Sometimes I Feel Heartbroken When My Patient Passes Away, I Hope They Know I Cared

I wonder if the mother of the child that drowned 7 years ago knows that I still think of her. Does she know that her guttural sobs and animalistic screams upon holding her lifeless child still echo in my head if I think about it for too long? Would it bring her comfort or sadness to know that her baby would be the same age as my nephew, and I have thought about her boy and all of the moments she has been forced to miss?

Does the son of an elderly man know that I continue to think of his father every Christmas Eve because years ago I held his father’s hand while he took his last breath so he wouldn’t be alone? I remember thinking about how his family would never hear his voice say Merry Christmas again, and how this day will forever hold a memory of an empty phone call. 

I’m curious if the parents of a teenager know that I will forever think of them when I hear Taylor Swift’s “Love Story” because it was their daughter’s favorite, and they played all of her most beloved songs on repeat after the doctors declared her brain dead.

My shoulder has been the place where childless mothers and motherless children have shed tears. 

Despite this,  these are the stories that I don’t share with many people due to the sacred nature and protection I feel around them. Some of the most gut-wrenching and transformative moments in my career occurred in the solitude of my patient’s room and replays in the tenderness of my memory. Unfortunately, the stories that my friends and family most likely remember involve the stupid, sarcastic, and often times mean comments shared by patients and nurses alike. These soft but painful moments have the tendency to be overshadowed by the humorous and often heartless stories we share as a means of self-protection.

With compassion fatigue at an all-time high in the nursing profession, onlookers could easily make the judgment that such high exposure to sadness and grief for an entire career might drive a nurse to develop a heart of stone. But what strangers don’t realize, is that many nurses don’t want to talk about the cases that have deeply affected us. Sometimes it’s because we don’t know if we will be able to tell the story without audibly choking up reliving those experiences. Other times, it might be because those moments feel too sacred and vulnerable to share with people that can’t empathize with us. But for many nurses, the truth is that many of our patient’s stories have woven their way into our outlook and had an impact on our view of the world.

Our hearts only have the capacity to hold room for so much sadness and tragedy. 

Hospitals don’t attract people when they are having the best day of their lives, and nurses have had to learn to take on aspects of a counselor and therapist to provide the best care for patients during their heartbreaking moments. In order to keep our personal lives minimally affected by the work we do, many nurses have developed coping mechanisms that involve detaching from patient stories or keeping them at an arm’s length away from our hearts. 

When friends or family members ask about our day, we have a tendency to glibly respond by saying how we cared for a patient that had a horrible situation happen to them. And, although we might have deeply cared about this patient and their stories, the way in which we tell our stories might come across as callused and cold. At times, this might be a response to wanting to escape the sadness of the day. At other times it might simply be that once we reach the door of the hospital, we no longer have the capacity to carry our patient’s burdens home with us.

Although the rate that nurses experience burnout has excelled at an exponential rate especially due to COVID and the ongoing nursing shortage, I hope that a positive consequence of the past few years will be normalizing the difficult seasons of nursing. If nurses feel more at ease talking through challenging social aspects of the job with one another, it may lead to a more positive expression of our work to people who do not work in this profession. Similarly, as nurses begin to debrief and build this level of comradery with one another, it might spur on the ability to have more vulnerability in the tender moments with patients.

Sure. There are plenty of nurses in the world that have managed to build strong walls around their hearts and show up to work day after day without being affected. But they are the minority. Many of us care deeply about the joys and trials that our patients face and have come up with individualized methods for creating boundaries between our work and personal lives. 

Despite this, that doesn’t mean that we don’t continue to think of these stories for years to come and wonder if the families know how deeply their loved ones have touched our lives.

Source: nurse.org

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Home Care Agencies Are Desperate For Workers Amid Nursing Shortage

There is a nursing shortage everywhere. Staff nurses are leaving for lucrative travel positions. ICU nurses are burnt out and leaving the bedside for, well, anything but bedside nursing. And home care nurses are in short supply. While hospitals and healthcare systems can hire travel nurses to fill voids, mandate overtime, assign too many patients, and “figure it out” - home care agencies are finding it harder and harder to fill the voids.

Every year, according to the AARP, an estimated 12 million Americans who are infirm, chronically ill, or disabled individuals depend on some form of in-home care, according to the National Association for Home Care and Hospice (NAHC). Many are 65 or older and have serious underlying medical conditions.

