I remember when I was a young girl seeing a cartoon based on the novel Black Beauty, and I still recall the pain I felt in my gut at watching that exhausted horse be abused. Even though it was an animated version of one of God’s creatures, when I saw that poor horse whipped I wanted to cry. It was just tired! It had gone as much as it could, and as it lay collapsed on its front legs its driver continued to beat it hoping it would get back up and work harder.
Sometimes that’s how nursing feels.
It may sound melodramatic, but if you have ever been at the end of a mental rope at the critical care bedside you might know exactly what I mean. In the midst of the rush to bring a very sick person from the brink of death you reach this chasm where you are certain you can perform no further. Your brain is frazzled, your bladder beyond full, your tummy empty, and your patient load overflowing. And just when you think you might be finally seeing the light at the end of the tunnel, perhaps in the way of an empty MAR or a blood pressure at last compatible with life, you hear in the distance, “we’re getting one from the ER!”
Some days it never stops, and the only reprieve for your sanity comes in the form of the oncoming shift to relieve you. Even then you stay after completing your charting, trying to make sure you didn’t miss a mistake, but watching the time so you don’t get reprimanded for staying too late on the clock.
And if you’ve ever been contacted at home regarding an error following one of those really crazy shifts then you’ll know exactly where I’m coming from with this post. Somewhere along the way the powers that be have decided that nursing is so tolerant and broad shouldered that it can withstand the weight of more than it should legally carry. The nursing profession has more handed to it that it can realistically handle, and then it’s given a little bit more. Like a child’s poorly constructed tower of blocks, one by one another piece is added to the already unsteady tower, yet everyone wants to get wide-eyed in shock when it all comes tumbling down.
We’ve known for a very long time, at least since the beginning of things like reimbursement and satisfaction surveys, that nursing has far too much on their plate. The ratio of sick outweighs the staff, the baby boomers are mostly retired, the nursing shortage continues, and documentation becomes more and more with each passing week. It’s no surprise hospitals are understaffed, yet no one thinks a thing about how much is slowly being piled upon the bedside nurse. Until something adverse happens, that is. Then everyone takes notice.
I remember when I used to swim in college, and our coach would have us tread water in the deep end. He would begin to toss us these rubber bricks to hold. More and more to see just how much you could take. Your egg-beater legs would begin to fatigue, your breath would quicken, and your head would slowly start to sink. After all, you can only tread water so long.
Eventually you either get out of the pool, or you drown.
After being in the same bedside setting for ten years I’ve seen more people exit the “pool” than I care to count. Some don’t even make it a year. But I can’t really say I blame them. Remember the horse I mentioned above? That poor beast could only go as far as it physically and mentally could go. No matter what task it needed to complete, it hit a breaking point. We all do. Sadly that’s the downfall of nursing. You can love it all day long, be called to the profession in a lovely, awe-inspiring way, but even the nurse who adores his/her job the most is still a human being with limitations. There are limitations of time and also what one can endure physically, mentally, and emotionally. And that’s not even hitting on the subject of human error when those limits are pushed too far.
Most of us just keep swimming, praying that we won’t sink. For some there’s this straw that finally breaks their back, and for a former coworker of mine, that’s literal. He now walks with a limp, slightly hunched over.