdotal, yes, however my experience certainly isn't unique.
Keep in mind there is nothing wrong with furthering one's education but we also need worker bees who have more than a year of experience running the floors to give patients care.
It's become overwhelmingly common place for nurses to get 1-2 years of experience before jumping ship and becoming an NP. Thus the reason the market for NP's is becoming saturated in areas. I've yet to talk to a recent nursing grad that didn't have this plan, I haven't spoken to any new grads in recent years that have stated they intend to be a bedside nurse long term. Anecdotal, yes, however my experience certainly isn't unique.
Keep in mind there is nothing wrong with furthering one's education but we also need worker bees who have more than a year of experience running the floors to give patients care.
Depends on where you work. I worked in a community hospital where none of my RN coworkers had any desire to become NP.
On the other hand, when I worked at a research hospital as a psych tech, 80%+ of the techs and many of the RNs are there to become NPs, MDs, PAs, or MSWs.
There is no nursing shortage and competition to work in bedside is fierce at large hospitals. % of NPs currently is still <10% of the entire nursing population. There are plenty of folks working bedside.
Everyone is making the assumption that leaving bedside means going for NP, which is untrue. Plenty of nurses leave bedside to do other things or just retire.
Specializes in Mental health, substance abuse, geriatrics, PCU.
2 minutes ago, umbdude said:
Depends on where you work. I worked in a community hospital where none of my RN coworkers had any desire to become NP.
On the other hand, when I worked at a research hospital as a psych tech, 80%+ of the techs and many of the RNs are there to become NPs, MDs, PAs, or MSWs.
There is no nursing shortage and competition to work in bedside is fierce at large hospitals. % of NPs currently is still <10% of the entire nursing population. There are plenty of folks working bedside.
It's amazing how regional our issues can be in nursing.
Where I live we have quite a shortage in most settings, hospitals do heavy out of state recruiting in an attempt to fill positions, so many nurses leave positions in my area due to higher education leaving a situation where newbies are in charge of newbies. Been that way for a few years here acute care settings and long term care are hungry for workers.
Floor nursing on the med-surg unit wasn't what anyone in my class of 1991 wanted to do long term, as I seem to recall.
I'll admit, I was surprised, only a few years after my ADN, going to Urgent Care one day and seeing an NP there I had graduated with. He sure didn't work long as an RN.
I remember feeling a little like he had cheated the system.
I think the bedside is just damn hard work for not much money, and always has been.
Once had a call light flashing for 20 minutes not answered, and when I got to the room , patient wanted her water cup re-filled, as 3 family members sat in the room and looked at me. True story.
I love nursing, it's the only field I've ever worked in and I truly have a passion for it. That said, it has taken a heavy toll on my mental health. I won't blame nursing for my current condition but I certainly believe the stress and the experiences have contributed to my decreased ability to function. Nursing has many problems I just hope one day we will finally address them.
I read the military asked vets and their families to tell how their service had impacted them, hoping for positive comments, but instead heard about grief and pain. Obviously, while we are not endangered to the same degree and I know nursing is not in the same class (don't want to rile anyone), I do think it does take a toll on us, physically and emotionally, although some people are more "resilient" than others. I believe the stress of nursing and the poor working conditions many work under exacerbates anxiety and depression that someone is already struggling with. Allnurses should be a safe refuge for people to come to for support, but obviously doesn't take the place of medical care when needed.
It still think nursing can be a decent job not only for the reasons that I listed, but also because of the 12 hour shifts. How many jobs facilitate three day work weeks? Also, if you are someone who prefers to work nights and weekends, it's even better because of the extra pay. Nursing allows three or four days per week" to do what you want. I think this is especially the case if you can enter the job at a younger age and do so with minimal debt. Thus, if you live someplace beautiful like Hawaii, Washington, Oregon, California or elsewhere you can do your "three nights in a row" and then enjoy nature on your off days.
Hoosier_RN, MSN
3,968 Posts
Nurses also leave because of entitled demands by patients that is backed up by managers, assault by patients, and the list goes on. Been at it over 20 years and it just gets worse. And yes, the many newbies who think this is a big money job, only to get in and find out that there's real work involved. They then do online programs to advance an education that has no experience. Administration can get them cheaper because they don't have experience or know the difference, nor having the footing to protect the group that they manage