Historically speaking, home care nurses are some of the lowest-paid nurses. According to Payscale.com, home care nurses make on average $28.69 per hour while a surgical nurse makes $32.14 per hour. Furthermore, according to data, home care nurses with 10-19 years of experience only make $30.24 an hour on average. This is lower than the average pay for a surgical nurse.

The ongoing nursing crisis is one that there is no foreseeable end to, unfortunately, but the home care nursing shortage is one that requires immediate attention and action. Furthermore, this shortage related to home care isn’t just nurses. There is also an ongoing shortage of certified nursing assistants and home health aides.

The Maine home-based care program, Catholic Charities, has a waitlist 925 people long; those applicants sometimes lack help for months or years, according to officials in Maine, which has the country's oldest population.

Katie Smith Sloan, CEO of Leading Age, which represents nonprofit aging services providers, says the workforce shortage is a nationwide dilemma.

"Millions of older adults are unable to access the affordable care and services that they so desperately need," she said at a recent press event. State and federal reimbursement rates to eldercare agencies are inadequate to cover the cost of quality care and services or to pay a living wage to caregivers, she added.

Effect on Patients

Without home care nurses, home care agencies have had to deny referrals. As a result, patients requiring home care are either remaining in the hospital, are putting stress on loved ones to care for them, or are risking injury by not having the proper individuals to care for them. 

The staffing shortage that Bayada has experienced late is unprecedented, according to David Totaro, the chief government affairs officer of the Moorestown, New Jersey-based Bayada Home Health Care.

Specifically, it has had to deny service to approximately 50% of all new case referrals due to a lack of staffing. That has not improved, even as the pandemic has eased.

“Our denied referrals have increased from half of all new cases to a record 64% in the tri-state area of Pennsylvania, Delaware and New Jersey, which is our largest coverage area,” he said. “We today are declining nearly two out of every three new home care cases due to a shortage of available caregivers.”

Effect on Families

The home care nursing shortage is affecting families across the country. Recently, the NY Times met with the Mead family from New York whose 7-year old son suffers from spinal muscular atrophy, a rare muscle-wasting disorder, and requires around-the-clock nursing care. Prior to the pandemic, the shifts were fully staffed and the parents would serve as a back-up when a nurse was not available. 

Now the family goes upwards of 36 hours without any nursing care. And they aren’t the only family begging for home care nurses. Parents are taking to social media asking for anyone with specific experience to lend a few hours in order to get their loved ones home from the hospital. 

Madeline Michael recently posted on Facebook asking for help filling holes in their son’s home nursing schedule. Some hospitals require around-the-clock nursing care for a specific number of days or weeks following initial discharge from the hospital. This depends on the medical needs of the child. 

Their son, tentatively due for discharge on December 7th, will not be able to be discharged without the nursing coverage. As a result, this young family is desperately seeking local nurses to help fill those vacancies. While appealing on Facebook is a great idea, it often doesn’t yield the results needed. Furthermore, willing individuals must apply to the home care agency, Bayada in this case, and go through the entire onboarding process. This can be long and might not be completed in time to help the family. 

Unlike the Mead family, Michael’s son will not be discharged from the hospital. And they aren’t the only family seeking nurses. Long-term units and trach vent units are full in hospitals waiting for patients to be discharged. But without the nurses and aides to care for the patients, they remain hospitalized. 

The Fix

Sad to say, there is no quick fix. This will continue to be an ongoing dilemma even once COVID is no longer a concern. The pandemic merely sped up a problem that was going to hit the nursing profession head-on. As an increasing number of baby boomers retire, individuals live longer, and there are treatment options available for chronic medical conditions - the need for home care nurses is going to continue to rise.

More than half of Americans will need formal long-term care and services as they age, according to LeadingAge. According to professionals and government officials, without funding from the government to improve wages, training, and recruiting and retention efforts, the number of home care workers will only continue to decline and the shortage will become even more drastic.

According to home care nurses, the biggest deterrent is pay. While federal guidelines allow Medicaid programs to cover in-home nursing care despite a family’s income, states generally pay home care nurses at much lower rates than they would for equivalent care in a hospital or other medical center. However, Medicaid is reimbursing for similar charges and fees as in the hospital.

Jen Semple, a registered nurse in South Carolina, worked as a home care nurse for one patient over the last four years despite hourly pay that rose just $1 during all that time. When the pandemic began, she cut her home care hours to administer vaccines for a local health care system, at an hourly wage $7 higher than she had been earning.

