You’ve all seen the memes by now, and chances are even if you aren’t a nurse your feed is full of nurses ON FIRE. Recently, a video snippet of Senator Maureen Walsh of Washington was released of her discussing nurses complaining about being tired working 12 hour shifts even though she bets they play cards a majority of their shift- and let me just say her comments certainly didn’t slide to the side, as they shouldn’t. Since I didn’t see the entire video, nor was I present at this conference, I am unsure of what the motive was behind her words or what her advocacy point brings- I like to think her initial intentions were good. 12 hour shifts are hard and we are tired and do I personally think 8 hour shifts could benefit both nursing satisfaction and patient safety- maybe, and that is appropriate table conversation in my book. But whether we agree or disagree on that aspect, it seems pretty clear that the general consensus of how she went about it was less than inspiring. Nurses bottoms are appropriately roasted on the topic, and I can’t hesitate to advocate from the other side and simply offer some perspective on why nurses are complaining and why nurses are “tired”, and straight to the point- why nurses stop nursing. I can tell you the hours are minuscule in the grand scheme of nursing shortage.
We all know mental health is devastating our populations- secret’s out. It is debilitating and while we persist to find resources, we still greatly lack. Depression alone affects 9% of everyday citizens, but interestingly enough according to the Robert Wood Johnson Interdisciplinary Nursing Quality Research Initiative (INQRI) in 2012 with Letvak as a key researcher, clinical depression affects 18% of nurses. Nurses, who are just regular humans might I add, are glorified into the healthiest, most resilient beings. In addition, media and TV shows portray nurses working at 2:00 PM, well rested with adequate times to their families and loved ones. On the hallmark channel the nurse gets off work before dark to go home on Christmas Eve- and we all know the ending, she kisses the boy. Here’s what the world needs to know: nurses are suffering. 100% of nurses are not playing cards at work, and 18% of nurses don’t see life in general in the cards for them solely because of their work life. Here’s what those 18% of nurses wish Senator Maureen, and many, many others in a position of change would talk about instead.
Everyone hears about a “nursing shortage”. To put it right out there, when I applied for nursing school I was turned down by a grand majority because of a “wait list”. Nursing schools were “too full”. Nurse practitioners are now “over saturating the field”. So let me just outright say that the nursing shortage is not because of a lack of nurses becoming nurses, it is because of a lack of nurses remaining nurses. Why? Nurses get great pay, great benefits, and are always compensated for their hard work both in words of appreciation and cash bonuses, right? Let’s fascinate that idea for a while, and ask ourselves then- if nursing is what the general public makes it out to be, why don’t nurses want to stay nurses? Why is double the nursing population clinically depressed in comparison to that of the overall human population? What’s under the surface?
I’m glad you asked.
Nurses deal with some serious stressors. No- I’m not talking about one nurse who’s not doing anything with their aggressive workload asking “do you have the swordfish” and then the other nurse who’s avoiding their patient decompensating says “no” and then everyone knows who has a swordfish. Not that kind of stress. Nurses stress includes shift work leading to severe work-life imbalance (Maureen is on the right track), role stress, heavy workload, clinical duties, managing critically ill patients (IN ALL SETTINGS), low support and recognition from family members, moral distress, and conflicts with managers and coworkers. According to the Journal of Critical Care Nurses, this amount of stress leads to medical errors, depression and absenteeism, and SUICIDE. If that simple fact isn’t knocking you to your knees reading, I don’t know what will.
Let me hit you with some more shattering facts. According to a journal article in Nurse Leader the 2008 National Sample Survey of Registered Nurses showed that 466,564 or more than 15% of registered nurses are not employed in the nursing profession. In addition, it was found that 31% of nurses who still were already had extensive plans within the next 1-3 years to remove themselves from the profession, and in a survey conducted by the International Council of Nurses in 2009 nearly 50% of nurses reported they had no desire to remain in nursing. Sure, families and tides changing in a person’s life may have some contribution to these numbers, but it is naive to assume that only those components make up these alarming statistics. Nurses themselves have reported what makes them leave the profession. Here they are: salary, career aspirations, role conflict, burnout, job stress, environmental issues, work demands, colleague support (or for better terms, a lack of), bullying, verbal abuse, understaffing, supervisory relationships, and on top of that they still have to go home and make dinner and be responsible beings in the external world as well. This isn’t an abrupt decision, these aren’t abrupt changes. These complex issues have been formed over time- long before even I entered the profession.
Let’s get back to the bullying and verbal abuse- two things that really get my goat in the human world. Nurses get abused verbally (oftentimes emotionally, physically, and even sexually, too) by patients, patients families, interdisciplinary team members, and hold my drink- BY OTHER NURSES. In fact, according to that same article in Nurse Leader the most common source of verbal abuse is from one nurse to another making up for 80% of interactions, and with an additional 20% of verbal abuse from those in a managerial role. It doesn’t take a rocket scientist to determine that that surely contributes negatively to job satisfaction and the quality of patient care provided. Additionally, new nurses are the most likely to receive abuse from others. So tell me, would you put on a smile and stay put? The answer- WE TRY.
You’re next statement might be- if you’re that unhappy then leave.
And the nurse says, good call- I’m out. And unfortunately, alongside that one are many, many others. Not that big of a deal right? Wrong. Ask 98% of nurses and they will tell you that when nurses leave the acute care setting, patient care goes in the hole (while those left are still held to unrealistic standards via patient surveys), and another large chunk might tell you that when nurses leave all this does is make other nurses follow.
How do we even have nurses then?
Because nursing is not rational. It is emotional. It is a calling. Nurses know the work is hard- that’s not what’s off-putting. Nurses are not leaving hospital settings because they are lazy, nurses are not leaving because the standards they are held to is irrational, they are leaving because their love for caring for others has been saturated with politics and because the system asks them to see patients as consumers. They are leaving because they are utterly exhausted from the inside out. They LOVE nursing. They LOVE people. And whether they remain in acute care or not (or even nursing as a whole), they always will. They are giving up their families, their weekends, their holidays, their sleep, their sanity, their health, their entire quality of life to fight a system that feels so flawed even duct tape can’t fix it. And duct tape can fix ANYTHING.
So yes, nurses are TIRED Senator Maureen. Nurses are not playing cards. Nurses are saving lives. And unfortunately, nurses are also losing their own lives at the depths of depression, anxiety, and from just plain being TIRED. Please don’t fail to recognize that.
Light & love.
Gellasch, P. (2015). The Driving Forces Behind Nurses Leaving the Profession. Nurse Leader, 13(5), 63–68. https://doi-org.ezp.waldenulibrary.org/10.1016/j.mnl.2015.01.001
Sun, J., Bai, H., Li, J., Lin, P., Zhang, H., & Cao, F. (2017). Predictors of occupational burnout among nurses: A dominance analysis of job stressors. Journal of Clinical Nursing, 26(23–24), 4286–4292. https://doi-org.ezp.waldenulibrary.org/10.1111/jocn.13754