What Do You Think? –Are We Working Nurses To Death?

Did that question grab your attention? It sure did mine as I was scrolling Facebook and came across a nurse friend's shared post. The title grabbed me and I instantly spent some time reading the article as well as our mutual nurse friends' comments which all seemed to agree that sadly the answer is yes, we are working our nurses to death.

One part, in particular, stood out and it's a subject all nurses can attest to: staffing levels.

"Minimum is maximum staffing,” Letvak says. “We don’t have any easy days anymore. If the [patient load] is low, which happens all the time, they send the nurses home, instead of them having a light afternoon. How few do we need? That’s all that you’re getting. Every time you are at work, it is a bad day. There really isn’t a chance of having a lighter day anymore.”

Other highlights from the article include:

  • "Nurses do the work that neither hospitals nor patients could live without, which comes at an ever-increasing physical and emotional cost, as they are expected to aid sicker patients for longer hours with less support."
  • "Nearly a quarter of hospital and nursing home nurses aren’t satisfied with their jobs, according to one study, and more than a third feel burned out. “Burnout is an occupational hazard in nursing,” says Jeanne Geiger-Brown, dean at Stevenson University's School of Nursing and Health Professions. “It is hard to generate a lot of caring about other people, because you are so depleted yourself.”
  • “What’s causing the overwork is the increased acuity of patients,” says Susan Letvak, a professor at the University of North Carolina at Greensboro School of Nursing. “You are only in a hospital if you are so acutely sick that you can barely move. The minute you can move, you are kicked out the door.”
  • "The push is to get everybody out of the hospital as fast as we can,” echoes Bernadette Melnyk, dean of the College of Nursing at the Ohio State University and the university's Chief Wellness Officer. Melnyk and her colleagues recently published a paper that shows depression among nurses is associated with both burnout and medical errors."
  • "How does the quicker and sicker approach add up for nurses? Physically, it means the shifts themselves are much harder, especially since shifts are often twelve hours to begin with, which itself is a risk factor for burnout and mistakes in a place where patient alarms are constantly sounding. “It’s not healthy for the nurses, it's not safe for the patients,” Melnyk says."
  • “Minimum is maximum staffing,” Letvak says. “We don’t have any easy days anymore. If the [patient load] is low, which happens all the time, they send the nurses home, instead of them having a light afternoon. How few do we need? That’s all that you’re getting. Every time you are at work, it is a bad day. There really isn’t a chance of having a lighter day anymore.”
  • "Overworking nurses extinguishes their lifesaving impact. Aiken and her team have shown elsewhere that every ten percent increase in the proportion of nurses with bachelor’s degrees lowers the risk of death for patients by five percent. A study by a different group found that a 10 percent increase in registered nursing staff saves five lives for every 1,000 people discharged. (If five saved lives doesn’t sound like a lot, try replacing “five” with five names of your loved ones.)"

 

You can read the article in its entirety here. Take a look and then add your thoughts in the comments section below.

 

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38 COMMENTS

  1. Try working in a nursing home taking care of 23 to 28 patients…
    Co morbities, obese mental health issues drug and alcohol abuse
    Sometimes with 10 diabetics
    You do all the meds tx assessments and charting….
    With no help..
    The CNAs have 12 to 15 patients a piece..
    Yeah we are getting burned out but not as bad as in a nursing home….

  2. I have been an RN for 30 plus years – and yes – nurses are being worked to death! The sad part is, nobody cares. When you fall over dead, they will kick you out of the way – and forge on. I work in critical care, and I am the “last man standing” as far as being a “knowledgeable, wise, skilled, senior nurse” – all the other older nurses have retired or moved on. We hire the young ones – but, they only put up with the crap we do for a couple of years and then they move on – or find completely different careers. They are smart, and not putting up with it. The turnover rate is ridiculous! The nursing shortage is only going to get worse and the BIG question is: “Who is going to do this job in the future??”

  3. It is an entire system failure. For profit healthcare is a conflict of interest… from the direct care to the insurance companies.

    Unionize. Yes, unions have their own issues- but federally MANDATED staffing levels- like the CA model. Don’t leave it to the states. Must be federal mandate. For-profit healthcare systems have the $ to hire lobbyists. We need to unionize and have our own powerful lobbyists. If decision is left to the states- it’s like a divide and conquer strategy. We are fractionated with many diff nursing organizations. So keep the diff organizations since each have their focus- but each back one formed national nurse’s union.