Jarred Rhatigan, a 31-year-old nurse from Nassau County, worked part-time several days a week for Caring Hands, a home care agency, making roughly $40 per hour. Once a vaccine became readily available, he dropped all those shifts to administer vaccines at sites across areas of New York for upwards of $75 an hour. This in turn allowed him to pay down his student loan.

While both Semple and Rhatigan were sad to leave their home care jobs and patients, the pay difference was too much to walk away from. Money talks, even for nurses, and in the end home care nursing positions can not compete against hospital positions from major healthcare corporations.

Source: nurse.org

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UPMC Launches Internal Travel Nursing Agency, 800 New Jobs

The University of Pittsburgh Medical Center has unveiled its new internal travel nursing program. With nursing shortages exacerbated by the COVID-19 pandemic, hospitals and medical centers are having to find new ways to attract talent and deliver quality care. 

This new program is the first of its kind and provides participants with premium pay and flexibility. 

UPMC hopes that the program will also allow them to send support to the facilities that are most in need. Nurses will change locations every six weeks so that hospitals can keep up with demand and quickly address staffing needs as they arise. UPMC includes 40 hospitals across Pennsylvania, Maryland, and New York, so participating travel nurses will cover this territory.

Many nurses have joined travel programs that send them to cities all over the country. Most are attracted by the chance to travel and earn competitive wages. However, there are some drawbacks to this lifestyle. Travel nurses are often far away from friends and family and don’t get to enjoy the same sense of camaraderie and teamwork that is typical to clinical environments.

Pay Details

UPMC hopes to provide the best of travel nursing while also keeping nurses within the same system for some sense of continuity and familiarity. Participants will stay within the UPMC benefit structure and start at $85 an hour.

Ultimately, the program is hoping to win back those who have left to be travel nurses and hire 800 travel staff. Currently, the network employs 8,000+ nurses, so while the hiring binge sounds ambitious, it still only represents a fraction of the entire staff. 

If the program is successful, other large healthcare systems may follow suit in order to more effectively maintain adequate staffing, especially during times of crisis. 

Source: nurse.org

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5 Things To Think About During The Holidays if You're Working as a Nurse

So often some of the most coveted words we hear nurses speak when they take a new job away from the standard 12-hour shifts are “no weekends and no holidays.” In fact, no holidays are one of the driving forces nurses might leave the bedside for clinic or office jobs. 

Unfortunately, choosing a career in nursing almost guarantees missing out on certain events including holidays due to the unconventional schedules. 

During parts of the year it might mean missing out on the first T-Ball game of the season, while at others it may be sending your spouse solo to Parent-Teacher conferences due to the Thursday work grind. But almost without question, nurses that work at the bedside will have to work some part of the winter and summer holidays.

Although there are often the few unicorns in the department that prefer to work the holidays due to a lack of family or because of the added pay incentive, the large majority of people would much rather have their work schedules mimic their family’s days off. Some departments spend weeks fine-tuning the most perfect blend of pot luck assortments to fill their stomachs in an effort to curb the void of missing sitting around a table with their own family. Other departments have spent their precious few minutes of downtime creating Christmas and holiday décor out of the most unconventional materials. Some hospitals offer employees a free holiday meal in hopes of easing the burden of having to work and miss time with family. 

And yet others seem to ignore it all completely and act as if the hospital maintains running and functioning the same year-round. These hospitals tend to forget that despite the hustle and bustle of the hospital, especially now during the ongoing pandemic, that the staff is silently suffering without their friends and families. 

5 Reflections on Past Holiday Shifts

But, the holiday magic that floats around Hallmark movies like the feather from Forest Gump doesn’t forget the staff that shows up to work all of these special days. There is a different energy in the hospitals on national holidays. All non-essential employees are still snuggled up in their beds, while the faithful and true continue to clomp the hallways in our mystery-stained Dansko’s. The hallways feel empty as management and administration do not show up to work, so it can often feel like mom and dad have left for vacation and it’s time to pull out all of the party tricks. But also management enjoying the holidays at home with loved ones does leave a slightly bitter taste. 

By the time the rest of the team shows up for huddle, it is almost as if everyone has accepted their fortunes and made peace with having to come into work on the holiday. 

1. These shifts lead to some of the most memorable and cherished times with coworkers. The secretary is shoving dollar store hats on the most reserved nurses and the charge nurse announces that our family picnic will commence in four hours. The normally dull unit is now interrupted with a Spotify Christmas station. 

