Nurses are the 'Canary in the Mine'

The profession of bedside nursing is in crisis. There are advantages to staying the course and waiting for change, but is it worth the risk to nurses as they are continually being asked to do more?

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Nurses are the 'Canary in the Mine'

Nurses wonder, in the middle of a moral crisis, should I continue in bedside nursing; amid the nursing shortage, the Covid-19 pandemic, and the broken healthcare system? Nurses are trained to apply skills and interventions that are evidence-based which helps their patients feel better, have hope, and improve the quality of their life.  But some nurses are questioning: "Is it possible to give quality care to patients and at what risk is it to me?”

Advantages still exist for the profession of nursing.  The pay is great, and the hours are flexible with a choice of morning, afternoon, and night shifts.  The length of the shift varies from either four, eight, or twelve hours.  There is always lots of overtime for those who want to make a ton of money!  The uniform is comfortable and feels like pajamas, available in different styles and colors with the potential for coordinated comfy shoes.  No need to exercise, already getting that at work! Most nursing jobs are active with intermittent sitting, bending, and walking all day or night long.  Lucky for nurses, there are millions of job openings to choose from.  But you just may have to update your education to take advantage of them. The on-call doctors are a lot friendlier nowadays.  Job satisfaction used to be a great benefit with an opportunity for nurses at the bedside to connect their scientific minds with a compassionate heart for the benefit of patients. A nurse could clock out and despite being exhausted still feel rewarded with the thought that they have made a difference in someone's life. 

Nurses are unique and very special.  They are like angels because they are drawn to helping others with understanding, compassion, and knowledge of the burden of care.  Unfortunately, some nurses neglect their own health and other obligations; to work overtime.  They are working more hours than they want or need to, due to the shortage of workers.  They work overtime, sometimes adding an additional four or eight hours to equal twelve or sixteen hours straight, and then they will come back and do it over again.  Often nurses are working multiple days in a row, more than four to five days which is beyond safe for patient care and for themselves, especially for night shift workers.  Traveling nurses have told me that sometimes they work from far away and are so tired that they aren't safe getting to and from work. In the aftermath of Covid-19, nurses are flaming out.  Other nurses see the writing on the wall and are fearful this may happen to them.  Admittedly, nurses are so drained; that they are losing their hearts for their beloved profession.  

Thanks to the corporate model, the profession of nursing has become less about the heart and more about money. Most nurses are working overtime now, whether they want to or not.  Employers are desperate to recruit new staff to fill open positions and take the pressure off full-time nurses. So, they offer sign-on incentives to new staff and competitive pay but exclude those already working, who remained loyal and worked so hard to stay the course through the pandemic.  Unfortunately, there just aren't enough nurses to fill the open slots.  As quickly as nurses are trained, they or others already in place; leave after burn-out or for another job with better wages.  Nurses have growing anger and increased fatigue with work/life imbalance.   They feel intimidated by their employers who constantly ask for more and more of them.  Some say, "the money is not worth it,” and so they choose to back away from the work they love, or the needs of the patients and the huge demands made by the employer. 

Nurses are being asked to do and be it all.  Due to the pandemic scare, there are fewer housekeepers, phlebotomists, nurse aides, kitchen workers, and janitors in healthcare settings.  Nurses are the housekeeper, who cleans and dumps the trash in the patient and breakrooms.  They are the absent nurse's aides, who ordinarily assist the nurse with patient personal care and most importantly, are an extra pair of eyes for patient and resident safety.  Amidst all this, the stressed nurse feels the heightened demand to give adequate care, administer medications on time and as needed, and detect changes in the patient. No wonder nurses are leaving this scenario, the staff has only a few minutes to do what they need to do with each patient and then on to the next.  This is a no-win situation for the patient, as well as the nurse.  The fatigued nurse cannot give patients the emotional support they need and that leaves the patient feeling guilty for being so needy and lonely due to the lack of support from the tired staff. 

The Covid-19 pandemic is the last straw.  During the past two years and still today, nurses are asked to wear the tight-fitting KN95 or N95 masks in addition to plastic shields over those masks when caring for their patients and residents.  It is hard to communicate with another with one mask, and almost impossible with both the mask and the shield; especially if one is hard of hearing or very hot with little or no air circulation.  Granted this is all in the name of safety because of the risk for contagious spread, but with so many interventions that nurses already need to perform; the pressure on all providers has steadily increased. 

