Nurses Are Leaving the Bedside In Droves

[panurse9999]

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.

[HomeBound]

24 minutes ago, myoglobin said:

It sounds as if you live in California. California is the pinnacle, the absolute zenith for nursing related laws. Mandatory ratios, overtime pay after 8 hours, you actually get a lunch break (in 11 years as an RN I can count on two hands the number of times that I've actually gotten my lunch break, I must clock out, but it's not safe to actually take the break since it means leaving another ICU nurse with four patients). For me the first step in improving nursing retention is making more states like California, at least with regard to nursing ratio laws, and lunches. However, even this relatively meager step seems almost impossible to accomplish despite studies showing that the California law has contributed to patient safety.

I did do many contracts in CA. I am a travel nurse right now and have been for many years.

yes. I liked certain things about the laws of CA that concern nursing.

Like I said in another thread though--- I can take any issue and make it controversial ?

The thing about California is that it is a testing ground for hospital systems as well---to hone their ability to skirt these laws. And they do. Daily.

I worked for KPH and the UC system. I also worked at several critical access hospitals.
Here's how they skirt the laws:

fudge the acuity rating system--you may get your 4:1 or your 2:1---but those patients are so, so heavy that it's unsafe for you as well as the patient.

push people through with little to no actual care being given--I routinely saw people discharged that in any other state...would have been admitted...because they were still that sick.

the use of travelers. no benefits and no overtime. ever. there is a large travel company who has probably 70% of market share---who worked with the CA hospitals to subvert the laws---by denying "overtime after 8". Ask any traveler and they will tell you---not only did we not get "overtime after 8" but we also were banned from working one second over.

***this particular travel company was recently sued...successfully...for this practice, colluding with the hospital systems to cheat travelers out of "overtime after 8" and therefore saving millions of dollars.

they have split and staggered work shifts. Meaning...they will mandate that you come in every single day---for 4 hours per day. They also use almost exclusively....PART TIME positions so that they don't have to pay benefits or the employee has to foot more of the bill for them. Very rarely will you EVER see a "fulltime" position at KPH.

the union sucks $120/mo out of the nurses under the contracts that have negotiated these low ratio, high salary positions. Thereby knocking down a good portion of whatever you might make.

The jobs were NOT easy and even as a traveler---we were crapped on to such an extent that when I was offered a fulltime job---I said no.

The taxes in CA are some of the worst in the country. The high pay isn't such high pay after you get done being raked by the hospital and the state.

Job insecurity is a daily thing in CA---because the hospitals are working daily to find ways to tilt the table back into their favor.

[ThePrincessBride, MSN, RN, NP]

3 minutes ago, myoglobin said:

Often the reality is that these issues either won't be fixed or won't be fixed for many years. That is to say the issues are "structural". Thus, since we all have finite lifespans often the easier thing to do is to move to places where things are at least somewhat better than where we currently live. This is especially the case when it comes to NP's and independent practice states. It is also worthy of consideration for a bedside RN living in say Florida making say $30,00 per hour when they could move to California and earn at least $50.00. Even more the case if you have a husband/wife RN team (both going from 30 to $50 plus) and even more the case if they are in a position to be travel nurses in a state like California where they could earn more like $75.00 per hour (each). In the last case you are talking about significantly impacting your standard of living simply by being flexible where you live.

You are forgetting that cost of living plays a role in pay. Sure Cali pays more, but the housing costs are ridiculous. My 300k childhood home in the Midwest would cost about 4 million in California. No joke. Plus, there are higher state and local taxes, etc. Whereas Florida has no state income tax in comparison and housing prices aren't so inflated in most parts.

[myoglobin, ASN, BSN, MSN]

You make good points that is why the "California route" probably only makes sense when you are looking at a husband wife "travel team" where one can take the housing, and the other take the extra housing pay. Or at least a husband wife team where they both get a significant bump in pay. It may also help to "skirt the system" by living someplace like Vacaville or Fairfield California where you can rent a place for around $2,000 and commute to San Fran. where the pay is top notch. Or maybe to even live in someplace like Carson City or Lake Tahoe and do your "three in a row" in Sacramento staying in a campground or hotel, airbnb, or with a friend and then going back to your Nevada home. Or even going the "Traveling Robert" route and getting a small camper that you pull with your SUV and then parking it for $1200.00 per month at a California RV park. That way "having you own RV" you could be in a position to take "high need travel assignments" on short notice since you would basically be "pulling" your housing. Also, with an RV your housing is essentially tax deductible as a work expense (if you are a travel nurse).

