Why are Nurses Leaving the Bedside?

[RNperdiem, RN]

Interesting article. One part that really rings true for me is the lack of ancillary staff. I think there is an even bigger shortage of nursing assistants, transporters, unit secretaries and housekeeping staff than ever. 

I feel the shortage in ICU were we are set up to be less dependent on ancillary staff. On the med-surg floors, the assignments are designed with the expectation that a unit secretary will handle the phone, the CNAs will assist with passing meal trays, getting patients to the bathroom and assisting with turns. Our CNAs are now pulling trash and linen bags for lack of housekeeping staff. 

[Okami_CCRN, BSN, RN]

It is difficult to point to one particular reason that is causing the exodus of staff nurses from hospitals. 

Work-Life Balance
Hospitals across the country have little respect for work-life balance, I get text messages at all hours of the day/night asking if I can come in or switch a shift to "balance the numbers". I am also expected to serve on a committee/council outside of my scheduled shifts as participation is tied to mid-year and yearly evaluations. 

Workplace Violence
It is no surprise that healthcare has one of the highest incidences of workplace violence. Patients and families are becoming more hostile, suspicious, and accusatory to staff at all levels. Patients/families are recording interactions and posting them on social media with little to no context and garnering views. 

Pay
Nurses have a disproportionate rate of professional education, responsibility and accountability to pay. Nursing pay varies widely from location to location and yet with inflation at an all time high it is incredibly difficult to make ends meet. 

Nurse to Patient Ratios
Gone are the days when patients with mild issues would be admitted, insurance regulations require strict criteria to be met prior to inpatient/observation admission. This means patients are now sicker than ever and nursing ratios have changed little for the majority of the country. Nurses on med/surg units report have a 1:8-10 ratio which is wildly unsafe. 

I do not like to use the term resilient/resiliency, it shifts the blame of burn out from the system to the individual. No amount of self care can overcome the systemic damage that the healthcare system has created. 

I'll get off my soapbox now!

[RNperdiem, RN]

My unit has several people leaving. NP, CRNA and travel jobs are the most popular escape routes. 

[RN WRITER NC, ADN]

Thanks for your comments, perhaps Long-

term care is getting hit harder than other specialties.  

[Hoosier_RN, MSN]

2 hours ago, RN WRITER NC said:

Thanks for your comments, perhaps Long-

term care is getting hit harder than other specialties.  

In my area, yes

[kbrn2002, ADN, RN]

On 6/30/2022 at 4:24 PM, RN WRITER NC said:

Thanks for your comments, perhaps Long-

term care is getting hit harder than other specialties.  

 

On 6/30/2022 at 6:52 PM, Hoosier_RN said:

In my area, yes

Same. I left LTC about a month before COVID hit, my timing was accidental but couldn't have been better. I still have friends from there I keep in contact with and it's brutal. Despite offering large sign on bonuses and bumping starting pay considerably they still are having a difficult time attracting new staff that stays. Plus thanks to those big sign on bonuses and a large increase in starting wages without giving established staff similarly large raises they are losing even more of the experienced staff. 

[samsn]

As a nurse manager, I can say that most of our staff left for two reasons. Money or easier work. My unit was converted from Rehab patients, to medicine which was a huge change in acuity. Overnight we were at 1:5 medicine ratios with no training or warning. Patients were assigned from some person in an office somewhere and we lost control of our bed board, room assignments, and ability to speak out against this practice. ER patients were brought up and dumped off with no report or warning and little to no work up done prior to arrival. Since many of our competitors were paying more hourly plus sign on bonuses, the staff left. There was no feeling of mutual respect or loyalty left. Moral was in the toilet. Safe harbor became the norm. 

[vintagegal, BSN, DNP, RN, NP]

After years of loyalty your lucky to get a 1-2% raise. I’ve had friends in fast food make 10% raises yearly.

[Tweety, BSN, RN]

On 7/7/2022 at 12:21 AM, vintagegal said:

After years of loyalty your lucky to get a 1-2% raise. I’ve had friends in fast food make 10% raises yearly.

We got about 3% but I didn't get one because I'm "maxed out", meanwhile inflation raged on.

It does seem that workers in areas in high demand like fast food have seen their salaries and benefit packages up in response to labor shortages but nursing somehow hasn't. 

Although there have been times when we've gotten "market adjustments" due to demand, so I can't say never.  

[Tweety, BSN, RN]

I know a lot of nurses burned out because of covid.  I knew a few nurses that retired instead of deal with it, or risk their health or bringing it home to elderly parents or immunocompromised family members.  

For me, while I made the highest income in 2020 and 2021 the overtime nearly burned me out and I haven't worked overtime this year yet.  Have to set boundaries.

I might also had that while nurses were concerned with getting too much C02 and reporting some symptoms or difficulty breathing, for normal healthy nurses getting enough oxygen with PPE is not an issue.  You don't hear much about that these days from covid nurses.  Maybe we're just so used to it by now?

For me, the main reason I would leave the bedside is the dreadful 6:1 ratio that seems to be more the norm these days.  Every day I say "I can't do this much longer".

 

[RN WRITER NC, ADN]

Completely understand, still looking at my options, despite starting a new business for freelance writing.  Anything that is successful, takes time and this is what I am realizing right now.