Last (Wo)Man Standing

COVID Fatigue

I can only speak for nurses and incorporate what I have experienced, but we do not want to hear that you are tired of wearing a mask, not being able to go on vacations, or not being able to go out drinking. The truth is, we all are sick and tired of everything - how the pandemic was addressed, and how politicized common sense has become. COVID rates are on the rise, people are getting sick, and hospitals are filling up to capacity once again and we have not even made it to the Fall.

The solution is incredibly simple: get vaccinated (if medically cleared to do so), wear a mask, and don’t be an idiot. Are those three steps that hard to follow? For Americans, it truly feels like pulling teeth. For what it’s worth, it is better to be vaccinated and receive partial immunity than zero immunity; everyone looks better wearing a mask; and this Fall is not just going to bring COVID, but all sorts of respiratory infections which were held at bay due to social distancing and wearing a mask.

As medical advancements are researched, the human lifespan is prolonged (despite the average lifespan for Americans declining last year, but that's' neither here nor there; that's just due to a failing healthcare system and people who do not adhere to medical plans of care). The longer people live, the more comorbidities they acquire, which leads to the need for more medical interventions. This inevitably causes them to become even sicker and more difficult to medically manage than what the healthcare system faced a decade ago. What I am trying to say is that hospitals act as a revolving door for the chronically/acutely ill and are full of very sick patients. Having the hospitals already full of chronically ill patients (who do not necessarily comply with medical advice) puts a strain on resources and staffing. This strain is only intensified with the constant waves of COVID patients.

I feel like we can now compare this pandemic to the wild fires experienced by those out West. The smallest of embers (those infected) just need a bit of wind/accelerant (those unvaccinated) to ignite and continue to burn and spread. As the pandemic lingers on, the infection and death rates rise, staff are jumping ship left and right.

As we are all well aware, 2020 was a very difficult year; not just for nurses/the medical profession, but society as a whole. And due to many variables, including but not limited to: greed, entitlement, capitalism, politics, and just plain stupidity, 2021 and 2022 are not looking to be any better.

Let me break this situation down for everyone tuning in: nurses are jumping ship. They are over dealing with the pandemic and are quitting at an astonishingly fast rate. Having watched literally all of my coworkers leave, I have compiled the most common reasons for nurses quitting right now.

Safety (Staffing)

If you read my last post, you understand the current staffing situation. Let’s throw COVID back into the loop: I have 7 patients at night, 4 of which are COVID patients who need constant monitoring and medicating as they are at a very high risk of decompensated respiratory and heart failure, 2 of my patients are aggressively and violently going through alcohol withdrawal, and my last patient is a cancer patient undergoing chemotherapy. This is a common occurrence and not a hypothetical situation. Out of the 7 patients, 6 of them are completely unstable and at risk for harm or death. The constant running in and out of rooms, donning and doffing PPE, and sanitizing can only get you so far. As a nurse, I am inadvertently spreading COVID from room to room, patient to patient, and putting my “clean” patients at risk for death; this scenario is happening all over the world. It is disheartening, but when you are not allocated the appropriate resources (i.e. staffing or PPE), you are doing the best you can to provide the highest quality of care that you can to all of your patients.

With the trained staff leaving, the new nurse residents/newly graduated nurses take their spot, and back-fill with travel nurses, where is the mentorship? To whom is a new nurse to go to for advice, for when their patient is declining in health, or if an emergency occurs? The travel nurse could have as little as one year experience; they are not trained enough to understand how the individual facility operates or necessarily have the solutions a nurse with 20+ years of experience would have. The new nurses and travel nurses have their hands tied and it’s a safety concern for them and their patients.

I will literally be the only cardiology-assigned nurse who is going to be working nights; most of the night-shift floor nurses have left for other opportunities, and on top of that, our manager and assistant manager quit as well.

The ship has no captain or first mate at this point and it is only getting worse.

“We Don’t Have it in the Budget”

Hospital administrations use this phrase all too often. Why not increase the pay for staff and incentivize them to stay? We don’t have it in the budget. Why not hire more staff to fill the holes and reduce the strain on the current staff? We don’t have it in the budget. But I guess it is okay to hire contracted workers for 13 week contracts at more than double the current hourly rate of a full-time employee? How is this fiscally justified?

Travel nurses came to the rescue in 2020. But hospitals are still continuing to utilize them as their base staff despite them being temporary/contracted workers. The average floor nurse at my hospital makes less than $4,000 a month. The average pay for a traveler nurse at my hospital makes more than $4,000 a week (and that is on the low end, as I have seen others make over 8K a week).

