I didn’t sleep that well last night, and I don’t suppose anything angers me more that being flat exhausted after a thirteen hour shift on my feet yet being unable to sleep even a full five hours before going back for another. I can usually pass out quite efficiently after a hard day, but this morning I woke prematurely thinking about work. And that’s even worse than dreaming about work. It’s a close second, sure, but for me insomnia does trump answering call lights in my dreams.
It was thoughts about my upcoming shift that kept me from succumbing to the sandman in the early morning hours, and I mentally organized my day right there from my pillow. I was scheduled to be in charge, and that was something I usually passed along to those around me who enjoyed that position of minimal authority for some pocket change. Sometimes, though, despite my desires to just take care of my patient assignment, I had to drive the boat because of my seniority. Hence, my insomnia I suppose.
Today I was lucky because I had a great crew, and being in charge of rockstar nurses made it a better day. But what about when you don’t have a good support group? After all, you’re only as good as your team.
Something happens after about ten years in the field of nursing if you so happen to still be serving bedside. One day you look up and you realize you’re not the new guy. So even though there’s a plethora of stuff you still learn every single day, suddenly you’re the one people look to for answers. But it gets worse. You look around to see who you’re supposed to ask and there’s nobody there.
What I’ve discovered is that fewer and fewer nurses are staying in the trenches, and those of us who do are a fading minority. It’s not that there’s anything wrong with new graduates, as I used to be one myself, but even the new graduates are leaving fairly soon compared to previous years.
Now everyone is either pursuing higher education right off the bat or waiting their turn in line for a managerial position, and while I’m all about furthering one’s future and career, the bedside is being left pretty empty as a result.
So what happens is a meager handful of stressed out nurses with experience are left to train the influx of orientees. They will work diligently to pass along twenty years of knowledge in about a month before their new charges are let loose to save lives and take names one chaotic shift at a time. And just about the time their protégés begin to settle smoothly into their new roles, taking up copious amount of slack, it all starts over.
Disgruntled, overworked nurses leave for a hopefully less stressful office position. Or the year of critical care experience is up and acceptance into a Master’s program has been obtained. The vicious cycle repeats itself. Short staffed, not enough orientation, stress over unrealistic expectations, unsafe nurse to patient ratios, overworked and under paid. That seems to be the consensus anyway.
I get it; I do. Being responsible for multiple people’s lives at a time is stressful. Not getting lunch break until two hours after the cafeteria stopped serving it is the pits. Being stretched so thin physically and frazzled to the point of crying is awful. And being expected to handle it all with a cheerful attitude is hard. Imagine how I feel. I’m still here.
The reward for those who stay is more responsibility while maintaining patient safety, and all the while you just pray it will change. You hope that new nurses will love the bedside and want to stay rather than lining up their prerequisites as quickly as possible to get into a Nurse Practicioner program. You try to impart what you’ve picked up as best as you’re able with confidence that the fresh staff won’t burn out quickly. You think, we’ve gotten through worse before, or even, maybe this time it will be different…
I get asked a lot what can be done, and I wish I knew the answer. I wish the patient population wasn’t outgrowing the nursing one every single day. (I guess we’re too good at what we do). And I wish the expectations of society today were more realistic of its caretakers. (We’re human too).
I certainly wish nurses didn’t get sick and call in, or need a “mental health day.” (Yep, we’re still human). I wish people stopped getting sick when their caregivers were, but that doesn’t happen. Instead short staffing happens. After all, we only have just enough staff to work as it is.
Morale plummets, there’s much gnashing of teeth, and resignations abound.
Nurses are leaving the bedside because nursing is hard, and it’s only getting harder. People are getting sicker, and nurses are getting fewer. Required documentation is becoming more lengthy, and the time a nurse can spend actually enjoying the bedside is getting shorter. The knowledge and accreditations required are becoming more as medical advances are made, and the time spent tweaking technology issues and glitches that arise sadly slows you down rather than making life easier.
In the end it’s no wonder the newer nurses entering the field are leaving the bedside sooner than their predecessors. So what about those who stay behind? Well, I guess you could say we’re pretty tired.
Michele Davis says
I worked as a bedside nurse on a medical oncology inpatient unit for over17 years. I loved the constant challenges and learning opportunities. I loved mentoring new nurses and sharing the knowledge I had gained along the way. Unfortunately the grueling physical pace wore me down. I now work in an oncology infusion unit and love it even more. For everything there is a time and a season. I’m thankful for those willing to work the bedside .
Bri says
Another frustration we’re running into is pay by performance. If a patient I’m taking care of ends up with a CLABSI or a CAUTI, there goes my raise, even if it didn’t happen on my shift. It’s exhausting as it is taking care of sick patients, but constantly being concerned about taking out lines for patients to prevent infection, it’s just continuing to beat nurse morale down at my hospital. As nurses we always want the best for our patients, but were being stretched thin in every direction and being made to feel like the bad guy.
Teresa says
AMEN!! It is even more frustrating for a nurse educator sending those new grads out into the trenches. Knowing they will not stay and about 10-15% leave nursing all together within their first year.