  4. A bedside nurse for 30+ yrs(ICU/PACU) To be honest, I’m not a happy camper anymore. If I could find anything-(someone would pay me close to what I make now)- I’d toss my lisc. in the toilet and walk. It comes down to: Profit vs Care-with us in the middle. I wanted to save the world-way back then(not make administrators rich). Now at 60-Drawing SS and living on potted meat & alcohol- doesn’t sound that bad at all.

    • Well said!! I hate to admit it, but I feel the same. I’ve been a nurse 35+ years as well. I hear nurses asking what will they do at retirement. I can guarantee it won’t be in the nursing field for me!! Seasoned nurses can speak to seeing the decline, the need for the ‘look, or ‘perception’ of ‘the best hospital’, but all at a price: do more with less. We are the legs, the arms, the being of keeping a hospital running but not valued very much. the best rewards are the patient’s whose lives you touch, you connect, you make a difference…and they tell you!

      We use to get catered lunches for Nurse’s Day, Doctors greeting us at the door or turkeys for holidays. then it went to we’ll plant a tree in front of the hospital in honor of; then we got pizza for lunch. Not that I’m not appreciative, but Oh! how things have changed! Now even nurses 2-5 yrs out are leaving the hospital
      Since staff nursing, I have done case management, worked for Hospitalists group and insurance companies and I can tell you it’s no different anywhere else.
      I’ve resolved to be true to myself, my ethics and morals and do the best I can for my patient/client/member. Come on retirement!!

      • Mark and Terry –
        I too am in the 30-35 year range as a RN and like you I channeled my knowledge into non-clinical work – first in Public Health Emergency Preparedness and now in teaching (non- nursing) at a university. However, I do remain clinically active in a part-time position where I do health assessments or volunteer to mobilize for disasters. I am grateful that my positions leave me in the position to work for many years in the future and still enjoy what I do.

        L.A. Nelson MS RN NHDP-BC

  5. I can already feel the burn out after working for almost 2 years in a hospital system that gets the sick of the sick because “we’re one of the best.” Our patients are mostly surgical stepdown patients but we’re not considered a step down. We recently changed our staffing grid and it is really hurting our nurses and patients. Most of our nurses are 5:1 on day shift and 6:1 on night shift. I work 3 days plus one day of overtime a week because that’s the only way I can pay all my bills. I’m so tired I can’t even enjoy my limited time outside of work. I feel unsafe and like I can’t spend any time taking care of patients. It should be a discretion of current staff to send a nurse home. (Which never happens on our unit anyways). It’s time to start taking the power out of the corporate hands and back into the people doing all of the dirty work.

  6. After a particular my hard shift in the ER, being short staffed as usual, I left work exhausted. I fell asleep driving home, and woke up just in time to avoid hitting a cement median. When I got home I wrote out my resignation. 34 years in the emergency department was enough. I wound up teaching clinicals in a nursing program. I love it. No job is worth killing yourself for.

  7. I am a home health nurse and can also relate. We get very sick patients out of the hospitals. Usually they can’t even get up to the bathroom without help. It’s really scary. We have even less resources available in the home. If a patient goes home with no one we are scrambling to get the social worker out there immediately, usually on a Friday afternoon late!!! The patients suffer the most.

  8. Sadly all the above is true. I have been a nurse for over 27 years only to see things like “nurse burn out” go from minimal to extremely common! My own solution is to just say, “NO!” to working extra on my off days and “NO!” to having second prn jobs. The extra money would be nice and I would love to help my co-workers out when short staffed(which seems like every day). I have resigned to just working on the days that I am scheduled. I use my off days to rejuvenate, re-energize, and take care of me! I know that might sound selfish, but it is the only way I can survive my hectic days at work and with working short staffed. While at work being totally stressed out, I plan in my mind what I am going to do when I am off. This gives me the energy to give my 100% and make it through the shift. I use to work extra shifts not hardly seeing any of the bonus money or time and a half rate because a lot of it would be taken out in taxes. Plus I’d be too exhausted to even enjoy it! It really didn’t feel worth it all! Now by just working my 3 12-hour shifts I have more enjoyable time with my family and friends. I even manage to get to the gym sometimes. I am working on exercising more regularly. I have perfect attendance and am only committing to the days that I am scheduled. I have great frustration just like every other nurse when I come to work and we are short staffed. There is only so much one nurse can do. I get anxieties trying to multitask and often feel overwhelmed! I imagine that so many nurses feel like this and our just deciding to do something else. For right now this is my solution, try to do my best with whatever my situation is at work, enjoy my time off, and take care of me. Working yourself to death will only cause disappointment and lots of regrets. Once the nurse is gone he/she will only be a memory. The employer will just get another nurse to work in that person’s place!

