Nurses Are Leaving the Bedside In Droves

[panurse9999]

We can debate the why's, where's, how's, when's of the toxic culture in many hospitals and nursing homes.

More work, less support staff. More work, less pay. Too many patients. Higher acuity, more orders, fewer nurses being hired. My boss is dumb. My boss is toxic. Yes, its a BIG factor in a nurses decision to leave. We hate drama. We want to do our jobs in peace.

But those are just workplace semantics. There is drama in every workplace, wether in nursing, retail, law enforcement, food services, housekeeping, gaming, farming, hospitality, transportation, or basket weaving. Yes, its there now, and yes, it was there 50 years ago.

Truth be told, years ago, before corporate mergers/ takeovers/ acquisitions became as simple as buying pizza, we had hospitals and nursing homes. Today we have hospital systems and nursing home chains. With these corporate conglomerates at the helm, our profession was taken away. We lost our voices. We lost our sanity. We lost our zeal. Same thing happened to the banking system in the 1980s. Local stand alone banks were bought up, one by one, until we had 6 or 7 worldwide megabanks.

Corporate mentality stole the nursing profession and burned it at the stake. What used to be patient focus, is now billing focus. Today we do not have patients, we have inventory. Some generate substantial money, others are a drain. This is why, when and how "staffing to census" began rearing its ugly head. Back in the old days, there was no such thing as staffing to census. Nurses were hired on certain units, and that is where they stayed. Some days were super busy, others were not.

Staffing in hospitals and nursing homes today is soley based upon inventory (patients) and money (acuity). Not enough inventory in the burn unit? Float the nurse. Not enough inventory in L & D? Tell the nurse to stay home. Too many nurses on telemetry? Send 2 home, or let them work as techs on med-surg. And the list goes on.

What used to be paper documentation by exception, became EMR to generate maximum amounts of reimbursements from medicare, medicaid, and insurance. This is why we have box checkers (formerly known as nurses) spending 75% of their time at computer stations, and 25% of their time at the bedside. If you're lucky. So the next time your wife, husband, brother, sister, friend or companion starts mocking you for being a serial job hunter/ hopper, send them to this article.

Spread the word. Nurses didn't leave the bedside, the profession left us.

[ThePrincessBride, MSN, RN, NP]

On 6/2/2019 at 1:02 PM, Hoosier_RN said:

The 20 year NPs in my area make about 5,000 a year more than new NPs so I am making about 2000 less is all, and for the comparison in liability and hassle, seems to even out. This pay variance is because of market saturation, and Indiana has a few hospital systems running it, and they own just about every practice through the hospitals. They call the rates-if you don't want the offered salary, go elsewhere, "Susie" is still working at the bedside and wants the chance to work as an NP and will do it for way less. For many, moving isn't an option, as we have family obligations and our spouses may have obligations as well. Market saturation is eventually going to catch up. Me, I am making 6 figures now. Again, it's area dependent.

Someone mentioned not getting lunches, since I've changed to this new job, I always get regular breaks. My cousin who is an NP states when she was in independent practice as well as back with MD, lunches are a bite here and there, running past her desk. The NPs that work in my area speak to the same. The ones who have 20 years say years ago, before reimbursements changed, they did take normal breaks. Not now. Again, this is all area dependent. I wish all of you who are pursuing NP luck, but there isn't enough money for me to do that.

That is insane. Only 5k? The NP pay ranges for most jobs where I live are 82k on the low end with max pay at about 125-130k. But psych and rehab NPs can make much more.

To be fair, if I were you I wouldn't bother going back for NP either. But I am in my twenties and I don't necessarily want to work another fifteen years with minimal raises and abusive patients in order to top out and make $$$. I also plan on leaving the work force in my very early fifties, so it makes sense for me to maximize my pay as soon as I can. My employer is covering my tuition 100 percent so why not?

