The healthcare industry has changed in the past decade with new technologies, hospital mergers and tighter budgets all with the potential to affect how patient care is delivered.
The industry’s changes have altered nursing as well, with higher workloads and more stress, causing some nurses to quit in search of a better atmosphere or working conditions. When analyzing why nurses leave their jobs, several reasons emerge.
What makes nurses unhappy at work? Some of the common issues include mandatory overtime, bullying or toxic behavior, bad managers, floating to other units and excessive interruptions.
1. Mandatory Overtime
Typical 12-hour nursing shifts often stretch longer when paperwork and duty handoffs are included. Some overtime is expected such as to cover gaps in shifts or co-workers who are out sick, and some nurses may welcome the opportunity to earn extra money. But not all want to work overtime, and in many hospitals, they have no choice, sometimes told to take on another shift with only an hour notice.
If understaffed units continually rely on mandatory overtime to provide adequate coverage, patient care may suffer, as can staff morale. Eventually, nurses may become fatigued, burn out and lose motivation. Mandatory overtime also may increase the chances of medical errors. Over time, facilities that require mandatory overtime risk losing good nurses.
Toxic environments aren’t ideal in any workplace, but they can be even worse in hospitals, where patients’ lives are at stake. Physicians, supervisors and fellow nurses who behave badly can throw nurses off their game, make them question their abilities or simply make it impossible to do good work.
Nurses may experience verbal abuse from physicians, which affects morale and turnover. Bullying and intimidation can be prevalent in hospitals and healthcare facilities. Whether it’s general mistreatment, spreading rumors, refusing to help, humiliating, insulting and slighting nurses or treating them with a lack of respect, bullying behavior can have a significant impact on a nurse’s willingness or ability to stay in his or her position.
Ongoing bullying creates a toxic culture that can affect everyone’s morale. Healthcare organizations should institute zero-tolerance policies, raise awareness and create solutions to thwart this harmful behavior.
3. Bad Managers
“Bad” managers can be a real challenge for nurses. Unfortunately, some hospitals hire nurse managers with poor leadership skills, while others ruin good managers by overworking them. Common frustrations with poor managers include communication failures, lack of support, lack of mentoring and failure to set expectations. Bad management leads to a cycle of declining morale and nurse turnover, but some hospitals tolerate ineffective and even aggressive managers.
Nurses are often assigned to other units to cover vacations or sick colleagues. But floating can cause stress when nurses are assigned to an area where they feel their skills are inadequate, such as when a maternity nurse is floated to the critical care unit.
Excessive floating can be a sign of poor management or larger staffing issues. One solution to this problem is creating a floating pool of nurses who are cross-trained for a number of areas.
5. Interruptions and Non-nursing Duties
At hospitals that are understaffed nurses may be asked to take on extra tasks on top of their normal job requirements. That’s why asking nurses to assume additional, non-nursing work can lead to burnout. A nurse’s number one priority should be patient care – not gathering supplies or cleaning rooms. At the same time, constant interruptions can compromise the quality of patient care. Some frequent distractions for nurses include phone calls, missing charts, inconsistent charting systems and computer systems that don’t “talk” to one another.
Yes, nursing is a fast-paced profession, and multi-tasking is expected. But too many interruptions can lead to patient errors or a decline in the quality of care.
Hospital Administrators: Know the Signs
When nurses are subjected to difficult working conditions with mandatory overtime, too much floating and interruptions, bad managers, and bullying, they won’t stick around for more. Retaining skilled nurses requires a concerted effort to create a positive working environment free of these stressors.