We have all read post after post, blog after blog, thread after thread, article after article, etc...About Nursing, Patients, Doctors, Patient Care, Patient Satisfaction, etc. And for the most part, everything I have read, I can honestly say has been true.
So you are probably wondering why I am writing another "Blog" if you will, about Nurses/Nursing. Well, because sometimes we all get a little 'Burnt Out'. And there are many reasons behind this, not just one...
Unfortunately, it seems to be more common today than in the past. A lot of Nurses find themselves going back to school for something else. Whether it be their Masters in Nursing (to teach or manage) or their Nurse Practitioner Degree, Med School, or maybe something completely unrelated.
I will say this though. After being a nurse for 10+ years, working with both Adults/Geriatrics and Pediatrics (which is where my heart is)...I have seen the changes throughout the workplace and the expectations and the way Nurses are treated, etc. And no, this is not a long time compared to some of you who have been in Nursing in upwards of 20-30+ years. I can't even begin to imagine the changes y'all have had to go through and deal with.
We all go into Nursing (or should be going into Nursing) because we love to help people, we have compassion and it's simply something we feel like we are going to love to do. Because Nursing is NOT for everyone. It's a tough job.
You definitely DO NOT go in it for the money and you DO NOT go in it for the work hours.
Most Nurses find their spot in the workplace and tend to stick with it...whether it be the ER, the ICU, Acute Care, PACU, OR, IMC, etc...They find their 'Comfort Zone', a place that they love and feel they can provide the best patient care, with a group of co-workers that they enjoy working with as a TEAM and management that supports them.
So then...what is the problem? Why are Nurses getting burnt out? Why are they leaving their professions and finding something else to do in their life/with their careers? Or why are they going to other hospitals to find new jobs?
Here is my two cents on WHY (in no particular order, and I might ramble off a little here and there so just bear with me)
1. Underpaid.
I say underpaid b/c you are LUCKY to make $30/hr for going to school for 2-4 years for a specialized degree, where you are SAVING LIVES!!! And it makes no difference whether or not you have your Associates or Bachelor's Degree (in most places) as to what you get paid. Maybe a little experience might get you a bit of a higher salary, but not much.
And don't get me started on the Nurses who have their Associate's Degrees who have been Nurses for 20+ years and are now being told that they have to go BACK to school NOW to get their Bachelor's Degree by such and such time so that the Hospital can obtain Magnet Status, and there is no incentive, no increase in pay...just a piece of paper saying "I have my Bachelor's now, but I have been a Nurse longer than you have been working in Healthcare." And most of these Nurses are the ones I would want taking care of me if I were in the hospital. Hands down. They know what they are doing. They have been doing it for YEARS upon YEARS. I don't need another piece of paper to show me that they can do their job any better than before.
2. Under-appreciated/Undervalued.
This is a HUGE subject for me and one that gets to me pretty easily. Nurses are constantly being 'watched' for mistakes (which is a good thing, don't get me wrong), because otherwise we wouldn't know how to fix things or know not to do it the next time, etc...However, we rarely get praised for the good that we do. Instead we get evaluated and are told, you need to improve on this, you need to work harder on that, we have had complaints about whatever, etc. Over a certain amount of time, you start to question your ability as a Nurse and wonder if you are doing anything right.
Example : I just helped save a seizing kids life by by noticing such and such on his EEG and EKG and got him over to the ICU and they rushed him to the OR immediately. Not a word was said to me. No good job, no good catch, nothing. Instead, I get...why was this kid on our Unit for so long and why didn't anyone notice this sooner? That's it. Why don't you just punch me in the gut?
And this doesn't just come from Management or Doctors or fellow Nurses/Techs/CA's. This comes from family members as well.
Some family members are so appreciative and so thankful for everything we do as Nurses and want to help in any way that they can. Even if their loved one passes away, some will come and hug you and thank you for all that you tried to do to save them.
Then you have the ones who think that the Hospital is a Holiday Inn. I'm sorry, but it's simply not. We are here to help your loved one the best that we can. If we can help you in any way possible, we will. But my FIRST priority is the one laying in that bed. I do my best to make sure their medications are given on time, that their pain is under control, that they have the proper nutrition, that their IV lines are all compatible and infusing where they should be and not all one big tangled mess, that they have clean sheets and that they are clean as well, that they don't get bed sores, that any drains are properly cared for, if they are intubated/ventilated - that they get the proper mouth care and no sores, etc etc etc...the list goes on and on and on. And that is just ONE of my patients.
So...If you call out and if I don't respond right away, I apologize sincerely. Ask or look around for another nurse. Don't assume that I don't want to be there or take care of your loved one. Because I could be coding my other patient. Be thankful it isn't your loved one.