2. Patient interactions can also be much more meaningful during this season as well. To some degree, the holidays bring an added level of stress that can often go unmatched, especially as families are dealing with pain, trauma, and financial burdens. However, grace and kindness also seem to abound with generous fluency. It is almost as if visiting family in the hospitals during Christmas time feels more like an event, and can often be an excuse for family members to simply relocate their traditional gatherings.

3. Special moments between patients and families. Pre-Covid, it wasn’t extremely uncommon to walk into a room and see a family huddled next to Grandma as they brought her leftovers and finished opening gifts together. In fact, those moments are the ones that bring a smile to even the most cold-blooded nurses.

4. A mild and unique bond occurs between a patient, visitor, and nurse. When they realize that neither one of them are where they would like to be. But, since they both find themselves in the same room, they might as well make it an experience worth remembering. Or at least one that doesn’t bring sadness and loneliness into the picture. Even if they recognize one another’s sadness, the magic of the holidays has a way of curating a more vulnerable space between them to fully express themselves. 

5. This time of year leads to many easy conversation starters with patients, particularly the young and the old. Listening to older generations talk about their memories surrounding holidays and traditions can be quite capturing.

These shifts can be hard. Many nurses have small children that do not understand why mommy has to work on Christmas, or why dad had to go sleep and miss eating turkey with them in order to work that night. Although many nurses get more days off a week than other professions, the slow grind prevents us from taking many prolonged stretches of vacation off, particularly around the holidays. In fact, most hospitals don’t even allow for PTO directly around the holidays. 

Hospitals also see a natural rise in patients due to increased travel and time spent in large gatherings. Now more than ever - hospitals continue to see a rise in admissions due to Covid and other winter illnesses. Even though most nurses would much rather be spending the days with their family and friends carrying out old traditions and forging the path for new ones, the holiday magic, and hospital mandates, pull us back to work with hope and expectation that the shifts will be full of laughter, memories, and cherished times.

Source: nurse.org

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“Smart Hospital Rooms” Powered by Alexa are Being Introduced in Many Healthcare Facilities

Move aside, call lights, because there’s a new way to get nurses’ attention: Alexa.

In hospitals and senior centers across the country, a form of Alexa—powered by Amazon and under the brand Alexa Smart Properties, which is already used in hotels and apartment complexes—is being installed as part of integrative healthcare technology. The voice-powered technology is meant to both better connect patients to team members and help them with quality of life. For instance, Alexa can be used to both send a message to the healthcare team when a patient needs something (like a dry turkey sandwich or a new pillow), control things like lights in the room and the TV, as well as bring the patient news or entertainment, all completely hands-free. 

The beauty of using a technology like Alexa in a hospital setting, of course, is that it’s voice-powered. Patients that are bed-bound or have mobility restrictions can still utilize voice in order to communicate or even control things in their room, such as lights or bed settings. 

There are clearly many benefits that can be imagined with Alexa technology and it doesn’t look like it will be too long before voice-powered AI in the healthcare setting is completely normal. But will it be a boon to healthcare? Here’s what we know so far, along with how the technology is being utilized and what nurses can expect from working alongside Alexa. 

“A Game Changer”

While voice-powered technology in patients’ rooms might sound a bit futuristic, apparently it’s already been rolled out. Cedars-Sinai installed Amazon Echoes in 100 patient rooms in 2019 and BayCare Health System in the sunshine state piloted the technology in two hospitals the same year, with plans to install Alexa devices in 2,500 patient rooms across 14 other hospitals. 

Peachy Hain, executive director of Medical and Surgical Services at Cedars-Sinai, said in a statement that the technology will be a “total game-changer” for enhancing the hospital’s experience for patients. 

"Voice is intuitive for patients, regardless of age or tech-savviness," Peachy Hain stated. "Since it's so easy to operate, patients can use Alexa to connect with their care team and stay entertained as soon as they settle in, while care providers can streamline tasks to make more time to care for those patients. It's a total game-changer for enhancing our hospital experience."

The Alexa technology that has already been implemented also works with patients outside of the hospital setting as well. By integrating Alexa into their healthcare systems, some hospitals and healthcare companies are utilizing the technology to provide services to parents and patients who are looking to make an appointment or wondering what the ER wait time is. 