Elizabeth says
At least you’re not getting evaluated on retention…in my hospital, unit retention goals are now part of the pay-for-performance (which honestly is kinda meaningless because we never get raises anyways). So if our unit doesn’t meet its retention goal, then you get dinged…even if you did your part by, ya know, staying. Seems legit.
It shows how out of touch administration is that they put pressure for retention on the unit level, without also putting pressure on THEMSELVES to improve retention. We are doing everything we possibly can at the unit level to make things better, but if the big things (like pay and benefits) don’t change at the administration level, there won’t be a big difference. Nurses aren’t stupid. They know when administration doesn’t care about them, and they’ll respond by being quick to leave.
Leann Slack says
That is the worst thing I’ve heard yet. I also left nursing after 22 years after my position was eliminated thanks to Obamacare. I was offered another job for $5 less/hr. It was no longer worth working holidays/WE’s/12 hr shifts. So frustrating.
Trish says
I love this. It is so well written and conveys so many things I’ve felt lately. Charge nursing was really fun for the first year and a half I did it. Then many of our “rock star” experienced nurses left and it was me leading many new nurses and older nurses who don’t care very much. It went from being fun to terrifying. I don’t want to leave the bedside, but I don’t know how to sustain this.
STEPHANIE says
Wow, your comment speak volumes: I dont want to leave bedside but I dont know how to sustain… its real how do I sustain this. I experienced a miscarriage due to stressors at work. I love being a nurse but do I put my life and future family on hold for work?
Silvia says
The answer to that is no. Work will always be there. Your family….is much more important.
-a stranger from the Internet.
Nurse Bennett says
Amen! A job, no matter if it’s nursing or being the CEO of a major corporation, is still a job. Family is EVERYTHING. – a former nurse.
Cricket says
I had 2 miscarriages and preterm labor with my 2 viable pregnancies because I thought I could make a difference on one of the hardest med surg units in a large hospital. 1:7 nurse patient ratio most nights as charge nurse. I was killing myself with physical exertion and anxiety about whether we were staffed. I was chair of councils, patient advocate, and super user. I obtained certifications at m cost to help my hospital obtain magnet status. I finally resigned after our hospital chose to veto the nurses and change our computer system. 2 years later the doctors have forced it out and they still don’t have magnet status. I work 3 bedside jobs PRN and finally making it work. I should’ve listened to my husband, I couldn’t changes hospital alone and I didn’t have the recruits to fight. I’m tired of being tired and fighting for better working conditions.
Lou Hoskins says
You paint the picture with great accuracy. Ive been nursing for 43 yr, last 20 in home health. I do not have any answers either. I see the nurses at our hospital give excellent care but they are tired. The healthcare system is in a slow decline due to reimbursement issues, every increasing governmental regulations that are impossible to acheive.
Veronica says
Bri you said a mouthful. Well done. What’s worse is after all those years dedicated to the bedside, you’re practically thrown away. When you can no longer work twelve hour shifts or handle the heavy patient loads, you take a pay cut for a clinic position or a less stressful job. All your years of hard work rewarded with a pay cut. Graduate schools want to know what you’ve done to prepare while working at the bedside? I’ve been in charge, precepting and innovating. Doesn’t that count for something? No. It doesn’t. Healthcare is a billion dollar industry at the vey least they can improve the quality of life for its nurses. We are exhausted and burned out. Taking care of others while often neglecting ourselves and our own families. Well said.
Alicia says
After 21 years of bedside nursing (nicu) I became so burnt out from short staffing issues and technology issues that I left. The technology that is supposed to help with the care only seemed to take me further from my little patients and forced me to spend more time with the computer. I felt bad for leaving and really tried to hang in there and not abandoning ship but I couldn’t continue to give sub par care. It was changing who I was as a person. Life is short , you know? It has been about a year since I got out of the trenches and I am so much more content. I feel like I can breathe again. Life is fantastic and I am very grateful. Babies are still a part of my working life but in a different capacity. I have switched gears and am now a nanny for babies. So refreshing and rewarding!
Dorinda Evans says
If only being a nanny paid enough for me to support myself and my children.
Susan says
I am a 40 yr nurse. My first 37 years were in large busy hospitals. Only 6 of these years were not bedside. My last 2 years at bedside in ICU were eye opening.
In past years, we were short staffed but had a fabulously collaborative team of nurses, seasoned and dedicated.
Susan says
The current climate is ” every person for themselves” as if it is a competition. Not much team work. Very isolating and cold. Stress abounds. Anger is just beneath the surface. Lots of judgement, blame, and plain mean all around. Pressure cooker ready to explode. Far from a healing environment for patients or staff. We need the HEART to be returned to our healthcare system. Unfortunately the Administration treats is as a BUSINESS. That is a poor model since care and compassion are not considered.
I am doing homecare now. Lower pay yet I can be the nurse I want to be for my patient and their family.