    • One thing being left out by everyone. Short staffing is caused by people calling off all the time. I went for my MSN as directed. Now I’m barely hireable because I cost to much. Looking for a job? Leave out urgent care PA MA”s only. Your stuck working the job of 2 because of people in hospitals because of those who don’t show up, or driving 200 plus miles a day in the middle of no where to do home care. Heaven forbid they move to town with kids until the crisis passes, nope WE have to cater to them. Nurses are being worked to deatb refardless of the position. The only ones profiting are upper management who couldnt care less. Its all about the buck. You bouce an opinion your gone as a malcontent a new grad hired because “people do die”.

    • I love your comments. You are so true when you say you must take care of yourself. We must do this in order to maintain a healthy mind and body.
      I’ve been a nurse for 42 years. The work we do is more complex and many days can drain you. I too use my off days to revitalize.
      The current staffing levels worry me. Nurses used to stay at a job for years. Not any more.

  9. I gave my body to my profession so yes, we are getting worked to death, including physically. I have been hit and had my fingers & wrist bent back & sprained by patients, slipped a disc lifting 200# + patients (no help in home care), fallen & messed up both knees. I was retired with a failed knee replacement. Do you think anyone in management cared? Nope, just work the next nurse to death. I love my profession & the appreciation from my patients & their families is what kept me going for 40 years. But I am now unable to work in my profession due to my limitations & awful pain, so am forgotten. This is not how I wanted to spend my retirement.

    • This is so sad. Many of my nurse friends and I can relate to this article, and all of the comments about this article. Yes, we are worked to death, or at least to poor health and probably earlier death than if we had not been nurses.
      it is not only hard to be a nurse under such circumstances, but it is scary to be a patient.
      I have read various articles about all of this, and also how older, seasoned nurses are pushed out the door when they hit a high pay rate and/or right before retirement, and are replaced with young, inexperienced nurses. However, is anything being done to change this? What can be done to change this?
      P.S. Nursing Managers/Administrators may be patients some day. Are they going to be comfortable with the care they receive from what they have created – burned out, overworked, exhausted, understaffed, drained, ill, broken nurses?

  10. I was a ICU nurse, my last jobs was in a rural ICU/intermediate unit; I spent over 44 plus years in my career. After my last job, the long commute, only 3 12 shifts a week, and the time of commute pre and post, as well as never finishing up my shift on time of 14-16 hours/days, it became too much. I am a baby boomer, and I hung in there with the new generation , pulled my load and more , was appalled at the care I seen, found, followed in this job. Countless communication to management, in one ear and out the other, they would even complain about the slackness in care delivery and documentation. They would pay you money to work extra but not a salary increase; they hired travelers,then let then go. After a mass turnover of 27 RNs in 30 months of employment, including the nurse manager, turning age 65, I said good bye and wished them well. It saddens me I ended by career on a sour note at my last nursing job, but I had some great experiences and some not so great in my career. It is unfortunate that as a senior I will be at the hands of those whom only do enough to get by or lie with documentation. The future generation of nurses are doomed; money and profit is all it is about now. Good luck future Nurses of America. Shadow, talk with staff before you are hired. A $10,000 bonus for a commitment of 2 years due to the shortage of staff, think about it; if the facility is willing to pay that , then you wonder why the nurses aren’t staying !

  11. I work in a rehab and long term facility and the story is the same. My group I began with is left with just 2 of us out of an initial number of nine. Staffing is a terrible headache, with lots of call outs. This make it just too hard on the nurses available. The burnout is taking a heavy toll on us.

  12. Here’s the saddest thing of all: None of this is new! I will soon have 34 years of it (will NOT be finishing the 35th because, like my middle-aged colleague above- and unlike her, I’m older – my body is virtually done with it). And they keep asking more. Minimum staff IS the max.
    Hospitals say they are ‘evidence-based’ systems, so the evidence being used must be purely economic. Part of this is insurance driven, part is political, and part is greed. We are like the soldiers sent into a made-up war designed to benefit a wealthy few, executing the ‘good fight’ at an absolute minimal cost to them, no matter the cost to us and our patients.
    Though I am glad to soon be leaving, I will still be concerned for my fellow nurses and will always vote to help, and, should a good union come seeking members, I will support its efforts.
    Hospitals and nurses will always be needed. They should not be abused, certainly not for the money.

