EP 141: 4 Problems in Nursing

Problems in nursing have been there since the beginning, but not a lot has been changed or resolved.

Nursing is the nation’s largest healthcare profession, with over 4 million registered nurses nationwide. Yet it feels like nurses have no voice, no say in what goes on in healthcare.

The struggles nurses face seem to be a nationwide occurrence.

Nurses are plagued with the same revolving problems nationwide. Management in nursing seems to be driven by politics.

The idea of healthcare is centered around patient care. It looks more like hospitals are centered around money.

Top 4 Issues in Nursing We Are Facing

Slowly nursing and healthcare are becoming more of a business. Patient ratios, nurse retention and recruitment, burnout, and patient satisfaction are the current nationwide issues that nurse managers are facing.

Here are some of the problems in nursing we face:

Patient ratios are among the problems in nursing

Currently, California is leading with the best and most complete nursing union. The whole state is union-based, meaning that every hospital in the state is required to have a nursing union.

Some people are anti-union, and it is understandable why but as nurses who have worked in both union and non-union hospitals, we see some major differences.  The main difference is patient ratios.

California has the best nurse-to-patient ratios because its nursing union sets strict guidelines on how many patients a nurse has.

It also states that based on a certain level of acuity, a patient might need closer monitoring. These guidelines are clear-cut and strictly adhered to. 

When there are good patient ratios, this increases nurse satisfaction. It is hard to understand that nurse managers don’t seem to address this issue.

If you were to ask nurses what would make their job less stressful and empowering, they would all say better staffing ratios. This shouldn’t come as a surprise, as it is a common problem in nursing.

With appropriate nurse ratios, care would be more personal to the patient and patient-centered.

Let’s face the facts, nurses are overworked, and the amount of tasks they have to do decreases the nurse-patient experience.

This means nurses have less time to get to know the patient, and the concept of holistic care fades because we only have time to treat the body, leaving out the mind and the soul. 

Nurse Retention and Recruitment

Another problem in nursing that we face is nurse retention and recruitment. Retention and recruitment are something managers struggle with all the time.

Especially during a pandemic with increased demand for nurses finding and keeping them is tough. If your hospital was already short prior to the pandemic, it is most likely in an even worse state.

Trying to keep a nurse is always a struggle because there is endless opportunity for the nurse.

They don’t have to be tied down long-term to one area because almost every staff position has openings, meaning nurses can almost come and go as they please. 

The struggle with nurse retention is related to job satisfaction. Nurses don’t just leave because they feel like it. There is a reason for them wanting to work somewhere else.

Job satisfaction seems to be the biggest motivator for a change in employment. This means that nurses are unhappy. It can be due to many things, such as unit politics, working conditions, stress, workload, and pay.

There shouldn’t be a surprise that nurses are leaving a unit to pursue travel jobs. They pay more, allow you to travel, and explore different units.

If you can’t pay your nurses fairly, don’t expect them to pass up opportunities. 

Tough on Managers

Recruitment is also tough on managers. Finding nurses to hire in your unit is a mission in itself. New grad nurses are easier to hire but usually more expensive and use up more resources upfront because they are fresh out of school and need a lot of training.

New nurses are an investment. Nurses from other positions need to be sold on the new job because they don’t want to leave their current job and get stuck with a worse one.

Higher pay and a better working environment are the best way to maintain nurse retention and increase recruitment.

It may seem impossible to provide those, but as we’ve seen during the pandemic, there is money for nurses in healthcare.

Burnout is one of the most common problems in nursing

Another problem in nursing that plagues nurse managers is the burnout of their nurses. Being burnt out leads to less productivity and a weaker work environment.

There are two culprits to nurse burnout, one is related to the work environment, and the second is related to overtime,

Stressful work environment

Nurses get burnt out because of poor work environments. This means an environment where the nurse is overworked mentally or physically.

Unit politics plays a big part in this because no one wants to work at a job where there is constant negativity.

Nurses talk about other nurses, day shift vs. night shift mentality, and a lack of teamwork deafly to a unit. It is important to foster cohesiveness in the unit to promote a better work experience.

A lot of this also has to do with ratios and proper staffing. It is hard to be happy in a career where the expectation is to always do more because there is a lack of support. 

Too much overtime

Some nurses work a ton of overtime. For whatever reason, a lot of nurses pick up too much overtime.

This leads straight into burnout because, many times, the reason why nurses pick up is to help their coworkers due to staffing issues.

It’s great to help out your peers, but there comes the point where you start to forget to help yourself. You lose touch with yourself and your emotions, get stuck in a fog, and slowly fade from your true self.

You start feeling tired every day, and in a slump you cannot get out of; that’s how burnout feels.

Nurses also pick up overtime for financial benefit because they can earn more. This can be due to college debt that many nurses suffer through.

Making more money is always good, but money isn’t always the root of happiness.

Many nurses that pick up overtime to make more money don’t even enjoy that money because they don’t even put aside the time to spend it on themselves and take care of themselves.

It’s just more numbers in the bank. And it’s a growing problem in nursing that we all face. 

Patient Satisfaction

We hear about patient satisfaction scores during our huddles and monthly meetings. Are we hitting the quota for the month?

The medical industry puts continuous emphasis and patient satisfaction and positive care experience.  Nurses have proven essential for driving patient satisfaction.

It’s ironic because if you’d like to increase patient experience, we would need more time to deliver holistic care, which does not happen in our current healthcare system.

Making time for patients, listening, and having empathy take time; our time is only so finite in work. Nurses are currently busy charting on the cash registers instead of giving empathy to patients. 

Topics covered in HCAHPS Survey:

• Nurse Communication
• Doctor Communication 
• Responsiveness of Hospital Staff 
• Pain Management
• Communication About Medicines 
• Discharge Information 
• Cleanliness of Hospital Environment
• The Quietness of the Hospital Environment

What are these nursing issues we face? How can we solve the problems in nursing? Watch the full episode here 👇👇

TIMESTAMPS:

0:00 Introduction
0:49 Sponsor Ads
2:34 Episode Introduction
2:58 Issues in Nursing We are Facing
6:48 Patient Ratios
11:17 Nurse Retention and Recruitment
20:00 Burnout
20:24 Stressful Work Environment
23:16 Too Much Overtime
27:24 Patient Satisfaction
28:02 Topics covered in HCAHPS Survey