Victoria VanDalsen says
I became a nurse later in life. I graduated 3 days before my 49th. birthday. I worked in a busy Med/Surg/Oncology unit. I loved it. The first three and a half years I worked the 3-11 shift. To get on a day shift, I agreed to work 12 hour shifts. I loved my job and I loved nursing. By the time I was 56, my back gave out and I had back surgery. I had fusion in my L5-S1 with implementation. I have four titanium screws and a spacer in my lower back. I have permanent numbness in my lower legs. I went back to work after six months of medical leave. I had to or I lost my benefits and my job. I worked another four years and I just couldn’t do it anymore. The work load, the patients were sicker. Documentation took up so much time that should have been spent caring for patients. Short staffing and mandated overtime were occurring more often. Raises were nonexistent. Raises were based on merit, not longevity on the job. Merit meant you also had to be involved in many committees. I hadn’t had a raise in over 4 years. By the time I was 60 years old I was getting pain injections in my lower back every 8 weeks. I couldn’t do it anymore. I went on medical leave again and I applied for social security disability and was approved. I saw newer nurses leaving for positions that were M-F working 8 to 5. Newer nurses were getting married and having babies. Some just didn’t come back from maternity leave. Maybe if I had left bedside nursing sooner, I wouldn’t have ruined my back. Nursing has been the hardest, most back breaking job I’ve ever had. It is also the job I loved the most. I found it rewarding and fascinating.
Shameka says
The first half of your story sounds like my moms. She’s 56 and has been retired/disabled for about 3 yrs. She worked for 30+yrs in nursing. Now has a bad back to show for it. She loved it though and she misses it. I’ve been nursing for 7 yrs and have found a M-F 8-5 so that I can be with my kids. 12 hr shifts cause you to miss out on your family.
sewreffic40 says
Hi I have been a nurse for 13 years now and I reached my burnout officially last year. I decided to get off the floor and work in the home and it is heavenly. One patient to be responsible for not office politics, no uncooperative cna’s, no office gossip and jealous coworker. I am a free spirit. I cant see myself ever returning to the floor again.
Erin says
I like this! When some people say there is no solution to this matter I do not understand. The solution is get those nurses that bully others out of the hospital. They are the same nurses that make other nurses call out or leave work altogether and we complain of short staffing! Young and old nurses(mostly old) should stop competition, back stabbing, petty politics and jealousy!
Roz says
I worked with a bully. She looked down her nose at her co-workers, reduced LPNs to tears, spoke condescendingly to patients and families. Even though multiple complaints were filed against her, she kept her job. Most of the nurses she was nasty to quit or transferred to other departments. I quit that job 10 years ago, I couldn’t stand the misery. She’s still there and still a bully.
Nichole says
I think one of my biggest frustrations is that working I am icu we are always the first area in the hospital they pull staff from…it’s OK for the icu to work short staffed while every other floor in the hospital can have a free team leader.
Kat says
Nichole…..try the ER. We don’t get EVER get help from the in-patient side of the house, but are still expected to man, Pre-triage, triage, Charge Nurse, Psych, and the ER Medical rooms. I can’t tell you how many times, we forgo the Pre-triage (much to the dismay of the higher ups) have 1 nurse in triage (sometimes for a full 12 hour shift) our charge has charge, psych and a med pt team and there our 2 other nurses have 4-5 a piece in the ER…. without techs. It’s not fair for the critical Areas to be used as float staff for the rest of the house. I totally get it.
Veronica says
This will continue to deteriorate. They build cancer centers because they know they will have patients to fill them up. Work their nurses until they burn out bc we are replaceable. The biggest con to the east coast is the lack of nursing unions. We work just as hard as construction workers. Everyone hates floating. Perfect way to ruin a shift. It’s a multi billion dollar industry and our pay reflects it. ( sarcasm)
Tammy says
I was called in with a desperate plea to help my unit then was pulled to another unit. So discouraging. After 4 yrs as an RN I left nursing. Insomnia, anxiety and being worked to death was making me miserable.
Margaret says
When Health Care adopted the “Business model” it went downhill from there. It will never recover as long as the profitability remains a top priority. I have seen at least 3 cycles of a dearth of bedside nurses in 28 yrs….this one may take the cake.
Christy says
Kuddos to Brie!! Your short synopsis hits current nursing on the nail! Brie, you captured everyone’s thoughts in an unbiased way. I applaud you!
I have been a bedside nurse on a highly acute inpatient med-surg renal unit for 24 years. In this 24 yrs on the same unit, I not only have seen multitudes of new grads come and go, but what may be worse I have had 13 new managers! So this is a double whammy for me in my struggling challenges as an aging bedside nurse.
Someone above commented abut “the heart” of nursing is gone! The new millennium nurses do not have the heart for nursing! I am currently a glorified charge nurse. Over the past 5 (maybe more) years, I have noticed that the new generation of nurses spend more time and desire to be at the nurse’s station charting. These same nurses don’t have the “heart” or desire to be a true bedside nurse. These millennium nurses (because of the computerized charts) are more concerned about getting all the “check marks” completed on their patient’s charts. These new nurses have no desire to be at bedside with their patients, getting to “really” know their patients!
I keep saying, “what is being taught in nursing schools now?” I don’t know if it is within the nursing curriculum at schools, as much as this new generations’ work ethic. The majority of this new generation of nursing lack motivation, critical thinking, and work ethics. These areas can not be taught in orientation. Yes, these skills can be modeled, but the desire to acquire these skills is needed. This new generation lacks the desire.
Many comments above have mentioned that healthcare is a business now more than ever. This is so true. Everything is so scripted. We can’t be ourselves. HCAPS’s not only gear our payments, but they have determined how nursing should be done! This form of nursing is not how I thought I would finish my career. (even if it will be another 24 years before I can retire).