We have not known a pandemic in over a hundred years.  Couple this with society's growing distrust of healthcare and government policy, there is fear and uncertainty almost everywhere. Everyone is on edge, not knowing; will Covid-19 ever end?   Perhaps, if nurses and their advocates speak up for more efficient healthcare policies in boardrooms of corporations, on social media, and in the legislative government; something will change.  Nurses are one of the most respected professions today.  Nurses have been deemed trustworthy and must share their perspectives.  Board members and CEOs need to listen and understand that nurses want a seat at the table and an opportunity to help create the change that needs to happen for improved care of the patient and residents.  Hopefully, this will bring back nurses to the profession they love so dearly.

Margaret Scranton, RN

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RN WRITER NC

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Specializes in Med nurse in med-surg., float, HH, and PDN.

Said that all better than I could have!

Board-members and CEO's might listen, but they don't REALLY HEAR, because their solutions seldom address the real-life problems in the nursing practice and profession. They come up with other bright ideas, because making a REAL change in nursing, well, that's just not profitable.

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On 5/13/2022 at 8:00 AM, RNWriter NC said:

Nurses are unique and very special.  They are like angels because they are drawn to helping others with understanding, compassion, and knowledge of the burden of care.

This is a sentiment that might be acceptable/understandable coming from a grateful patient. From the perspective of a nurse, things really aren't this simple.

Believing these sentiments, imagining that they are true, acting upon them and perpetuating them is no small part of the reason we find ourselves being taken advantage of and treated with such disdain and disregard by employers.

Not to mention a good number of us, although generally kind, are not here to lovingly mop brows. Many of us are primarily drawn to some other aspect that nursing inherently involves such as problem-solving, use of a particular skill set, a love of the 3Ps, or one of many other aspects. We are individuals, not supernatural beings and not some special breed of person.

Also, we have other life responsibilities, bills to pay and sometimes additional mouths to feed. We support ourselves and our loved ones by providing professional services that we have been educated and trained to provide, not by floating on the mist from here to there and performing supernatural healings and words of comfort. We work hard.

We do need to stop making it so easy for others to imply that we should always be able to give more and to accomplish more for less/with less. This will require that we see ourselves and our situation realistically.

IMO some of this unique/special/angel mindset is sometimes intertwined with buried or unrecognized self-esteem issues. Some of us could do well to address that issue rather than tolerating abuse by thinking of oneself as an angel.

There are just numerous reasons why we should be leery of thinking of ourselves this way.

Sorry for picking out one aspect of your post.

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"No need to exercise, already getting that at work!"

Exercising outside of work is extremely important for mental health as well as physical health.

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Specializes in Nursing challenges, Alzheimer's disease, Dementia.

Amen, thank you. I AGREE!

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On 5/14/2022 at 8:22 PM, JKL33 said:

This is a sentiment that might be acceptable/understandable coming from a grateful patient. From the perspective of a nurse, things really aren't this simple.

Believing these sentiments, imagining that they are true, acting upon them and perpetuating them is no small part of the reason we find ourselves being taken advantage of and treated with such disdain and disregard by employers.

Not to mention a good number of us, although generally kind, are not here to lovingly mop brows. Many of us are primarily drawn to some other aspect that nursing inherently involves such as problem-solving, use of a particular skill set, a love of the 3Ps, or one of many other aspects. We are individuals, not supernatural beings and not some special breed of person.

Also, we have other life responsibilities, bills to pay and sometimes additional mouths to feed. We support ourselves and our loved ones by providing professional services that we have been educated and trained to provide, not by floating on the mist from here to there and performing supernatural healings and words of comfort. We work hard.

We do need to stop making it so easy for others to imply that we should always be able to give more and to accomplish more for less/with less. This will require that we see ourselves and our situation realistically.

IMO some of this unique/special/angel mindset is sometimes intertwined with buried or unrecognized self-esteem issues. Some of us could do well to address that issue rather than tolerating abuse by thinking of oneself as an angel.

There are just numerous reasons why we should be leery of thinking of ourselves this way.

Sorry for picking out one aspect of your post.

