"Heading For The Exit"

Brita01 · Feb 4, 2004

Excellent report. I can definitely relate.

NurseHardee · Feb 6, 2004

Yep, the execs at places like HealthSouth are killing the geese that lay their golden egg.

Nurse Hardee

live4today, RN · Feb 6, 2004

That article states that over half of New York City's Staff Nurses were born outside the U.S.??? :eek: What a mind blower that is to me. :eek:

As far as hospitals waking up to reality regarding why nurses are exiting the hospitals in record numbers, well.... :rolleyes: ....dream on, huh?

NurseHardee · Feb 8, 2004

You know those "exposes" of American men going to find wives in foreign countries? And then enslaving them and abusing them because they got their papers held in limbo.... Are they hospital administrators, or what? lol... and crying, too.

Nurse Hardee

Hellllllo Nurse, BSN, RN · Feb 8, 2004

Great article! I'm posting the text.

REPORT: February 2004

Hospital Staff Nurses Burning Out, Exiting Early

by Nancy Webber

Hospital staff nurses are facing greater amounts of stress and are leaving the nursing profession at an earlier age than RNs who work in any other setting, according to details of a survey of New York Registered Nurses.

When the State Education Department announced the results of its statewide survey of RNs last fall, it identified hospital staff nurses as a group that demanded more detailed study. According to the researchers, this was based on their large numbers, their importance to hospital-based patient care, and their unusually high level of job stress. The study of hospital staff RNs has been posted on the SED Web site: (http://www.op.nysed.gov/nurseissues.htm) as Volume 3 of the survey results.

As hospital staff nurses make up more than half the total number of RNs in the state, their exodus from nursing is compounding the effects of a nursing shortage already fueled by the aging of the nurse workforce. NYSNA has long argued that workplace conditions are forcing nurses out of their chosen profession. The Association has introduced legislation and negotiated contracts that attempt to deal with issues such as understaffing and mandatory overtime.

Stress on the job

Hospital staff nurses experience greater workload-related stress than all other RNs working in New York State (4 on a scale of 1 to 5) and 36.5% report being under great stress almost every day.

Nearly half (48.6%) of hospital staff nurses work overtime, compared to 26% of RNs in other care settings. Of the staff nurses working overtime, 22% say it is sometimes mandatory and 7.2% that it is always mandatory.

On the young side

Just over 67% of RNs working in New York State are hospital inpatient staff nurses, or an estimated 61,500 full-time positions.

Hospital staff nurses are considerably younger than RNs in other settings, with an average age of 43.6. The average age of all RNs is 47.

About three quarters of RNs under the age of 29 are working as hospital staff nurses. This suggests that most newly licensed RNs work in hospitals as staff nurses.

Planning to leave

Of hospital staff RNs under age 52, 48% are planning to leave either their current jobs or the nursing profession within the next five years, compared to about 44% of all RNs in the state.

Among RNs under age 52, the average age of hospital staff nurses planning to leave the profession within five years is only 39.4 years.

Hospital staff nurses who have recently left the profession cite stress as the top reason for leaving (29%) - more than retirement (26%) or family obligations (17.7%). Staff nurses who say they are planning to leave the profession within 12 months list job stress as the top reason (35.4%), followed by retirement (21.7%) and low pay (12.3%).

The survey results overwhelmingly support that argument.

Job satisfaction low, overtime high

The survey shows that hospital staff nurses experience high levels of stress on the job, much of it related to workload and overtime. Hospital staff RNs who are working longer hours experience greater job stress and are planning to leave their jobs in the near future.

Job satisfaction scores show some similarities between hospital staff nurses and hospital nurse managers. Both value nurse-to-nurse interaction and fair pay. Nurse managers, however, appear to give higher priority to clear lines of communication with upper management, promotional opportunity, and autonomy. Staff nurses' job satisfaction is more closely tied to manageable workloads, getting along with physicians, and adequate resources to do the job.

Heading for the exit

Not surprisingly, job dissatisfaction is contributing to the large percentage of hospital staff RNs who are planning to leave the profession within the next five years.