WOW, 24 more years of bedside nursing under these circumstances! Bedside nursing will be the death of me at this rate. Government run healthcare, revolving door of new hires, more young millennium staff, lack of experienced nurses at the bedside, 12 hr work shifts (at the age of 70 plus years), sicker patients, and higher nurse:patient ratios, nursing is doomed!
I could apply for another job with banker hours, no weekends, or holidays, but I will take a huge pay cut. Also will the grass really be greener on the other side? Will I be able to be the nurse I want to be and was educated to be? I took pride in being a new grad and working at a hospital that supported nursing decision making with nursing driven committees and nursing protocols. I also took pride in nursing diagnoses, yes nursing care plans were a nightmare in nursing school, but believe it or not I miss them!
But as you and others said, how do we fix these areas to make bedside nursing become more desirable career to endeavor? I don’t know the solution either. ( although, I have some far fetched ideas!!)
Brie, thanks again for sharing!
AmandaG says
This is absolutely wrong for most new bedside nurses….we desire to be at the bedside but charting is what stops us from being able to. We are held liable for what we chart. If it is not charted you didn’t do it. This is the fault of the Healthcare system not the nurses. I work on L&D and absolutely adore what I do!!! I hate that charting takes up so much time and pulls me away from where my heart truly lies, which is with my patients!
Maggie says
Just because “millennials” may have different values than you do, does not mean they “don’t have the heart” for nursing. We are different from you because we grew up in a different world than you, but in no means are we less driven or compassionate. I work on a floor where the majority of the nurses have less than 3 years of experience and we just won 2nd best patient satisfaction for a floor in our whole state. We have awesome teamwork and I love my floor. We’re surgical so it is grueling work and we do experience high turnover due to short staffing/high patient to nurse ratios/constant take-aways with our new contracts, but our new hires kick ass. It can be challenging to work with people from different generations who have vastly different ways of communicating/ expressing themselves, but do not blame this problem on us. If you truly have such a negative view on our future nurses, then you have no business continuing on spreading negativity in the work place. We need to build up our future, not tear it down.
Erin says
Thank you Maggie!
suebee51 says
Well said, Maggie. I am an old retired nurse and I worked with many “millennials” and found them knowledgeable, caring and invigorating. I just retired this past year after 41 years.
One of the beauties of nursing that I found was the flexibility.You can work different shifts in different areas, I worked in NICU for 8 years as a new nurse, then when my children were born, I went to a peds office. When my husband lost his job and we needed insurance, I went back to the hospital and worked in maternal-child. During that time, our three child was born and I was able to work just weekends because the hospital offered bonus pay for weekends. That year I made more money working strictly weekends than my husband, a corporate accountant, did working full-time.
I did a short stint in an internal medicine office when we moved to Chicago for four years, then I returned to the peds office when we moved back to our hometown. I was there 11 years and was beginning to get the “you’ve been here so long, we can treat you like crap and you won’t leave” feeling, so I quit. The management was shocked that I quit. They couldn’t understand it. “We didn’t know you were so unhappy.” Really? Apparently, they weren’t listening when my mouth moved.
I planned to stay out of nursing after that, but a former co-worker asked me to come work for her. She was a manager in a NICU. I told her I didn’t feel comfortable because I hadn’t done NICU for over 30 years. She said not to worry, “babies don’t change.” I replied, “But the things we do to them has changed!” I returned to the NICU and loved it. I worked with primarily young nurses and they were great. There were a few “mean girls” but I just treated them like anyone else and ignored their bad behavior as long as patient care wasn’t being compromised.
I was often asked why I didn’t “go on to be a doctor” or why I didn’t take a management position. I always preferred direct patient care because that is where the real action is. That is where I felt I really made a difference.
Nursing offered me a flexibility other professions wouldn’t have. I remember when I was pregnant, a gal at my husband’s company was also pregnant. She was vice-president of her division, She had to decide if she would give up her position and spend more time at home with her baby or if she would continue to work in her position, get good money, and have all the responsibilities she had an upper level administrator in a large corporation. I, on the other hand, could work part-time, make a pretty good wage and was able to spend a lot of time with my newborn.
Many comments have mentioned pay and not being able to afford to quit or change jobs. I think money can be a trap for us. We have a lot of options but we tend to be a society that “wants it all.” In order to save my sanity and my tired body, I was willing to “downsize” a little. It wasn’t that hard. I made fewer trips to Target and the mall. I found I really didn’t need the latest products. I could live with the dishes I had, the linens that hadn’t worn out yet, the electronics that still worked. We didn’t go out to eat as much. It is amazing at how much you can save by rearranging priorities and not worrying about having less than someone else. In the long run, it pays off.
One of the NICU nurses I worked with is the same age as I and she told me she will never be able to retire because she can’t afford it. She didn’t contribute to her retirement plan when she was younger and now she is stuck. Now she is tired but has to continue to work to maintain her lifestyle. Lesson: Save for your retirement!! If you think it’s bad now, try working 12-hour shifts when you’re 65!
