We are three years into a pandemic and there has been a surge of nurses leaving the bedside and the field all together. A survey completed by Incredible Health shows that 34% of nurses plan to leave the field by the end of 2022. A similar survey by Nurse.com found 29% of nurses plan to leave. The similar numbers are frightening especially when compared to the same survey from 2020 that resulted in 11%. The number of nurses leaving the career has increased from one-in-ten to one-in-three, but why?
#1 Burn out and mental health
More and more nurse now more than ever suffer from burn out and mental health. The last two to three years of a pandemic have increased in patients sicker than any others and death became a daily component to the job. Most people go into the health field wanting to help people. Several years of death have taken its toll on the human psyche. Nurses report increase anxiety and stress at work. Davis et al. reports that US nurses and Physicians have a risk of suicide that doubles that of the general public. In recent news two Californian RN committed suicide, in Spring of 2022 one nurse shot themselves in the supply closet during their shift. In spring of 2021 a nurse left their ICU unit to get something out of their car a few day later their body was pulled out of the water. Mental health is a huge problem and needs to be acknowledge, our mental health in our country is in need of work, but if you or someone you know is struggling, please reach out for help.
#2 Continuing Education
One way nurses move away from the bedside is continuing their education. An Associates will get you a position, mostly everywhere. Some facilities require higher degrees to enter into management. I have known nurses who only have their Associates and are fine their whole career. One way many nurses propel both career and income by going back to school for a Master’s degree, PhD or DNP. Either of the graduate degrees will find positions away from the bedside at a hospital or out patient clinic under a physician. Both positions of Nurse Practitioner (NP) or Advance Practicing Registered Nurse (APRN) helps with the growing demands for Primary Care Provider.
#3 Staffing Issues
The post pandemic US has staffing issues everywhere, from retail stores, fast food and sit down restaurants, and the hospitals. Every hospital has dealt with the financial crunch of the Pandemic in different ways. Staff from all over the hospital, tech/CNA, phlebotomy, respiratory, radiology and house keeping/janitorial staff, are all short staffed. Every member is imperative for every patient. When a hospital has 500 to 1000 or more patients with only 2 phlebotomist in house, blood will not be drawn in time and patients that STAT draws or a code or trauma takes priority and will lead to delay in care. On the units the tech/CNA assist the nurses with all aspects of direct care. When the CNAs have thirty patients to take vitals and care. Patients will get a basic care. Nurses come in with a higher ratio of patients and have to do the care necessary, whether that blood draws or even cleaning a room for a new admit. The less staff in a hospital means more pressure and stress for the nurse to get through their shift and care for their patients.
#4 Ratios
Let’s talk ratios. There is so much research that shows smaller ratios improves patient care. Nights with four patients are more efficient and productive than those with five or six patients. Our population is increasing in age, the baby boomers born between 1946 and 1964 the majority of that generation is 60 or more, with the youngest joining them in 2024. People today are living longer with more co-morbidity and those that stay in the hospital are more complex and sick. When ICU has 1-to-3 or 1-to-4 ratio, Med-Surg 1-to-6 or 1-to-8 and nursing homes 1-to-25 or 1-to-60 in extreme cases. What care can be done in an 8 or 12 hour shift with one nurse taking care of six surgical patients, or one nurse to twenty-five residence. The nurse is only able to pass medication and tend to the most acute patient. Nurses get tired and care gets missed. Burn out is a large factor that nurses deal with when it comes to staff ratios.
When one-third of the nursing force planning to leave, what does that mean for nurses. Work environments may get worse before it’s better. The increase of an aging population, in 2011 65+ was 41 million as of 2019 71 million. Another million nurses are needed to help this decade long shortage. Other than the addition of nurses our medical system is in need of an over haul. There are seven states that mandate a staffing committee, and only one state that holds legal ratios. A Med-Surg nurse will have max of 4 patients with a flex nurse that helps in 15-minutes and 30 minutes breaks. More attention needs to be placed in mental health. Therapy in the US is hard to find and keep up. Burn out is a real thing and hospital need to re-evaluate staff retention.