For instance, Boston Children's Hospitals uses a form of the technology to connect with parents of patients for recovery progress updates and schedule post-op appointments. Swedish Health Connect (by Providence St. Joseph Health) uses it to help patients find an urgent care center near them and schedule appointments. And with digital health company Livongo, Alexa can respond with members’ last blood sugar readings, track blood sugar trends, and relay personalized health nudges. 

How Does it Work?

In the initial rollout in Cedar-Sinai, an Amazon Echo was placed in-patient rooms and used for voice control for things like the TV or to send a message to a nurse. The Echo would then “interpret” the message and it would be routed to the appropriate team member. Medication requests would go to a nurse, for instance, while a request for water might go to a CNA. The message is also moved up the chain of command if it is not addressed (which definitely doesn’t happen with a traditional call light, so that’s an interesting feature).

In the upcoming rollouts, the Alexa technology will work much like a smart hub in a home does: the entire room will be a “smart room” and the patient can use voice controls to do things like send a message to the healthcare team, order meals, and adjust the TV or lights. They can even use it as a communication portal to talk to their loved ones directly from their room. Especially during the pandemic, nurses and other healthcare team members used Alexa for “Drop-Ins” to remotely “drop-in” on residents and patients to see how they were doing, communicate something to them, or provide education. 

In assisted living and senior care facilities, the Alexa device also serves as an information hub, relaying information such as the activity schedule, weather, menu, along with brain-boosting entertainment like interactive games and podcasts. Each patient can have its own programmed contact list, so the patient can talk to loved ones with only a voice control. And the Alexa device can even be set to “Do Not Disturb” if the resident would like to take a nap or rest. 

And because the Alexa Smart Properties brand was specifically designed to first be implemented in senior care facilities, the technology is also HIPPA-compliant. So while the devices can be used for helpful medical care like medication tracking, safeguards ensure health information is protected. Additionally, voice recordings are not stored. 

Pros and Cons

Obviously, spokespeople for Amazon are excited about the possibilities for using Alexa in hospitals. (As if Bezos needed more income. Sigh.) 

“The current use cases for Alexa Smart Properties are just the tip of the iceberg,” Liron Torres, global leader of Alexa Smart Properties told Fierce Healthcare. But is that iceberg going to lead to a disaster? Let’s consider some of the pros and cons of using Alexa in a healthcare setting. 

Pros

◉ Less used surfaces to disinfect. This is a big one—things like remotes, in-room phones, light switches, and call lights could all be significantly touched less or even eliminated, cutting down on cleaning and possible contamination between patients and care providers. 

◉ Hands-off communication. Another huge benefit of voice technology is clear after the COVID-19 pandemic—voice technology would enable contact-free communication between a patient and healthcare team. A nurse could safely talk or communicate needs without having to don valuable PPE in order just to find out what the patient needs, then take it all off, dispose of it, then re-don it. 

◉ More patient control. Gone are the days when patients would be left in a room without so much as an update. (That shouldn’t happen anyways, but if you’ve ever worked triage in a small rural hospital short-staffed on a full moon, you know it happens.) A smart room could enable patients to see live updates about their plan of care and feel more in control about their care as well. 

◉ Improve patient spirits. Isolation was a major problem in the pandemic and some patients who had the Echo in their room at Cedars-Sinai spoke highly of having the technology, because it allowed them to feel less alone and more connected with the outside world. 

Cons

◉ Discomfort with technology for some patients. Voice technology could be a barrier for some patients, especially the elderly who may not understand or feel comfortable with voice commands. Additionally, there may be a potential for language barriers.

◉ Glitches with roll-out. New technology will inevitably have glitches that could impact care or perceived quality of care.

◉ AI > humans. Patients may feel a lack of real-live human contact or perceive that AI is preferred over face-to-face communication. 

◉ Costly. Obviously, a technology like Alexa in a healthcare setting will be a costly investment. Not only will that initial rollout cost a pretty penny, but the technology will need continual updating and servicing. One can’t help but wonder how the investment compares to the cost of, say, paying staff nurses more or hiring more staff who could actually check on the patients in-person? 

◉ System burden on staff. Last, but not least, integrating Alexa into current healthcare software and systems means adding yet another new piece of technology that staff will have to learn how to use. 

Source: nurse.org

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This Legislation Could Cap Travel Nurse Pay Rates

It’s no secret that there has been a disparity in agency nurse and staff nurse wages over the past year and a half. And the disparity is becoming increasingly bigger as the weeks pass by. Travel nurse pay has never been higher since the pandemic started, with August numbers showing a weekly average rate of over $2.5K, compared to a December 2019 average weekly pay of just over $1K. And as staffing issues continue to plague the entire country, they show no signs of slowing down. 

