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July 23, 2008
Are You Ready to Quit Nursing?
I had a long work weekend. Patients kept on coming through the revolving doors of the Emergency Room. Hallways were filled with patients in various states of sickness and health, lying on stretchers or sitting in chairs. A few homeless individuals walked the hallways, chanting to themselves. And now, a new American Nurses Association poll has been released. Seems that many of us want to quit!
About half of the 10,000 nurses surveyed in the poll are thinking about leaving their current jobs -- because they're worried about inadequate nurse staffing levels. Those are staggering numbers -- 50% are thinking about leaving their current jobs. No wonder 1000 RNs picketed outside the Milstein Building at New York-Presbyterian for about a week in early June as the sun beat on the hot pavement. I’m sure that staffing was a key issue.
Back to the survey results -- nearly 75% of the nurses polled by the ANA reported that staffing levels were basically insufficient. On the other hand, approximately 26% said that staffing levels were reasonable in their facilities. (I wonder where they work?)
Are you ready to quit because of staffing levels? Tell us about your staffing experiences. Are they getting better or worse? Can you suggest any solutions?
To contribute to the survey, log onto the ANA site.
July 23, 2008 in Beka | Permalink
Comments
MY ,MY,My all of this is making me scared to death. Im a LPN student after makin my RN transition and its hard so far so I can amagine how the RN course can be...but that's not gonna stop me from becoming the only thing I can see myself doing...I live in Nj and don't know what the pay rate for LPN at the moment but I plan on working part as a LPN while getting my RN degree..all that mumbow jumbow about don't become a nurse because its not what its all cracked up to be..but if you really want to be a nurse(CNA,LPN,RN,etc) nurseing and caring for people is not talent its a gift and its a gift im ah keep giving.....oh and may I say the pay for nursing here in jersey is pretty decent.($40$59, and maybe more depending on experience and how long you've been a nurse,and that s for a RN)
Posted by: LPN to RN student | Dec 31, 2008 10:04:14 PM
just think: we all could have gone into vet school!!
Seriously, I want to be happy, and nursing is ridiculous.
Posted by: just to let you know | Oct 23, 2008 8:08:34 AM
All that I keep hearing about is "The nursing shortage" and I have to laugh. I have been an LPN for 20 plus years and have seen a drastic change in the new nurses (RN's and LPN's) that have graduated in the last 5 years. And not for the better. I had one nurse swear up and down, at her license renewal time she had placed her license on her kitchen table and since the "Taliban" was watching her, "THEY" stole her license so they can keep track of her. Another, attempted to remove a peg tube from a patient stating the family no longer wanted it (family was never notified of this one) along with actually CUTTING the call bell cord from the patient (after three months of informing my DON this girl was sent to crisis for seven days because she was passing herself off as an RN). As far as the influx of overseas nurses, in this area we have WAY TO MANY. Most speak VERY broken english, I don't even want to go into the transcription mistakes, and then when you attempt to explain to them the problem they get VERY defensive. I had one fillipino RN spend five minutes looking for a nurses aide because a patient had to have a BM. Since I was passing meds, I had closed my cart, walked down to the patients room which took all of 10 seconds only to find this patient had defecated on herself (this patient was alert and oriented and ambulatory and very embarrassed by this incident) all that the RN had to do wass assist her in standing up. The RN response..."THATS NOT MY JOB". It took all I had to not only hold my temper, but to hold my self back from actually wiping the BM all over this nurse. I had one ask me if I had replaced a colostomy bag on one of my resident's (mind you I was in the middle of chest compressions on a patient, while she was asking me this). Come to find out she did NOT know how to do CPR!!!