We do the exact same job, and yet get paid pennies; it is no wonder why everyone wants to become a traveler.

If the opportunity arises for me to jump into traveling, I will gladly take that leap.

So, regular staff are beyond stressed, overworked, and severely underpaid; they quit and take outpatient nursing jobs or become travelers. Hospitals hire temporary nurses at insanely high pay-rates to replace their seasoned regular staff, creating constant turnover and an unsustainable fiscal operating practice. As seasoned staff leave the hospitals, the only people who are left are new graduate nurses and contracted workers. The new nurses are seeing what the current staff are going through and are quitting before they even reach the end of their probationary period.

The Pandemic

Facilities are not fully equipped to provide effective care to the massive surges in COVID patients; ICUs are smaller units for a reason (to provide continuous monitoring to patients on the verge of life or death). As the ICU beds fill, other units like med/surg, cardiology, and oncology take on COVID patients. Limited resources like negative pressure rooms and ventilators lead hospitals to triage patients and allocate the sufficient resources to the patients who have the best probable outcome. The regulars are filling the hospital, and COVID patients are dumped on top of that; it is impossible for a system to function at such a capacity.

One would think that the healthcare system would learn from the initial onslaught of this virus and be more prepared (i.e. resource allocation) for the next massive surge; from my point of view, this does not seem to be the case.

Also, for some reason, despite some nurses experiencing the immense death and tragedy head on, they are protesting and quitting/being fired instead of getting vaccinated against the very virus they are trying to fight. Some nurses even compare this mandate to the rights being taken away from those who were Jewish in Nazi Germany...ummm excuse me, that’s a little extreme, don’t you think?

This is the complete truth and not my perspective: those who are vaccinated are less likely to get COVID; if they do get COVID they are less likely to experience a fatal outcome. Those who are unvaccinated have a high chance of experiencing adverse health outcomes and will most likely die. Almost all of the patients I am caring for now, who have contracted COVID and who are unvaccinated, end up being ventilated and a good majority of them die in the ICU.

Burnout

Nurses are leaving bedside nursing in droves; and I do not blame them. At this point in time, this job honestly sucks. I have gone from enjoying my job, saving lives, and working to make lasting positive impacts on the lives of my patients to having constant anxiety attacks, counting down the minutes until I clock out, and praying that all of my patients make it to the end of my shift alive.

The amount of death we see and stress we undergo is immense.

If medical professionals did not have mental health issues before 2020, they certainly do now. This, along with the amount of stress, unsafe working environments, constant 16-hour shift mandates, and little pay is what is leading nurses to jump ship across the board.

The staffing department constantly calls nurses at home, who are on their day off, asking if they can come in to pick up a 4-hour shift. 4 hours, that’s nothing, why not go in? The issue now lies with the fact that the staffing department is mandating those who volunteer to come in and help out on the floor for 4 hours, to work an additional 4-8 hours. So you’re going to punish someone who volunteered to help when they did not have to? It is no wonder why we are all ignoring phone calls when we see the staffing department show up on our Caller ID.

Family

Another reason nurses are leaving is because they are missing out on a sense of normalcy outside of the hospital and the important people in their lives. The constant mandates make it so nurses are at the hospital more hours a week than they are with their families. When they are not at the hospital, they are sleeping constantly.

I applaud those who are able to have a social life all while working 45+ hours a week; I want to know the secret.

Nurses are missing out on: birthdays, holidays, anniversaries, funerals, and the normalcy of having a social life and being with humans other than coworkers or patients.

The hospital is a scary place, as it has been for a while now. Everyone, from PCTs and Phlebotomists to Respiratory Therapists and Medical Providers, is doing their best but we are all functioning on fumes at this point. Despite having faced COVID head on in 2020, hospitals are not equipped to handle such a situation again; the situation is getting worse despite what most might hear on the news. If the New England region has States with some of the highest vaccination rates and I am experiencing COVID the way I am currently, I cannot imagine what the life of a medical professional is down in the southern states. What is it going to take for people to realize that COVID is not going anywhere without compliance, a death of a close friend? I’ll tell you right now, that even the death of a spouse or a family member will not change the minds of those so politically motivated or brainwashed; it happens too often. Being in healthcare is mentally/physically/emotionally exhausting to say the least, which is why I can say Nursing is My Cardio.