[HomeBound]

16 minutes ago, ThePrincessBride said:

Someone needs to take a chill pill. I said second-career nurses. I said nothing about age of said nurse. I am willing to bet to make 118k you have many years of experience. Probably work some holidays, evenings and weekends. You said thirty-five, right? There are new grad NPs in my area making 112k and won't have to work 35 years to make 118k. And I'm willing to bet your cost of living is pretty high too in order to make that kind of money without overtime, holiday pay, weekend or shift differential. I live in an area with medium cost of living so 90k here is QUITE a bit more in places like Cali, NY, etc.

Your post comes off rather abrasive and quite frankly, rude. I may not have thirty-five years of experience, but guess what? I haven't been alive for even thirty, so yes, I have only four years of RN experience, but it is in multiple specialties. Plus, I have almost ten years of paid hospital experience in numerous facilities. I know what I am saying, and the players may be different but the *** is still the same.

I get you don't care about younger nurses, but the vast majority of us aren't party animals who drink all the time and complain about the hours. Many of us work multiple jobs, paying off crazy student loans and have far less opportunities to advance than previous generations. But if it makes you feel any better to think of us a lazy, no-good Gen Yers, have at it!

I make $118K because I take 4 months off a year.

My COL is low. I own a house free and clear--and I have to do the "duplicated expenses" thing for the IRS--but I have friends and family pretty much everywhere I have chosen to do a job (which is why I choose the places that I do).

This has nothing to do with "not caring" about younger nurses. Again...you and some other poster are quite hyperbolic when there is no reasonable answer as to why this perception persists---that the newer nurses are there for the quick buck, the easy path to NP, the ones we see on the boards crying that they were fired for this or that posted on their fakebook accounts.

Why is that? Why do you think that this perception persists? Where did it come from if this isn't reality?

My whole point is being made by your post. Why are you working "multiple jobs" with "crazy student loans"? Unless you haven't noticed, that's the point of this thread.

"Why Nurses are Leaving Bedside".

It irked me that you implied that "second careerists"--are just blind idiots that had stars in their eyes, ergo, nursing. We just had no idea what hard work is...

"....left their cushy jobs for nursing and just had no idea how hard nurses work..."

Really? Nurses are the only hard working individuals? That's the implication with your statement. Also that second careerists---who are generally >40 years old....are just uninformed and have zero life experience that they can't possibly be as informed as the "Gen Y" nurses.

I am speaking from 35 years of experience. When you get to 35 years old--are you telling me that you will have no additional experience that a 19 year old really doesn't have?

You're insulted because someone with far more life and work experience than you is giving a well rounded perspective?

At 4 years I was just like you---knew everything and was so annoyed with old timers who actually did know more. There's a reason for the saying "If I'd known then what I know now....I would have done things differently."

This is about making better choices--OP is a making a point that the lies that are handed out by facilities, nursing schools and yes...other nurses...because of their own agendas---robs people of informed choice. The exploitation of nurses, by those facilities, nursing schools and yes....other nurses...is the problem.

Not my feelings towards anyone ridiculous enough to take pictures of their cleavage and post it on social media, wondering why no one takes them seriously.

[Workitinurfava, BSN, RN]

1 hour ago, HomeBound said:

I make $118K base pay right now. As a floor nurse--no overtime, no shift differential, no "extended hours" to kiss orifice in order to convince someone I am the best choice.

I don't bill. I don't deal with insurance companies telling me that I have to code something in a certain way in order to be paid. I don't have to fudge something in order to be paid.

All while still dealing with the rude patients and their crazy families. The violent drug seekers. The ones who follow you out to your car or wait for you in the parking lot as you exit your "urgent care in a CVS broom closet".

I didn't go into nursing with $$$ in my eyes. I was bored with my former profession. I had hit the ceiling and was literally going through the motions. In a hospital. I've been employed by hospitals since I was a candy striper at age 14.

Don't give me that whole schtick. Older nurses, entering after life experience last longer. It's the YOUNGER ones that cry and whine and complain about how haaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaard it is to work weekends. and nights. and are expected to work overtime. put the phone away. get off their orifice instead of sitting at the nurses' station checking their instagram. taking selfies with the booze and party hats (so that they get fired and then wonder WHY?)

