What do hospital nurses want/need?

[khillbrt]

Given the trends we have seen with mass exodus of hospital and bedside nurses, I am interested to know what would make it better? 

-Better nurse/patient ratios

-Better pay

What else? What actual methods of appreciation would make a meaningful difference to you in this role? We all make fun of the "pizza parties" and crappy Nurses Week gifts, but what WOULD make a difference to you?

[Red Shirt 6, CNA]

These are some things I would like and would make things better 

More paid holidays (every holiday that a bank and or school acknowledges), even if I have to work them the extra helps make up for it. 

Housekeeping and maintenance 24 hours a day and not only 16.

Beds that are maintained and lubricated regularly. 

Night/graveyard shift included on nurse's week and other type of events. 

Student Loan assistance 

[Annon16453799]

RN1987 said:

This is STILL a topic? Really? I'm not and will never be one of those who think nursing is a calling. It's a job, a toxic career choice, we aren't the Flo Nightingales, she's dead, times have changed.  Nursing is the way people make a living. A  good place to start would be to adjust the wages and pay in $$$$ instead of peanuts. The benefits need to be better. Nursing education needs revamped. Stop placing so much emphasis on the freaking care plans and start teaching actual skills. 

This comment makes me afraid of nurses. Nursing is a profession. Your profession is a reflection of your passions. If you are passionate about money, nursing is a labor level job. Find something else. 

[mtmkjr, BSN]

Annon16453799 said:

This comment makes me afraid of nurses. Nursing is a profession. Your profession is a reflection of your passions. If you are passionate about money, nursing is a labor level job. Find something else. 

Well said. I do think there is something different about caregiving, evident in what happens when caregiving becomes a paycheck.

No one should be in it without a certain amount of empathy and compassion, and increasing pay will not necessarily bring more people passionate for caregiving to the profession. Most people consider nursing to be fairly compensated.

Where I think the difference can be made is in work environments and expectations - understaffing and penny pinching patient care is unacceptable, almost like punishing someone for following their passion, and ultimately harming the people we care for.

[brandy1017, ASN, RN]

Annon16453799 said:

This comment makes me afraid of nurses. Nursing is a profession. Your profession is a reflection of your passions. If you are passionate about money, nursing is a labor level job. Find something else. 

And mtmkjr, BSN said

Well said. I do think there is something different about caregiving, evident in what happens when caregiving becomes a paycheck.

No one should be in it without a certain amount of empathy and compassion, and increasing pay will not necessarily bring more people passionate for caregiving to the profession. Most people consider nursing to be fairly compensated.

This theme of how dare nurses think about the money and they should only be in it to care for others is a really harmful and toxic mindset endemic in nursing and contributes to the mistreatment of nurses, low pay, short staffing and disrespect because we are supposed to only care about others and not ourselves. God forbid we care about the money! 

Yet how do you expect people to support themselves and their families?  You forget the practical realities that money doesn't grow on trees and college costs a lot of money, not to mention housing, food, health insurance, and cars.  The inflation on everything is insane!  Please get off your moral soap box that only people of a noble and virtuous nature should be allowed to be nurses!  You are doing a serious disservice to the profession and your fellow nurses who deserve to be treated fairly with respect and compensated adequately.

As to nurses get paid enough, you obviously don't know the truth!  Nurses don't get paid enough and the benefits get worse every year!  Plus there is a lot of wage compression and many times new grads end up making more than a nurse that has 5 years experience at the same place if there isn't a union! 

Covid really made it clear how hospital management felt about nurses as they didn't protect them, made them reuse the same paper TB mask for weeks, some tried to sterilize this single use paper mask with chemicals!  Threatened and fired nurses who spoke out for safety, thousands of nurses died from covid!  Some nurses were denied hazard pay, raises, the ability to take vacation time off to recover and mandatory overtime was endemic.  Some hospital systems even forced their nurses to float to other hospitals, nurses who were just staff, not float pool!  It really made it clear how we weren't valued, nor respected and that lead to a mass exodus of nurses; but go on and tell us how we should be more noble and we are paid enough! 