[OUxPhys, BSN, RN]

3 minutes ago, ThePrincessBride said:

That is insane. Only 5k? The NP pay ranges for most jobs where I live are 82k on the low end with max pay at about 125-130k. But psych and rehab NPs can make much more.

To be fair, if I were you I wouldn't bother going back for NP either. But I am in my twenties and I don't necessarily want to work another fifteen years with minimal raises and abusive patients in order to top out and make $$$. I also plan on leaving the work force in my very early fifties, so it makes sense for me to maximize my pay as soon as I can. My employer is covering my tuition 100 percent so why not?

If, IF, I were to go back for NP Id do it for something like pain management or rehab. If your employer covers 100% then go for it.

[ThePrincessBride, MSN, RN, NP]

1 minute ago, OUxPhys said:

If, IF, I were to go back for NP Id do it for something like pain management or rehab. If your employer covers 100% then go for it.

That is the only reason. If I had to pay for it all, I would reconsider.

But why pain management? I heard that is a shady specialty.

[Hoosier_RN, MSN]

14 minutes ago, ThePrincessBride said:

That is insane. Only 5k? The NP pay ranges for most jobs where I live are 82k on the low end with max pay at about 125-130k. But psych and rehab NPs can make much more.

To be fair, if I were you I wouldn't bother going back for NP either. But I am in my twenties and I don't necessarily want to work another fifteen years with minimal raises and abusive patients in order to top out and make $$$. I also plan on leaving the work force in my very early fifties, so it makes sense for me to maximize my pay as soon as I can. My employer is covering my tuition 100 percent so why not?

It's a good plan since your employer is paying 100%. But read their stipulations before you do it. The hospital systems in this area (and since it was all of them and they all did the same thing, I thnk they are in cahoots) all did that, the fresh NPs have to work for them for 6 years in whatever capacity they deem necessary

As far as retirement plan, never get married or into a relationship that mixes finances. I had the same plan with the money I had set back (I inherited some, saved like crazy, etc). Ex hubby got most of it in divorce, so retirement plans down the drain--and yes, we had separate accounts. I found out that a judge can do that if s/he wants!

[OUxPhys, BSN, RN]

14 hours ago, ThePrincessBride said:

That is the only reason. If I had to pay for it all, I would reconsider.

But why pain management? I heard that is a shady specialty.

I dunno, seems like it would be low-stress. I haven't heard that about pain management but then again I don't really know the good/bad areas of being a NP.

[ThePrincessBride, MSN, RN, NP]

On 6/3/2019 at 5:17 PM, Hoosier_RN said:

It's a good plan since your employer is paying 100%. But read their stipulations before you do it. The hospital systems in this area (and since it was all of them and they all did the same thing, I thnk they are in cahoots) all did that, the fresh NPs have to work for them for 6 years in whatever capacity they deem necessary

As far as retirement plan, never get married or into a relationship that mixes finances. I had the same plan with the money I had set back (I inherited some, saved like crazy, etc). Ex hubby got most of it in divorce, so retirement plans down the drain--and yes, we had separate accounts. I found out that a judge can do that if s/he wants!

No stipulations for now but I imagine that will change.

I can't believe that judge let your ex drain you! That is insane. I'm sorry.

I have no plans to get legally tied to anyone. Maybe have one or two love kids but marriage? Nah.

[benharold1, BSN]

I think it is sad that so many bedside nurses feel abandoned by the profession. I am looking for a less-stressful nursing or other job that I will enjoy.

I love working and interacting with clients and families but absolutely cannot stand what cooperations and management have done to nurses and patient care.

Anymore, it's all about profit, even for non-profits. Emphasis is on improving survey scores by encouraging patient/family perception of great care, not necessarily actual great care. Instead cooperations hire consulting groups as the answer to "training" staff to say "the right thing." Where is the fiscal responsibility in wasting money for concepts they easily could have devised themselves. Staffing decisions are decided by people who do not have a clue what it takes to care for patients safely and compassionately.