Sorry....but i don't think I've ever seen a nurse at 50+ years old taking selfies of her alcohol induced self love fest for the world to watch....including the cleavage shots.

There's another little girl on my unit who struts around saying she's "going to be a CRNA"---she's applied! One whole year of ICU---and she still needs her preceptor to help her handle anything more complicated than 2 drips and a vent. She's just so sure. She's gonna own it all.

Oh. Yeah. She forgot. You gotta do all that hard stuff....organic chemistry. Biochem. Statistics. Pathophys and advanced psych.

Omigerrrrrrsh! Don't these CRNA people know who she is???

Medical school and these skilled advance practice jobs---such as CRNA---are hard. FOR A REASON.

But but but but but....I wanna make $170K like someone told me I can by flying through barely 1 year of actual clinical training and 4 years of writing papers! Someone told me I could!

There's yet another person on my unit who is going the "Psych NP" route...as well as my best friend who is pursuing it.

Why? Both of these men say the same thing. "All I have to do for a paycheck is sit and tune out some crazy while they talk...write a care plan and prescribe". Crazy person complains? Who cares. Nobody listens to crazy people anyway.

This is the general attitude of the "younger nurses" that I have come across. My friend is early 40s, and he's pretty much the exception to that I've met.

And before you go all---well---I know so many in my 3 whole years as a nurse. Have you been a traveler? Have you gone through these other hospitals across the country and had a good dose of this? Have you worked in hospitals alongside and as a nurse for over 35 years? Have you even changed units within your own hospital system?

Here's another tidbit---floor nurses that work for Kaiser Permanente make $160K to start. Just sayin'. Wanna know why it's so hard to get into that system? Because their pay is ridiculous---but it's also got it's serious problems---and signing a confidentiality agreement is standard procedure with that company if you do get hired on. And it's not about "proprietary information". It's about appalling work conditions and standards...how they treat patients as cattle.

I shouldn't have to live in upstate Wisconsin or in Death Valley in order to make a decent living. I shouldn't have to be threatened, kicked, punched, spit on, followed or otherwise placed in mortal danger---if I wanted that---I would become a deep sea fisherman in the North Atlantic or a police officer.

I am hearing:

Yes....we do get threatened and it's crap on the floors and my colleagues suck and the patients are horrible and I never sleep and my back is broken and my pay is garbage to do all of this.

But I just looooooooooooooooooooooooooooooooove nursing and I'd recommend it to my kids!!! You all just are so unhappy that you can't just get over the third world working conditions! What a bunch of malcontents. Oh I know. You must be the "older, second career" nurses.

...

[HomeBound]

7 minutes ago, Workitinurfava said:

This is a why nurses are leaving the bedside in droves post. It's nice to hear you love it but it doesn't totally come across that way. There is some agression in your post, and to me it suggest that you aren't really that in love with it. That is okay. All that matters is you go to work and do what is right by the patients. I hope you aren't taking things out on the younger nurses at work, because they are just "little girls" and not grown women who are age appropriate to be nurses. You will find that nurses of all ages vent their fustrations about the nursing field on this site. Most of them go to work and do what they need to do.

I am actually leaving nursing. For just the reasons I stated. Exploitation of nurses by facilities, nursing schools, patients/families...and other nurses.

The money I make is ridiculous---as long as I am okay with sacrificing everything. It should not be that way.

This is the point. You and others are missing it. It is alarming that young (or older) people coming here wanting to be nurses or are early in their nursing careers...come here and just pour out this despair.

Have you read the titles of the posts here? And AN isn't the world, you know. This is actually a very very small forum. I've mentioned this site to others since I had joined---and I get a blank stare. Few if any of my colleagues have ever heard of AN.

I don't take anything out on anyone. AGAIN that is my point. The craptacular attitudes that go on---bullying, hazing, slamming---I am on the side of the nurse that is the victim of this behavior. Jeezus. Seriously.

I get that 5 years of nursing and 28 on this earth makes an expert out of anyone---but there is just this....disconnect....between facts and "wants".

If you want to work 4 jobs to make ends meet? Do it. If you want to work nights and weekends while getting little more than a living wage? Do it. If you want to get punched, kicked, spit on and attacked by family? Do it.

It's not glamorous nor does it make you a martyr for putting up with it. It's masochistic---and to recommend nursing to a young person (or an older person) without the facts of the situation is disingenuous.