But I agree it is about much more than money, to me it was about safe staffing, enough patient equipment and respect.  I was one of the ones who left and took early retirement rather than stay and work under these conditions as a martyr!

 

[Tweety, BSN, RN]

Since we're talking about money, I made more money during the covid year of 2020 and even more in 2021 than I did my entire life.  It was rough and I nearly burned out at times,   I don't think I was a martyr, I was just doing my job and it was my choice to work for big bonuses and extra money.  I was able to remodel my bathroom and pay cash.  

Anyway, I do have to agree that nurses are decently compensated otherwise thousands of applicants wouldn't be turned away in school every year. "Decently" doesn't necessarily mean high income.  It's a nice middle income for an Associates Degree/BSN and since becoming a nurse I stopped living paycheck to paycheck, I have a home, a car, and have traveled around the world.   I appreciate that there are some nurses with families and other issues that might struggle but for me you can throw more money at me, but that won't increase my job satisfaction at all. 

 I think this is where I would start as most new grads are going to be working in hospitals, my wish list would include a way to get more RNs out there to help us.  

The other thing is what other nurses have echoed ratios.  I work med-surg and it's acceptable to our management to have 6:1 ratios often and this kicks my butt every time and needs to be stopped.  

 

 

 

[abbnurse]

brandy1017 said:

 

Covid really made it clear how hospital management felt about nurses as they didn't protect them, made them reuse the same paper TB mask for weeks, some tried to sterilize this single use paper mask with chemicals!  Threatened and fired nurses who spoke out for safety, thousands of nurses died from covid!  Some nurses were denied hazard pay, raises, the ability to take vacation time off to recover and mandatory overtime was endemic.  Some hospital systems even forced their nurses to float to other hospitals, nurses who were just staff, not float pool!  It really made it clear how we weren't valued, nor respected and that lead to a mass exodus of nurses; but go on and tell us how we should be more noble and we are paid enough! 

 

💯💯💯 Well said, brandy1017  !  

[brandy1017, ASN, RN]

Tweety said:

Since we're talking about money, I made more money during the covid year of 2020 and even more in 2021 than I did my entire life.  It was rough and I nearly burned out at times,   I don't think I was a martyr, I was just doing my job and it was my choice to work for big bonuses and extra money.  I was able to remodel my bathroom and pay cash.  

Anyway, I do have to agree that nurses are decently compensated otherwise thousands of applicants wouldn't be turned away in school every year. "Decently" doesn't necessarily mean high income.  It's a nice middle income for an Associates Degree/BSN and since becoming a nurse I stopped living paycheck to paycheck, I have a home, a car, and have traveled around the world.   I appreciate that there are some nurses with families and other issues that might struggle but for me you can throw more money at me, but that won't increase my job satisfaction at all. 

 I think this is where I would start as most new grads are going to be working in hospitals, my wish list would include a way to get more RNs out there to help us.  

The other thing is what other nurses have echoed ratios.  I work med-surg and it's acceptable to our management to have 6:1 ratios often and this kicks my butt every time and needs to be stopped.  

 

 

 

Happy for you that you made good money, received bonuses and volunteered for OT.  That is the way it should be.  I'm all for that!  I was happy for the travelers I worked with and glad to have them.  But not everyone had fair pay, voluntary OT with bonuses some were forced with mandatory OT and floating.  Some were denied hazard pay and raises and there was even a CNO of one hospital that had an attitude when called out about the lack of raises how dare they complain.  My hospital got a 2.4% raise only because we were union the rest of the national system did not so they lost staff as they should.  Plus many nurses quit for travel jobs for more money.  People have bills and if they can travel and want to why not!  The hospitals don't put us first so put yourself first!

I've mentioned before a coworker of mine worked tons of OT during and after covid only to have a mental health crisis and take early retirement, call in sick and they used that to deny her 200 hr PTO!  I believe this same system will take your PTO when you leave or are let go unless a state/city law prevents them.  So once again I say use your PTO, even if to just take a staycation to relieve stress or look for a better job!  Don't let them steal your PTO!

