Nurses have simply had enough and are walking out of acute care. How far will it go? Have we seen the peak yet?
Updated:
Here are some conversations that are taking place at hospitals everywhere across the country. Do they sound familiar?
"Did you hear Kim is leaving?”
"Kim !?? Kim in Step down?? Nooo! You don't mean Kim! She's been here forever!”
"Ya! and I hear 2 more step down nurses turned in their notice.”
Nurses left behind while their colleagues and friends grieve the loss. Years, decades, even, of experience walk out the door, leaving those behind to pick up the slack and cope with working with an inexperienced workforce.
Later on at the same hospital, at the evening command center safety huddle, it's reported that 28 nurses are out on leave.
The educators in Staff Development are informed that 26 travelers are coming on Tuesday of this week, and must be onboarded.
Where are all the nurses going?
My sister works in a hospital across the country from me and nurses are running out of her hospital as well. "Where are they going?", I ask. "Anywhere", she says. "Just out of here.”
It's one thing to work hard and pull together for a national emergency. It's another to work hard with no end in sight and to not feel valued.
COVID was the tipping point. COVID took a stressed-out, unappreciated workforce and pushed it over the edge. Exhaustion coupled with unappreciation equals nurses talking with their feet.
Conversations continue.
"I saw the MedSurg manager taking care of patients this morning!.”
"Seriously, did she even have Pyxis access? She hasn't worked bedside in 8 years! How come the charge nurse isn't taking patients instead?"
"She is! She's charge and has a full load.”
The boilerpot situation breeds deep frustration and anger...and anger wants a target. Staff who have worked at their hospital day in and day out, month after month, year after year, are orienting travelers making twice as much pay. Meanwhile, staff nurses' phones are blowing up with requests begging them to stay later, come in earlier, and work on their days off.
Nurses are angry at managers and Directors who are seen as out of touch and insensitive. Administration blames managers if their staff leave. "We all know employees leave or stay because of their managers.” Ironically administration rarely asks nurses themselves what it would take for them to stay.
Brenda, an NP who loves ED medicine, is quitting and going to work in a plastics office because she can no longer tolerate the chaos.
When COVID resurged with the Delta Variant, and the ED staff was stocking tents erected in the parking lot in 108 degree weather, she texted her manager to see about getting some flats of chilled bottled water for the staff. Her manager texted back she was out getting body work done on her car.
Nurses are angry when work gets shifted to them from other departments. An out-of-ratio ICU RN caring for 3 ICU level patients with one patient alone on 4 different antibiotics went to the Pyxis only to discover that suddenly this morning, she has to mix and label her own antibiotics. She calls Pharmacy and is told, "It's because we're short-staffed".
Nurses are angry at patients who brought this on themselves. Nurses put their lives on the line once for over a year, but many aren't willing to do it again for people who could have been vaccinated but chose not to.
Signs on patient doors say PAPR required for aerosol inducing procedures...what..? We aren't routinely given PAPRs, just N95s! Is the sign wrong? Or is the practice wrong? Are we at risk? Why can't we trust the information we're given?
Nurses are practicing in chaos with conflicting directions and changing guidelines. Discovering that they weren't protected after all. There's distrust in government agencies and hospital administrations.
"I heard 3 nurses turned in their notice on 7SE.”
"Wow. Maybe I'll quit, too.”Leaving is contagious. It starts as a trickle and ends up a flood. I'm not at all sure it's possible to stop it midstream, but could it have been prevented?
What do you think? Why are nurses quitting?
Ohio NP: Spot-on! I'm thankful for the knowledge from nursing...it keeps me away from conventional medicine. Also glad there are many career paths for women that are exponentially better than wiping butts which is really most of what the job entails [no pun intended] anymore. Nursing needs to change....desperately. The field is stuck in an era of Theory X management. Have had it with the control freak frumps...seems that's mostly what is in nursing mgmt. Regret the day I stepped foot in this field though I don't beat myself up over it...the vision of the field most of us held before entering it was one of truly offering something to others, feeling good about our work, all while enabling one to make an "average" living. Greed abounds and it's hard to find people who actually like the field except for those who state they're on a mission, it's a "calling" or other fluff.