[Workitinurfava, BSN, RN]

3 minutes ago, HomeBound said:

I am actually leaving nursing. For just the reasons I stated. Exploitation of nurses by facilities, nursing schools, patients/families...and other nurses.

The money I make is ridiculous---as long as I am okay with sacrificing everything. It should not be that way.

This is the point. You and others are missing it. It is alarming that young (or older) people coming here wanting to be nurses or are early in their nursing careers...come here and just pour out this despair.

Have you read the titles of the posts here? And AN isn't the world, you know. This is actually a very very small forum. I've mentioned this site to others since I had joined---and I get a blank stare. Few if any of my colleagues have ever heard of AN.

I don't take anything out on anyone. AGAIN that is my point. The craptacular attitudes that go on---bullying, hazing, slamming---I am on the side of the nurse that is the victim of this behavior. Jeezus. Seriously.

I get that 5 years of nursing and 28 on this earth makes an expert out of anyone---but there is just this....disconnect....between facts and "wants".

If you want to work 4 jobs to make ends meet? Do it. If you want to work nights and weekends while getting little more than a living wage? Do it. If you want to get punched, kicked, spit on and attacked by family? Do it.

It's not glamorous nor does it make you a martyr for putting up with it. It's masochistic---and to recommend nursing to a young person (or an older person) without the facts of the situation is disingenuous.

Good for you for leaving. That is all I have to say.

[myoglobin, ASN, BSN, MSN]

5 minutes ago, HomeBound said:

I am actually leaving nursing. For just the reasons I stated. Exploitation of nurses by facilities, nursing schools, patients/families...and other nurses.

The money I make is ridiculous---as long as I am okay with sacrificing everything. It should not be that way.

This is the point. You and others are missing it. It is alarming that young (or older) people coming here wanting to be nurses or are early in their nursing careers...come here and just pour out this despair.

Have you read the titles of the posts here? And AN isn't the world, you know. This is actually a very very small forum. I've mentioned this site to others since I had joined---and I get a blank stare. Few if any of my colleagues have ever heard of AN.

I don't take anything out on anyone. AGAIN that is my point. The craptacular attitudes that go on---bullying, hazing, slamming---I am on the side of the nurse that is the victim of this behavior. Jeezus. Seriously.

I get that 5 years of nursing and 28 on this earth makes an expert out of anyone---but there is just this....disconnect....between facts and "wants".

If you want to work 4 jobs to make ends meet? Do it. If you want to work nights and weekends while getting little more than a living wage? Do it. If you want to get punched, kicked, spit on and attacked by family? Do it.

It's not glamorous nor does it make you a martyr for putting up with it. It's masochistic---and to recommend nursing to a young person (or an older person) without the facts of the situation is disingenuous.

Your scenario illustrates why you should consider becoming an NP and opening your own clinic (in a state that permits it). In this way you could have an impact on the dynamics regarding the very issues that you find most appalling (at least for your patients and employees). Thus, you could allow for longer appointments, pay a living wage, and treat your patients and coworkers/employees with the respect they deserve. Indeed, if enough NP's go this route they will create pressure on MD's and even hospitals to do the same (lest they lose staff and clients to these practices).

[Workitinurfava, BSN, RN]

Realistically someone has to be a nurse. We can't do without them. Good, bad or ugly. It is a matter of it being something you can or want to handle.

[HomeBound]

9 minutes ago, myoglobin said:

Your scenario illustrates why you should consider becoming an NP and opening your own clinic (in a state that permits it). In this way you could have an impact on the dynamics regarding the very issues that you find most appalling (at least for your patients and employees). Thus, you could allow for longer appointments, pay a living wage, and treat your patients and coworkers/employees with the respect they deserve. Indeed, if enough NP's go this route they will create pressure on MD's and even hospitals to do the same (lest they lose staff and clients to these practices).

There's an easier answer than my old rear end becoming an NP.

UNIONIZE.

[OUxPhys, BSN, RN]

1 hour ago, HomeBound said:

I make $118K base pay right now. As a floor nurse--no overtime, no shift differential, no "extended hours" to kiss orifice in order to convince someone I am the best choice.

I don't bill. I don't deal with insurance companies telling me that I have to code something in a certain way in order to be paid. I don't have to fudge something in order to be paid.

All while still dealing with the rude patients and their crazy families. The violent drug seekers. The ones who follow you out to your car or wait for you in the parking lot as you exit your "urgent care in a CVS broom closet".

