In honor of Nurses Week, I am writing out the top 5 fears and concerns I have about my beloved field and what these fears mean for non-medical folk. I’m sure there are variations on these points depending on the facility/hospital/unit, but maybe this will still be pretty relatable. You’re not a nurse? Well, this is still important because if you or a loved one ever becomes terribly ill, these are the conditions your nurses may be working with. And that impacts you directly.
- We’re dropping like flies.
The field of nursing doesn’t have the longevity it used to. For one, it is so physically back breaking that it is not sustainable to be at the bedside for a whole career anymore. Not to mention that the pay is so dismal, that most of the nurses that come to work in the ICU are using it as a stepping-stone to get into gaduate school. Lastly, I know of facilities that pay upwards of $10/hr more than other facilities, which cause nurses to run in droves to where the money is. There are tales of many ICUs in several hospitals that have lost over 20 nurses last year, which is typically about 25% of a unit. Which brings me to my next point.
- Who is considered “senior”
Every unit has a seniority list, which is the list that shows how many people have been on the unit longer than you. This is crucial when getting small perks that are based off of said seniority. That is nothing short of frightening. That means there are only 18 people on my unit who have more experience than me! Some days it’s no big deal, but sometimes if I sit and really think about it, it’s insane. It’s not just my unit. Remember in point #1 where I said everyone is going to graduate school? That’s in all the ICUs, so now you’ve got babies teaching babies.
- New Grads
Love me some new grads. After all, they are the future of our profession. However, it scares me when a unit has a staff that is over half new grads. It is hard to give them all adequate assignments, it’s hard on the preceptors who don’t get relief from teaching, and it’s hard on the new grad to not get the attention/time they need. You see, to handle the staffing crisis, the answer is to shorten the orientation time so we can get more warm bodies on the floor. Not to mention that we use new grads to replace the nurses with 10, 20, 30 years of experience, which is just mind-boggling. They are not the same! It is not a 1:1 trade! Back in the day, new grads had to fight to get into the ICU; they had to be the cream of the crop. Nowadays, it seems like a bus load gets dropped off every other month and it’s a bit much.
- H is for Hotel
As JACHO, Medicaid, and management try to promote family-centered care, the way that care is given is changing. How many nurses know the struggle of trying to accommodate families who keep asking for 5 blankets and 4 sodas before you’ve even finished your assessment? I have helped care for a deceased patient where we had to ask the family to move their pizza party from out of the room (and off of the foot of the bed) so that we could finish our care. The motto says that it should be patient-centered care, but it seems like we are expected to put on appearances for everyone else first in the name of getting a good satisfaction rating on a scorecard.
Incentive pay has long gone away, that is, the extra money for coming in extra. It doesn’t seem like much, but that incentive pay did do a lot for morale and to bring people in the door. When staffing ratios are pushed to the extreme in order to keep beds open, the burnout ratio is rising. Couple this with the fact that more than a half million nurses are expected to retire out of the field by 2022, forget the nursing shortage crisis- it’s about to be an epidemic.
I will say that everything isn’t negative. I love my patients. Making a real difference in someone’s care is an incredible feeling. Getting to advocate for them? I’m on top of the world. I admire my coworkers and some of them have become my absolute best friends. There’s nothing that bonds people like a code (blue or brown- it doesn’t matter). But these fears are very real fears, both as a nurse and as a patient. I worry that I won’t have enough help or be able to have the ideal scenarios to give the best care possible. I worry as a patient that myself or my family members will have longer wait times or be more likely to fall through the cracks because the workload is too much. I don’t have all the answers for what needs to change, but maybe we can start a dialogue today. Let us know in the comments what you have noticed. Are these issues the same in other fields or in other parts of the country? This is so important because nurses are in the rooms around the clock and are the last line of defense for the patient. Nurses are educators and advocates. And I’m proud to be a nurse.
Happy Nurses Week.