In a time of patient satisfaction scores, fear of litigation, and working in environments that are concerned about the proverbial “bottom line”, it is time to start treating our nurses better.
At the ripe age of 30, I have spent the better part of the last 10 years employed in the hospital setting. I started my nursing career as an LPN. It didn’t take me long to see that I wanted more from my nursing career than taking vital signs, administering pain medication, and generally being abused by my patients.
While working night shift on a telemetry unit, I pursued my ADN. It was hard work but I was triumphant. I continued working night shift on the same unit after earning my RN; however, I started to get sick repeatedly and ultimately required a tonsillectomy. My doctor issued me a warning: get off of night shift or keep getting sick.
It was easy to blame it on the lack of sleep. In retrospect, it was a combination of a lack of sleep, increasing nurse-to-patient ratios, and always worrying about metrics – how long had that urinary catheter been in place? How about that IV? Had I inadvertently missed a post-op antibiotic in the allotted 24-hour time period?
So, I posted to a day shift position, thinking it would solve my problems. In reality, it didn’t change anything because in addition to most of the past problems, I was also dealing with more cranky doctors and families who understandably wanted the best care for their loved ones, but were often cruel in their pursuits. (For example – “I’m writing down EVERYTHING you do and say!”)
At the age of 27, I left bedside nursing because I was exhausted. I have since earned my bachelor’s degree and some extra letters behind my name (certified diabetes educator – CDE) and I’m still working in the hospital setting, but as a patient educator.
I am passionate about the direction my career is heading; however, I may have never taken this direction in nursing if I hadn’t felt so overwhelmed at the bedside.
I went into nursing to take care of patients in their worst hour, to offer encouragement during times of trouble, and compassion during times of sorrow. Instead, my days were filled with constant worry – did I pass my meds on time? Did I change that IV? ANOTHER admission? Every time my manager called me into the office, I was worried it was about a patient complaint. It was a good day at work if I left at the end of my shift knowing I could do the bare minimum and hadn’t left too much work for my relief.
So…what could potentially bring me back to the patient bedside?
In my naivete, I thought for a long time that my facility was a bad place to work. After all, we were (and the bedside nurses still are) working mandatory overtime and there was a continual influx of new nurses because the facility doesn’t retain their staff. Then I heard of a family member in another part of the country, spending the night on a stretcher in the ER hallway. It was then that I realized, this is not just a problem in my area, this is nationwide.
There are a lot of things that could be done to fix this broken system. I will always believe that keeping the patients happy is priority number one because they are the reason we all went into nursing. However, keeping nurses happy in their place of employment is important as well. This can be done in a number of ways.
Imposing standardized nurse-to-patient ratios would be a great start. Currently, the only state to have standardized nurse-to-patient ratios is California. In 2014, the American Nurses Association (ANA) did a literature review regarding safe staffing and patient outcomes. It should come as no surprise that in areas with safe staffing ratios, patients fared better in all areas compared to areas with unsafe staffing ratios. For example, “A study determined that seven additional lives would be saved for every 100 patients if nurse numbers increased from four to six per bed.” In addition, a study performed in California after the passage of their staffing law; this study compared nursing satisfaction between 2004 and 2008 ad found that the nurses had an increased job satisfaction.
Which brings me to my next point. Happy nurses = happy patients. Even if standardized nurse-to-patient ratios are not imposed, finding ways to show appreciation for nursing staff is a good start! I’ve found that some facilities appreciate their nurses during one week of the year– Nurses Week. We all love Nurses Week celebrations, but recognizing the good work we do on a daily basis is important. It doesn’t have to be a big show. Often it feels like nurses are called into the office only when a patient complains or a medication is missed. Call us in the office for a job well done too. Buy the staff pizza or cake after an especially hard shift, or just get in the habit of saying “thank you.”
Retaining nurses is also an issue. I continually felt like I was training a new nurse, just to watch him or her leave when a better opportunity came along. Hospitals should also be celebrating the nurses that stay.
When our healthcare system is so concerned about the almighty dollar, it is hard to focus on the happiness of the nursing staff; however, it is a necessity, not a luxury.