Every day, I see nurses who are either changing to nonbedside specialties or leaving the profession entirely.
While there are many reasons to leave any field, the following ten reasons are specific to bedside nursing.
Understanding these reasons can reveal clues for retaining bedside nurses.
Reasons Nurses Are Saying “Bye” to the Bedside
If there are some others that I didn’t mention but you think I should have make sure you let me know in the comment section below. I read all the comments.
1. Not Enough Staff
A recent survey found that 90% of hospital workers think their facilities are understaffed.
While this survey is of hospital workers and not just nurses, it impacts my job because I need enough technicians, nursing assistants, and other related staff to care for patients safely.
Having enough nurses is vital for patient care, but it’s hard to care for patients when you need to restore organization to the supply room, clean equipment, or do other tasks outside your job description.
2. Mental and Emotional Turmoil
Working in such conditions is also hard when you’re surrounded by other nurses living the same life.
No one is as effective when they’re exhausted, mentally tired, and burning out. Even before the coronavirus pandemic, 31.5% of nurses left the profession due to burnout.
Nursing has always been a challenging field. We’re with patients during some awful moments, which takes a toll.
As a fourth-generation nurse, I’m highly suitable for the profession and still find myself dangerously teetering toward burnout at times.
An environment where 73% of us work overtime under such stressful conditions is a real mental pressure cooker.
3. Insufficient Funds
I’m sure I’m not the only nurse who received numerous postcards promising high sign-on bonuses, covered moving expenses, and higher pay during the pandemic.
I’m a real hot commodity these days. One would think I would have plenty of money, and they would be right that the pay is good.
Unfortunately, medical and other expenses related to work and the reduced spending power we all have due to inflation leave me with very little ready cash at the end of the month.
4. High Patient-Staff Ratios
High patient-to-staff ratios are a perennial problem for nurses. In fact, I was surprised that more sources didn’t name them as the top reason nurses leave bedside care.
Even adding one more patient is difficult in a setting where a four-to-one patient-to-nurse ratio is typical. I’ve taken care of as many as 11 patients at one time and can attest that taking on extra patients makes for a long day.
This is true even when you work where there are enough resources to have a stellar support staff.
5. Quality Issues
As with anything else, quality of care suffers when the numbers aren’t there. I know that I’ve felt pulled in many equally urgent directions.
I’ve seen firsthand the power of working as part of a team in a nursing home or group home compared to being a lone ranger in a home setting.
More eyes and ears and more hands and feet have helped me identify issues sooner, resulting in better health outcomes for patients.
6. Workplace Violence
As an Asian American, I’ve faced verbal abuse. Fortunately, I’ve been surrounded by enough people to protect me from physical harm.
As a result, I’m not surprised that the hospital worker survey I referred to in the first section of this post stated that one in two employees had been verbally abused by hospital guests or one in three had suffered violence from patients or family members.
In an environment where patient safety is paramount, it’s more than a bit ironic that I routinely risk my own safety.
7. Physical Wear and Tear
When I was in my twenties, a friend told me that the brother that ended up with me would get a bright, smiling face and a strong back as I moved a solid wood church pew by myself.
I am strong, but even I am not immune to the rigors of providing hands-on nursing care – and I’m not alone.
A study of nursing staff found that emergency department, intensive care, and general nurses demonstrated that they were six times more likely to have hand and wrist issues when they carried a high workload.
A similarly high workload also increased the rates of lower back or waist and knee issues by 3.25 and 2.28 times, respectively.
8. Problematic Managers
As a young nurse, I was encouraged to have a “speak only when spoken to” attitude toward management because they, like insurance adjusters and tax auditors, are not my friends.
This advice came from my mother, and it has served me well. The reasoning is that, at the least, such sharing gets you branded as an informant.
Depending on what you share, you might even lose your job. The hospital workers’ survey found that 40% of workers believe managers ignore worker input anyway, preferring the opinions of other administrators.
So, mom was right, and the bosses wouldn’t have listened to me anyway.
9. Inflexible Schedules
In a time when I and the rest of the nursing universe are emerging from pouring every ounce of energy and strength into work, dissatisfaction with schedules is not a surprise.
When the shift ends, and a relief worker is nowhere in sight, it’s definitely discouraging.
In the days before my state limited mandated overtime to no more than 16 hours of work without an eight-hour rest period, I ended up in a patient’s home for 20-something hours.
Fortunately, I keep emergency soup cans in the car.
Unfortunately, I had spent the morning running errands and spending time with family, utterly oblivious to the extra hours to come.
10. Mergers and Mayhem
As nurses, the organizations we work for make a huge difference. It was wonderful when I found a rehabilitation facility that ran things the way that I would.
I was able to provide care and had the backing of the administration. Unfortunately, nursing home reimbursement hasn’t kept pace with patient costs.
As a result, facilities are closing, merging, or being acquired by larger corporations. Since 2020, insufficient funding has shuttered more than 300 nursing homes.
Since nurses are to care for patients “according to facility policy,” this means that a new company brings changes in how the job gets done daily.
For someone dissatisfied with their position, so many changes can move them closer to leaving bedside nursing for another specialty or another career.
What You Can Do
While there are no fast solutions to any of these issues, many of them start with advocacy.
When my governor announced a $425 million long-term care investment, we all celebrated.
When it came with the stipulation that at least 70% of it needed to be spent on bedside care, I swear I heard the angels sing.
While money doesn’t solve all of our problems, being able to recruit, hire, and train more Certified Nursing Assistants and other staff will help exponentially improve our everyday working conditions.
If you don’t live in Pennsylvania, you can advocate for similar funding in your state by writing your politicians to demand change.
You can also approach hospital administrators regarding higher salaries and better working conditions for your nursing staff.
If you’re a nurse, you can advocate in some other crucial ways. You can read over this list to help focus your efforts toward getting more education or finding a new position.
After commenting, search our job postings or school information areas for ways to improve the field you love.
Have You Read These Yet?
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- What Can a Nurse Delegate?