On 9/26/2021 at 7:54 PM, Texas Military Mom said:Chances are rigid and or unethical management may be the blame.
OK, nurses have been taken advantage for a long long time. Forced overtime, in dangerous understaffed shifts. Insane work loads like one nurse do the work of two. A breaking point was sure to arrive when an opportunity presented itself. And that is happening now after the second covid wave. Nurses are just leaving, even if just for a moment, they don't care, they just leave. The insanity and inefficiency of our broken health care have finally come home to roost.
Everything is disposable theses days..paper, plastic, styrofoam utensils even nursing staff. The business model clearly puts profit over patients. Since businesses are clear about making money, nurses have left to make money too. Travel nursing pays very well. Nurses command the pay rates they earn. Nurses leave to make money too.
On 10/25/2021 at 2:05 PM, Bluefamily said:Everything is disposable theses days..paper, plastic, styrofoam utensils even nursing staff. The business model clearly puts profit over patients. Since businesses are clear about making money, nurses have left to make money too. Travel nursing pays very well. Nurses command the pay rates they earn. Nurses leave to make money too.
It goes both ways doesn't it? No loyalty goes both ways. You can't commit to me, I can't commit to you. I'm looking around, who pays more? Is that good for health care? No it is not. Do they care? No they don't.
Let me tell ya how bad it has been in our stand alone ED. 20+ in waiting room, 3-4 ambos waiting. No place to send admitted patients too because of staffing or no beds. Transportation taking 4-5 hours to p/u patients if get placement and at one point they couldn’t even give us an eta. Primary care docs telling patients they can’t see them so just go to Er. Housekeeping short so sometimes nobody to clean terminal COVID/ flu etc rooms. Can’t just close them off to clean later and get told from main hospital that “we have to clean our own rooms so you can too!” What else can ya say, when is collapse gonna happen and we are just in thanksgiving surge, Christmas surg gonna happen at end of January!
On 10/26/2021 at 10:41 PM, Leonardo Del Toro said:It goes both ways doesn't it? No loyalty goes both ways. You can't commit to me, I can't commit to you. I'm looking around, who pays more? Is that good for health care? No it is not. Do they care? No they don't.
It used to be that nurses were loyal to employers whose benefits and overall conditions were fair and commensurate. Today however, benefits (esp. dental/medical) in many facilities are pathetic, the nurse/patient ratios and staffing are dangerous, and wages are stagnant. Personally, I am loyal to no hospital, facility, nurse manager, or location. I will (and have gone) to hospitals that offer more money, better benefits, less call, less stress, less work....
Now, in the wake of Covid, with mass exoduses taking place across the country, I'm seeing hospital administrators beginning to squirm like never before. What are the answers to this nursing shortage......hmmm? First off, how about beefing up nurses' starting wages, offering attractive sign-on/retention bonuses, get rid of employee dental/medical insurance that is hollow and pays for nothing, stop the redundant work process/hyperregulation, and honestly address N/P ratios! Anything less is disingenuous and just smoke and mirrors!
On 8/25/2021 at 1:50 PM, EMTdude said:It’s funny reading these comments “I made lower than minimum wage!” “I have 20, or 40 patients that I have to do Adl’s and there’s no end in sight” BUT I bet 95% of the RN’s complaining on this forum were 100% okay when it was their PCA and tech experiencing the same thing, and all while the techs and PCA’s also had to go to school full time, AND we’re making LESS than minimum wage (at least I was, working in Boulder, CO in 2018 at less than $11 an hour, despite the median income being over 75k for the city.