However, in an attempt to stop the ballooning wages—and perhaps better balance the gap between staff and travel nurse pay—some states have introduced legislation to cap agency nurse pay. As you can imagine, the idea has a lot of people talking, so here’s more on what the legislation is proposing, and how nurses are responding. 

State and Federal Moves

There have been both state and federal moves towards enacting legislation specifically aimed towards more regulation for staffing agencies. Supporters say that the pandemic has thrust the need for more requirements for staffing agencies into a major spotlight and that ignoring the financial and regulatory issues brought on could lead to long-term impacts. 

Nationally, the American Health Care Association (AHCA) sent a letter to the Federal Trade Commission (FTC), urging the FTC to use its authority to protect consumers from anti-competitive and unfair practices regarding agency staffing. Statewide, Massachusetts and Minnesota are the only two states to already have agency wage caps in place, but some states did make initial moves to address high wages during the pandemic. (Although, notably, Massachusetts raised its caps by 35% for the amount agency staff for nursing homes could be paid during the pandemic.) In Minnesota, wages were also raised, but only slightly: agency RNs can make a max of $58.08/hour at regular pay and up to $99.90/hour for holiday pay. 

Other states have tried to make some kind of moves towards regulating staffing agencies. For instance, with the advent of the pandemic, Connecticut prohibited profiteering during emergencies, with violators subject to fines by the state Department of Consumer Protection and the Office of the Attorney General. The New York State Health Care Facilities Association has also tried to introduce legislation, but has not been successful yet. So far, Pennsylvania is the only state that appears to have the most concrete plan in place for moving forward with legislation specifically aimed at regulating staffing agencies. 

What the Legislation Says 

Although the legislation in Pennsylvania hasn’t been formally introduced yet, Pennsylvania Representative Timothy R. Bonner wrote a memorandum on November 5, 2021, that he plans to introduce Pennsylvania Health Care Association (PHCA)-supported legislation that will “require Contract Health Care Service Agencies who provide temporary employment in nursing homes, assisted living residences and personal care homes to register with the Department of Human Services (DHS) as a condition of their operations in Pennsylvania.”

As part of the requirements, the proposed legislation would establish maximum rates on agency health care personnel. Bonner noted that nursing homes in Pennsylvania lost 18% of their workforce, with 68% of the state’s facilities struggling to meet minimum staffing requirements. As a result—like many other healthcare facilities in the nation—agency staff filled those needs. However, in his memo, Bonner cited a statistic that 39% of the surveyed facilities said that they would not be able to afford to keep their facilities open for more than one year. 

Part of that, he added, was the added cost of paying staffing agencies. In some cases, wages have ballooned to over 400% above the median wage rate for long-term care facility staff. Additionally, some of the facilities themselves have lost their own staff to travel agencies. And because long-term care facilities are funded primarily through Medicare (70% of all care in the state’s facilities are through the Medicare program), paying high agency staff wages has significantly drained Medicare funds as well.  

Although the legislation would incorporate a cap on agency pay, it also aims to allow state agencies oversight of supplemental health care service agencies, which they currently do not have. That would include everything from registration requirements to an established system for reporting and penalties. 

“Recognizing the increased role that these agencies play in the day-to-day operations of nearly 700 nursing homes and 1200 assisted living residences and personal care homes, we must ensure they are operating in a manner that supports the long-term care sector and high-quality resident care,” Bonner wrote. 

What Nurses Think

As you can imagine, travel nurses have something to say about this legislation. In a travel nursing group on Facebook, over 270 comments poured in during a discussion on travel nurse wage caps. 

Some nurses hinted that they would strike if legislation capping pay came to pass, while others warned that there would be no need for a formal strike--travel nurses could simply not pick up new assignments, making staffing shortages even worse. 

“I have just had my best year ever. I could easily sit out for 6 months or change careers,” wrote one nurse. “They do not want to screw around with nurses right now. It is curious that people making legal policy don't possess the professional credentials to do our jobs but believe that they know better than us anyway,” this nurse added. 