Nursing Management is often just a cheer-leader for cooperate non-sense and enforces crazy policies that do not ensure better nursing care.

[VivaLasViejas, ASN, RN]

Ugh. I remember when the Studer Group came to my hospital. Their recommendations put more and more work on us nurses and turned the place into Disney World. We didn't have scripting, thank God, but we were instructed to make the patients feel like they were in a five-star hotel. The one good thing they did was revamp the entire dietary department, where we had 24-hour meal service and patients could order whatever they wanted off the considerable menu. Dietary aides also brought up the food which relieved us of having to pass trays. But once that duty was removed, we got others in its place, and we lost CNAs and had to clean rooms if housekeeping was busy elsewhere. I left not too long after these changes had been made, and so did several other older nurses who could no longer keep up. Needless to say, I don't have a single good thing to say about the Studer Group or any other consulting firm that works against nurses and regards us as merely "the help".

[Bri1231, BSN, RN]

On 5/25/2019 at 12:47 PM, NICU Guy said:

They never wanted to be bedside nurses to begin with. Their plan after nursing school was to get the minimum amount of experience necessary and start on their Masters for NP. As soon as they are done with orientation in their first nursing job, they are signing up for NP classes.

This is so so true. The amount of nursing student these days that say oh how do you get to be a band six ( charge nurse ) or a NP or a CNS and this is before they have even written their first end of year paper. The thing is years ago nurses became nurses and that was it apart from the obvious management roles. Then nursing changed and you could be so many different types of , shall I even say, nurse , that is not at the beside, or you could as is even more so now, progress to medical roles. The options just were not there not so long ago and now for a lot of people they do not want to say oh I am a nurse on a med-surg floor. They want to say I am a nurse manager or a NP or a CNS etc etc.

[Forest2]

Sounds like they think nurses have no value except for how much work they can get out of one. You know, I don't mind helping with baths, etc when there is an actually shortage of aides that day, but to spend 40% of my time doing aide work on a regular basis because the regular schedule doesn't allow for the proper number of aides to do the work is just plain dumb. To my thinking it would be better to give the nurses more patients and have them only do nurse work, but have more aides so the nurse doesn't have to do those things, wouldn't that work out better financially??? If so, then why not do it?

[Bri1231, BSN, RN]

10 minutes ago, Forest2 said:

Sounds like they think nurses have no value except for how much work they can get out of one. You know, I don't mind helping with baths, etc when there is an actually shortage of aides that day, but to spend 40% of my time doing aide work on a regular basis because the regular schedule doesn't allow for the proper number of aides to do the work is just plain dumb. To my thinking it would be better to give the nurses more patients and have them only do nurse work, but have more aides so the nurse doesn't have to do those things, wouldn't that work out better financially??? If so, then why not do it?

Nurse work is bathing and answering call lights , toileting etc. There is not just aides work. We as nurses are responsible for all of that. So if it has to be done that 40% 'aide' work it has to be done. That being said I know the struggle when there are not enough aides which is why I love having them. That would probably not work out better financially because the problem you mention would continue to exist except with more staff and more patients. That balance will never be right

[Forest2]

10 minutes ago, Bri1231 said:

Nurse work is bathing and answering call lights , toileting etc. There is not just aides work. We as nurses are responsible for all of that. So if it has to be done that 40% 'aide' work it has to be done. That being said I know the struggle when there are not enough aides which is why I love having them. That would probably not work out better financially because the problem you mention would continue to exist except with more staff and more patients. That balance will never be right

Yea, but, not at the expense of doing nurse work. I would think it better to have the time to check a copd'rs lungs which an aide can't do, compared to taking someone to the bathroom which anyone can do. In my situation, I am doing aide work because there aren't enough aides and I am not doing all the nurse work I feel I should be doing. If "nurse work is bathing and answering call lights , toileting etc." then I would not need a license to practice nursing.