I'm a nurse, and I'm tired.

After 14 years as a nurse, I'm tired. Just about every nursing job, specialty and setting you could think of, I've worked in. The problem though, is not the duty of nursing. Nursing my patients has always been, and continues to be, enjoyable. So, what's the problem? Why are nurses tired? Why are we burned out? Why do we eat our delicate young? Why do we bully each other? Why is management unsupportive, and how do we prevent workplace violence, lousy teamwork and aching feet? Well, in my new blog, we will be discussing all of these issues and more, right here.

Looking back, nursing has certainly evolved over the last decade and a half. Some changes have had positive impacts on our profession. Staffing ratios being addressed, at least in hospitals, has brought national attention to the work load we nurses carry. Finally.

Nurses essentially do it all, particularly in the acute care setting. Thank goodness for those precious nursing assistants we can rely on to help us through many of our routine, time-consuming tasks. However, nurses are still responsible for administering meds, assisting patients with activities of daily living, ensuring meals are the proper diet and suitable for patients. Nurses assist with and perform complicated, advanced procedures at the bedside, as well as coordinate and manage care between all disciplines of the healthcare team. The task list is endless-and that's the problem. Of course nurses are tired! They have so many tasks to complete in a 12 hour shift that they can't even take the time to pee! I'm fairly certain nursing has the highest UTI rate of all professions....

So, what do we do to remedy this invasive problem in nursing?

One situation nurses often find themselves in at work, is wearing multiple hats. The secretary is on lunch? Sure I can do her job for an hour. Short staffed on aides? Sure, we can take care of all of our patients' meds, treatments, procedures, IVs, drains, tubes, foley. And, help them to the bathroom, keep them from falling, change their bed linens, change their gown, feed them, walk them down the hall, get them ice every 30 minutes, stumble over 22 family members in the room, put them on the bed pan, empty their catheter, reposition them every 2 hours. New socks? Sure, coming right up! May I remind you, nurses are not super heroes, as memes and t-shirts try to depict.

With the level of acuity of our modern patients, it is impossible for one person to adequately care for, complete tasks for, monitor appropriately, and note minute changes in assessment early and address them, so that the patient's life can be saved, all in a single shift. Throw being short staffed into the mix, and you have a recipe for disaster. Nurses are able to wear too many hats and are capable of too many care modalities. We can do the job of several other healthcare professionals, but not many others can do our job. This is where nursing and nursing support have gone wrong with scopes of practice. If support staff, such as nursing assistants were trained on, and could effectively perform more tasks, perhaps the nurse would have more time available for core nursing practice and assessment. In addition, if nurse assistants were trained on a wider variety of skills and allowed more autonomy in the work place, perhaps more would want to get into the field, hence providing more support for nurses and less shortages of assistants..

There are few things I won't do for money (be nice). I venture to say that this is true for many folks. Yes, nursing is a well compensated job compared to the majority of other shift work jobs. However, as a whole, nurses don't feel adequately compensated for all that we have to deal with. Perhaps hourly pay doesn't have to be the only area where compensation improves. Although difficult due to the nursing shortage, extended vacation packages from employers would make any exhausted nurse refreshed. Management can manage the patients on the floor while we're gone. That's what they are for, right? How about more incentives such as extra pay for not calling in? More sign on bonuses and retention bonuses? When I started nursing, sign on bonuses were everywhere. These seem almost a thing of the past since hospital reimbursement has changed. Bummer.

There isn't anyone that I trust, want, or like making my schedule. This is my life, my schedule. And lets face it, schedulers really don't care about your life, they care about numbers. And it sucks. Self-scheduling on units has increased in popularity, but I would like to see it become more utilized in nursing. It is certainly a selling point for a job or facility to participate in self-scheduling. This allows autonomy that nurses most desire due to the stressful nature of the job. Sometimes an extra day off or a day off at the right time makes all the difference in a nurse's stress level. Lowered stress levels equate to nurse retention, and they're certainly less tired!

What are other ways that can decrease nurse exhaustion and increase retention?