Nurses are Fleeing the Hospital

Nurses have simply had enough and are walking out of acute care. How far will it go? Have we seen the peak yet?

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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.”

Tipping Point

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.”

Anger

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.

Lack of Trust

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. 

Leaving Begets Leaving

"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?

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I agree that the work force in the USA is sick of being abused and watching the Ivory Tower folks sit on their butts, getting their nails done, working banker's hours.

This will play out badly. But it will be interesting. When it negatively affects the rich/powerful among us, then it will be noticed. Not before then.

Specializes in Progressive care, cardiac surgery, telemetry.
34 minutes ago, SmilingBluEyes said:

This will play out badly. But it will be interesting. When it negatively affects the rich/powerful among us, then it will be noticed. Not before then.

I think there's a decent chance that this will affect the rich and powerful. Lack of those of us who provide essential services (including healthcare workers) will eventually reach the rich and powerful, which we can hope will lead to the changes we seek.

Specializes in Dialysis.
25 minutes ago, deej394 said:

I think there's a decent chance that this will affect the rich and powerful. Lack of those of us who provide essential services (including healthcare workers) will eventually reach the rich and powerful, which we can hope will lead to the changes we seek.

Possibly, possibly not. Some of the rich and powerful are using concierge medicine. I don't know how it will affect those folks. Only time will tell

Specializes in Community Health, Med/Surg, ICU Stepdown.

I think a good portion of the “one percent” lives here in the Bay Area, and wealthy people are complaining about the wait times and lack of service at restaurants. I went to a restaurant (outdoors and I’m vaccinated!) this weekend, and the tables were dirty, food took forever to come, items forgotten, even some of the plates dirty. I noticed they had only 3 servers for probably 60 tables.

We didn’t complain because the 3 people looked extremely stressed. We asked for the table to be wiped off and take the stuff that never showed up off the bill, but not in an angry way, and gave a good tip. Servers experience abuse from customers and here they are making more on unemployment so I totally get why they would prefer to stay home. Many of the people still showing up to service jobs here are undocumented so can’t get unemployment. Maybe wealthy people will start supporting increased wages and workers’ rights if lots of essential businesses close. Instead of those making millions a year voting down propositions to increase the minimum wage. But some super wealthy are leaving the state because they’re tired of being taxed so high for all the social programs here, so we’re not yet moving toward fixing wealth inequity. 

I don't see wealthy people standing up for service people (and sorry to say it but that includes us) anytime soon. What I do anticipate happening is wealthy people getting mad that they aren't getting the service they feel they deserve, making a ginormous fuss about it followed by administration laying the blame squarely at our feet. It matters not that the very same administration has stripped us of the tools we need to provide good patient care. 

Specializes in ER, Pre-Op, PACU.

As I have mentioned before, I think covid has simply illuminated what was already broken in healthcare. I do know I left the ER during covid for a Preop/PACU job and now no one can pay me enough to go back to the ER.

We are working sometimes 24 hours though between our regular shifts and on call (which have turned into holding admitted patients). I will say though our leadership team has been right there with us trying to cover part of those shifts and pulling some of that time themselves. The administration though has truly shown how worthless and useless they are (yes this is the CNO, etc). I do see our actual team coming together to help each other - I have seen anesthesiologists and CRNAs taking patients to the restroom and surgeons offering to help transport patients with us. I know I personally have kept an eye out for other jobs to stop having to pull the 24 hour shifts (which can’t often be covered even with pay being offered equivalent to travel nursing) but the sad thing is that I don’t think things are better at any other hospital and likely are even worse. I am just glad I am out of the ER…..

Specializes in Community Health, Med/Surg, ICU Stepdown.
4 hours ago, Wuzzie said:

I don't see wealthy people standing up for service people (and sorry to say it but that includes us) anytime soon.

That is probably true. There are some nice and generous wealthy people, but often extreme wealth is made at the expense of others. Some people would rather have millions sitting in a bank making more millions that they could never even spend in multiple lifetimes than give a tiny percentage of it to others, even if that tiny percentage could be life changing to someone else. 

Specializes in orthopedic/trauma, Informatics, diabetes.

I have an amazing manager. It's the person 2 people above her that is the one we are angry at. Our manager has come in at 0300 to help out. Our team leads are working the floor. Charge RNs are taking pts. We are all trying to do our part and it is very hard not to get upset at the people that will not get vaccinated: including colleagues. How can people who work in the trenches really believe that the vaccine is dangerous. Especially those that parrot what they have heard on certain news stations. ?

 

Specializes in Mental Health.

This article completely missed the possibility that there might exist a general culture of poor work ethic contributing to this problem. Then again, it could be that my ADHD loves the chaos... LOL 

Specializes in Med-Surg, Geriatrics, Wound Care.
44 minutes ago, Rionoir said:

This article completely missed the possibility that there might exist a general culture of poor work ethic contributing to this problem. Then again, it could be that my ADHD loves the chaos... LOL 

I don't know. Not sure a poor work ethic is really the issue. Sure, some people may not work as "hard" as others. Maybe some people take a full unpaid 30 minute lunch break *and* 2 fifteen minute breaks during their shift. Some people may even try to urinate when not on an official break! Or maybe the fact that I've never heard of nurses getting 15 minute breaks is the problem?

2 call-offs today. 5 staff usually level-headed staff members in tears this morning. I called on  our psych CNS to intervene (they are primarily staff-support CNSs). I should not have to be the one to do it. Our tone-deaf and obviously blind manager should be aware of what is going on and getting us the support we  need. 

Six weeks and you can be a real estate agent, sweeping thousands into your bank account with every sale and little effort.  Yet, the waitress with CPR role, aka nursing, makes minimal sums for extreme responsibility.  The pulling on the benevolent strings has maxed out.  No more can hospitals hijack phones, push a guilt trip, and think people are going to jump.  It's been a longtime in the making.  For decades, the execs perched in the executive suites have enjoyed stuffing their pockets from the work of those dripping sweat from running and denying their bladders a break.  Enough is enough and today's nurses "get it" and are not going to put up with the extreme imbalance.   Glad to see it.  About time!