We Really, Really Need More Nurses

This post is a response to Alexandra Robbin’s op-ed column “We Need More Nurses". It isn’t just that we need more nurses to exist; they are out there trying to find jobs. I keep hearing about this nursing shortage, but I keep seeing hospitals laying nurses off and keep seeing new grads waitressing because they can’t find jobs as nurses. The problem isn’t a nursing shortage. The problem is that we need more nurses in staffing ratio so that patients can receive safe care.

It’s true that nurses are leaving the profession, and I can’t blame them. I’ve been nearly out the door myself. On the one hand you’re told that you will have more and sicker patients, and on the other hand you’re told that you also have to prioritize patient satisfaction. You can have one or you can have the other, but the feeling at being told that you have to do both is the same I would get if someone said, “I’m going to need you to go ahead and grow 6 inches taller by tomorrow.” It can’t be done. Why try?

Healthcare is throwing nurses under the bus. The evolving changes have been meant to ensure that patients receive better-value healthcare, but what has happened instead is that management squeezes the nurses to make sure their bottom line doesn’t change. It has become a familiar litany to most nurses to hear about all things we have to do lest we be fired. We become almost numb to “we’ll fire you if you don’t do this,” and we live in constant fear of losing jobs we hate.

Here is a quick list of things I have been told I could be fired for over the years:

  • Clocking in late.
  • Clocking in early.
  • Working after 7:15, when shift report should be over.
  • Not staying as late as I need to do ensure the tasks from my shift are complete.
  • Not documenting I was in all my patients’ rooms every hour (if you have six or more patients, good luck).
  • Not verifying that physicians are entering their orders correctly.
  • Not making sure that a physician sees my patient within a certain time period.
  • Having a patient fall.

This list goes on and on. The operative point is that nurses are threatened relentlessly about things we largely cannot control. The result is a constant exhaustion, a constant log-running experience that makes nurses just want to jump off and stop trying to run.

And in the middle of all this, we have to worry about patient-satisfaction scores. For example, no one has ever explained to me why pain management falls on nurses. We don’t order the stuff. If you are my patient and you have pain, I will certainly tell your physician about it. I will even add my impressions and assessment most of the time. However, if that physician does not want to give you another 2 mg of Dilaudid, I can’t magically make that happen. Yet pain management comes down on nurses.

This post is a bit of a rant. I am writing it because I am tired at this moment. I am tired because I have been working several overnight shifts in a row while sick. I have to go to work sick because, you guessed it, I will get fired if I call in. The reason I am sick is that a patient coughed in my face the whole time I was starting her IV, and when I asked her to cough in the other direction she first asked why (because I don’t want to get sick) and then told me I was rude and uncompassionate. My caring about patient satisfaction is at a low ebb.

They’re getting this all wrong. Look at NURSE satisfaction, and patient satisfaction will follow. Keep this kind of thing up, and no one will be able to receive safe health care.


About Megen Duffy

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Megen Duffy, RN, BA, BSN, CEN, is a practicing nurse, blogger, and contributing editor for the American Journal of Nursing. Megen has practiced in a variety of settings from emergency rooms to prisons.