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?
