Exploitation. It is a strong word that might not ring true in your own nursing career. But for many nurses, the word is a looming “elephant in the room” that just will not move. The COVID-19 pandemic removed my rose-colored glasses and I now see things a bit clearer. I don’t want to accept “the normal” treatment of nurses. Read on to learn how exploitation fits into my nursing experience.
A Story of Our Own
As nurses, we each have unique experiences that builds our story and this article is a piece of mine. I graduated nursing school in 1993 and obtained a master’s degree years later. I’ve spent years of my career away from the bedside in leadership and education roles. Four years ago, I returned to bedside nursing at a large hospital in Alabama. In the hospital, amid COVID-19, is when I felt most devalued in my career. Today, my story is wrapped around the uncomfortable feelings of frustration and anger.
This Normal Will Never Change
According to Gallup polling, nurses rank highest in honesty and ethical standards when compared to a list of other professions. Nurses have held the most trusted spot for 18 consecutive years. Why? Because people trust us to put people first and do the right thing. With or without the pandemic, the profession will continue to provide compassionate care while maintaining human dignity and respect. This is the “good stuff” that attracted me to nursing so many years ago.
I Feel Exploited Because…
I know nursing will always be a demanding job that changes rapidly. I also understand healthcare is a business and there will always be financial constraints to deal with in nursing. However, I am drowning in resentment that my desire to make a difference is being devalued by an employer seeking to deepen financial pockets. My employer is placing unsustainable demands on nurses without providing the necessary resources or support to be successful. Hospital leaders depend on nurses to go above and beyond to meet patient needs, even if it comes with personal cost.
Eventually, like many of my co-workers, I will reach the end of my rope and leave. A large group of new hires will start orientation and the cycle will repeat itself. There is something arrogant in the executive philosophy “nurses are expendable because there is a pool of nurses just waiting to sign on”. Management practices that would be outliers in other professions have been normalized for bedside nursing, for example:
Standing policies, based on best practices, are in place to protect staff and patients from COVID-19. Staff are then provided with 1 surgical mask for protection and it is to be used over multiple shifts. Should the 1 mask become soiled, the nurse must track down the house supervisor for a replacement.
Your supervising nurse calls and asks you to come in on your off day because your department is short-staffed. When you arrive, the house supervisor pulls you to another floor. You explain the agreement was that you would come in on your off day to fill a gap on your floor. The house supervisor simply states, “it doesn’t matter, you agreed to come in’.
You float to an unfamiliar unit and you have no experience with the treatment orders. When you voice concern, you're told, “a nurse is a nurse and nursing is nursing”.
Raises are infrequent and never exceed 1% of your hourly pay. Everyone, regardless of performance, dependability, or productivity, receives the same raise.
Exhausted nurses ask management to provide some relief by hiring agency or contract nurses. They are told this was not an option because employees would resign to work for the agency, and it did not fit into the budget.
A group of nurses approaches their manager and voice safety concerns with the current staffing grid. The manager agrees and takes the concern to administration. Later, your manager announces a small change has been made to the nursing assistant grid, but the nursing staffing grid was reduced.
You have accrued a significant number of paid days off and want to take a vacation. However, you are asked by management to hold off plans until staffing is better.
You are a charge nurse and visitor’s behavior is making you and the nurses uncomfortable. You contact the house supervisor and are told: “I’m tied up but...you got this”.
It is rare you actually get to take a full lunch break, if you eat at all. When you submit the paperwork to be paid for missed meals, you are told to better manage your time in the future.
The hospital changed the vendor for wound care in order to reduce costs. Bedside nurses did not have the opportunity to pilot the products or participate on the deciding committee. Bedside nurses did not know of the change until the new supplies just “appeared” in the supply closet. Unfortunately, the bandages are difficult to use and skin prep is no longer provided.
It saddens me that treating nurses unfairly for financial benefit has been normalized. Now, I don’t think administrators gather in a room and diabolically plan to take more from nurses than they are giving in compensation and resources. But, the burden COVID-19 has made some motives and mistreatment more visible.
Values Taken for Granted
I recently read a New York Times opinion article, The Business of Health Care Depends on Exploiting Doctors and Nurses, written by Dr. Danielle Ofri, a physician at Bellevue Hospital and New York University. In the editorial, Dr. Ofri asserts the U.S. healthcare industry profits from the work ethic of physicians and nurses, stating:
Quote
By now, corporate medicine has milked just about all the “efficiency” it can out of the system. With mergers and streamlining, it has pushed the productivity numbers about as far as they can go. But one resource that seems endless — and free — is the professional ethic of medical staff members.