Now if you happen to work for the state of NJ, the starting rate of pay for someone with my experience is $19.80 an hour, 40 hours a week, every other weekend, and most holidays. For an RN with 1 year experience fresh out of school...$55.00 to 60.00 an hour. As far as patient care experience(actual hands on) during the course of their schooling...ZIP. When I have to mentor a new RN, my first question is "why did you become a nurse" Out of 100 responses, all 100 responses are the same..."because it's good money"
Being from south jersey, the opportunities for LPN's are very limited. I have been out of work since May of this year. I have actually sent out 153 applications since August, the reponse is always the same "We are really looking for an RN" I had even asked one prospective employer, would they hire an RN with no experience over an LPN with experience? YES was the answer. The hospitals in this area will not hires LPN's, the assisted living facilities only hire med tech's. LPN's are being fazed out, for less experienced less educated personel. So can someone tell me where the nursing shortage is, because down here I don't see it.
Posted by: Marine O'Brien | Oct 14, 2008 2:46:30 PM
I recently got a second bachelors(accelerated program) in nursing and am about 2 months into working at a busy med surg floor in nyc-boy do i HATE it! I feel so abused, underappreciated and made to feel like an incompetent idiot by my preceptor and private nurse aides (the hospital CNAs are great tho) who probably couldn't pass any of the classes I had to take. why the uncalled for power trip? i came here to help,remember??
I'm already planning to quit and return to my first degree-the RN isn't useless, i'm more than ever motivated to push the importance of preventive medicine and do whatever it takes to really succeed with my first degree (which I was doing well with but mistakenly thought nursing would give me an edge in truly helping people)...
the turnover rate with new grads is probably high because at this point in time, catty unprofessionalism, vocal griping at work, obnoxious remarks in front of pts, and an overall atmosphere discouraging teamwork is just totally shocking. Who wants to be treated that way? I've seen more nurses acting like jerks to MDs than the other way around although i understand the stress and intensity of the work. But where's the civility? And, i can't understand the lack of equipment on the floor-people hiding infusion pumps, no o2 sat machine to be found-can you imagine a bar running out of vodka???
sorry for the gripe, i'm upset i invested 18months for a bsn,rn, and $$$ only to realize working on the floor for just 2 months has made me sick,exhausted,severely depressed, and unfulfilled. i have to work 4 12 hr shifts in a row, to make up for two days i called in sick since i'm still on orientation.i dread waking up in the am for work tomorrow-but after these 2 weeks i will most likely quit. not because i'm weak willed, or not quick enuf to handle it as my preceptor will make it out to be, but because i'm smart enuf to bail before wasting any more time being unhappy.
Posted by: cukla | Aug 21, 2008 12:34:49 AM
I don't think i will quit now although my country still have not appreciate nursing staff enough. my organisation treated nursing as a bussiness tool. All the extra DR work that need a nurse to do and the end of the day the money go to the DR and the organisation, praises goes to the DR, we get the work to be done and our small pay, but i still do appreciate nursing in a different way, i still love what i'm doing, even with all the dissatifaction and dissapointment goes along but nursing not just hardship,
Posted by: N.G | Aug 11, 2008 3:11:01 PM
I have worked as an RN for 30 years in the same hospital. Our staffing has always been up and down and we are continually having to precept new people. I can tell you that precepting new people and seeing them leave after a short time is extremely frustrating. The biggest bone of contention I have is with the way more experienced nurses are continually being passed over when it comes to compensation. In my hospital there have been many salary adjustments in order to be competative with the other hospitals. The problem is the way they figure the adjustments. When they figure it they only give credit for 15 years experience. What that means is that if you make more than a nurse with 15 years experience you don't qualify for a salary adjustment. So the less experienced nurses are getting closer and closer to making the same salary as I do. It seems that years of experience and dedication to the hospital amount to nothing. It makes you feel extremely unappreciated. I have been seriously looking for another profession. I'm ready to get out.
Posted by: Dianne | Aug 7, 2008 10:15:28 AM
I am a student RN - in my third year now - if u ask 100 students if they have considered leaving im sure that more than 50 of them have, in fact i would bet probably more. I know i have many times.....im thinking it now.
Anyways, I feel that the poor 'recruitment' and 'retention' of students is a major issue contributing to this 'nursing shortage'. Just something to ponder.
