The struggle to retain nurses confounds many a healthcare administrator, as numerous studies that place annual nurse turnover around 17 percent can attest. For employees actually performing this work, however, the reasons behind this harrowing stat are clear.
Understaffing, low-pay, more high-acuity patients, abuse from peers and leaders, physical injuries and burnout — these factors and a lack of adequate response from administration all drive nurses away from the bedside. But according to a recent Twitter chat, such experiences are just the tip of the emotionally-exhausted iceberg.
Every week, Lessons from the Bedside (@lessonsbedside) hosts a conversation to encourage clinicians to talk about the challenges they face (where to begin…). A particularly captivating one, held in early September, elicited dozens of responses about why nurses decide to end their battle with the bedside.
Below are some of the most compelling stories…
Waning patient safety
A1: For me it was having to do more with less all the time. Constantly compromising patient and staff safety to save money. #TweetRN— Melissa (@MelissaAGNP) September 10, 2019
Charting and auditing and boxes, oh my!
A1: In general, not feeling as though we get to BE nurses: it’s so much charting/auditing/checking boxes at times rather than engaging, stimulating, and patient-centered. #TweetRN— Ari BSN, RN, OCN (@ArianaMasGrande) September 10, 2019
Day-shift vs. night
T1, A1, the system will ultimately make me leave. Yesterday I triaged an older lady on the early shift. She was seen by a nightshift doctor. The lack of beds, short staffing, high acuity of pt’s will eventually cause some sort of fatigue. #tweetRN— Karla (@KarlaMayPeachey) September 10, 2019
School as the solution
A1: I've been looking at going back to school, because I don't think it's normal to work somewhere that you have to worry about different kinds of abuse from your manager, coworkers, patients & their families, and then be told you aren't "happy" enough at work.— CharlieceratopsRN (@NurseChargaryen) September 10, 2019
Did we mention charting?
A1 – so many redundant tasks, too – i.e. why do we need to put daily weights on flow sheet/NP report sheet/kardex/white board/NP weight list and in computer? Why copy what feels like half of our flow sheet onto that NP report sheet when they take both to review anyway? #TweetRN— M (@SabresAndSoccer) September 10, 2019
Feeling your mental health suffer
A1: Agreed with what a lot have said before me, but I find myself knowing my days are numbered due to lack of respect from management/physicians, my toxic work environment, and the high acuity that is working me to death and affecting my mental health #TweetRN— ICU RN troll (@icu__troll) September 10, 2019
Where does the PTO go?
A1: too much documenting, having to put in PTO months/1 year in advance, bullying from nursing peers— Charmy (@heycharmy) September 10, 2019
Pay the physical toll
My Mister retired from icu nursing after 26 yrs bc his back was too badly injured to continue moving pts, pushing beds etc. Hopefully, ergonomic improvements will keep more nurses providing bedside care. Injuries from doing our jobs add to the problem of nurses leaving.— NeuroNerd (@superneuronurse) September 10, 2019
Minimal job flexibility
I would have to do my full 40 hours plus weekends/holidays to keep bedside. With small kids, that wasn’t really an option.— Evidence-based Karen (@karendgibbs) September 10, 2019
A little R-E-S-P-E-C-T
Having my work life dictated by non-nurses who say patient care is priority but really it’s not. They don’t respect nurses, they abuse us. I’ve been at bedside for only 8 years and I’m currently looking for something else. I simply can’t go on being abused. #fern #er— Hot Lips Houlihan (@theOGFlo) September 11, 2019
Don’t quit your day job
Moral distress in all its forms, increased acuity with decreased staff, abusive families, and right now our biggest issue is that there’s a 3+ year wait to go to days. People are leaving rapidly as they decide they want a day job. #a1 #tweetRN— NICU RN (@nicunurselife) September 10, 2019
The upside is that earning a nursing degree, especially if you go back to get your doctorate or master’s, provides you with opportunities to work in a variety of settings. But the bedside shouldn’t be forgotten.
Join Lessons from the Bedside’s #TweetRN chat Mondays at 9 p.m. ET.