Why do you think nurses leave the profession?

[Nacki]

I've been a nurse for awhile and have always contemplated what makes nurses leave the profession (or bedside for that manner). As a matter of fact, I have thought about it from time to time in the 13 years I've been a nurse. From my experience I have found that aspects such as short-staffing, too many tasks, lack of upward mobility, poor management and underpayment contribute to a nurses' unhappiness in their career.

I just wanted to ask the general nursing population regardless of how long you've been a nurse what your thoughts were. Do you think leaving the profession comes from one of the aspects listed above? Or is it something else entirely?

To be clear this is not a school assignment...

[SHGR, MSN, RN, CNS]

Of course things are always multifactorial, but hands down the biggest reason I left bedside nursing (I'm still heavily patient-facing, though) is the physical toll on my body. Years of boosting, lifting, getting slammed into the wall by people going through DT's, etc etc etc not to mention long night shifts with no breaks. I am surprised that bodyhurt didn't make the poll choices.

[jadelpn, LPN, EMT-B]

Tired of working hard, loving what you do, patient's are important in that they function better, you advocate more.

Never making it an issue to be adapting, changing, being proud of the work that you do. You get certified. You are engaged and interested. Passionate even. You leave work at the end of the day satisfied, and put it away until the next shift. You feel completed in your work life.

Being loyal, mindful, taking pride in the care you provide. Mentoring, encouraging, sunny side up--stopping to really ask "how are you" and listening to the answer. Brainstorming for the patient's function. Team where there is no "I" (even hidden in the "A").

Then one day you are not good enough, not educated enough, no one wants ideas unless it is how to meaningfully use, spinning key phrases meant to give patient's illusions. And hopefully, it sticks well enough for them to fill out a survey, and the facility is paid.

We magnet, and outscore and do all sorts of things to show we are "diverse" and "clinical ladder climbers". There is not a thought about how a patient is going to function once they leave. Not our issue unless they get put back into the place before a certain re-admission no-no time has come and gone.

Corners are cut, we all learn to do more for less.

Bottom line-- much like the reality TV show "Survivor" every person for themselves, ya either sink, swim, or get eaten by a shark. But who cares, you are replaceable.

Some of us come from a long ago time where we had job security, never thought 2 things about it, everyone had everyone else's back, with the goal not to stab the same. Where every idea was bantered about, people smiled, we are in it together.

Then the bottom dropped out. And some of us fell hard.

Just ask the many, many LPN's who are no longer working nurses.

[been there,done it]

Because we are worked like a mule with brutal work conditions..

with unsafe ratios.. to make money for the man.

[stickit34]

Everything TheCommuter listed and more. I'm still a nurse, but left the bedside after just a year. I couldn't take the unsafe ratios (10 patients on med-surg tele with no tech at a Magnet hospital - are you kidding me?! Good thing that status does), babysitting other people's actions like others have mentioned before, being physically beaten by patients and told not to press charges by my employer, stagnant pay while managers got bonuses and my hospital bought 3 new health centers and a hospital, ungrateful and rude patients, the list could go on for hours. But for me, the most was that my opinion on a patient's status was never taken seriously. It was always "We'll ask the doctor, he'll come check it out, I'm not comfortable with a NURSE'S guess".

Now I'm in ambulatory care and pursuing a higher degree. There may be some hope for me to find happiness in healthcare, but it most certainly will not be at the bedside as a bedside nurse. Kudos to all that stayed at the bedside, you're bigger people than I am.

[ArtClassRN, ADN, RN]

I would add that nurses who do little or nothing to advance their education or career are in danger of ending up "trapped" in a job they hate.

[LadyFree28, BSN, LPN, RN]

I would add that nurses who do little or nothing to advance their education or career are in danger of ending up "trapped" in a job they hate.

That's actually an interesting perspective...