Posted by: buzz | Aug 7, 2008 9:37:02 AM
So long as so much is required of a nurse, with ever increasing liability but no legitimate support by employers, there will be a logrithmic exit of quality nurses from the ranks of American Nursing.
It's all about doing what is right,compassionate and moral that is lacking in nursing. There is no reason to stay in nursing when there are careers that don't destroy your health, place intimate relationships at risk because employers think they own your time, and then are willing to allow you to be sued or take the fall for decisions that were made or not made because someone somewhere counted their bank account or ego more important than doing what was right.
Lots of demands on nurses, very little appreciation.
Too many arm chair nurses out of touch with the overload at the bedside. They are paid more than they are pragmatically worth, and have lost empathy and compassion, if they ever had it to begin with.
Posted by: Lucille | Aug 6, 2008 8:26:56 PM
I would encourage every nurse to read, "Nursing Against the Odds" by Suzanne Gordon. I make sure every friend I know in nursing school is given a copy as a gift. It is powerful reading and completely reoriented my thinking on many of the nursing issues we eoncounter as a profession. For the record, I love my job, but I have an exceptional group of physicians and nurse practioners who are generous with their knowledge, unstinting with their support, and have always let me know the sky's the limit with whatever I want to persue professionally in the clinic.
Posted by: Robyn Reince, RN | Aug 4, 2008 3:31:34 PM
Yes, I would quit nursing right now if I could. The standards for education seems to always be rising and the compensation is not. With 26 years of nursing behind me many feel we should be able to help with the educator problem by teaching. We are told you need your MSN or PhD now. We are cutting our own throats, when many very experienced nurses are willing to teach what books can not, experience and intution!
The hostile work environment from fellow nurses who are trying to climb the ladder or just women backstabbing women is enough to make you sick. Why should I work in nursing in a hostile work environment, when managemnet refuses to do anything about it.
Posted by: Kathleen Curry | Aug 4, 2008 8:29:54 AM
For Mandy -
I think that you take advantage of your new PT job to learn to organize and prioritize tasks. Nursing like all professions has its pitfalls, but also great successes.
Do not be afraid, ask questions and they will be answered. Choose a mentor and work with him or her as graduation nears. And you will do fine. Hold your head up high.
beka
Posted by: Beka | Aug 3, 2008 6:06:24 PM
I have read all of your posts and I am now scared to death. I am a senior nursing student very close to graduation after a minor set back and almost a nervous break down after I thought I would not be able to finish nursing school...now I am back and just landed a position as a PCT at a local hospital part time while in school to help with experience. I am terrified of what I have gotten myself into and put my family through so far....for this???
Posted by: Mandy | Aug 2, 2008 1:31:09 PM
I am a male nurse. I've been an RN for 31 years. For 10 years I worked at the bedside, for 10 years I worked in administration and management, and for the past 11 years I've worked as a health management analyst. My progressive movement away from actual nursing was progressive and calculated as I could see that regardless of the foundational premise that hospitals exist so patients can receive nursing care that nursing staff were not the principle benefactors of hospital businesses. While a hospital must make a profit in order to remain a viable business most successful service businesses invest heavily in the primary human resource that makes the business successful. Because the fundamental nature of nursing is "caring" healthcare institutions use the nature of nurses to get around making this investment. We who become nurses wish to "care" for others. It is part of who we are and as a result we accept being treated as we are because the notion of standing up to the industry makes us the bad guys whom we don't want to be thought of as being. The industry can make the claim that nurses will place the patient at risk in order to squeeze a dollar more out of the business and because we care, we each according to our on unique capacity to cope with "not caring", individually cave in our protests. When Nursing unifies and stands up for itself as a profession and demands change it will happen but in order for this to happen we have to accept that patients seeking our "care" are going to have to be allowed to suffer during the porcess. It is a slippery issue that won't be resolved without radical action on the part of the nursing profession and until it happens this trend of people leaving the profession is likely to continue. Further, it won't happen soon and when it does it will have an impact on our society so extreme that it will alter healthcare in unexpected ways.
