Low pay, understaffing, increased patient ratios, higher acuity patients, abuse from peers and administration and burnout are just a few of the reasons why nurses are running away from the bedside. According to the RN Work Project, their 10 year study found 17% of newly licensed RNs leave their first nursing job within the first year, 33% leave within two years, and 60% leave within eight years. I am part of that 17% who left the bedside within the first year of nursing. I stayed at the bedside for about 6-7 months before I left my first job as a medical surgical nurse.
As a nursing student it is engrained in your head that you need to work bedside. Many nursing instructors recommend starting in medical surgical for a least a year before specializing. Often times this is repeated over and over to students and students believe it. I believed this and when I graduated nursing school I applied to my first bedside job on a medical surgical unit and I was thrilled. After all, the hospital I was going to work at had Magnet status, had “Accreditation with Distinction” from the American Nurses Credentialing Center (ANCC) and has received national recognition as one of the best hospitals. It was a dream come true and I thought my opportunities there would be endless. Sadly, after six months I was burnt out and walking away from bedside nursing.
So what went wrong? Why was I walking away from the bedside after only six months? Well, nursing at the bedside was not what I thought it would be. The current model of education does not prepare students for the realities of real life nursing. As a nursing student in clinicals you are assigned to a nurse and about two to three of that nurses patients. The student is given an unrealistic number of patients and this does not allow you to develop time management or set prioritizes. My education focused on seeing skills and performing some skills if the opportunity arises and if the facility allowed students to perform those skills. As a nursing student I was also able to dispense medications and push medications. Again, there was never a focus on time management or prioritization. The important skills that are required as a nurse and that you only develop with time and practice. Time was spent on care plans and understanding the medications we were dispensing. I will tell to this day as nurse I have never written a care plan.
So here I was a new nurse and working on the unit. I got through orientation and was doing residency and the day came to fly solo. There I was with 5-6 patients and still felt like I had no idea what I was doing. Yes I learned skills and was able to perform them. The problem came with time management and prioritization. I had no idea how to prioritize. Another massive problem that I was unaware of when I was hired was the inability of the hospital to keep staff. After I started my position I was told by others that most of the new nurses quit before the first year. What a way to feel confident and welcomed as a new nurse! We were always short staffed and would have to pick up extra patients. We also were short staffed with aides. A 31 bed floor with two aides. You are set up for the impossible. Nonstop call bells, turning every two hours, wound care, hanging fluids and drips, drawing labs, monitoring telemetry, calling physicians, round the clock medication administration, rapid responses and then the massive amounts of time needed to document. Then dayshift would come in and complain about a task not being done. You are exhausted and did not get a break in those twelve hours, never got to use the restroom and here you are being reprimanded for not inserting a new IV. It was exhausting and I was burnt out faster then I ever imagined. Residency classes were not helpful and when you had an issue it was not addressed. My personal experience and opinion is it felt like they offered residency for the title and look that came with offering it. They offered nothing to help me develop my skills as a floor nurse. I felt alone and like nobody cared. Then came the six month mark and somehow on certain nights I became the most experienced nurse on the floor. Talk about a scary situation when you are a brand new nurse who has been at the bedside for less then a year and you are the most experienced nurse on the floor. Sure there were experienced nurses you could call for help that floated the hospital but they got to you when they could so you better be able to wait until its your turn.
I quickly became exhausted and burnt out. Driving home became dangerous because I would doze off at the wheel from exhaustion. I would cry before work and after work and my anxiety was elevated. I felt like a failure, I felt like I could not do anything right. I was constantly being told what I was doing wrong but also how good of a job I was doing. I was confused and felt lost. I was terrified I was going to hurt someone because I always felt rushed. So one day I started looking at other jobs. I can not stress how much I felt like I was a failure for wanting to quit already. I thought if I quit and leave the bedside I am not a real nurse. I thought people would look down at me and see me as a quitter. I thought nobody will hire me with what little experience I have. Doubts and questions where constantly running through my head. What would my fellow nurses think of me? What would my fellow nursing classmates think of me? What is wrong with me when it seems like others where surviving but here I am falling apart!
I just couldn’t do it anymore and I knew I could not stay miserable for much longer. So I started looking for other jobs. I was desperate and was willing to take anything to get some freedom and that is exactly what I did. I took a job working with medially fragile kids. I never wanted to work with kids but I ended up enjoying the job! What a relief it was leaving bedside nursing! I had a patient load I could handle, got a pay increase and more importantly was no longer burnt out or feeling depressed. It felt like a weight was lifted off my shoulders.
If you are a new grad and feel like what I was feeling when I was working at the bedside please know you are not alone! These feelings are more common then you think and you are not the issue. The system is broken! Nurses are being stretched thin while ratios and acuity are increasing. The bedside may not be the place for you and that is okay because your options are endless. Life is to short to be miserable and you need to make yourself a priority. It’s okay to simply quit things that are no longer making you happy. You are and always will be a nurse. You will develop new skills anywhere you work whether it is at the bedside or not. You are valuable to the field of nursing. If you ever need someone to talk to please feel free to reach out to me. There are a few things I was wrong about when I was working the bedside. First, I was not alone because many of my peers felt the same way as I did but some people are better at handling stress. Secondly, you are not less of a nurse for not working at the bedside. The great thing about nursing is you have many opportunities. Nurses are needed away from the bedside to keep patients out of the hospital. You do not need that one year of bedside nursing to find jobs away from the bedside. Last, if you have a passion or calling in a certain area of nursing, pursue it!