Nurse: An Endangered Species
Rebekah Price
January 21, 2008
Sound like an end to the nursing shortage? It´s not. Many nurses are not happy and not staying in the profession of nursing. So just what is the problem? The answer is, there is not just one.
The number of aging nurses reveals a disturbing trend that nursing schools may not be producing an adequate number of new nurses to maintain the current nursing population. The same report revealed the average age of a nurse in the workforce is 46.8 years. That median age increased since the first report generated in 1980, confirming a future shortage of professionals is on the horizon. Like global warming, this growing crisis is sneaking up on us.
The decline of adequate education is another reason. Three types of programs were available to those aspiring to become Florence Nightingales in the ´70s and ´80s: the 2 year AA degree, 3 year Diploma and 4 year Bachelor´s degree, each producing differently skilled nurses. The 2 year program churned nurses out more quickly, adding increasing numbers to the workforce. The three year program, dedicated to clinical, hands-on experience from day one, began its demise in the ´80s, allowing the 2 year programs to flourish. The 4 year programs continue to produce nurses who enter the workforce at a higher "rank"--bottom line meaning more money and different opportunities--and better prepare them in leadership and research roles.
Young nurses ("young" being used to reflect a recent graduate not the person´s age) are often unprepared for the real nursing environment. Stresses of being the "new nurse", having little or no support system, unsafe working conditions, lack of quality leadership, and inadequate corporate support overwhelm new graduates. They have not yet developed the coping skills or the supportive network to assist them in navigating through those early, turbulent waters. Many are so grateful for the increased pay, that they will continue to struggle through the hardship of "paying their dues". After a few months of getting some actual nursing experiences under their belts, young nurses will often move on, scouting for better paying positions in kinder environments.
Some more experienced nurses who have stuck it out turn sour, burned out. They continue the day-to-day grind, enhancing it by myriad complaints against their colleagues and "the system". They feel like they have paid their dues so insist, by word or deed, that others do the same. Horizontal violence springs from this: the back-biting, sniping sabotage that most all nurses have seen and many have experienced first-hand in some form or another. These experiences can range from getting a "look" to frank assault. As a result of working side by side with nasty, burned out nurses, many good nurses leave. Fed up with inadequate, if any, intervention from their superiors,some change nursing jobs; others change whole careers.
In interviewing nurses about their careers and goals, most overwhelmingly felt undervalued and underappreciated in their roles. Many carry guilt associated with being at their jobs more than with their families. They felt their employers expected them to give 110% of themselves and as they tried to do that, their families and relationships suffered.
One seasoned nurse said, "I give and they (the hospital) take, and they take, and they take. There is nothing left for my kids but an exhausted lump. When that´s gone, there is nothing left of me by the end of the day!" She went on to state that work was "not just nursing", that the hospital expected her to join committees, volunteer in the community, not to mention stay over to help if someone called in sick. She stated there was no remuneration for those expectations and, because she worked full time on the unit as a single mom she could not do it all. For that, her annual evaluation suffered.
Nursing lacks the cohesiveness that other professions appear to have. Nurses have fractured themselves into so many specialties, isolating themselves from each other, by insisting on specialty certifications that cause many to feel inferior with only an RN after their names.
In fact, one hospital was reported to have requested all nurses to start signing in to meetings and adding all the letters of their certifications after their names. One nurse said she was so embarrassed that all she could put was RN after her name that she did not attend the meeting and was reprimanded for being absent. She felt like she was being singled out that she had not "done more" with her education and felt inadequate. When she was asked if she made the same money as her peers she replied she thought so, but felt her worth as a nurse was less than theirs. Another stated she was disgusted at the implication and just wrote "N.U.R.S.E." after her name. She was called into her supervisor´s office for a disciplinary lecture for being "rebellious" after the meeting. Both of these nurses have over 30 years clinical experience between them.
What a sad commentary on a noble profession. The art and science of nursing belies an ugly side that is destroying competent nurses, forcing them to make choices against their chosen profession. Each of the nurses interviewed said they "loved their patients"; but all agreed the work environment is in desperate need.
Our nurses are being consumed by internal professional strife, corporate ambition and avarice. Supporting these hardworking professionals is tantamount to securing our health care into the 21st century. However, in this enterprising age, nurses must smarten up and band together in a movement of change, commanding respect as a whole, and not remain splintered in groups of ´them and us´. The number of US nurses is formidable, especially if bonded together. Only then will this invaluable group of health care professionals ensure their survival.
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