I pray that you all keep up the good work. I agree that administration is often clueless. That was my experience for most of my 41 years. I don’t think that is going to change. So, deal with things at a unit level, doing the day-to-day as best you can.
Teamwork was mentioned. I agree that that is very important, so anything you can do promote that is great. Recognize each other’s qualities and good work, be positive (even though it’s hard sometimes) “kill your co-workers with kindness” and it will become contagious.
Remember, you make a difference. Take care of yourselves and each other. Yours is a noble profession that needs you.
brieann.rn@gmail.com says
Love your comment. All of it. Thank you.
Jonelle says
Christy, I am not a millenial but I feel like those comments are uncalled for. I have been a bedside nurse for 10 years and have worked with fantastic, enthusiastic new graduates. As many nurses with years of experience have noted in these comments, things have gotten progressively more difficult for nurses- short staffed, higher patient ratios, sicker patients, less support staff, more charting and constantly increasing responsibility and expectations to provide not only great healthcare but fantastic “customer service”. This is what new nurses are walking into from day one. Think of what your charting is like now compared to when you started- no one “desires” to spend all their time charting but so much documentation is required now you don’t really have a choice. I still have many friends at the first hospital where I worked (and left because of my husband’s job change) and what is expected/demanded of nurses there now compared to when even I first started is unbelievable. I currently work with a relatively new nurse who is caring, smart and hard working and I can tell she’s already thinking about leaving. She told me the other day during report that she can’t sleep at night because she lies awake feeling so stressed about what she’s going to walk into the next morning. Starting a career that way and thinking about the possibility of doing it for another 30-40 years? No wonder so many young nurses are going back to school at the first chance! Try to have a little compassion for your younger coworkers and be the one to encourage them and demonstrate the “heart for nursing” instead of the contempt you’re displaying for them here.
Patricia says
Amen! I’ve been a NICU nurse for 25 years. Couldn’t agree more that we, the seasoned nurses; need to encourage and build up the newer nurses. It’s such a difficult profession. Yet often a very rewarding one.
And more awareness/discussion in the general public needs to happen about subjects that were touched on by others here. Such as REIMBURSEMNT and LACK of reimbursement from insurance companies in the case of VAP’s ( ventilator assisted pneumonia) and CLABSI’s (central line acquired blood infections/sepsis). As well as nurse/patient ratios!
How about the fact that the MAJORITY of patients that are on vent’s/ have central lines, do so because they are critically ill with poorly functioning immune systems! Many of them are immunosuppressed from medications necessary for them to live! How is this the staff and/or hospital’s fault if they then develop pneumonia and/or infections in many cases?! How dare insurance companies be allowed to NOT pay for any of the care surrounding these diagnosis’s The profit margins of many insurance company big shots are becoming more obscene by the minute.
How did we as a society, and better yet, how did our elected officials allow Insurance companies to make SO MANY OF OUR HEALTH CARE DECISIONS, let alone decide what/when they would reimburse for?! Raise awareness and demand change. It’s too important to allow these issues to continue.
Elena says
Exactly!!
Kara says
Thank you Jonelle for standing up for us “millenials.” It is attitudes like Christy’s that cause many of us newer nurses to want to change positions and question if the bedside is the right place for us. I have worked on two different units in 3 years and I have found on both units that there are some older/experienced nurses that treat the newer nurses with such disrespect. As a newer nurse I want to be able to look up to the experienced nurses and use them as resources but often this relationship is severed from the start due to negative attitudes on the unit (this is not true of all older or experienced nurses but of some– I do not want to stereotype). From my experience I can say that the majority of new, young nurses are excited when entering the field and have great work ethic; I think it is the stress and demands put on us right away that cause us to turnover more quickly. With my two jobs I have been at both a small community hospital and a large teaching hospital, and I did not feel supported as a new nurse or a new grad at either institution. Maybe there need to be more new grad transition programs and even mentor programs for new nurses. I don’t know what the answer is to decrease burnout but in the end we are all a team and in it together, whether one has one year of experience or 40 years of experience.
brieann.rn@gmail.com says
Thanks for your comment. I love our new nurses. They are the future, and I always treat them as such. I think you all are put to unfair expectations, and orientation and mentoring programs could be much better. I think a worn out preceptor doesn’t help either.
suebee51 says
So true. Nurses need to stop “eating their young” and, instead, nurture and mentor.
Nice article, Brie. I’m pulling for you and all the bedside nurses trying to get through. Bless you!
(I retired from nursing last year after 41 years. Some of the issues you raise were ones we were dealing with back in 1978. They just had different names! Nature of the beast, I guess.)
Jocelyn spratt says
Wonderful article. I’d like to add nurses leaving due to being injured on the job. Please Include the back injuries that accumulated over time yet the job says it didn’t happen while you were working. Also, on the job injuries leading to light duty.