Posted by: | Aug 1, 2008 2:08:06 PM
The most frequent complaint is nurse /patient ratio, pa,y long hours and poor management support.
I see the documentation problem critical and think a possible solution could be documentation nurses and a bedside nurses. Any way you consider this the doumentation takes us away from patient care which intern reduces quality care and and endless array of problems as we nurses are all aware of.
I have several programs and ideas that I could expand on this.
Posted by: Linda | Aug 1, 2008 10:40:46 AM
I have worked in nursing since 1978. Worked outside of the hospital setting for almost 20 years. Got out of the hospital setting because of working short and stress. Office setting can have it's own set of problems, lower pay and the chronic stress of reimbursement cuts and continuing rise of care. Now I work for a free clinic and the staffing is poor, no money to pay staff, plus we have very ill clients that no one wants because there is no reimbursement. Volunteering physician's still in practice don't want the headaches. If I could get out of nursing I would. The problems just keep getting more and more and there is very little reward. My nephew recently said it best in reference to the up coming election. "It really makes no difference who we put in office, they have no real concept of what the hard working people want nor do they really want to know!"
Posted by: Peggy | Aug 1, 2008 9:41:35 AM
Looking at all the comments above, I'm struck by how caring nurses are and want to be. I'm so grateful for my coworkers. Every state I've worked, I've met the same people, people who want to do the best job, to protect our patients. I've been in nursing for 20 years. I love nursing. I'm also leaving it. And I encourage my children to NOT become nurses.
There is research out there (google nurse staffing and patient mortality) that says if nurses have a decreased ratio of patients, the nurses have higher satisfaction (because we want to take excellent care of our patients), but the patient satisfaction is also higher (something hospitals are looking at and reporting on their websites). There is also a decreased infection rate, better discharge instructions so patients know when to call the doctor, and therefore less ED visits, and go figure, a 30% decrease in patient deaths within the 30 days after getting out of the hospital after surgery. Interestingly enough, the patients with the nurse with a "lighter" load, leaves the hospital sooner, because they're better cared for and better prepared for discharge, so the hospital can actually have more patients coming in to the hospital, having their procedure and going home.
When California instituted mandantory patient ratios, nurses who had left nursing came back to nursing and nurses in other states came to work in California. Nurses want to work and to be able to take care of patients and not clock out 2 and 3 hours late. But change is coming too slow for me. My solution is doing something less stressful and is more work/life friendly than nursing.
My solutions for fixing nursing are:
(see number 1 below) 2)PAY NURSES MORE (you should have heard the chief nursing officer's mumbo jumbo on why we couldn't have a pay raise)(and my favorite bonus was $54.87.... for the year; my husband and I each have 4 year degrees and he made more than me and is treated lightyears better. We nurses had degrees, we had all this responsibility at yet we had to beg for a raise. Nurses should be paid more.
1)FEDERAL MANDANTORY SAFE STAFFING RATIOS because the for profits (and the fake not for profits) won't change unless it's mandantory and expect a lot of screaming from the hospital council political action committees because you're cutting into management bonuses and bonuses for everyone else who isn't at the bedside. (why don't they give the nurses bonuses for decreased infection rates and patients getting out a day earlier because you did such a good job with patient care and discharge teaching and bonuses for increases in patient satisfaction? (but could we even trust them to calculate it correctly?)
3)WE NEED MORE NURSING INSTRUCTORS and THEY NEED TO BE PAID A LOT MORE, but they get paid a pittance and they're trying to make sure their licenses aren't destroyed, and they work on the weekends at the hospital to be able to afford to teach. We're turning away 50,000 nursing students a year because we don't have enough instructors.
4)MORE PUBLIC EDUCATION about health issues.
The other thing that I've noticed is that when I stood up about these issues at work, I didn't get very much support in front of management. I'm not sure whether nurses are wonderful caring people as well as doormats or maybe we're not the patient advocates we're supposed to be. I'm also grieved that the same management that I reported to and the Directors and CNOs, all used to be nurses, at the bedside, and yet they seem to have no qualms about cutting staffing and getting their bonuses.
