I love my job, but it was about to break me.
I have been an ER nurse for almost seven years. For some of you, that may seem like no time at all. I have met many a veteran nurse who has been grinding at the bedside for 20, 30 and 40+ years. I applaud you. You deserve to be knighted. Our healthcare system survives because of your perseverance and expertise. #careergoals
The rest of you might be thinking – “Dang! She’s been an ER nurse for SEVEN YEARS.” Seven years probably seems like a lifetime to those of you still in school or recently starting your nursing career. The truth is that seven years is kind of a long time to be an ER nurse. Emergency department nurses have one of the highest rates of turnover within all of the the nursing specialties – an impressive 21.1%. Per a study completed by NSI Nursing Solutions, many emergency departments will turnover their ENTIRE RN staff within 5 years.
Why are nurses leaving so quickly?
- Low Salaries - Nurse salaries vary widely across the United States. However I started in rural Georgia at a whopping $20.13 per hour in 2011. Even after a whole lot of overtime, there was no way that I was going to pay off my student loans from nursing school in less than 10 years. While I loved my hospital and my job, I left and moved to California where I found myself making a much more competitive wage. This allowed me to pay off my student loans in less than 3 years and has already set me up better for retirement. While my story is just one example, it is one of many similar stories that I have heard where nurses cannot support their families on their full-time job's earnings. And the situation for LVN- & ADN-prepared nurses is even more difficult in many states. Lives literally depend on our work. It costs a lot to get our education. Nurses should get compensated accordingly.
- Staffing Issues - Unless you have been living under a rock, you know that there is a national shortage of nurses. Many facilities are trying to get creative with staffing, which sometimes leads to unsafe nurse-patient ratios. This increases stress on staff and increases potential for unsafe patient care. The U.S. Department of Health and Human Services states that "Hospitals with low nurse staffing levels tend to have higher rates of poor patient outcomes..". Good staffing is good for nurses and patients alike.
- Stress - Healthcare is becoming more and more concerned with time. Nurses now have to do everything faster, while still ensuring perfection with every task. Medicine does not look favorably on errors. The essence of nursing is fast, efficient care that people's lives depend on. If that's not stressful, what is?
- Abuse - Nurses experience all kinds of abuse. Period. Verbal, emotional and physical, there are few days on-shift where I personally don't get the joy of one of these. This has to stop to keep nurses. The American Nurses Association (ANA) has a campaign called #EndNurseAbuse that is working to decrease the amount of abuse that nurses encounter in the workplace. In addition to the loss of nurses, the ANA cites that the financial cost of workplace abuse of nurses is $4.3 billion annually or about $250,000 per incident. Healthcare has to address this problem if they want to end the nursing shortage and improve patient outcomes.
- Nurse Burnout - Burnout is physical, mental and emotional exhaustion caused by stress, often being suffered by "helping professions", such as nurses. With all the abuse and stress that nurses are facing in the workplace, is it any wonder that they are experiencing burnout and leaving the bedside?
How my job almost broke me.
Like I said earlier, I love my job. Sometimes, I love it too much. I am a fixer – a person that wants to get in there and find a solution to all the problems. I want to fix my patients. I want to fix my colleagues' problems. I want to fix all the issues in our department. I want to fix all the challenges in healthcare. I want to take it all on and solve the problems, so that everyone can be happy and healthy.
A few years ago, all of that almost crushed me.
All of the things that I was trying to fix led to increased stress and major burnout. I didn't have wa healthy work-life balance. It was all work. All I could think about was work problems at home, when out with friends and family, or laying awake in bed at night. I wasn’t sleeping. My health was poor. Things were not going well for me.
I decided to take a vacation from nursing.
There was a point when my husband and I decided that I needed to take a break from bedside nursing. I needed to be away from patient care. I didn’t need to be going to any meetings. I needed to not be at the hospital. I had to take a big step away.
I made some changes. I started working on that vacation.
Over the course of a few months, I started slowly taking steps to get away from work. Every time the Charge Nurse asked if someone wanted to go home early, I volunteered. I started asking the PRN/Per Diem staff if they wanted to pick up my shifts. I took some personal days. I started looking for a part-time or Per Diem position. When a Per Diem spot finally posted at our other campus, I applied and took it. I started in a new emergency department, not on any councils or committees. Just as a bedside, Per Diem RN.
And then, I took some time off.
I traveled. I hung out with my friends. I took time to explore the world of nursing. I gained some perspective and a new appreciation for my profession. The idea for New Thing Nurse started to cook in my brain. I grew as a person and as a nurse.
I got my nursing groove back.
This plan won’t work for everyone.
I know that it is not possible for everyone to say BUMP IT to your full-time job and suddenly go rogue as a Per Diem nurse. However if you are feeling the symptoms of burnout, you need to make a change. Untreated stress and burnout will lead to the end of not just your nursing career, but also can manifest as physical and mental health issues. I have talked about my mental health journey before. It is no joke. You should do regular self-assessments of how you are feeling. Take the time to take care of yourself if you want to be successful in all things.
Things that you can do to combat nurse burnout –
- Take a vacation. - This can be anything from a few days off to a several week adventure. The main thing is that you GET AWAY from the clinical environment. Don't check your email. Block the short-staffed text messages. Give your brain some time to forget about patient care and focus on self-care.
- Find some quiet. - Do you dream of alarms going off? Pumps beeping? Your zone phone ringing to deliver another critical lab? You need to get out of that mindset. Find some quiet. Engage in silence. Breathe. Meditate. Take a nap. Just find a place where there is no beeping or buzzing going on that will take your mind back to the bedside.
- Exercise. - The mind-body connection is real. Your brain needs to be well for your body to be well and vice-versa. Exercise helps you manage stress. It helps you feel physically better. It is good for you. I am not saying to jump into an Iron Man, just encouraging gentle exercise. Try to move a little, and see how it makes you feel.
- Eat well. - You body needs to good calories to have the energy to do all the things. Try to avoid processed foods and soda. One of my favorite dietary tips is - "If it wasn't in the kitchen when your great grandmother was cooking dinner, don't eat it." Try to stick to fresh things that look like real food.
- Get enough sleep. - Sleep is foundational to everything. If you are not getting enough, you will be testy and experience increased stress. Everyone has their own sufficient, minimal amount of sleep, but always try to get that amount every night. If things are getting in the way, triage your tasks and find time for rest. It is essential.
- Appreciate yourself and others. - It is time to remember how amazing you and your team are. Take a moment to appreciate yourself and others. My department recently started a Shining Star Award and are picking one person a quarter to give it to. The winner gets a pack of Starbursts and their picture up on the staff fridge. It's not a big deal, but everyone so far has thoroughly enjoyed knowing that their work is appreciated.
My Current Vacation from Nursing
I am currently on another vacation from nursing. I have been calling it my August sabbatical. While I am still working on New Thing Nurse projects, I am only working three shifts in the ED this month to give myself some time to take care of the projects and myself. I continue to LOVE my job and think that I am a pretty awesome nurse.
But - I have come to recognize that time away from the hospital is just as important as time at the bedside to ensure that I continue to be the best nurse that I can be.
- Sarah @ New Thing Nurse