I think that you get what you give, that’s why I got into nursing, after having a heart attack - looking back, if I had a dollar for every time I got an eye roll or an “I’m busy, sorry” when asking my nurses for help to turn, or assist, all while they were hanging out on theirs cellphone at the nurses station, maybe I wouldn’t have gone homeless, at that time and would still be going to school for a masters.
Seems like a lot of nurses never really cared about fairness and wages, except for their own, and now nursing as a whole is in a crunch… when you loose sight of caring for one another, and that means the people below you, then you have nothing to stand on because you are the ones who never respected or cared about the foundation that supported you without a fault (or hard work many do for decades, and RN’s say anything because the way the majority treat their PCA’s is that they “don’t matter” or it’s “just the way it is”.
From one person with multiple degrees, to all those entitled nurses with one degree, who hate their job, and have forgotten what perspective is - get a new one, what makes you so special or different? You’re not the only ones who have had their dreams crushed by terrible coworkers, and policies all meant to make you feel the squeeze - besides, “that’s just the way it is now”.
I haven’t seen one nurse on their cell phones where I work and we ALL help each other including housekeeping chores when needed. Did you ever think as a nurse you’d be unclogging a toilet?
It is not like what you described everywhere. Not all nurses are what you described.
Every point you make hits a nerve.
Nurses live in contradictions of convenience. We are told what we should be doing for ourselves and how to care for ourselves, to stand up for ourselves and say, "This is how we were told it should be." Not to report to work if we are sick. To take proper rest breaks. When attempting to be that nurse, excuses are made for why the standards have shifted and why what was once deemed unacceptable is now permissible.
Employee health has provided a list of symptoms and reasons that indicate it is best not to come to work. Various agencies such as DOH, JACHO, and NIOSH provide rules and regulations regarding workplace safety, necessary equipment, and required conditions for different types of care. They conduct research and provide information on these matters. We are tested and monitored closely.
But when it suits the hospitals and clinics to wave those guidelines for their benefit, those rules are no longer followed.
I understand the pandemic has brought about changes and I am willing to accommodate any urgent requirements. I discovered that even now, it is deemed appropriate to house a patient who has tested positive for COVID for four days in a standard room that lacks negative pressure and no ventilation windows. This room is in a high-risk clinic where the nurses have undergone FIT testing, but not all have access to the appropriate masks.
One clinic would not provide a PAPR in case of a volatile chemotherapy spill. To them, an N95 would be okay.
These are nurses' lives they are playing with!
To be told that if we need to watch our overtime, no one offers to cover lunch breaks that day, or the supervisor leaves a little early without asking if we need help when we are overwhelmed and struggling...
They are contradictions of convenience.
When you have minor grievances chip away at you for years, and more and more join them until they become more intolerable, you are exhausted, and all you think about is walking away.
Yes! We're all told these things and yet it's impossible to do with the demands on us. What should we choose? The safety of our patients or ourselves? How do we protect our licenses from all the impossible standards thrust upon us without taking shortcuts? No one wants to shortcut care but are pressured to meet expectations, that once again are unreasonable, including redundant charting, checklists galore and backing up other disciplines such as pharmacy, doctors orders and yes, even dietary. We are obligated to know what is appropriate and safe with their orders and make sure they have carried out them out correctly. Nurses are dumped on at every turn. It's so wrong.
The increasing number of nurses leaving acute care is worrisome. It's hard to predict the extent of this trend or if it has peaked. Factors like burnout and staffing shortages contribute.
Solutions are crucial. Improving work conditions, staffing, and mental health support can help retain nurses and maintain care quality. Ongoing efforts will shape the future of this trend.
Ohio NP
13 Posts
Agreed to the lack of leadership in nursing and that the nurse “leaders” are just administrative shills. The ones who aren’t, and I’ve worked with many, are pushed out by Administration and replaced with yes people who share their disdain for the nursing profession. I’m so disappointed with the entire healthcare experience I wish I had made other choices. On a positive note, I know that it’s just a numbers game so can make decisions regarding my healthcare and my loved ones healthcare with eyes wide open. The only upside to this miserable career path.