Please consider reading Nursing Against the Odds, by Suzanne Gordon, 2005, who has solutions beginning on page 402 with The Case for Safe Staffing Ratios. It's at Barnes and Nobles. I really love nursing, and would love to come back to it but only if it's much improved.
Posted by: teresa | Jul 31, 2008 1:13:14 AM
better look side on other countries especially in asia philippines is the largest production of nurses and yet still undertstaffing exist and possibility of unemployement because most filipino nurse wanted to work abroad. Ask fellow collegue filipino nurse of what is situation happening the Nursing in the philippines im sure you find it interesting
Posted by: rody | Jul 30, 2008 7:47:44 PM
I was one of those fresh faced just graduated nursing students five years ago. Went back to school as an adult to get my RN. I knew nursing was where I belonged. Got hired into a "good" teaching hospital on the floor I wanted. What else good I ask for??! After eleven preceptors and many which told me that I could follow them but don't ask any questions since they don't teach, I had my fill. Approached mgmt many times telling them I needed one person to follow who could help me settle in so that I do no harm to my pediatric patients, many post-op and hem/onc. You need to know how to do something before you can expand and try other ways. I was told "there are many ways to bake brownies". I left my dream behind in the hospital and settled into a private pediatric practice. Yes the pay isn't equal to the hospital but I am paid nicely, have hours that I can still enjoy my family and work with doctors who appreciate the work I do for them. With a staff of five nurses who all work part-time splitting the week, we experience nursing at it's finest. I spend quality nursing time with my patients, often just to lend an ear or hold a hand. No regrets leaving the hospital scene at all.
Posted by: vicki | Jul 30, 2008 2:32:53 PM
This is all so sad. I have been a nurse for five years. I'm an LPN, working on my RN (the state where I reside treats LPNs as second class citizens). I have been working at SNFs since graduation and staffing is no better there. My assignment last weekend consisted of 20 patients with 2 CNAs to assist them. Out of those 20, 9 were total assists for ADLs. I had 17 dressings to do in addition to morning and afternoon med pass for those 20, finger sticks for a 1/3 of them, 15 minute checks for a suicide watch, all my VS, I&Os, notes, etc. It's disheartening when a fellow nurse has been made to leave by the DON when her license-protecting documentation isn't finished all in the name of budget, bonus, bottom line. We have many areas of triple or quadruple charting and if these don't get charted, we get called back in and/or written up. My shift was 7-3, I left at 5:30. The time isn't so much the issue but what the expectations are from the higher ups.
Posted by: kathy | Jul 30, 2008 8:14:30 AM
I'm appalled! We have a shortage and work short staffed frequently but nothing compared to some of the stories here. We have 7-9 pts at night on a 25 bed surgical oncology floor, recently we had 3 murphy drips running full, and these pt were still bleeding and clotting off, requiring q6hr HCT and blood transfusions. Never mind the Whipple who just came out of ICU whose BP was low, and the Nephrectomy who was going into renal failure. How about the open and close 54 yr old who is facing death, who is tachy in the 170's and all this with 1 experienced nurse and 3 new nurses, and the ICU saying sorry we don't have a bed for your failing pt. People are dying. We are burnt out as a group, many nurses have quit our unit this summer. New grads are being hired, and I feel sorry as they all are idealistic, and gung ho.They are thrown into a scenario like this and I see the fear in their hearts. I know their idealism and gusto will be snuffed out in a short time due to the crisis we are in. We bedside nurses won't leave our patients in danger and just walk off like other occupations do,(union or not) and there they have us right where we've always been. In the dirty palm of the hand of some greedy administrators. Sorry we are only approved so many FTE's and can't go over. I've heard this for so long I want to scream. In the writing above that states her manager wouldn't hire because it would go over budget and cut her and all managers bonus, is sickening! TOO BAD! Do the bedside nurses get bonuses? HA, NO!!! Someone has to have the backbone and stay when told to go home. ! What will they do , fire a whole entire group of RN's for staying at work!! I think not! That is the reversal of what other places have. USE the advantage! (Please this is not meant to be personal , the idea of a manager doing that is infuriating).
