Bringing a Stop to Nurse Cannon Fodder Syndrome

By Keith Carlson via Multibriefs

Nurses are virtually irreplaceable as the vital lifeblood and connective tissue of any healthcare organization or facility. From the emergency department and the ICU to home health and dialysis, nurses do the highly skilled work that keeps the healthcare engine humming.

When nurses are treated as so much cannon fodder thrust on the front lines without appropriate support from an enlightened and forward-thinking leadership, things can go terribly awry. Being thrown under the metaphorical bus is unpleasant in any circumstance, but when nurses are left to fend themselves while healthcare outcomes and patient safety are compromised, such circumstances are morally and ethically unacceptable.

Nurses as Sisyphus

The myth of Sisyphus gives us the image of a man condemned to roll a large boulder up a hill all day, only to have it roll back to the bottom of the hill once he reaches the top. Sisyphean efforts often go unrewarded, and, sadly, many nurses can relate to such a predicament.

When nurses show up to work, their uncompromising mission is to keep patients safe and provide the highest quality care possible. However, myriad factors make nurses’ labor a Sisyphean effort at best, and leadership who are blind to their situations let nurses and patients down in profoundly impactful ways.

Identifying Roadblocks to Quality Healthcare and Nursing

Healthcare delivery can be jeopardized by a large variety of challenges, not the least of which is egregious treatment of essential staff members. Ignoring staff’s needs, tolerating incivility, and turning a blind eye to toxic workplaces do nothing to assuage the numerous problems in healthcare.

In far too many circumstances, nurses are treated as disposable tools who can be replaced by the next person willing to step into their well-worn shoes. In reality, replacing nurses at a high rate of turnover is both costly and risky in terms of continuity of care, safety, and institutional memory.

When it comes to the nursing workforce, 21st-century roadblocks to quality healthcare include, but are not limited to:

• Rampant bullying and incivility
• Mandatory overtime
• Unsafe staffing levels and nurse-patient ratios
• Lack of true mentorship
• Poor onboarding and orientation practices
• Ineffective leadership
• Toxic workplace environments

The roadblocks to quality care are numerous, as are the solutions that can be employed so that nurses no longer feel like cannon fodder when doing what they’re meant to do.

Nurses Out of the Fire

Nursing can feel like skipping the frying pan and landing directly in the fire, and some challenge helps to build clinical strength as nurses’ careers progress. Having said that, when leadership fails to ensure nurses get a fair shake in the workplace, that’s another story.

In order to help nurses not get burned on a regular basis, there are numerous strategies for doing so.

• A focus on healthy workplace environments is key, including zero tolerance of bullying and incivility, the creation of ergonomic workspaces, and assurances that nurses will have breaks for meals, hydration, and the restroom.
• Enacting safe nurse-patient ratios and staffing practices is essential, as is giving nurses a voice in how their units, agencies, and departments are run through the adoption of shared governance.
• Safe harbor legislation enables nurses to refuse unsafe assignments without fear of reprisal by uncompassionate employers.
  
  Onboarding, precepting, and mentoring programs need to be well-designed, robust, and organized to give nurses the best possible chances of success, no matter their level of experience.
• Nursing and healthcare leaders need to recognize nurses’ value, initiate organization-wide conversations about employees’ needs, and focus on creating tolerant, healthy workplaces that reject toxicity and embrace respect and camaraderie as an expectation, not an anomaly.

If replacing a nurse can number in the tens of thousands of dollars, then unnecessary nurse attrition is the thing to avoid. And if numerous employees report leaving jobs due to poor management, we then know that leadership is truly a key to retention.

Keeping our nurses out of the fire is a major duty of all healthcare leaders, and creating workplaces where nurses can thrive is our mandate. After all, a healthcare system without its lifeblood and connective tissue is a poor system indeed.

Keith Carlson, RN, BSN, NC-BC, has been a nurse since 1996. He is the blogger behind the award-winning blog, Digital Doorway and a widely read freelance nurse writer. Keith is also the co-host of RNFM Radio, a popular Internet radio station devoted to the nursing profession. Under the auspices of Nurse Keith Coaching, Keith's passion is helping nurses and healthcare professionals create ultimate satisfaction in both their personal and professional lives.