A Nurse Contemplates Leaving the Profession [Updated]

Dinner last night with an old friend who toils in the mines of Labour and Delivery. She has worked there for four years. She told me of an incident not too long ago working the night shift, faced with a post-partum patient who was bleeding, hypotensive, and tachycardic, in short, showing all the signs of going into hypovolemic shock. She was running around, starting IV lines on flat veins and hanging blood products. Packed red cells. Platelets. Cryoprecipitate. And by-the-by, saline by the bucketful. She called for help from her colleagues. Apart from this patient and another who was walking the halls a few hours from delivery, it was a slow night.

Of course, you know the end to this story, don’t you?

No one came.

No one even popped their head in the doorway to ask, “Is everything okay?”

All of  them were at the nursing station, playing Draw Something on their phones, watching the season finale of Grey’s Anatomy, what have you. Too busy to help a drowning colleague with a shocky patient.

My friend went to her educator and her manager. They shrugged it off. No biggie, they said. Clearly my friend had things under control. “The patient lived, didn’t she?” they said. And then: “Maybe you need to improve your organizational skills to handle critically ill patients.”

This last to a 50-something woman who has been nursing 25-plus years, almost all of it in critical care settings.

For my friend, this incident may well be the last straw. She is definitely leaving L & D. Why would she want to stay? The workplace culture on this unit is awful. She feels alone and isolated when going into work. She can’t trust her colleagues. “Why,” she asks, “would anyone want to work there? There is no teamwork. No solidarity. Nurses backstab each other at the first opportunity.”

The only question remaining is whether my friend will leave nursing altogether and take her 25-plus years of experience with her, which included not only the knowledge to provide expert care to patients, but the potential to share that expertise in mentoring and nurturing new nurses. She’s uncertain what she would otherwise do, but leaning towards abandoning the profession which has shaped her adult life. She only needs an out — which she hasn’t found yet. She is that disgusted.

You might tell me that stories like this are unusual and not representative of nursing. Unfortunately, we all know better. So in the end, I don’t blame my friend for wanting to leave. I would do the same.

So what would be your response?

UPDATE: Some comments from Twitter:

@TweeterERNurse @TorontoEmerg I was “spoken to” about helping other nurses too much, as it increases MY pts time in the ER. I applied for another job.

@SqarerootofeviL sad but true.. seen my ma & aunt live it.- “No teamwork. No solidarity. Nurses backstab each other at the first opportunity.” @torontoemerg

@NorthernMurse @TorontoEmerg So how do we change this culture? What do I, as a student and soon new grad, do to improve the #NursingCulture?

@TweeterERNurse @NorthernMurse @TorontoEmerg Learn more than your manager about regulations. Google everything on the inservice boards. Become the expert.

The second to last tweet from @NorthernMurse is probably the relevant question, don’t you think?

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  1. #1 by suki on Tuesday 29 May 2012 - 0936

    I so relate to this story. I too am looking for my way out.

  2. #2 by Beth Boynton on Tuesday 29 May 2012 - 0948

    I think it is sad and such a huge loss to the hospital, future patients, staff and your friend. AND, I totally understand. When colleagues and organizations are not responsive and don’t value the expertise your friend has it seems like only a matter of time before she gets burned out. You might find some validation in this related blog post: Protecting Second Victims from Work Performed without Passion & Toxic, Unsafe Workplace Cultures by Dev Raheja, Author-Safer Hospital Care

    http://www.confidentvoices.com/2012/03/15/protecting-second-victims-from-work-performed-without-passion-toxic-unsafe-workplace-cultures-by-dev-raheja-author-safer-hospital-care/

  3. #3 by nurseinterupted on Tuesday 29 May 2012 - 0950

    Well I think you know my response.

  4. #4 by Ali on Tuesday 29 May 2012 - 1408

    has she thought about being an instructor and passing on all that knowledge and expertise to the next group of nurses? They need someone to tell them “don’t be like THAT”

  5. #5 by Susan (@SusanFelicity) on Tuesday 29 May 2012 - 1602

    Politics in the workplace, which of course means bullying in the workplace. Cliquiness, unkindness; I can just imagine it would be a horror story. Hate to say it, but when it’s mostly women – I wouldn’t take it for any money. All depends on the management, you have to find a place that’s managed well. Start a nurse’s newsletter, get feedback from across the country. Find out which hospitals are best; rate hospitals the way that University professors are rated independently by students on the internet. Find a way to put pressure on hospitals to improve management. This sort of thing shouldn’t happen.

  6. #6 by Jenn Jilks on Tuesday 29 May 2012 - 2131

    I found that leaving MY profession, after 25 years, was the right thing to do.
    I was burned out and burned up.
    You cannot change these people and your health will suffer, mine did.
    The younger teachers were nasty. They manipulated the system and we old farts.
    Tell her to fly, break free, and find new joy doing something else. She will bring with her all her knowledge and skills. LIfe is short.

  7. #7 by The Nerdy Nurse on Tuesday 29 May 2012 - 2223

    I can relate to her situation. I have been drowning and begging for help only to have to charge nurse tell me she wasn’t going to do my job. When I later reported it to my manager I somehow came out of the incident with a write up and being told to develop better clinical judgement… this squeaky wheel sure got greased.
    So what did I do? I started a blog and moved to another specialty in nursing.

    Best decision I ever made.

  8. #8 by Jennifer Olin, RN on Tuesday 29 May 2012 - 2227

    There are so many things wrong with this story but the point that stands out to me is the business about “The patient lived, didn’t she?” they said. And then: “Maybe you need to improve your organizational skills to handle critically ill patients.” I have heard this myself when I once complained about a lack of support from my colleagues in a similar situation. Those are contemptible phrases and show a complete lack of respect for the RN and lack of interest in the patient. And, I’ve heard it said to others as well. I am sorry we, as a profession, could lose this valuable resource but I get it.