  13. I have not worked in 3years and it is no better now than then, maybe even worse. First of all most units are short staffed, so nurses end up taking care of more patients than they should. You get called on your day off to see if you can work or you have mandatory overtime. It is too bad organizations do not see the need to try and have adequate staffing. This would increase nurse satisfaction. I worked for 35years and my first years of nursing were very satisfying. I retired early because it was just too much, no work life balance and no one seemed to care. I feel so sorry for the patients. We do the best we can , but there is not enough time in a 12 hour shift to give these patients all they need since we run from one thing to another and never have a minute of time for ourselves.

  14. I work in a clinic. We are understaffed right now as it takes, literally, months to get a new person hired. We are also tasked to work in the lab. Mind you we are RN’s and LPN’s but we draw, rest, spin, separate and bag for transport to the lab the next day, this includes urine, stool, mucus or whatever. We do, finally, have a position advertised for a lab person (I’ve been there almost 3 years and this is the first time they have advertised the position.). Again, from advertise to person actually working in the clinic is usually AT LEAST 3 MONTHS. This takes almost a full day away from our nursing duties but we are expected to keep up with that. We also were just told out providers MUST see 12 patients a day, we have two of them, AND they are told we MUST see any walk in that shows up. We are not an average clinic as the biggest majority of our patients are elderly with multiple chronic diseases that require extensive management of these diseases. We also do teleconferences for our patients such as pharmacy, diet or several other appointments. For that we have to weigh each one as well as do blood pressures. Right now there are 3 RN’s (one the assistant nurse manager) and 2 LPN’s. The manager spends all day doing patient care and stays over every night to do the management portion of her job. Oh, and don’t forget those phone calls! I average 6-10 a day! And we have a program that the patients can send us messages about things they need us to do for them. Our clinic serves over 2000 patients and we are gaining about 2 new ones a day. I go home exhausted, overwhelmed, and ready to quit each day. I pray for retirement as I am almost 61. I don’t want to find another job as nothing else will pay what I get now or I would have to work 12’s in a hospital. I was hospital for 15 years and my beat up body from those years of lifting, pulling, or battling patients has taken a toll. I went into nursing in my late 40’s so I was doing all that physical work on an already aging body. Now, my back is trashed, my shoulders were both hurt at several points, my hips are sore and I really can’t do 12’s like they expect (4 on 3 off at the local hospital). I’m just so burnt out I have to push myself to go to work some days. I’m not one to call in just because I’m exhausted but some days that idea sounds SO GOOD. So, I will do my best to carry on for 4 more years, IF MY BODY OR BRAIN hold out!!!

  15. I loved being a nurse, for 26 of my 29 years ,I worked in the same hospital, mostly critical care. But when I spent more time charting than doing patient care, when physicians were no longer capable or reliable and every day brought 100s of e-mails adding more expectations and hurdles to jump, I resigned.So happy to be out.

  16. It does not matter where you work hospital, dialysis, out patient clinic. The nurse staffing is just getting worse wherever you go. I will not encourage any one to get into nursing unless they want to be over worked, cranky
    and feel like they should have done more. This is not a good feeling.

    • you are right. currently I am in the Hemodialysis unit, working 15 hrs for 3-4 days. A lot of times we are short staffed or if fewer pts left some staff has to go home leaving the rest running around to end the day. Start the day @ 5am but wake up at 3:30 am and go home past 8pm. Sometimes have to go back the next day with the staff so tired feeling like a punching bag for being overworked. Sometimes I want to quit nursing for good. But I’m still hanging on. I love taking care of people but sometimes I need to take care of myself too. My body is my capital for this kind of job. If I’m too burnt out how can I function. It’d be unsafe that’s why I usually say NO if I am asked to work extra. I’ve been working too extra everytime somebody calls off. And I never call off.

  17. CEO’s of non profits getting seven figure salaries plus bonuses. RN’s burn out and leave, easily replaced with fresh grads. Bottom line is all that matters. Overworked and tired, make a mistake and under the bus you go. Scariest word “union”.

  18. Call outs are frequent at my job. If you are the charge nurse and no coverage can be found, then you are forced to work over 4 hours and the charge nurse on the next shift must come in 4 hours early. We are already short staffed to begin with. Our Director of Nursing does nothing to help out on the floor. She does her time, then she’s out of there! She always crams teamwork down our throats! She doesn’t practice what she preaches.

  19. Agree, agree. i used to think badly of nurses that would tell me don’t do it -don’t go to nursing school. Now I wish I would have listened to their advice. It gets worse every year.

  20. This article says it all! There are no more light days , every day is a tough day. it is true we are always operating with minimal staff.