Carol Kelley says
I worked in the ER for 13 years, with some work in acute-care, ICU, surgery, and house supervisor along the way. I left my love for the ER two years ago. The stress of the job, always working short staffed, the unrealistic expectations of “do more with less” and the impossible expectations to make every patient a “satisfied customer” helped to push me out the door. (Everyone’s gotta love patient satisfaction surveys in the ER environment!!) Now I work Monday through Friday 7A – 4P in a clinic setting. I am the charge RN over five LPNs. We have seven providers in our clinic. It’s a busy clinic. But a busy day here will never be anything like the easiest day in the ER as far as stress level goes. I love my new job. Sometimes I feel like I don’t make a difference in my patients lives. And maybe that’s true to a certain extent… No ACLS here. No Cardizem drip’s here. No pushing Adenosine to convert that SVT. But that’s OK. Patients don’t die here. I get to know my patients and they get to know me. After work I go home, calm and ready to spend the evening with my family; as opposed to stressed out and ready to go to bed. The decision to leave the bedside in the ER was very difficult for me. But as medicine is changing, and I’m not getting any younger, this really was the best decision for me.
KML says
There’s also the problem of being targeted by your managers and/or administration because you have a brain and a mouth, and you’re not afraid to use either. I worked bedside in the ER and I loved it. But I wasn’t a sheep, which made me unpopular with a new-to-the-hospital manager, so I was involuntarily pushed out, after 10 years of dedicated service to the hospital (in comparison to her 6 months). And administration took her side (even though grievance committee sided with me) – but of course they would – they hired her.
So I left bedside, and now work for my local hospice, which was a great move for me. I miss the ER, but I don’t ever want to work for a hospital administration again.
Jennifer says
I also left bedside nursing for a home hospice job. Best decision I ever made !
Laura Ehlers says
Brie, you have voiced our frustration very nicely. I am coming up on my 32nd year as a bedside nurse – med/surg, OR, ER and now PACU. Different types of areas but all bedside. We are lucky that as nurses we do have the opportunity to move to a different specialty as we get burned out on the first, and this is an important fact to remember. We build on our personal knowledge while bringing fresh perspective to the new one.
You spoke to having a ‘rock star’ staff, some of the time. I completely understand. It is so much easier to be in charge of some teams than others. But it is also important to remember that overall, we are all a team. We have to little in our own control these days, but we can support one another in a positive manner. Congratulate each other on little victories, gently instruct and support the nurse who needs help. Make everyone feel a part of that ‘rock star’ team – even if you have to run in the med room and roll your eyes on occasion. And never assume those nurses who always hold it together are all good. I just got the biggest hug from a co-worker after she got back from a break to find I had transferred her ICU patient to his room. She was near tears she was so relieved and it took me completely by surprise as this nurse never appears frazzled and is always calm.
We can’t implement quick fixes to the healthcare system, it will take a long time to get policy makers to understand that patients also need to be responsible for their own health, but we can do everything we humanly possibly can to support one another.
Don’t take this as a criticism.
I am replying to this after working a 10 hour shift where staff were criticized for wearing ‘team colors’ for baseball opening day, all 3 of our ICUs were full, a staff member was punched in the nose by a patient, we had 5 call-ins and we still managed to move 110 patients through our PACU.
Carol says
I commend you for your beautifully written article, it’s like you were in my head speaking my thoughts I’ve been in nursing for 33 years…31 of them in the NICU and I often wonder can I stick it out another 7-10 years before I can retire. Just as you stated the younger generation don’t stay, they don’t have the same work ethic and as I say often the only thing seniority gets you in my unit is vacation. You have the harder assignments and are woodcuts to pick up the slack. I do want to say there are some exceptions you do have some new nurses that care are eager to learn and push themselves. Us dinosaurs as we call ourselves often wonder what the quality of nurses will be when we get sick and need a bedside nurse. Thank you all for sharing your stories.
charlene peede says
I did bedside nursing in our local hospital for 45 years/I retired in 2015/the stress was the main issue and that stress came from all angles/I just couldn’t take it anymore/I loved my job but not all the so called laws that prevent u from actually nursing
Randi says
Been a nurse 40 years, 34 years on the same unit…..Injured my back in 2003… End result 5 back surgeries, Last surgery was ALIF, with posterior Lumbar lami fusion L5-S1 cage and TPS…Each back surgery has resulted in reducing my hours….R/T chronic back issues. I Currently work one 12 hr. shift per week as charge on a surgical unit…I love nursing and very much so miss bedside care….You are correct HCAP’S is killing nursing…All the documentation IE computer charting and audits it’s overwhelming!! It’s sad what is happening to this profession…. More time is spent with the so called paperless trail then caring for the patients!!! Political BS is killing this profession!!! And in response to Trish’s comment your team and the teams attitude can make or break your day…. Give me the A players and life is good!!!!!
April L McColly says
Stop the 13 hours shifts go back to 8-10 hours.
Jonelle says
It was somewhat timely for me to read this article since I had a terrible night at work last night. We had no tech, and between the three staff nurses we got an admission every 30 minutes for 4 hours in the middle of the night. I wasn’t even done with my first admission when I was told I had another one coming up and then was trying to be both nurse and tech to the patients I already had. For the first time in my life, I almost fainted because I’m 7 months pregnant and was helping to hold a patient for a procedure and started sweating and seeing spots. I realized at that point I hadn’t eaten in almost 10 hours and literally had not gotten to sit down (even to chart) for over 3 hours. Everyone kept telling me to go take a break, but with no one available to relieve me what was I supposed to leave undone so I could eat something? The scheduled narcotics on my new admission sickle cell patient? My bradycardic patient on bipap who had IV meds around the clock and whose schedule would be completely thrown off (not to mention the “ding” I would get on an audit) if his meds were late? My newly admitted, dehyrdated infant who took over an hour to get an IV in and who needed IV fluids stat? My patient whose vitals were due almost 2 hours ago? Not to mention the last 4-5 hours of charting that had not been completed. I try very hard to handle my own workload but finally told one of the senior nurses that I was drowning, but so was everyone else so no one could do anything to help. This is just not physically sustainable, and I’m in my early 30s. The saddest part is, in my 10 years of bedside nursing this is easily the best of the 3 hospitals I’ve worked in- and all 3 have had Magnet status.
