Not long ago, city bystanders would erupt in applause during shift changes as healthcare providers exited and entered hospitals. Their applause signaled gratitude for the healthcare heroes bravely battling the front lines of the COVID-19 pandemic.
Nurses (RNs, LPN/LVNs, and UAPs alike) became the face of heroism. Instead of flowing capes, nurse heroes donned scrubs covered by paper jumpsuits, masks, and goggles. The public recognized that nursing is a calling, a deep-seeded passion for helping humankind. This was never more evident than in 2020.
But there is a dark side to being a hero. The same passion that ignites the fire of heroism is also its kryptonite. With the name “hero,” nurses are often expected to overextend. The more nurses are touted as heroes, the easier it becomes to justify short staffing, low resources, and a lack of adequate compensation.
In the middle of this heroic battle, nurses have discovered their boundaries. I am one such nurse. A 10-year veteran of labor and delivery working beside an amazing, rapidly shrinking team of nurses, I am proud to be an advocate for my community. Because nursing is not just a calling — it’s a profession.
What are nurses’ most pressing pain points?
Hospital systems may be taking employees for granted when they launch major marketing and public outreach programs or initiate billion-dollar renovations during a staffing crisis.
Leaders should consider that nurses might feel disrespected or underappreciated when their hard work or self-sacrifice as “healthcare heroes” appears in hospital branding. Inside the hospital, nursing units might realistically be a cauldron of stress and anxiety.
Healthcare industry organizations have surveyed nurses and related staff to discover the biggest issues and solutions that may exist as a large percentage of nurses threaten to leave the industry. Let’s focus on the biggest nurse pain points.
Stressful work environment
A survey of 1,800 nurses conducted by Fierce Healthcare revealed that 39% of nurses reported a stressful work environment, and 53% reported that there was insufficient staff to meet patient needs. Similarly, a connectRN survey found that nine out of 10 nurses believed that the quality of patient care was suffering due to nursing shortages.
Not being able to provide care to patients that meets our nursing expectations is disheartening and frustrating. It does not align with our calling as nurses.
As the end of a shift looms, my colleagues and I look towards the ceiling and thank the ‘OB gods’ for a hemorrhage that was not worse, a shoulder dystocia that easily resolved, or a C-section successfully performed because we simply did not have enough staff to circulate, scrub, ‘catch the baby,’ and monitor other laboring patients at the same time.
Misplaced pay allocation
Relias’ Nurse Salary Report evaluated 2,516 nurses and found that nursing salaries are up approximately $5,000/year post-pandemic compared to 2020. But Nurses are still demanding increased compensation. Nurses from the Fierce Healthcare survey stated that they needed increased pay and work incentives to stay in the field (86%).
Travel nursing and flex nurses have been a saving grace by offsetting the current staffing shortage. But these programs come with a price, literally.
The Nurse Salary Report indicated that 90% of hospital leaders hired travel nurses in 2020. Travel and flex nursing is known for high pay, which happens to be the number one motivator for becoming a travel nurse, followed by dissatisfaction with management and desire for flexible work schedules.
Staff nurses and travel nurses can successfully help manage patient care. However, the staff nursing community is angry with a system willing to pay travel nurses two to three times more in hourly wages. This does not even include the extra time required for staff to orient the new nurses to charting systems and unit logistics — uncompensated, of course.
How is it that the hospital can choose to afford these nurses when their in-house staff is demanding higher compensation? These ‘band-aid’ actions may stabilize patient care, but they are not stabilizing the nurse staffing crisis or enhancing professional satisfaction. Wouldn’t it be better to find a compromise in pay that can lead to higher retention levels? Don’t overlook the nurse heroes you have on staff.
Nurse burnout and turnover
The Fierce Healthcare Survey reported a 35% nurse burnout rate, while a Scrubsmag.com survey reported a 50% burnout rate. These high figures indicate nurses may continue to seek employment elsewhere.
The Nurse Salary Report found that 29% of surveyed nurses were considering leaving nursing by the end of 2022, an 11% increase from the previous year. Nearly half of new grad nurses are choosing to leave the profession within two years. Astonishingly, of the staff intending to stay, 47% are open to new opportunities though not actively seeking them.
Reported nurse turnover rates vary from 20-30%. The massive turnover of veteran nurses leaves a huge knowledge and experience gap. These statistics are unsustainable in the healthcare industry. They are proof that the staffing crisis is not improving, and something more needs to be done.
How to retain nurses
Many changes that nurses desire would need to come from a corporate level. However, some changes could come from nurse leadership to boost nurse satisfaction.
The Nurse Salary Report found that 75% of nurse leaders know that the emotional health and well-being of their staff is a top challenge. Nurses testified that their relationship with a manager was important (59%). Discontent with their manager represented one of the top reasons for a switch to travel nursing.
Nurses are also calling for:
- Flexible scheduling to attend training or educational seminars
- Opportunities and support for career advancement
- Stronger management training
- Transparency and communication with nursing leaders
- Advocating on behalf of nurses to hospital executives
Listen to the nurses. We have made our demands. According to the Nurse Salary Report, factors that would motivate nurses to stay are:
- Higher pay
- Better support for work-life balance — for example, mental health services, encouragement of using personal days, and streamlining processes
- More reasonable workload
- Better benefits, such as merit increases, bonuses, tuition reimbursement, and profit sharing
- Improved regard for nurse safety
- Better manager interactions
Tellingly, Scrubsmag.com reported that hospitals that have invested in burnout reduction programs spend 36% less on recruitment. Strategies include:
- Financial compensation for mentoring or precepting new nurses
- Mandated patient-to-staff ratios
- Equitable workloads
- Educational opportunities with reimbursement
Nurse heroes will remain, but it is important to remember that nurses are human. We are exhausted and frustrated. We feel slighted, underappreciated, and at times even outraged. The calling to be a nurse is clouding, and our compassion is dwindling.
Nursing is at an incredible turning point. Beautiful lessons often come out of suffering and heartbreak, and the current nursing crisis is going to be no exception.
The passion is still there, pushing nurses forward, willing us to call loudly for better pay, adequate staffing, more resources, and management that is truly invested in something other than the bottom line.
We nurse heroes will then rise, boundaries set and demands made, so that we may continue to compassionately serve.
Addressing Retention Concerns for all Healthcare Professionals
We brought together a panel of experts to discuss some of the most relevant topics to today’s healthcare industry. During this session, panelists addressed ways nurses and employers can work together to reduce burnout and moral injury while improving safe practice, retention, and team satisfaction.View webinar →