Told to move faster or seek work elsewhere

Dear Nurse Beth Advice Column - The following letter submitted anonymously in search for answers. Join the conversation!

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I like both the advice, and critical feedback I get on this site it is a great reality check hence my reasons for writing. I work in long term care and like any other form or area regarding nursing its hard mentally, physically and in some ways spiritually.

I got a wake up call today and was reminded I am in the overtime from management and was more or less politely told move faster or seek work elsewhere. I do understand a need to be accurate which is critical for me, and I also understand that we do not have enough staff in the building and I am not allowed it say we are "short" but a euphemism of this as "adequately staffed". 

I have thought about this for long while in fact have not slept a single hour over the past twenty four hours because of it.  As sadly as this sounds I have to trim the preverbal fat from my work day.  I have noted I must cut my conversations to the very short and direct minimal, and cannot be as casual with my clients as I would prefer, and I fear I will become "Nurse Ratchet"!.

My priorities remain the same, Safety, Medication, Treatments, Order, and I truly do enjoy my clients, and I do a fair amount of advocating for the care staff as well as they take as much verbal and physical abuse as I do if not more, and they do amazing work that demands recognition.  I am capable at my post, and there are always crazy days, or "blue moons"  and and call ins every day, especially on the weekend. It was two weeks ago that I only had two care staff for over one hundred clients on one evening with all the behaviors to manage.

I  have no illusions of management being my friend however I have to do do what protects myself and my clients first is this selfish? This is a very hard and emotion thing for me to endure as it causes me to well up in tears to reflect about it.

I could always go back to school for four or five years, or find another place to work which will most likely be for better pay and benefits, but it is not about money for me and it never will only about money. I have more then enough money, and time on my side. Perhaps I just need to get tough. Complaining about a problem without formulating effective contingency plan is not conducive to my growth and development, and anecdotal evidence is questionable at the best of times, so I therefore have my path set to continue on. I am thank for for the time to express this as I do not do so for pity, sympathy or empathy I need brutal and direct advise from a peer.

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Specializes in Tele, ICU, Staff Development.

You seem like a thoughtful and deeply caring nurse, yet you're also frustrated and worn out. While you are devoted to your job, you find yourself at a crossroads, wondering how long you can continue without losing yourself.

You understand the reality of long-term care—it's understaffed, overworked, and underappreciated. Unfortunately, that's not unique to your facility. But how do nurses cope without compromising their values?

The Productivity Demand
Management wants you to move faster, but accuracy and safety are your top priorities—they're non-negotiable. While cutting out casual conversation is understandable, don't lose the human touch entirely—it's essential for your well-being. Try batching tasks, grouping medications when appropriate, and optimizing your workflow. 

The Staffing Reality
You're not "adequately staffed”—you're chronically understaffed. But you already know calling it that won't get you anywhere. You could keep objective documentation on staffing levels and patient loads (dates, times, who was working, and incidents that occurred). Not for management—for yourself, in case things ever hit the fan and you need to cover yourself.

Your Emotional and Mental Well-being
The fact that this keeps you up for 24 hours tells me the stress is hitting deep. You're emotionally invested, which is a double-edged sword. It makes you a good nurse but also puts you at risk for burnout.  If management is emotionally detached, it's not because they're being "tough" or "efficient”—they don't understand your struggles. And they don't want to.

Protecting Yourself
It's not selfish to prioritize yourself and your residents over management's unrealistic demands. It's necessary. You can advocate for your team and your residents but don't break yourself in the process. Document everything, polish your resume, and be ready to walk if needed.

What's Your Next Move?

Try adjusting before quitting. Test out ways to streamline your work without compromising care. If it's still impossible, it's a systemic issue, not a "you" issue.

Keep your options open. You don't need the money but a work environment where you're not constantly drowning. If that means moving on, so be it.

Toughen up—but don't shut down. Efficiency doesn't mean sacrificing empathy. Just establish clear boundaries—you can't save everyone if you go under, too.

You're in the trenches, and it's tough. But you don't need to sacrifice yourself for this cause if the job harms you. You already possess the mindset of a survivor—now, determine if this battle in this environment is worth it.

Best wishes,

Nurse Beth

 

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