Nurses working as inpatient hospital staff RNs not only have a higher burnout rate than nurses working in other job titles, but also tend to burn out at an earlier age. It is estimated that about 20 years of these nurses' professional lives are being lost because of an "early exit" from the profession.

According to the SED researchers, stress-related departure is resulting in an estimated 12% loss in the RN hospital staff nurse workforce. And, they say, this may be an understatement of the true cost. Other means of coping with a stressful work environment can include absenteeism, excessive sick leave, alcohol and substance abuse, and an array of mental health problems. These behaviors translate into lost time for patient care and a severe personal toll on nurses themselves.

Staff nurses younger, ethnically diverse

As a group, RNs working as hospital staff nurses are more than three years younger than the general RN population. In addition, a large portion (32%) identify themselves as ethnic minorities, compared to 20% of all RNs. Over 28% of hospital staff nurses were born outside the United States, compared to 20.4% of all RNs.

The numbers of minority nurses vary widely in different parts of the state. In New York City, 12.6% of hospital staff RNs are ethnic minorities, compared to 0.3% in rural areas. Well over half (55.6%) of hospital staff RNs in New York City were born outside of the U.S., compared to 5% in rural areas.

A relatively high percentage of hospital staff nurses are men (6.5%), compared to 5.3% for New York RNs as a whole. Men have made the greatest inroads, however, as inpatient hospital nurse managers-9.3% of RNs in this job title are male.

Changes are needed

In the sobering words of the survey report, "the rate of early burnout among the high-risk hospital staff RN workforce appears to be accelerating. Clearly, a major area of reform that must be addressed involves stress reduction in hospital settings. Any efforts to otherwise improve the 'culture of retention' in hospitals settings are unlikely to be productive if the pivotal issue of stress burnout is not addressed."

"These results should be a wake-up call to hospital managers and policymakers who think the nursing shortage will just go away by itself," said Lorraine Seidel, Director of NYSNA's Economic & General Welfare Program. "We are losing our valuable staff nurses and the quality care they provide. Workplace problems such as mandatory overtime and understaffing must be solved now."

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-jt · Feb 8, 2004

It's really not surprising considering that probably half of everybody in NYC was born outside the US.

Sadie04 · Feb 8, 2004

It very worrisome to think things are only going to get worse. It seems like the word is definitely out in the media about the nursing shortage, but at my hospital, that's all it is, just talk. The average age of RNs is 47 (very scary) but the higher-ups haven't taken any steps to work toward a solution. The VP of nursing where I work says that our state is in better shape than most, but I'm sure that's not going to last. I want to know what they plan to do about it!

It's frustrating and extremely stressful on my unit of 42 beds (ortho/neuro/trauma) when typical assignments consist of 8 patients on a day shift for an RN working with an LPN (the RN is responsible for all assessments, charting, IV meds, discharges and admissons, among other things). At night all RNs get 8 patients with no CNA or LPN. Not only do the patients suffer, but there have been several days when I leave work thinking "thank God I didn't kill anyone today!"

Although I love working with this population, I have to admit I can't see myself working in this environment for more than a few years; it's just too stressful!

This is my first post, I love this site and enjoy reading about what it's like for nurses in other states :)

oramar · Feb 8, 2004

Welcome and thankful for your insightful post. It seems like the best info on what is actually going on usually comes from the bedside nurse.

ernurse2244 · Feb 9, 2004

if I had to work a med/surg type unit I would be out of nursing for sure. I volunteered to come in and work med/surg one night last week because someone had called in. There were two RN's on, no LPN, no NA's, no ward clerk, no respitory therapist... We had 13 patients, 9 were incontinent and had to be turned. One patient was having significant bleeding, another got 3 units of blood during the shift. We had one admission. I was pulled to the ER for a code, was tied up about 45 minutes doing that. We made rounds on the patients at MN and again about 4:30. Forget turn q 2 h. No way could I live with myself if I had that on a routine basis.

Hellllllo Nurse, BSN, RN · Feb 9, 2004

Originally posted by ernurse2244
........ No way could I live with myself if I had that on a routine basis.

That is why so many of us have left the units, never to return.

heatherbless · Feb 9, 2004

good points about burn out/hty/