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Nurses call for changes to address burnout, safety, staffing shortages


As more physicians turn to employment by hospitals and health systems, they experience a work environment that nurses have endured for years.

sad nurse in clinic: © Pixel-Shot - stock.adobe.com

© Pixel-Shot - stock.adobe.com

Nurses across the nation and around the globe have been making their voices heard through strikes, highlighting the dire conditions they face on a daily basis. America’s persistent nursing shortage will continue to plague hospitals, and it's the patients and overworked nurses, along with physicians and other clinicians, who are impacted. These health care workers, often pushed to the brink of exhaustion, are battling an unprecedented wave of burnout. The consequences of this crisis are far-reaching, affecting both patients and the dedicated professionals themselves.

These strikes are a symptom of a greater issue going on inside the health care industry. The root of the issue lies not in a shortage of qualified individuals willing to step into these roles, but rather in the unbearable working conditions they endure. Nurses and health care professionals have reached a breaking point, and their grievances are symptomatic of a deeper problem. More and more physicians who have opted out of private practice to work as hospital employees are now playing witness to conditions that nurses have dealt with for years.

Staffing solutions

Nurse Jessica Sites, RN, BSN

Nurse Jessica Sites, RN, BSN

There are solutions to fix these issues. Right now, most nurses are overworked and stressed beyond their capacity. That is why it’s imperative to start mandatory patient care ratios for nurses to prevent burnout. This would help retain nurses and keep them in the work field.

The toll on the mental health of health care workers is evident when staffing levels fall short. Improving nurse-to-patient ratios can address many of the problems currently plaguing the industry – not just for nurses. It’s a matter of patient safety. Proper ratios make it less likely to have medication errors or mistakes in daily workflows. It just allows us to provide overall better patient care.

Pay vs. turnover

The pay scale and compensation is another critical issue. Many nurses work under difficult conditions, pushed beyond their limits, without receiving the recognition and rewards they deserve. Hospitals and health care organizations often look to see where they can cut costs. It’s usually the lower-level staffers, such as registered nurses, and licensed practical nurses, and certified nursing assistants, that take the hit. Basically, nurses aren't getting any kind of positive reinforcement and are choosing to leave the field.

The reason we don't have enough nurses is due to the high turnover rate. They try to fix it by bringing in nurses from other states, travel nurses, whatever they need to do to create a temporary fix. These nurses come in and are paid double, even triple the pay of the nurses at that hospital. What they really need to do is retain the nurses there on a daily basis. The ones who know the hospital inside and out. Why aren't they getting the recognition that they deserve? It's disheartening and discouraging, and it's a situation that demands immediate change.

Safety on the job

Ensuring the safety of nurses is another area of utmost concern. We need a nationwide, standardized protocol to address incidents of violence against health care staff. This protocol should clearly define when an event warrants contacting law enforcement, which departments should be notified, and what details need to be included in patient charts. The current practice of handling such incidents varies widely among hospitals, with some discouraging health care workers from reporting them to avoid negative publicity. They don't want to show that this happened because there's a lack of security measures, including metal detectors or adequate security staff. The majority of time they try to downplay it or suggest the person not report it at all. This approach is unacceptable and needs to be overhauled.

It’s a horrific experience for a doctor, nurse, or any health care worker who has gone through this type of incident. Instead of being supported, the administration often says, let's think about what we can do differently next time to avoid it. The way it's handled now is truly embarrassing and some health care workers even suffer severe injuries, including bites and physical assaults, with little recourse. Patient charts should include information about prior incidents and whether a patient has a history of violent behavior. There needs to be more warnings given to the nurses and these types of things need to be discussed in morning huddles.

Security is another pressing issue that needs immediate attention. Hospitals should implement stronger security measures and increase security staffing. These are all things that get pushed to the side.

Speaking up

Underreporting is yet another problem. Many health care workers are hesitant to speak out about negative experiences due to concerns about job security. They don't want it getting out that their facility might be unsafe because they don’t want to deter patients from coming there. Blanket social media policies create an environment that dissuades people from speaking out. The policies are loosely worded, leaving it within a hospital's right to terminate an employee or let someone go if they feel the worker said anything that could be misinterpreted or puts the hospital in a bad light. These health care workers don't speak out because they don't want to lose their jobs and they're scared of the repercussions.

A national answer

It's not too late to turn the tide in the health care industry, put an end to the strikes, and address staffing shortages. First, critical steps need to be taken to create a better work environment. We must pass legislation that guarantees fair pay, worker safety, and proper staffing requirements.

By passing legislation such as House Resolution 2530, the "Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2023," we can ensure that there are appropriate nurse-to-patient ratios.

If we fail to act decisively, the situation will likely deteriorate further before any improvements occur. It may require mandated changes rather than relying on hospitals to act in good faith.

Union yes

Unions are valuable allies for nurses and those in the health care field. It gives them a voice. It gives them somebody to speak out for the group and somebody who can go in and bargain. Be that mediator between the staff and management because that can be a difficult thing to do. If a nurse speaks out, it usually falls on deaf ears. It takes a figure that’s in a higher power and contracted with these unions to go in and lay out the demands. Sometimes, you have to fight back to get what is necessary and drive the impactful changes that patients and nurses deserve.

Rejuvenation starts now

The challenges faced by health care workers, particularly nurses, are not insurmountable. By addressing the issues of burnout, patient safety, staffing shortages, compensation, and workplace violence head-on, we have the opportunity to rejuvenate the health care industry and ensure that those who care for us receive the support and recognition they rightfully deserve. It's time for a collective effort from health care organizations, legislators and the public to stand with our health care heroes, empowering them to provide the quality care we all depend on. Let us remember that the path to a healthier and more sustainable health care system begins with acknowledging these critical concerns and taking decisive action to bring about the change we so desperately need.

Nurse Jessica Sites, RN, BSN, has more than two decades' worth of experience in health care as a labor and delivery registered nurse in Tampa, Florida. After 20 years of 12-hour shifts, she took a leap of faith to become a full-time social media influencer who uses her platform, decades’ worth of health care experience, and comedic talent to be a voice for workers in the health care industry.

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