2020: The Year of the Nurse and Midwife, but could it be the worst year for nurses yet?

I became a nurse in 2011 and over the past 18 months, I have had more thoughts of wanting to quit nursing than wanting to stay. I often think to myself, if I did not need the money, would I stay in this profession? I also have casually, but consciously set a stop date for my current way of working because I know I cannot take the stress of a teaching hospital for the rest of my life. This does not mean I will quit, but perhaps seek a new role. I pray often for those feelings transform, and while they are decreasing, they have yet to disappear.

I have spent many hours exploring the root of these feelings and have come to the conclusion that a huge part of my burnout and stress is related to the exploitation of the nursing profession overall. I spent seven solid years as an ICU bedside nurse running and giving and learning – missing meals, bathroom breaks, high on adrenaline in the ICU to the point where I didn’t feel the pain in my body until I laid in bed at night. But the satisfaction of helping people and being close to my patients and colleagues help put a bandaid on that pain until now.

Becoming a Nurse Practitioner was likely a turning point in my burnout. My work, and that of many of my APRN counterparts, closely mirrors that of a physician. The longer I work in my area of practice, the more independent I become. History would predict that I will not see a change in my salary to mirror the thousands of dollars that I bill anytime in the near future – there is no monetary incentive. If I learn more procedures, I will likely not be compensated extra for learning them. This will just be more proof to myself, to the public, to administrative and governing bodies, that APRNs are more than capable to initiate, guide, and perform intensive care. And perhaps this will lead to a compensation model based on experience and incentives for learning and achieving additional certifications.

I believe I speak for most APRNs when I state that we do not want to be physicians, nor are we trained the same way, nor do we want to be compensated the same way, and yes we learn from our counterparts every day. But the shear denial that we are unable to ever provide competent and comparable medical care by some some state and national organizations is simply inaccurate and exhausting.

My time as a nurse has been a non-negotiable benefit in my life, but a fairer system is imperative. Nursing needs to be recognized as a profession of leaders and innovation, yet it is often the system that hinders us from flourishing and being heard.

It is the Year of the Nurse and Midwife and I can’t get over the irony that it has been paired with a global pandemic. Nurses are caring for even more critical patients per shift, they are absorbing the heartache of the dying, exposing themselves to covid19 repetitively to decrease exposure of other healthcare professionals, and very few are even being offered hazard pay. Miners and construction workers receive hazard pay, electricians and plumbers receive compensation for inclement weather, but most nurses receive nothing extra for working during a pandemic. This should not come as a surprise considering nurses are also forced to sleep overnight in hospitals during snowstorms without extra pay, they are forced to be on-call for two dollars per hour, and are rarely compensated for additional projects or certifications, but the pandemic has shown the brightest light on the corruption within the healthcare system.

Perhaps this is partially because we are a female dominated profession (90%), it is no secret that women are paid less, and we are also highly underrepresented in the media. It also could be that most of the general public including media folk uphold the outdated stereotype that nurses are subordinate. In fact, nursing researchers and clinical nurses have had a significant impact on hand washing, proning, and hospice care, all very relevant to the pandemic, yet this is rarely mentioned in the media.

The media has profited from the faces of nurses with pressure ulcers from their N-95s. It has shown them wearing trash bags at work, it has given attention to the nurses who work for free out of the kindness of their hearts, but truthfully, working in unsafe environments is nothing new for most nurses. Countless studies have shown that nurse staffing plays a major role in complications and mortality rates, but nurses are still working, understaffed, underpaid, under appreciated, and now with even worse ratios than before, because most hospital administrators simply do not prioritize the health and well-being of nurses and advanced practice nurses.

So how do we begin to turn all of this around? In 2018, only four percent of hospital boards held a member that was a nurse. No hospital administrator will fight for safe staffing ratios if he or she has never experienced the work load of a nurse. I realize this is easier said than done, especially in a community that can make you feel inadequate. 

Throughout the years I have had my bouts of burnout and I’m in one right now. Whenever I’m burning out, for whatever reason, I regress. I instantly want to be away from work, my world becomes profoundly negative, and the problems with healthcare seem impossible to solve. However, instead of quitting, or imagining my last day of work, I try to remind myself that I just need a rest. Quitting will not solve these problems.

As nurses who are primarily women, we often have so many responsibilities that our minds are exiting the workforce before we have actually left, this is a concept presented by Sheryl Sandberg. Meaning, the second a family and children become an option, our minds plan for them and leave the workforce before the child is actually born or the event actually happens. However, if we want the aforementioned issues to change in nursing, we have to be there to change them and we have to lean into them.

I’m writing this post somewhat as a reminder to myself. I love being a nurse. Most nurses do not get into the profession to be heroes, we just have an utterly important affection for helping and caring for others – medically, psychologically, and emotionally. It’s an easy profession to love, but it is a hard one to stay in, and an even harder one to let go. We owe it to each other, and the ones before us to keep trying to make it better. My hope is, that if I can’t make it better myself, I will inspire someone else to continue the work.