I realize the bottom line has taken over health care just as the insurance company's have taken control of the Doc's. LUDICROUS! And we let this all keep happening! I don't have a solution that one person could accomplish, it will take nurses as a national whole to change it.
Posted by: Marcia | Jul 29, 2008 10:02:30 PM
Working about 3 years as an ER-RN. Love it and hate it. The push for high ratios is non-stop, on my worst day I had 4 ICU patients in DKA with hourly labs, fingersticks, insulin drips, and everything that goes with monitoring ICU patients! It was horrible! I was scared for my patients, scared that I had missed something, scared for my license! I think hospital administrators should be made to visit our ERs, floors and LTC facilities as orientees and undercover. I can guarentee things would change! I also believe physicians should be advocating for nurses-we are their eyes and ears. Heavy patient loads=missed symptomolgy and deteriorating conditions. Bad for the patients, bad for the doctors, bad for the nurses-bad for hospital publicity! I am currently in school for my MSN-want to teach. This is a second career-God only knows how long I will be able to work this way. I already resent that my time with patients is brief....my hands are tied....it's time to force change by fixing the system. Only people with letters behind their names can do that.
Posted by: mary | Jul 29, 2008 7:56:44 PM
I went into nursing in my 30's to be a "bedside" nurse. There just isn't such a thing today. I hated depending on others for my vital signs and direct patient contact. I always felt you can get so much information by listening to that pulse yourself and looking into your patients eyes. You get a feeling for signs and symptoms of problems. I was spending too much time doing computer work, which we never caught up on. Reports were always due and overdue.
I just left last year because the DON of the facility denied me time off for a year and a half because she "just couldn't leave the nurse manager on the floor alone". I called it quits and retired. No more stress! No guilt!
Posted by: Joy | Jul 29, 2008 6:29:24 PM
I have been a nurse for 50 yrs, am 69 yrs old, retired, and also working a full time job, and two call in jobs- all this to keep my sanity, and afford to live here in beautiful Honolulu. I love my job, my home, and location. I am an NP, and have worked as a staff nurse, supervisor, coordinator, faculty facilitator, and on site clinincal instructor- and- was also a DON in nursing homes (in the '70s).I have come full circle with the changes in the nursing profession. I worked harder in the '60s and '70s than most nurses do today. We had no such things as patient ratios- and the word "uncomfortable" was not in our vocabulary.
When the elevator door opened at the beginning of my shift, and there were 2 patients on gurneys, I was expected to take care of them both- and I did-- because I was the only nurse on the shift, and the thought of abandoning my patients never occurred to me.
Today, as I supervisor I take great pains to ensure that the shift I work on is staffed for acuity. Until all of the sick calls and the no show calls come in- then I am ready to lose my cool. If everyone who was scheduled to work came to work, there would be NO STAFFING Problems! and NO- I cannot cover for all of the sick calls- All nurses should make a committment to either remain in the profession or Leave-- and find another line of work- where they can go to work or not- as the spirit moves them---
Posted by: Mary Ann Foley | Jul 29, 2008 5:14:04 PM
How long is it going to take for the management of health care to see the problem is great!!! I have been a nurse for 40 years. LPN then RN and nursing care now is terrible. Never enough staff to take care of the patients. It does not matter about patients and the care they need, or the staff that is needed. Saving $$$$$ money is all administration is concerned about. Calling staff off, requiring staff to go to another unit to tke care of patients in unfamiliar areas. (This is very unsafe) HEALTH CARE IS ALL ABOUT MAKING MONEY.
Posted by: Anna | Jul 29, 2008 5:01:00 PM
The problems being described are typical of any collectivist system. One that we ourselves demanded.
Posted by: Joe | Jul 29, 2008 4:47:44 PM