Other nurses pointed out that a wage cap could potentially put both patients and healthcare facilities at risk amidst another COVID-19 surge or even another health emergency. “If they try to cap RN pay, what will happen if there’s another COVID surge,” commented another nurse. “Let’s say they cap our rate at 5K, if there’s another surge they will most likely not get much RN’s wanting to help. So they better tread lightly otherwise they will have bigger problems in their hands. A severe nursing shortage.” 

Another commenter chimed in to agree with Celne: “Right?” wrote a nurse. “If they cap, why would anyone want to go help with surges. I’m not going into a hot mess doing more work when I can stay capped right where I am for less work.” 

It’s left to be determined exactly if the legislation will pass and what the possible ramifications could be for both the travel nursing industry as well as the ongoing nursing shortage.

Source: nurse.org

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How to Find a Nursing Job You Love, If You’re Burned Out

The saying “a change is as good as a rest” holds true—particularly for nurses still grinding away in the trenches through the 4th wave of the Covid-19 pandemic.

Before you find yourself so burnt out from work, you wonder how (or if) you’ll ever recover, it’s probably a good sign you need to look for a different job as soon as possible.

And while you may be thinking “Better the devil I know than the one I don’t” in terms of switching jobs and maybe landing in a tougher job than you have now, we’ve put together this article to help you find a nursing job you love that will also show you some love in return.

12 tell-tale signs it’s time to look for another nursing job:

1. Quick nurse turnaround with your employer

2. Ongoing bullying

3. Your health is suffering (mentally and/or physically)

4. Lack of satisfaction with your job

5. Recurring or ongoing anxiety and/or depression

6. Struggling with compassion fatigue

7. Poor nursing leadership

8. Patient safety is at risk

9. You’re being asked to work outside your scope of practice 

10. Your license is at risk

11. Patient care is disorganized 

12. Patients are being abused (report this before you leave!)

Some other red flags that should be waving you toward another nursing job include:

◉ You frequently complain about work

◉ You have trouble waking up for work or dread it

◉ You’re drinking more alcohol or using substances to cope 

◉ You often think, dream, or talk about doing something else

◉ You have trouble sleeping—falling asleep or staying asleep

◉ You’re having more conflict with your co-workers than usual

Once you’ve decided it’s time to pack up your stethoscope and move on, it’s important to make sure you find a job you truly love waking up to each day— or at least like going to. 

Before you pull the plug on your current job, take some time to make a list of what’s important to you in your next nursing job. And don’t be afraid to dream! Remember: You don’t get what you don’t ask (or look!) for. 

Write down all the things that would make your next job ideal. 

8 things to think about in an ideal job: 

1. How much money do you want or need to make?

2. What kind of nursing role do you want to fill?

3. Do you want to get out of shift work or work at the bedside?

4. How far do you want to commute to work? Or would you prefer a remote work at home job?

5. What kinds of employer benefits do you want?

6. Is it important to find a family-friendly employer (yes! It’s possible. Keep reading!)?

7. If you need more education to land your dream job, is it time to start hunting for a nursing program (there are lots of online programs for busy working nurses)?

8. Can you find a nurse who is doing the job you want to do? Tell them you would love to buy them coffee or chat over Zoom because you would love to do what they’re doing and want to learn more about it.

Once you find a potential new job, it’s time to become a detective and do some serious sleuthing to find out all the details. 

Besides chatting with a nurse who works with your potential new employer as suggested above, go check out the place where you’d be working. What kind of vibe do you get when you walk in the door? How do the staff seem to be working together? Can you identify any nursing leaders and are they present and supporting their staff? Are the hallways clear, clean and free of bad odors? Peek in some patient rooms. Are they bright, airy and orderly or dingy with stuff strewn everywhere?

Some other important things to find out include the employer’s reputation and if they’re trustworthy, does the employer offer work-life balance benefits such as nutrition consultations, employee and family assistance programs, stress management workshops, grievance counseling, and financial planning help to name a few. 

It’s also critical to learn if nursing leaders are a key part of the leadership and decision-making team which is a key requirement of Magnet hospitals. Finally, does the employer have a good relationship with its employees—do they genuinely care about their staff and is that care and concern felt by the staff who work there?

Is it really possible for nurses to find family-friendly workplaces?

Yes, it is!—even if you work shift work as a nurse. The important thing to keep in mind is that the term “family-friendly” can mean different things to different people. Take some time to think about what this means to you. And what you’re willing to give up in return.

Having lots of work flexibility so you can meet the needs of your family is great but it might mean sacrificing other benefits including paid time off and regular work you can depend on for a paycheck. Keep in mind a salaried position may be more desirable if you’re looking for flexibility in work hours because you won’t be paid just for actual hours worked.