Nursing pays a living wage.  Many people are trying to become nurses because there are so few jobs out there now that pay a decent wage.  Plus the few that do tend to also have constant layoffs!  There are nurses on here who were engineers and teachers who after being laid off went back to school for nursing because they knew it was a more steady income.  But lo and behold nurses were laid off during covid and are being laid off now!  It is a common practice in non-union places to get rid of the older workers and then rehire new grads for half the pay! 

So even if you are a nurse you still need to plan for the possibility of losing your job or becoming sick or injured from the job.  So build up an ER savings.  I advocate a Roth IRA as you can take the contributions out in an emergency.  Also an HSA if you have a high deductible health insurance plan.

[Tweety, BSN, RN]

brandy1017 said:

Happy for you that you made good money, received bonuses and volunteered for OT.  That is the way it should be.  I'm all for that!  I was happy for the travelers I worked with and glad to have them.  But not everyone had fair pay, voluntary OT with bonuses some were forced with mandatory OT and floating.  Some were denied hazard pay and raises and there was even a CNO of one hospital that had an attitude when called out about the lack of raises how dare they complain.  My hospital got a 2.4% raise only because we were union the rest of the national system did not so they lost staff as they should.  Plus many nurses quit for travel jobs for more money.  People have bills and if they can travel and want to why not!  The hospitals don't put us first so put yourself first!

I've mentioned before a coworker of mine worked tons of OT during and after covid only to have a mental health crisis and take early retirement, call in sick and they used that to deny her 200 hr PTO!  I believe this same system will take your PTO when you leave or are let go unless a state/city law prevents them.  So once again I say use your PTO, even if to just take a staycation to relieve stress or look for a better job!  Don't let them steal your PTO!

Nursing pays a living wage.  Many people are trying to become nurses because there are so few jobs out there now that pay a decent wage.  Plus the few that do tend to also have constant layoffs!  There are nurses on here who were engineers and teachers who after being laid off went back to school for nursing because they knew it was a more steady income.  But lo and behold nurses were laid off during covid and are being laid off now!  It is a common practice in non-union places to get rid of the older workers and then rehire new grads for half the pay! 

So even if you are a nurse you still need to plan for the possibility of losing your job or becoming sick or injured from the job.  So build up an ER savings.  I advocate a Roth IRA as you can take the contributions out in an emergency.  Also an HSA if you have a high deductible health insurance plan.

I certainly appreciate that people's experience during the covid years were all over the place.  I think in some cases hospitals weren't prepared and were doing the best they could with staffing and supplies.  In other cases crappy employers showed their true colors.   We went through the same thing of losing nurses to travel, retirement and other reasons.  When covid came to Florida it came hard.  It wasn't easy.  

The biggest take away from your post and I'll say it louder for the people in the back "The hospitals don't put us first so put yourself first!".  

I've always worked in a hospital and always as a floor nurse/charge nurse as I know I couldn't do management.  So I sometimes have to remember my choice and make peace with the environment and get satisfaction from my own inner drive, not from my employer.  I know the executives in their suites, meetings and lunch hours don't care that I've worked on my feet for many hours without a break and I expect nothing from them and have to find a way to be there for myself and patients.  This includes stepping back and saying no to overtime and taking my PTO.  I can appreciate it's not the environment for everyone.  

The market where I live hasn't had layoffs, even for older more higher paid nurses, but it's always good to be prepared for a layoff, burnout or leaving an intolerable situation.  

[khillbrt]

canoehead said:

Seriously? someone is still asking this?

I'm making less than I was as a new grad, and I'm 35 years in when you take into account inflation. I'm working double time every shift. I resigned from a job with proper notice and good evaluations because the environment was unsafe for patients and they reported me to the nursing board three times in the next six months....but after all those reports my license is still completely clean because my offense was advocating for better care.

Quit spending time and money whitewashing the hospital to make it look good and keep up the PR. Pay your nurses double what you do now and you won't need travellers. Keep supplies stocked and equipment working. Give us enough space and staff to take the patient load- no more hallway beds, or holding more patients than a unit is designed for. And stop asking stupid questions when you already know whats wrong.