Your post is much kinder than the words I thought. We are not angels, nursing is not a calling. And it’s OK to expect a fair wage to commensurate with the level of responsibility that we have. To work overtime because your always short does nothing to alleviate the problem. And in the post that I quoted, the mention of self esteem issues was spot on and so important. I once asked a group of 12 nurses how many grew up in dysfunctional homes. 11 out of the 12 answered yes. I think the most important concept that I’ve learned in adulthood is that boundaries are a good thing in all aspects of our lives. 

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Specializes in Nursing challenges, Alzheimer's disease, Dementia.

Agreed, the other day staff got a lecture on what went wrong during the mock survey.  Of course, no mention that the potential reason we were deficient was that there has not been enough staff for a very long time. Management just does not want our input; they want to dictate.  

Thank you for your responses.  We all have perspectives that are valid and may be different, but that is OK.  The key is to create some positive change for the better!

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Specializes in Libs.

Let's not forget to mention the crisis of indoctrination that is taking place in nursing schools across this country.

There is no more room for dissent.  Go woke, or go broke. Academic freedom of thought and speech is no more.  

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Specializes in Cardiac surgery.

The American healthcare system is so broken from top to bottom I honestly don’t know how (or if) it can ever be fixed. 

I’ve been a bedside nurse for going on 5 years now and I can honestly say I would never recommend doing bedside nursing to someone whose physical and emotional well-being I cared about. 

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On 5/13/2022 at 8:00 AM, RNWriter NC said:
We have not known a pandemic in over a hundred years.  Couple this with society’s growing distrust of healthcare and government policy, there is fear and uncertainty almost everywhere. Everyone is on edge, not knowing; will Covid-19 ever end?  

One problem that I see rearing it's head is that some staff members are reacting inappropriately to normal, non-threatening, non-violent,  patient/family member behavior under stress (and being in the ED for many hours, being very ill, with an uncertain, possibly very serious diagnosis, is very stressful for patients/family members).  It creates more stress for patients/family members when they are shown irritation and impatience by staff members, including nurses, when it would be so easy and would do much more for patient/family member/staff relations to show simple kindness and patience.

The heightened focus today on violence from patients/family members towards health care workers misses the mark when some staff members appear to be so sensitized to thinking that normal, non-threatening behaviors by patients/family members under stress indicate aggression or other untoward behavior that must be confronted, and react inappropriately and unkindly towards patients/family members for behaviors that are in no way violent or threatening and that merely reflect patients/family members being under stress and fatigue.

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Specializes in BSN, RN, CVRN-BC.

We are locked in a vicious cycle.  Working conditions stink so nurses leave.  Hospitals throw money at the problem because it is cheaper to give a small raise than to fix the working conditions.  Since hospitals are paying more they expect more.  The raise works for a little while but then the burden of a higher workload overcomes the benefits of more money and nurses leave.  So administration throw more money at the problem and because they are paying more they expect more work  .  .  .  and the cycle continues. 

Perhaps they Koch bros and Bill Gates will figure out that if the working condition are fantastic that they don’t have to offer premium wages and they will build a series of hospitals that breaks the cycle.

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A few months ago I was offered a bedside position after several years away from a hospital setting. I thought I would be happy to get back to bedside after a hiatus from that flavor of nursing. The money that was offered coupled w/having days off during the week was tempting..but when I toured the unit I realized much has changed in the expectations of hospital nursing and I declined the position and instead moved forward in a M-F MD based practice that actually paid close to what the hospital offered. 

While it's difficult sometimes working a M-F position, I am also off on weekends/holidays/am able to take breaks, work "normal" hours, no call and work with a good group of people.

I, like others on here, don't feel I'm an "angel" or that nursing is my calling. In fact, it was my parents who guided me to the profession decades ago because they knew it would be a stable career that offered variety. I didn't feel forced by any means  to become a nurse and it has allowed me to move around within the profession but if I am honest, I would not encourage anyone to go into the profession now. It has changed too much and the pressures/demands placed upon nurses now are not only unreasonable but create in many aspects, an increasing recipe for disaster for patient and nurse on many levels. 

Healthcare is a breaking point and when the exodus of nurses continue, it will eventually break. Then, and only then, will the powers that be - listen and make real change.

  

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