Are you looking for on-site child care? Maybe paid mental health days and paid time off so you can take a sick child or ailing family member to the doctor? Or do you need a flexible work schedule so you can work around the more fixed schedules of your children? Would you prefer to work remotely if possible? Is maternal or paternal leave important to you?

Also, don’t be afraid to ask for benefits that may not yet exist with the employer. The nursing shortage and pandemic has prompted employers to rethink what they need to do to retain nurses. This includes thinking outside the box in terms of nontraditional benefits such as surrogate-support and fertility programs as this job-seeker asked for—and got!—as part of her new job.

What clues can I look for that might suggest a workplace is family-friendly?

Look for keywords on the company website and listen for keywords during the interview that the employer uses to describe themselves such as “compassionate”, “family-oriented”, “work-life balance”, and “mental health”.

A search of the best places to work online is another great way to find family-friendly workplaces based on reviews of current and former employees. Doing an online search for companies that have won awards for “best place to work” and “family-friendly” company or business can also help you find these gems.

How do I know when I should turn down a job offer?

Just because you got a job offer doesn’t mean you should take it. Nursing jobs are plentiful and new opportunities come up every day. If you made it to the stage of getting a job offer, you’ve hopefully had an interview and had a chance to do your homework about the employer. Nevertheless, some real deal-breakers can pop up during or after the interview that should make you rethink working for an organization.

7 Red Flags To Look For During an Interview

1. Distracted, unengaged, or conflicting interviewers

If during your interview the interviewer is distracted checking their phone or emails often, or if there’s more than one interviewer and they don’t agree on what they’re expecting of you as an employee, cross that one off the list. This shows poor leadership and interpersonal skills not to mention conflicting expectations that will be sure to frustrate you as an employee. And if the interviewers give you very different answers to your questions, this lack of consensus shows it may be difficult to meet employer expectations because even the interviewers don’t agree on employee expectations.

2. Lack of workplace diversity 

During your interview, ask about the employer's stance on diversity, equity, and inclusion (DEI) in the workplace. Ask if this is one of their corporate values and if so, how they promote and incorporate that value in the workplace. Ask for examples of what makes their workplace diverse and what they’re currently doing to increase and encourage diversity in their staff.

3. Employer rigidity

Another red flag can be a rigid employer. For example, if there’s no indication from the employer that they’re willing to help accommodate your need to manage family responsibilities such as caring for aging or ill family members or if you’re presented with a job offer without any discussion about what you’re looking for, you’re likely dealing with an employer who is only thinking of their own needs.

4. High staff turnover

During the interview, or sooner if possible, you want to find out how long the position you’re applying for has been vacant and why. If an employer has high staff turnover, it’s usually an indication that staff aren’t happy for some reason and choose to leave. Keep in mind that a large sign-on bonus will quickly pale as an incentive if you dread going to work each day. And large sign-on bonuses can be an indication of high staff turnover or an inability to attract staff.

5. No room for career growth

According to Fast Company, a recent Monster survey during the pandemic shows “the top two reasons people are looking for new jobs are burnout and lack of job growth or opportunities.” 

Employers should be identifying opportunities for career growth and advancement with their organization during the interview to entice and attract good employees to hire on and stay with the company. If an employer can’t describe what career advancement opportunities they can offer you—or you have to ask about this in the interview and they don’t have a good answer, it’s probably time to keep looking.

6. Pressure to accept a job offer quickly

Desperation is never a good bedfellow. If you’re pressured to make a decision about a job offer in a day or less—or even following an interview—be sure to put the brakes on and ask for more time to evaluate the job offer. 

Keep in mind job offers are a two-way street and employers need you as much as you need the job. Take some time to reflect on the job interview and discuss it with someone you respect. Ultimately, trust your gut feeling and don’t be afraid to decline the offer if something doesn’t “feel” right—even if you can’t put your finger on it.

7. No staff retention strategy

Lastly, let’s circle back to that big fat sign-on bonus the employer may be dangling in front of you…that’s a sweet incentive to start a new job. But, arguably, a more important question is, what is the employer doing to keep the great staff they already have? Remember—this will include you soon if you accept the job. This is a crucial question to ask in the interview. Employers who stumble to answer this are not places where you’re likely to be happy working for very long. Time to keep looking.

Source: nurse.org

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