I didn't go into nursing with $$$ in my eyes. I was bored with my former profession. I had hit the ceiling and was literally going through the motions. In a hospital. I've been employed by hospitals since I was a candy striper at age 14.

Don't give me that whole schtick. Older nurses, entering after life experience last longer. It's the YOUNGER ones that cry and whine and complain about how haaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaard it is to work weekends. and nights. and are expected to work overtime. put the phone away. get off their orifice instead of sitting at the nurses' station checking their instagram. taking selfies with the booze and party hats (so that they get fired and then wonder WHY?)

Sorry....but i don't think I've ever seen a nurse at 50+ years old taking selfies of her alcohol induced self love fest for the world to watch....including the cleavage shots.

There's another little girl on my unit who struts around saying she's "going to be a CRNA"---she's applied! One whole year of ICU---and she still needs her preceptor to help her handle anything more complicated than 2 drips and a vent. She's just so sure. She's gonna own it all.

Oh. Yeah. She forgot. You gotta do all that hard stuff....organic chemistry. Biochem. Statistics. Pathophys and advanced psych.

Omigerrrrrrsh! Don't these CRNA people know who she is???

Medical school and these skilled advance practice jobs---such as CRNA---are hard. FOR A REASON.

But but but but but....I wanna make $170K like someone told me I can by flying through barely 1 year of actual clinical training and 4 years of writing papers! Someone told me I could!

There's yet another person on my unit who is going the "Psych NP" route...as well as my best friend who is pursuing it.

Why? Both of these men say the same thing. "All I have to do for a paycheck is sit and tune out some crazy while they talk...write a care plan and prescribe". Crazy person complains? Who cares. Nobody listens to crazy people anyway.

This is the general attitude of the "younger nurses" that I have come across. My friend is early 40s, and he's pretty much the exception to that I've met.

And before you go all---well---I know so many in my 3 whole years as a nurse. Have you been a traveler? Have you gone through these other hospitals across the country and had a good dose of this? Have you worked in hospitals alongside and as a nurse for over 35 years? Have you even changed units within your own hospital system?

Here's another tidbit---floor nurses that work for Kaiser Permanente make $160K to start. Just sayin'. Wanna know why it's so hard to get into that system? Because their pay is ridiculous---but it's also got it's serious problems---and signing a confidentiality agreement is standard procedure with that company if you do get hired on. And it's not about "proprietary information". It's about appalling work conditions and standards...how they treat patients as cattle.

I shouldn't have to live in upstate Wisconsin or in Death Valley in order to make a decent living. I shouldn't have to be threatened, kicked, punched, spit on, followed or otherwise placed in mortal danger---if I wanted that---I would become a deep sea fisherman in the North Atlantic or a police officer.

I am hearing:

Yes....we do get threatened and it's crap on the floors and my colleagues suck and the patients are horrible and I never sleep and my back is broken and my pay is garbage to do all of this.

But I just looooooooooooooooooooooooooooooooove nursing and I'd recommend it to my kids!!! You all just are so unhappy that you can't just get over the third world working conditions! What a bunch of malcontents. Oh I know. You must be the "older, second career" nurses.

While we have disagreed about some things on here I do agree with you on this: it is the younger crowd complaining. Hell im 33 (still young I know) and I find myself complaining and get called out by the older RNs. My old job I was considered an old nurse. Young nurses calling off weekends, holidays, game 7 of the NBA finals because they “want to have a life”. They also tend to be on social media alot more too (and they arent smart about it either....phones out right at the nurses station).

[nate411]

12 minutes ago, HomeBound said:

There's an easier answer than my old rear end becoming an NP.

UNIONIZE.

Prior to nursing, I used to be against unions 100% , of all types, shapes and sizes. And now I am 100% for them. It takes no education , certification, or CE , physical stamina , etc...to be working the parts counter at Autozone, except the employees at Autozone are treated a whole lot better. I have never seen such a dime a dozen attitude aimed at the nursing profession, in ANY OTHER INDUSTRY. CNAs getting nurses fired. Secretaries getting nurses fired. Family getting nurses fired. Patients getting nurses fired. Nurses getting nurses fired. Doctors getting nurses fired...it just never ends. They just hit up the vending machine, and out pops the next nurse. Its sick. I think one has to be pathologically toxic to survive in this toxic profession.