I feel devalued when hospital executives take the work ethic of nurses for granted. Nurses will continue to experience limited resources, low compensation, and high patient to nurse ratios because... despite all these barriers, the business of healthcare knows most nurses will:
Absorb new tasks, even when additional resources are not made available.
Do everything possible to maintain quality of care, including working when burned out, sick or facing demanding outside responsibilities.
Be loyal employees, even when inadequately compensated
Will be resourceful when supplies are few or not available at all
Nursing Beyond COVID-19
As I write this article, I recognize my own learned helplessness. I don’t want to be the complacent and passive nurse that accepts “it is what it is”. And I admit, sometimes the norm seems impossible to change. But it is empowering when I take small steps to stand up, voice my opinion, ask for what is needed, and make suggestions for change. I may need the courage to walk away from my job and find something better. Can you imagine what post-COVID-19 would look like if all nurses expected to find something better? I imagine it would not be long before the work ethic of nurses would no longer be taken for granted.
Yes, nursing exploitation will remain long after COVID-19, just as it did long before. But, the profession’s invaluable role in fighting the pandemic has been noticed. The voice of nursing has become louder, more organized, and larger in number. Exploitation at some level may be part of the future, but there are many reasons to hope working conditions beyond the coronavirus will improve for all nurses.
Exploitation. It is a strong word that might not ring true in your own nursing career. But for many nurses, the word is a looming “elephant in the room” that just will not move. The COVID-19 pandemic removed my rose-colored glasses and I now see things a bit clearer. I don’t want to accept “the normal” treatment of nurses. Read on to learn how exploitation fits into my nursing experience.
A Story of Our Own
As nurses, we each have unique experiences that builds our story and this article is a piece of mine. I graduated nursing school in 1993 and obtained a master’s degree years later. I’ve spent years of my career away from the bedside in leadership and education roles. Four years ago, I returned to bedside nursing at a large hospital in Alabama. In the hospital, amid COVID-19, is when I felt most devalued in my career. Today, my story is wrapped around the uncomfortable feelings of frustration and anger.
This Normal Will Never Change
According to Gallup polling, nurses rank highest in honesty and ethical standards when compared to a list of other professions. Nurses have held the most trusted spot for 18 consecutive years. Why? Because people trust us to put people first and do the right thing. With or without the pandemic, the profession will continue to provide compassionate care while maintaining human dignity and respect. This is the “good stuff” that attracted me to nursing so many years ago.
I Feel Exploited Because…
I know nursing will always be a demanding job that changes rapidly. I also understand healthcare is a business and there will always be financial constraints to deal with in nursing. However, I am drowning in resentment that my desire to make a difference is being devalued by an employer seeking to deepen financial pockets. My employer is placing unsustainable demands on nurses without providing the necessary resources or support to be successful. Hospital leaders depend on nurses to go above and beyond to meet patient needs, even if it comes with personal cost.
Eventually, like many of my co-workers, I will reach the end of my rope and leave. A large group of new hires will start orientation and the cycle will repeat itself. There is something arrogant in the executive philosophy “nurses are expendable because there is a pool of nurses just waiting to sign on”. Management practices that would be outliers in other professions have been normalized for bedside nursing, for example:
It saddens me that treating nurses unfairly for financial benefit has been normalized. Now, I don’t think administrators gather in a room and diabolically plan to take more from nurses than they are giving in compensation and resources. But, the burden COVID-19 has made some motives and mistreatment more visible.
Values Taken for Granted
I recently read a New York Times opinion article, The Business of Health Care Depends on Exploiting Doctors and Nurses, written by Dr. Danielle Ofri, a physician at Bellevue Hospital and New York University. In the editorial, Dr. Ofri asserts the U.S. healthcare industry profits from the work ethic of physicians and nurses, stating:
I feel devalued when hospital executives take the work ethic of nurses for granted. Nurses will continue to experience limited resources, low compensation, and high patient to nurse ratios because... despite all these barriers, the business of healthcare knows most nurses will:
Nursing Beyond COVID-19
As I write this article, I recognize my own learned helplessness. I don’t want to be the complacent and passive nurse that accepts “it is what it is”. And I admit, sometimes the norm seems impossible to change. But it is empowering when I take small steps to stand up, voice my opinion, ask for what is needed, and make suggestions for change. I may need the courage to walk away from my job and find something better. Can you imagine what post-COVID-19 would look like if all nurses expected to find something better? I imagine it would not be long before the work ethic of nurses would no longer be taken for granted.
Yes, nursing exploitation will remain long after COVID-19, just as it did long before. But, the profession’s invaluable role in fighting the pandemic has been noticed. The voice of nursing has become louder, more organized, and larger in number. Exploitation at some level may be part of the future, but there are many reasons to hope working conditions beyond the coronavirus will improve for all nurses.
What is your story?