What is wrong with you? I am a nurse. I am doing research. I am asking the question, because nurses most commonly say what they DON'T want, but cannot clearly state what they DO want to increase their job satisfaction. I clearly stated apart from wages and ratios. 

I am not an employer. I am not the enemy.

Perhaps you could stop replying to posters who are your colleagues if you can't be civil and have a constructive discussion. You are the perfect example - all complaints,  no actual suggestions for a solution. 

[khillbrt]

canoehead said:

Seriously? someone is still asking this?

[....] stop asking stupid questions when you already know whats wrong.

What is wrong with you? I am a nurse. I am doing research. I am asking the question, because nurses most commonly say what they DON'T want, but cannot clearly state what they DO want to increase their job satisfaction. I clearly stated apart from wages and ratios. 

Perhaps you could stop replying to posters who are your colleagues if you can't be civil and have a constructive discussion. 

=============================

Unfortunately, this thread is exactly why I needed to ask - and made the mistake of thinking I was asking collegial peers for constructive ideas. I think perhaps 2-3 people had actual, usable suggestions as to things that would make their job or life better or easier that were not wages or ratios, which I already listed in my first post when I posed the question. 

I didn't design the healthcare system. I am not a hospital system/employer. I was looking for tangible things that would help improve things in this system. Like - more experienced staff, on-unit clinical educators to reduce preceptor duties for clinical staff, varying shift lengths, loan repayments, more tuition assistance, less paperwork. etc. I have thought of multiple things, but I wanted to seek opinions from other working colleagues. 

Apologies for my "stupid question". 

[brandy1017, ASN, RN]

khillbrt said:

What is wrong with you? I am a nurse. I am doing research. I am asking the question, because nurses most commonly say what they DON'T want, but cannot clearly state what they DO want to increase their job satisfaction. I clearly stated apart from wages and ratios. 

Perhaps you could stop replying to posters who are your colleagues if you can't be civil and have a constructive discussion. 

=============================

Unfortunately, this thread is exactly why I needed to ask - and made the mistake of thinking I was asking collegial peers for constructive ideas. I think perhaps 2-3 people had actual, usable suggestions as to things that would make their job or life better or easier that were not wages or ratios, which I already listed in my first post when I posed the question. 

I didn't design the healthcare system. I am not a hospital system/employer. I was looking for tangible things that would help improve things in this system. Like - more experienced staff, on-unit clinical educators to reduce preceptor duties for clinical staff, varying shift lengths, loan repayments, more tuition assistance, less paperwork. etc. I have thought of multiple things, but I wanted to seek opinions from other working colleagues. 

Apologies for my "stupid question". 

The problem is that most hospitals know what needs to be done or what could be done to improve things, but don't care and won't do it if it costs them any extra money!  My experience and others with shared governance, part of Magnet hospitals, is that nurses would be interested and invested in improving things, but it would end up being a waste of time and energy  when their ideas were discounted in the end.  By us the manager and educator even set the tone and decided what would be worked on in the first place which from my understanding is not the way it is supposed to be.

I don't know if you are doing this for a school project or for improving your own hospital unit, but this is the reality that I've encountered and others such as travelers who worked at other systems over the years have voiced as well.  

You appear upset that many of us have mentioned the need for better staffing and pay as you apparently didn't want that mentioned.  I'll be honest I guess I didn't read the fine print, but instead of being upset it should tell you how important these issues are to nursing satisfaction and retention.  To tell us to ignore two of the most important issues is to discount and disrespect your fellow nurses since these are some of the main problems, but certainly not all.

If you are planning on working in the hospital setting as an educator or manager and want to improve things, I truly wish you luck.  The problem comes down to the budget, will your hospital allow you to spend the money necessary to do things to improve nursing morale and retention and that is the luck of the draw.  A good one will, but there are many bad ones out there and with all the corporate consolidations and takeovers it makes it harder to implement common sense improvements in my opinion.  All the ideas you have mentioned sound great, and I hope you have success implementing them where you work!