Lois says
After reading all these comments, it makes me feel better knowing my feelings are not alone…it also makes me sad for the same reasons. I have been a bedside nurse for 40+ years and have never wanted out any more then now…all the reasons lay in the comments above. I’m tired of the fight to be with my patients…tired of being told I have a bad attitude for not agreeing with every new idea made by those who don’t have to implement these ideas, tired of being a dime a dozen. Being a nurse has made my life so much more than anything else I could have done. I have loved it and I know I was made to do this and am grateful for this enriched life! Saying that, retirement never looked so good. I gotta add that computer nursing needs to be done by computers, not people…just sayin
spritualseeker1 says
After 20 plus years in an emergency room, I have burned out physically, mentally and emotionally. My health has suffered due to twelve hour shifts at a constant run to keep up with my patient load that continues to increase with sicker and sicker patients. All you get is, ☆ sorry we are eliminating the weekend positions and if you want to have full benefits you now need to work an additional 12 hour shift to be considered full time or pay prorated rates . Oh and we will no longer be providing coffee for the staff, and no pay raise for a couple years in a row. There is no cafeteria available to night shift. The lack of compassion blows me away. The increase in the amount of NON nursing care, like the amount of education and competencies, meetings and commities takes more and more time away from my familyI’m out! Now working at an urgent care center, 8 hour shifts and less sick patients. No more greedy hospitals for me.
Kerri Weber says
I know exactly what you’re saying. I’ve been a nurse 14 years. 9 of those were at the bedside before I left to be a full-time nurse educator. I did spend a few months in a PRN position at an LTAC last summer and I thought that job would kill me or render me physically disabled. I look at the undergraduate students I teach and I know that the majority of them are already planning their graduate degrees because they aren’t impressed with what they see in clinical. They see overworked, burned out nurses who want to take good care of their patients, but are limited by the restraints placed on them by administration. The question is, what can we do? We all know that nurses are the largest group and could be the most powerful group in our country if…IF we speak up. But, we rarely do it when it counts. Look what happened when we were outraged at The View’s treatment of a Colorado nurse. Where is our voice when it comes to the issues affecting us at our workplace? We have a serious issue with corporate greed running health care. What would happen if nurses went out and got higher degrees in management and leadership? What would happen if we were the ones who took positions of power in health care facilities? I’m continuing my education because a DNP in Executive Leadership could be the key to affecting change. I’m only one person, but if enough of us work towards it, we can make a huge difference in the way health care is handled.
Andrea Carey says
Good luck to you all! I have been an RN for 52 years….retired 4 months ago and will retire my license. It was great…but not always easy. My husband was military and I worked in many states and did volunteer and patient Ed in foreign countries. It was great! I will miss saying “welcome to the world little one”. But I cherish the the times I held a hand to soften the pain or worry of a patient or family member. Keep the faith. you
Tony says
As the proud Dad of a excellent RN, I pray and shed tears for all in the nursing field. Y’all put your family on hold to love and care for others.
If any of you are in the field just for the money, please find that desk job. For the vast majority of you that aren’t, like my daughter who has wanted to be a nurse since she was 6, great may your reward be in heaven. Keep fighting the good fight and finish the race. YOU are loved and appreciated by many of us! My heart goes out to you all! God bless you!
One proud “Daddio”
Joyce33 says
Tony, you are wise. Your words are a bright spot for all who are hurting here.
Alex says
Your article hit nursing right on the head. After 10 years in bedside nursing, I left nursing completely and started my own business. Best decision I ever made.
Mary Murray says
I worked as a Term Nursery nurse for over 30 years, most of those years were very part time PRN. I homeschooled and my family comes first! I loved the babies and was very good in my role. My hospital kept making changes to policy that benefitted the permanent staff and negatively affected the PRN staff. Most of the times when I agreed to work for another nurse, I was pulled to another unit. I was NEVER oriented to these other units and never felt comfortable working on them. I got to the point of telling those who asked me to work for them, No, which was still my choice! The way I was treated after so many years of experience was deplorable! The coldness of middle management was disgusting! In an email announcing yet another assault to policy, they said if we didn’t like it, they would understand if we left!!!! Totally inflammatory and unnecessary statement! So, I am in a new career entirely! So happy to be gone from there!!
Max says
My gf is a nurse and just sent this to me. Heartbreaking to hear all your accounts of the job and how tough it is on you.
Can you not put pressure on union to make deals with hospitals to employ more nurses (get down to 8 hour shifts) or at very least have the union convince these hospitals to get POWs?
She works at the new Humber River hospital… All these fancy million dollar gadgets, $10,000 beds… But no money to pay PSWs? The greed is astounding.
