Recent Survey Sheds Light on Healthcare Burnout, and I Agree With It

Healthcare in the United States was in a state of crisis long before the pandemic hit. Understaffing, burnout, chronic stress, and low compensation rates were driving clinicians away from direct patient care.

COVID-19 accelerated the mass exodus of bedside providers. Daily news reports showed overcrowded hospitals and exhausted clinicians.

That raised the questions: Will there be nurses and doctors to care for me if I need to go to the hospital? How long can our healthcare system stay afloat if the outflow of weary professionals exceeds the inflow of new ones?

A Recent Survey Reveals Healthcare Professionals’ Thoughts

A July 2022 Bain & Company survey showed that one-third of US physicians, nurses, and advanced practice providers are shopping for a different employer, and 1-in-4 want to leave healthcare altogether. Of those who stated they plan to leave healthcare entirely, the most common reasons cited were:

• Burnout

• Personal health and safety concerns

• Concern for the health and safety of family and friends

• Financial insecurity

• Inadequate resources needed to provide quality patient care

The survey excluded the vast sea of other professionals who keep a hospital running, such as pharmacists, respiratory therapists, social workers, physical therapists, or dieticians. I can attest from my working relationships with many of them that they would likely agree with the sentiments expressed in this survey.

Why I Left Hospital Nursing

I believe these results because I left bedside care before the pandemic. I loved the ICU's intensity, quick pace, and collaborative culture. I also took solace in providing dignified care at the end of life. However, I did not feel I had the resources to deliver the level of care I felt my patients and loved ones deserved.

Hospitals task bedside providers with increasing responsibilities amid increasingly diminishing resources. I’ve heard countless anecdotes from nurses who higher-ups have reprimanded for not attending to hospital-imposed low-priority tasks (such as updating your patient’s whiteboard) while they are actively fighting to keep another patient alive.

My fellow ICU nurses and I frequently had to take on three patients (instead of the standard two) due to understaffing. One day a physician jokingly asked me if a three-patient assignment was the new normal for our unit, and the only safe response I could think of was, “I don’t have a diplomatic answer for that right now.” (I fully admit that I lose my sense of humor when I’m under stress. Ask my husband.)

California is the only state to have mandated nursing staff ratios, even though evidence suggests that lower nurse-to-patient ratios improve outcomes.

It was not usual for me to eat breakfast at 5:30 in the morning and not get to eat again until 3:00 in the afternoon. When I did get a lunch break, it was often a rushed attempt to reheat my food and inhale it between crises.

And don’t even get me started on the Joint Commission’s stance against having water bottles at the nurses’ station!

How Do We Keep Clinicians at the Bedside?

A wise nurse once told me our hospital’s policies were “penny wise and dollar foolish.”

Hospitals have historically failed to recognize that it is cheaper to retain staff than to burn out the people you have who keep showing up. The cost of replacing an experienced ICU nurse can be as high as $64,000, compared to the median salary of $77,600 per year for a registered nurse in the United States.

Unfortunately, hospitals often miss the mark in their efforts to show staff appreciation. Instead of addressing the core issues driving people away, they often provide useless tokens, such as yard signs, t-shirts, mugs filled with candy, or pins.

Clinicians who responded to Bain’s survey felt these improvements could effectively decrease staff turnover:

• Higher compensation

• Adequate resources to provide the highest quality of patient care

• A reasonable workload

• Greater flexibility in scheduling

Improving Health Equity and Reducing Healthcare Burden

There are also larger societal issues that impact health and healthcare delivery, called social determinants of health. These include:

• Economic stability

• Education and literacy

• Health care access

• Access to nutritious foods

• The ability to exercise

• Clean air and water

Lack of transportation prevents some from attending routine, preventative, or follow-up appointments. An individual living in an environment that triggers their allergies and asthma will not feel better from more inhalers and antihistamines. A patient who is unable to afford their medications for heart failure or diabetes may have to return to the hospital more frequently. Someone who lives a distance from a grocery with fresh fruits and vegetables will have a difficult time adhering to a low-sodium diet. All of these factors cause vulnerable populations to be sick more frequently, adding a burden to the healthcare system.

I agree that practitioners must be fiscally responsible and judicious in the care they provide, but operating healthcare under a traditional business model incentivizes profits over patient care.

I believe that putting people first is a vital first step to fixing our broken healthcare system. We need to fix social inequities that make it more difficult for many to maintain wellness. But we also must create an environment in which healthcare providers are able to focus on patient care instead of burdensome and arbitrary mandates.

Is It Time For a Change in Your Nursing Career?

A few months ago I was listening to a nursing podcast. The host was interviewing a nurse who had used her nursing background and expertise to start her own health-focused business. She said she had come to realize that she loved nursing, but she hated her job.

As contradictory as that statement may seem, it rang true to me, and I suspect it would to many other nurses, as well. Burnout is an all-too-real phenomenon in nursing. Compassion fatigue causes some nurses to become jaded and less effective in their jobs.

If you have been a nurse for some time, how can you decide if it might be time for you to consider a professional overhaul? Here are a few signs of burnout that may signal a time to take your career in a different direction.

You dread going to work. Most people do not jump out of bed with excitement at the prospect of going to work each day, but if you find yourself feeling anxiety over the simple thought of stepping foot in your place of employment, it is time for a change.