I found that advancing my education gave me a fresh perspective of things, as well as learning the ins and outs of this business has prevented me from having burnout; it also had allowed me to have a seat at the table in regards to policy, procedures, and allowed me to be an agent of change.

[Nienna Celebrindal]

So often I plan to wrote something only to find Commuter already said what I would have said but better lol.

To add, it just all becomes so emotionally taxing.

[Brekka, ADN, RN]

For me it comes down to 3 big issues: Staffing, workload, and management. The sad thing is, even with mediocre pay, if these three areas improved, the retention of nurses would rise. Not enough staffing leads to increased workload, which weakens nurse-management relations.

For example, I work in a rehabilitation center where I'm responsible for everything for 26-30 patients. I work (in theory, I was hired for) an 8 hour shift, 0600-1430. In this time all of these patients have 0600 medications and 0900 medications, half have 1000 or 1100 medications, and about a quarter have 1200 medications and 1400 medications. About a quarter are on PRN narcotics every 4-6 hours, and request them frequently. I have 6 AC finger sticks (I'm responsible for these), and weekly lab draws (also responsible for). Currently I have 8 dressing changes, one that takes upwards of 45 minutes. I have 2 IVs with medications due at 0600 and 1400. I have 6 foley catheters and a PEG tube. I have 6 wanderers who are high fall risks, 3 tissue-skinned patients who get wounds by simply pulling down their shirts, and 4 anxiety ridden COPD patients who work themselves up several times a shift and require frequent attention. Throw in there 3 unnecessarily needy patients who are on their call light a MINIMUM of once every 20 minutes - that's right, for two weeks straight I have timed them.

With all of this I get 2 CNAs. I also have to hand write a DAR note on each patient, and chart vital signs in 3 different places. If I'm lucky and find a bruise or other injury, I get more paperwork. Or with even more luck, I have an admit roll up to my desk without orders or a doctor.

This is an example of my day WITHOUT the toast. What is toast you say? Toast is a facility term we use to refer to the little interruptions to our days, coined when managements solution to meals running late was to have the nurses run coffee and butter the toast.

In the end, management gets upset that we're going over our 8 hours. We tell them how unreasonable the demands are, and their continued response is, "It has to get done, just try harder." This is the same management who get hourly smoke breaks and a full hour lunch. You try and explain that it wasn't possible to take a lunch because your 0600 med pass ran into your 0900 med pass, which ran into your wound care and noon med pass, which was interrupted by a patient with chest pain and shortness of breath, which was interrupted by Mr. Smith's request for a stool softener 'right now', which delayed the 1400 medications and 2 Lortab requests for mild pain, which was also interrupted by pesky shift change - but it's never heard, and the same issues continue.

So, there's my personal 3 issues with nursing with examples, though I do acknowledge that nursing differs. Part of this was a response, but part of it was also a rant, so kudos to you if you read the whole thing.

[angel337, MSN, RN]

All of the above along with horrible scheduling that gets old after so many years.

[kbrn2002, ADN, RN]

Brekka, I won't quote your whole post above in the interest of saving space. Just know I hear you! Sounds about like my days, you sure don't see management ever buttering that toast, do you?

[Brekka, ADN, RN]

Brekka, I won't quote your whole post above in the interest of saving space. Just know I hear you! Sounds about like my days, you sure don't see management ever buttering that toast, do you?

They do, at least once a year when State comes. Twice if corporate visits.

[lindarn]

If management thinks that all that can be done in an 8 hour shift, how about keeping track how much time each of the above things take of your time.

Start with med pass, dressing changes, treatments, the amount of time each interruption takes of your day.

Place it on a graph, and ask them exactly how they think that you can manage your time better. Better yet, ask them to shadow you for one of your shifts.

If they will not pay you OT to complete your tasks, move up the food chain to the state DOL, and let them handle it.

Nurses are notorious for complaining but having no plan of action to force management to see how unreasonable their demands are.

JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN,(ret)

Somewhere in the PACNW