But seriously, PUT PRESSURE ON YOUR UNION. Things need to change!
Thais B Winmill says
I left bedside nursing as a Telemetry nurse after 3 years. I had an amazing staff on night shift, 6-7 patients, and a nurturing environment. I burned out from shift work really fast, burned out from day shift consistently complaining that “we didn’t do anything at night anyway” so why wasn’t x, y and z done. But ultimately what drove me out was hospital politics: my pay at hire was $21, 3 years later it was $22; we were constantly harassed about Press Ganey scores and readmission rates; being involved in the hospital and doing improvement projects without being compensated for it; and heaven forbid you wanted time off! I am 4 weeks away from graduating with my FNP degree, I was accepted into NYU. When I told my night supervisor I’d be leaving in April since school was starting in May all she asked me was if I could stay until June so it would be a full three years of me being there so it wouldn’t affect their new grad retention rates. No congratulations, no we’re excited and proud of you, nothing. All she cared about was damn retention rates! I miss my coworkers and our team. My best friends are two nurses I worked with and we’ve now been bridesmaids to each other. My bedside nursing time will have be filled with amazing memories of the nurses I actually worked with, but forever stained by the horrid management and feeling unappreciated.
Lisa says
Thank you Brie for speaking so beautifully for all of us. As I read all of these stories and comments it seems it has all been said. But I just wanted to reply with a perspective from north of your border. Here in Canada we don’t have the insurance companies paying our wages but our taxpayers. Most days I am grateful for our Healthcare System and am proud to be part of a nation that entitles everyone to Healthcare. But our system is broken. And as almost every commenter has said, it is us nurses at the bedside who carry the burdens of fatigue and frustration at no longer having the privilege of providing our increasingly acute patients the kind of care we feel they deserve. Having spent 27 of my 30 years in Critical Care I have had the honour to work with an amazing group of dedicated and highly skilled professionals. Our unit was staffed with a majority of nurses who have spent 20+ years looking after the sickest of the sick. I have spent over half of my career preceptoring and often recruiting those same nurses. I have loved my work, felt proud of the care, compassion and expertise delivered to those in our care. But, like everywhere else, we are aging and our backs, necks, and shoulders are giving out. I suffered with acute and chronic neck and back pain for 10 years before my body said “no more”. And like a puff of smoke, my knowledge, and dedication meant nothing. I became a “liability” an “attendance problem” And was subjected to repeated harassment and threats by every level of management, organizational health, and Human Resource
Mary says
I have been a floor nurse my entire career. First on a med/ surf unit for 15 years and now on a trauma unit for 7 years. I love floor nursing! I was born to be a floor nurse but hospitals need to look at retention. I have maxed out on pay raising so no more raises for me I do get a bonus check each year instead of a merit raise but it is not much. Other than taking care of my patients there is NO incentive to stay! Short staffed shifts has made education myself on Safe Harbor a must for mine and my patients safety. I have been grateful for the electronic MAR but the electronic charting is a bust. It used to be faster than paper charting but now with so much that has to be charted it takes twice as long( even on good internet exception days). I see the new grads come out and be great til they get stressed over staffing issues then they leave. Staffing ratios need to be followed! Just because we have emty beds does not mean we have staff to care for the patient that upper management demands goes there! Sorry for the rant but I love bedside nursing and it’s getting harder due to the demands on nurses in this day and age! I am and hopefully will be til I retire a bedside nurse!
Helen Brom says
Nicely written article. I have been a bedside nurse for 42 years. MedSurg and ICU. I have worked all over the country and have seen the same issues over and over again. The minimal staffing, managerial bullying, institutional pressure, under trained staff, and personal degradation. These issues are not new and nurses leaving the bedside has been an issue since I started nursing. We are pressured on all sides to take on more roles, work faster, get more education, and above all please the customer. Above all at work I please my patient by giving them the best care I can, getting more practical clinical education to better care for them, work hands on at my patients pace, work with all other disciplines for a better patient outcome, and support the families within the framework of the patients experience. Within this profession of nursing I have been treated like an hourly factory worker for 42 years. I have served as a unit educator for advanced care practices, medical chart review, case management, quality assurance management, research project participant and leader, unit manager, and new graduate preceptor all while doing my daily bedside nursing job. I am sure that everyone has experienced that. I do not know of another profession that demands this much from its members. Nor do I know of another profession that uses threats and intimidation the way nursing does. My only validation of my value is within my patients eyes, my bedside colleagues gratitude for my instruction before they leave to sell real estate, and within myself. I have left the bedside due to a foot surgery that despite healing has left me unable to walk well enough or long enough to do shift work. In attempting to find a non bedside position in nursing I have learned that since I do not have an advanced and expensive degree and no other certifications I am not qualified to do paperwork. It has been a long road to a very disappointing end. I am grateful to all the patients I had the opportunity to care for and all they and their families taught me about life and myself. It is a shame that nursing itself never stops and looks to what we really are and strives to make patient care and those who provide it the priority. It is a shame that nursing continues to feel the need to justify itself by creating a continually self serving hierarchy and bowing to the bidding of the corporations.
brieann.rn@gmail.com says
Thank you so much for commenting.