What If the Nurses Disappeared?

By Keith Carlson via Multibriefs

Imagine a hospital devoid of nursing care. Picture a nursing home without nurses. Visualize a healthcare system functioning without its very backbone and lifeblood.

That is the world we build when we turn our backs on nurses.

Patient load undermines care

When corporate entities set nurse-patient ratios that support profit above all else, both nurses and patients suffer within that mean calculus. And when nurses are driven to burnout by environments that undermine their ability to perform, a recipe for disaster is brewing.

Nurses who cannot manage untenable patient loads will push themselves to the limit of their endurance in order to achieve the unachievable: optimal patient care. And when the workplace environment does not support optimal care and nurse well-being, burnout sets in.

Nursing is based on service to the patient and to the best possible outcomes. Nurses take their responsibility seriously, and yet the powers at work in our 21st-century healthcare system often undermine nurses' ability to fulfill the promises of their chosen career.

A broken trust

Nurses who feel unheard and unseen will lose their loyalty to their employer. Patients who feel that the healthcare system no longer has their best interests at heart will feel their shaky trust in that system disintegrating.

As the fate of the healthcare of millions of Americans is debated in the halls of Congress, patients lose even more hope as they worry for their uncertain future. Patients' understandable fears color their interactions with healthcare providers, and since nurses regularly interact most with patients, they tend to bear the brunt of patients' anxieties.

A culture of bullying

Bullying in nursing — also known as lateral or horizontal violence — is widely prevalent in the profession, to the point that such workplace violence and aberrant behavior drives both new and seasoned nurses from the profession.

Nurse bullying expert Renee Thompson reports the following on her website:

"Workplace bullying is a problem. Bullying is destructive, pervasive and undermines a culture of safety. Workplace bullying has been linked to intent to leave, poor patient outcomes, and poor productivity.

"85 percent of all medical errors can be linked to poor communication and disruptive behavior among healthcare providers.

"Of the new nurses who quit their first job within the first year, 60 percent quit due to the disruptive behaviors of their co-workers.

"48 percent of graduating nursing students are concerned about becoming a target of workplace bullying."

Inaction in regard to workplace bullying is essentially complicity with that behavior. Healthcare industry leaders must take concerted, long-term action to stem the tide.

The solutions are out there

Violence against nurses can be perpetrated by patients, patients' families or even law enforcement.

The solutions to these issues are not easy to come by, and the fight against bullying, nurse burnout and violence are fraught with difficult questions and decisions. However, we must create a culture of safety for nurses wherever they provide care, and nurse retention is paramount.

In light of the importance of healthcare in the lives of the citizens of any country, it is crucial to not turn our backs on any healthcare professionals dedicated to the provision of such care. And with nurses suffering unduly vis-à-vis the aforementioned issues, thoughtful and effective solutions are urgently needed.

Nurses consistently hold up more than their end of the bargain. It's time for the system at large to decrease nurses' load and protect them from the scourges that undermine nurses' wellness, career longevity and effectiveness as skilled healthcare professionals.

We should never put nurses in the position of needing to walk away and never look back.

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.