3. Long Hours.
Twelve hour shifts are brutal sometimes. Whether it be days or nights. And a lot of the time, those 12 hours, turn into 13. Yes, it might only be 3 days/nights per week, but it takes a LOT to get through those longs days/nights. Try staying awake and be on top of your game from 7p-7a. It isn't easy. Then you go home and try and sleep during the day the best that you can only to have to do it all over again. Day shift is the same way. Most of us run on 4-6 hours of sleep...tops. Then you add in Mandatory Minor and Major Holidays that you have to work. Which is different at every Hospital...but it is usually quite a few, leaving you with less time with your own family. Now add in Mandatory Education Classes and Mandatory Meetings and Training. All of that adds up. And not to pick on anyone, but it is hard for a Night Shifter to come to a lot of these Classes/Meetings/etc because this is the time that we sleep. Not to mention the Committees and whatnot they want you to join and participate in. It is mentally and physically draining. So now you have your shifts, your classes, your training...add on the required CEU's that you have to have every 2 years just to keep your Nursing License. Then add on other things such as your BLS/CPR, PALS, ACLS, TNCC, CPN, CCRN, etc...A LOT to keep up with. And not all of it is paid for...some comes out of your own pocket. Then you have the census fluctuations. This is the number of patients that the unit has. Sometimes the Unit is Full (no more patients can be admitted), they are begging and searching for Nurses to come in and work overtime. Then there are other times when the census is so low that they are canceling Nurses left and right. Try keeping your paycheck without blowing your PTO in order to pay your bills when this happens....
4. Management/Co-Workers.
I will say that this has played a huge part in my career as a Nurse. Having a Manager/Supervisor that backs you up, stands behind his/her Co-Workers, will go to bat for them, will listen to what they have to say before jumping to conclusions...makes a HUGE difference. And the people that you work with, makes all the difference in the world as well. You have to work as a TEAM. Learning to work together with some many different age variances, cultural differences, genders, etc...isn't easy. But it can be done. And once you learn to communicate and learn different personalities and how others work and learn best...You will have one of the best teams to work with. Without these two things (a good group of co-workers working as a team and a good management for a support system), I can say that things don't run so smoothly and it shows in the workplace.
5. Floating
And what I mean by this is having to "float" (go from your home Unit) to another Unit that you might not be so familiar with. This throws off a lot of Nurses when they hear it's their "turn" to float.
a) The Units are typically set up differently and you have to learn where everything is, how things are set up, etc.
b) You aren't used to the nurses, you don't know how the Unit is run, other than general hospital protocols. You kind of feel out of place, so it makes you a little uncomfortable at times.
c) If you are a Critical Care Nurse you are used to taking care of 1-2, maybe 3 patients at the most in a step-down Unit. If you get floated to an Acute Care floor, you now have 4-5 patients, maybe more in some Hospitals (yes, they aren't as sick), but your time management and charting is different. And if it's the other way around, you have to hope that you don't get a really sick kid out of your comfort zone (which you shouldn't), in which case, if you do, you need to speak up. Or if you float to the ER or NICU or PACU...oh my! It's a whole new life style there! Charting is completely different, kids are in and out, etc etc...LOL!
Just put it this way...We like to stay on our Home Unit for the most part!
6. Sick/Time Off.
Nurses get sick too. Yes, we get PTO. Yes we can have FMLA just like everyone else if need be. Yes we have short term and long term disability. However, for those of us who don't need FMLA or disability and just happen to get sick from the Flu or some GI bug getting passed around or Strep or a migraine...We cannot come to work with a fever or vomiting and risk getting your child sick. We also can only have a certain # of call ins in a certain amount of time. So we have to be very careful. We wash our hands continuously until they are dry to the point of cracking. We do everything possible to keep from spreading germs. But we do get sick too. And sometimes, unfortunately, our co-workers end up having to pick up the slack. But we don't come to work to help protect you and your families and our families (co-workers).
I could go on and on and on with WHY we get burnt out. And this makes Nursing seem like a terrible profession. But it's not. It is actually very rewarding when all is said and done.
The first time you save a patients life after doing compressions for what seems like hours, puts the biggest smile on your face.
But the first patient that you lose after coding them for hours, your heart sinks, you cry with and for that family and their loss, b/c you just lost a piece of yourself too.
I guess what I am getting at is this.
Nursing isn't just some profession you go into for the hell of it just to make a living.
You go into because you are compassionate, you are selfless, you are emotionally stable, you are detail oriented, you possess great judgment, physical endurance and communication skills, you are giving, you are caring, you love to help people, you don't like to see others hurt and do your best to make things better, you are supportive.
And as I once read:
"While doctors diagnose illnesses and prescribe medication, surgery or other treatment, it’s often nurses who explain medical procedures, help manage symptoms, respond to emergencies, listen to family concerns, allay patient fears, soothe worries and find ways to make difficult situations bearable."
All I ask is this from those of you with loved ones in the hospital. Please understand that us Nurses, are Humans too. I can almost guarantee that any one of us, or one of our family members or someone we love dearly has been in the same spot that your loved one is in. If you see us laughing in the hallway, it doesn't mean it has anything to do with you or your family. We all have our ways of coping too and ways of getting through the day/night. If you see us crying, don't assume it's bad news about your loved one...we could have just lost one of our other patients. Please try and treat us with respect and know that we are doing our best to provide the best possible care. If you have called out and we haven't responded for a while, we might be in the middle of something with another patient or might not have even received the message for whatever reason. Please ask another Nurse or the Charge Nurse if you feel your needs are not being met. If it is an emergency, definitely make it known. SOMEONE will be there.
I think I have said enough. I hope I didn't scare anyone away from nursing and I hope it shed some light on things that others may not have understood. We do care and want the very best for every patient that comes in our hospitals 24 hours/day, 7 days/week, 365 days/year.
Vanessa, RN