I accepted a position on a medical-surgical unit out of financial necessity. I knew when I started that my assignments would include up to 8 patients at a time, more in total if you count the ones who were discharged and then immediately replaced with new, sicker admissions. I hated every day of that job. I felt like I was simply walking from one end of the hallway to another, completing tasks between putting out fires. I left that job for an ICU position at another facility. A year and change later when my father-in-law had surgery at my previous hospital, I felt my heart pounding, hands shaking, palms sweating, and breathing becoming more labored as I entered the building. Yes, even though I was no longer employed there, my body still had a visceral reaction to the immense stress I felt there every day.

You know you could be happier in your workplace if certain changes were made, but feel no hope that anything is going to ever get better. Everyone has ideas on how their workplace could improve, but many feel like there is little hope anything is ever going to change. Employees in many facilities are solicited to give input, most of which never transpires into meaningful change. If you feel this way about where you work, a different environment may well be the answer for you.

You find it difficult to put on a smile and present a professional front in spite of your frustrations. Most of us try our absolute hardest to be professional in front of our patients. We save our griping for the nurses’ desk, out of earshot of patients and visitors. But if you find that you are complaining in front of patients or family members, or to them, you may need to stop and reconsider if you are ready for a change.

Your job is no longer compatible with your lifestyle. Just as the earth’s seasons change, so do the seasons of our lives. Working night shift was great for me as a brand new nurse, but once I got married, I did not want to be away from my husband three nights a week (and he didn’t fare well with me gone, either). I also struggled with the repeated 180-degree turn in my sleep routine as I neared my 30s far more than I did in my early 20s. Once I became a parent, I no longer wanted to work 12-hour shifts, not seeing my child for days on end some times. Many nurses decide to return to school for advanced practice degrees and need more flexibility in their work hours. A new job with a different schedule may help to alleviate such conflicts.

If you are interested in suggestions for alternative nursing career options, check out this blog post from MotherNurseLove blog writer Sarah Jividen, RN. She explores eight different roles for nurses outside of the hospital bedside setting.

One of the things I personally love about nursing is the wide variety of options available. Different specialties are suited to different personality types and lifestyles. In my next blog post, I will add to Sarah’s list of options for nurses who are searching for something new and different.

Why I Am Grateful for Social Distancing During Coronavirus

“Ugh,” I thought to myself when I found out my child was going to be home from school for three weeks. Then three weeks turned into four months, and I realized we would be settling into a new daily reality. Despite my initial reaction, I have found many reasons for joy and gratitude during this time.

We are staying safe and healthy at home. I am so glad I get to stay at home with my son right now. I feel great respect and deep concern for workers who have no choice but to leave their homes. If I were unable to work from home, I would be fearful every day, not just for my safety, but for my family’s. What if I were to transmit the coronavirus to a member of my household, or fall ill myself? Who would watch our child? My husband is working from home exclusively right now, but that doesn’t mean he is available to care for our child’s constant needs throughout the day, and we can’t ask our family to watch him without risking the spread of COVID-19.

We started recycling. There is a recycling center in our town. It has been here for years, but we never took advantage of it. Then one day I found a large, empty box, and we began filling it with recyclable items. We were surprised to see how much accumulated in just one week.

We planted a garden for the first time since our now-six-year-old was born. We had one every year for the six years prior to that, but once our child came along, we didn’t have the time, energy, or inclination to plant and cultivate it each spring. This project began partly as a means to occupy our time and partly as a science lesson for our son. He helped his father build the garden, and then he helped me plant the seeds. Now he waters the plants each morning, and every day we watch excitedly as the seedlings begin to sprout.

We are spending less money at the grocery store. I resisted ordering groceries for pickup because I like to comparison shop and select my own purchases. When ordering groceries for pickup became our safest option, I found that we were spending less money overall. Sure, we may be paying a little more for a dozen eggs or a gallon of milk, but I am only ordering what we need for the week and avoiding impulse purchases in the store.

We spend more time talking to friends and family than before. We had a Zoom meeting with extended family in another state that we rarely see. Prior to quarantine, we would not have thought to schedule a group video chat. Our son asked if he could see one of his friends, so I scheduled a virtual play date with his mother.

Our son resisted the writing assignments that came from his school. Getting him to focus on them was a daily battle of wills. He did, however, express an interest in writing letters to his grandparents, cousins, and aunts he had not been able to see. I asked his teacher if he could do this in lieu of his assigned writing worksheets, and she enthusiastically agreed that this was a suitable alternative. Our relatives loved receiving them.

We are spending more quality time together as a family. I asked my son if he misses school or would rather be at home together. He put his arm around me, replied that he’d rather stay at home, and my heart melted. The memory card in my phone is rapidly filling up with all the pictures I have taken to capture the fun and special moments we are having together: daily walks through the neighborhood, playing hide and seek in the yard, snuggling up together to read, board games, dancing in the living room.

Has our time together been stress-free? Not at all! I have yelled at my son for running around the living room while he was supposed to be concentrating on his schoolwork, gotten frustrated with the increased amount of mess around the home, and wished every day for just one hour of uninterrupted time before I fell asleep. We are relying on Netflix, YouTube, and Nintendo to survive, and I don’t feel guilty about it.

In spite of the challenges, though, our family has thrived during this time of quarantine. We have learned to work together in a completely different way than ever before. I have enjoyed watching my son grow and learn under my tutelage, even if I can’t match the expertise of his college-prepared and decades-experienced teacher. I will miss the chaos, listening to my son sing, and all the extra times a day I hear “I love you, Mommy.”