  21. As an Operating Room Nurse, we not only work our full shifts, we are expected to take call nights & weekends. It’s tough working my shift, being up several times during the night, then be back bright & cheery for the next day. Our weekends literally worked one of my colleagues to death: we were on call for the entire 48 hours. My friend had done so many surgeries during the weekend, that she fell asleep on her way to do another case, hit a tree, & died. After that, they cut our weekends to just 24 hours. My surg tech & I started on of our Saturdays at 7 AM, & they kept coming in: we worked straight through to 3 AM, ending with a bypass. I don’t know how we were standing – adrenaline, I guess. I was so wiped out that I turned my pager off after that, though still technically on call 4 more hours. I didn’t care – God forgive me. If anything else had come up, the night supervisor would have to get the next crew in, as we didn’t think we would be in any shape to safely operate anymore. I wish the hospital would pay to have a regular night & weekend staff, not kill us! Sorry I rambled…..I need a nap.

  22. These are the reasons I left nursing, and I was a good one- awards up my arse, but of course no increase in pay! 12 hour shifts are the scourge of nursing- Superman would not be the same nurse at 7am as at 7 pm- lunacy aa it puts lives at risk!. God help the poor patient who tanks at 6 pm!!
    I was in hospital nursing in ICU/Telemetry for 33 years. Every single staff meeting (whenever we rarely had one) was identical- just rewind the tape- nurses screaming about horrible staffing, and management saying they are doing all they can.
    BTW for 26 years, I got NO change in benefits- had the same vacation/holiday time at 33 years continued service, as 5 years- disgusting!! We are in real trouble folks, these smart young people aren’t going to put up with this BS

  23. I just read the title and didn’t really have to go any further because…DUH! We always here about the ‘nursing shortage’. I don’t think it’s as big of a deal than it’s made out to be. I just think we have a huge shortage of nurses who want to work in hospitals because of all the reasons in this article. I have gone into Case Management and now at a state psych hospital. I sometimes miss my days in the ED. 12 hour shifts at a Level 1 trauma center in a city are brutal. Then call outs and covering shifts. It’s not so bad when you are younger, but when middle age comes around, you start to feel what being on your feet working those long shifts does to your body. And this is just the physical side of the job. The emotional toll finishes us off.

  24. Let me just say that staffing to the minimum should be a criminal offense. Nurses are running their asses off, trying to do ten things at once, all of which are crucial to either a patient’s health, life or well-being, or a matter of making sure you and/or your facility don’t get sued, so it’s CRITICAL that you don’t make a mistake.
    You are set up for a huge chance of failure, and then are told how you NEED to manage your time better, or else. No one at the top cares, and everyone as high up as you can complain to, acts helpless to change anything.
    Try making life or death decisions or actions, while distracted constantly, interrupted constantly, exhausted, and with alarms and call lights screeching pretty much non-stop. And staying after work to finish up is “the norm.”
    It is a simple fix. Add more staff. Two more aides and one more nurse to every shift.
    But no. The staffing budget is stripped to skeleton crews, while they plant flowers and replace the parking lot, because “that’s from a different budget!”
    We know the budget started as one pot and was created by someone. It’s a ridiculous problem that is the worst-kept secret in the medical field, and it just won’t change.
    Maybe it’s because when we get “VIP” patients, like lawmakers or anyone who they don’t want to experience the typical call-light wait times, we are given the “suggestion” that this person should be a top priority.
    It’s outrageous.

    • I’ll never forget the time a VIP patient came in with chest pain. The ED was slammed. Hospital was full. The waiting room was full. We had to split a trauma room with rigged up bed sheets. Normally, the person in that room would have been turfed to a hall way or garbage chute or something, but there was nothing left. This patient was so down to Earth. He even asked me if it was like this all the time. I told him it was a bad day, but we have a lot of bad days every week. He got great care and sent a letter to the administrator about it. He asked what he could do to help. More VIPs need to see how things really work.

    • Agree! Well said. A recent job I had in an E.R. told me not to spend more than 10 min with a pt… they said get in & get out & get them upstairs or get them out…it was a motto..sorry, I didn’t become a nurse to increase corporate revenue

  25. Ooooh yes. More so much more is expected of nurses. Somehow people think they can pile the work on and some more on top of that! Administrators don’t listen to staff , they don’t know anything about patients care. Administrators are rewarded for holding back on nurses overtime, and any other benefit because they think it reflects badly on their management, when in fact, hospitals are understaffed, overworked, and unappreciated!

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