  9. #9 by Joyce on Tuesday 29 May 2012 - 2313

    Yep. I’d be leaving. Well, I guess I did, of sorts. I totally burned out… Went into pharma education, until that contract ran out. Now I’m back as a manager, hoping to be to the staff what I wanted my manager to be to me.

  10. #10 by suki on Tuesday 29 May 2012 - 2317

    Unfortunately it is so pervasive regardless of the specialty. The outright rudeness, catty schoolgirl bs, manipulation is done with almost every single specialty. Managers today are totally inept with dealing with this bullying that goes on today. In fact the majority take part in it and play it up to benefit themselves. It is sick when the bullies and the sick managers protect this type of behavior and attempt to push out the nurses (or other staff) that attempt to keep the units healthy. I’ve brought this behavior out in the open and informed staff and managers how unhealthy this is. Only to have it turned around on me. Reminds me so much of the sick dysfunctional domestic violence that goes on in many households today. Let’s keep it under wraps, hide our dirty laundry, don’t get “that one” upset because “you know how they get.” This just reminds me how unhealthy our profession can be. This is not healthcare. This is sickcare. To Jennifer’s comments; I so totally hear what you are saying! “the patient lived, didn’t she?” Or “maybe you need to improve your organizational skills………blah blah blah.. Lack of respect! The people that say these bs comments are trying to pull a number on you. They are using the manipulation tactic to make the nurse begin questioning their own self! I’ve been a professional nurse for over 30 years and it has gotten worse. I’m looking every single day for something different to do. It might be to go work as a Vet Nurse with an animal clinic. Could they (animal clinic personnel) have some compassion? I see very little in hospitals today!

  11. #11 by Marsha McGlamry on Tuesday 29 May 2012 - 2328

    Managed Burn Center for 10 years,been there,burned out,gone.

  12. #12 by torontoemerg on Wednesday 30 May 2012 - 0523

    Thanks for all the great responses.

    My observation: I find it more than a little depressing no one here thinks my friend’s story is unrepresentative of the nursing profession. How does that speak to the present situation of nursing and nurses?

  13. #13 by suki on Wednesday 30 May 2012 - 0806

    The truth art of nursing is being tossed aside today. I truly feel no one really cares. Upper management and administration will only support a manager that goes along with the flow. I know of a facility where the good managers were given the boot out the door. Why? Because they were told they were too “pro” employees! Does nursing really have a chance today? I don’t see how.

  14. #14 by Terri Schmitt (@onlinenursing) on Wednesday 30 May 2012 - 1206

    The post was true, but depressing. Reading the comments was even more so. There are two key ways to change this 1) within the modeling/mentoring of nursing faculty and how we raise the next generation of nurses. I hate to sound cynical, but there may be no hope for some unit cultures and areas of the profession. We must be the change we want to see in the world, as Gandhi once said. We means me and everyone else. Not Pollyanna happy and take whatever anyone gives, but we have to have each others’ backs, be supportive, encourage positive and professional dialog when we do open our mouths, always keep the patients first, and never gripe without a solution to the problem. 2) Nurses must have support (Financially and professionally) from all areas of hospital administration and be seen as equal care providers. The new CMS rules in the U.S. and Value Based Purchasing may be enough, combined with the I.O.M. report to fuel such support (Check out this article today on nurses being the key to revenue generation in the acute care setting. http://www.hhnmag.com/hhnmag/HHNDaily/HHNDailyDisplay.dhtml?id=5390002938 )
    Finally, when we need to leave, we need to leave. We have to care for ourselves first, because no one else will or should. I firmly believe the future of nursing , is getting brighter, unfortunately it continues to be an uphill battle for our patients and ourselves.

  15. #16 by CC on Thursday 31 May 2012 - 0613

    Actually, I have worked in 7 different hospitals in BC and only one of the L&D units I worked in was as you described above. Needless to say, I quit. I had only *just* finished orientation and that’s all it took – a batch of nurses with no patients on the board – I suggested going over and assisting the RNs on the Maternity ward and I was told a flat out -NO. …. (there were other things too, but this was the last straw….)

    Thing is…with all the hospitals I worked in (this also goes for 3 out of the 5 USA L&D units I worked in ) most had supportive RNs that made sure everyone helped out.

    If you don’t like where you are at…move to another place or change specialties. Or…as some have said….take retirement. In my 35 years of nursing…. I found out that there were more that worked together than not. I am no longer working in a hospital, and I still find my co-workers and management supportive and helpful

  16. #17 by Linda W. on Monday 04 June 2012 - 1212

    Unfortunately it just doesn’t happen on L&D- i work in cardiology and have the same issues. I’m running around while everyone is socializing at the desk and one of our techs is catching up on her soap operas! Really? I have been a nurse for 12 years and have been looking into something totally different- i might even go back to my Respiratory Therapist job. Nursing has totally changed since i started- the amount of paperwork is outrageous and they wonder why we can’t spend more time with our patients and why we constantly get out late. I totally agree with the burnout part-the families are getting more and more ridiculous too in their demands. They never leave when visiting hours are over and then they have 15-20 people in the room having a party. Management allows this and we can’t get our work done. What’s up with this???

  17. #18 by Darren Royds on Saturday 14 September 2013 - 1121

    You need to get out and find a decent job. Have a life , live and reduce stress. I have quit nursing and was the best decision I ever made. You will end up I’ll as so many do

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