Today Kara and Geary talk about how Nursing Retention is affecting the Nursing Community

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Good morning.

Welcome back to go crazy at the nurses round table.

My name is Gary and I'm Kara and we are here today to talk

about all subjects nursing.

So what's going, what are we gonna go crazy with today?

going over nursing retention today?

I believe right.

Yes

right now, 60% of nurses work in hospitals.

and so I think that it's important that we discuss.

How hospitals are handling retention right now.

What do you think?

What kind of job are they?

Are the hospitals doing in retention?

It's the

biggest topic that I've seen in staffing as far as hospitals?

Right now, everybody's talking about retention from physicians to MAs.

I don't know.

I think.

I would say that historically we stayed because we wanted a good retirement or

we wanted a good, you know, pension plan.

And as corporations move forward, the pensions are changing.

It's not a pension anymore.

It's a 401k or something else related.

And the pay isn't that great.

And people are starting to realize that the pay is just not enough for the work.

I think that's part of the that's part of the primary issue is that the pay.

It doesn't necessarily come intra with the work that nurses are doing

right now, because I don't know that people realize the physicality

that's involved with being a nurse.

And I think that's part of the, I think.

Part of the perception of nurses is that they're passing medications and they're

documenting they're on the computer.

Remember the plane, the cards comment.

Mm-hmm that went around the world.

Nurses were furious about that, right?

Because somebody said, oh, you're sitting around playing cards.

and that's just not the case.

It doesn't matter day or night.

If you work at the day shift or the night shift nurses are not

sitting around who has time?

I think people don't realize that our job is not a

12 hour with breaks kind of job.

Right.

You know, um, yesterday I worked in urgent care mm-hmm and from 8:00

AM or about 7 45 till 8, 15, 8 20, cuz obviously our job doesn't end if

there's still a patient in clinic and.

I think all of us took maybe 2, 2, 10 minute to 15 minute breaks.

There was no time in between the fluctuation of patients

to really sit down and eat.

I mean, I ate in front of my computer and that's everyone's daily life.

That's no surprise to any anyone who works in the medical field.

So retention, I think, I mean, we can look at the pros, the

pros of staying with a company.

Why do people stay?

Like, why would you stay Gary?

What, what kept you on the floor for so many

It was the nurses, the nurses

I worked with.

Oh, I loved them.

I loved all of them.

Uh, even the ones that didn't like me, . I still, I loved them from the first time

that I became a nurse, I loved the nurses.

I worked, My first position was night shift.

I worked night shift for three years, definitely paid my dues.

And I worked night shift in an intermediate progressive care unit,

sort of an ICU step down unit.

And on the night shift there were predominantly, Indian and Asian

nurses, and these were a little bit older nurses, and I loved them.

They were the best teachers.

They taught me so many things and they were so loving.

They would hug me and when I would get to work, they would greet me with a hug and.

They were tough, don't get me wrong.

They were tough.

They taught me so many things.

They taught me how to infuse potassium . That's a fun story.

Make sure you hang potassium with the fluids, right?

And, uh, they just taught me, you know, about drips and they taught me all of

those technical skills that you need when you're a newer nurse and you're coming

out of school and you've graduated.

You have your degree and you're ready to go, and you're so excited.

But then your skills, your technical skills you really have to work on.

And so I worked with all of these nurses on the night shift and they were amazing.

Just some of the best teachers, and I loved it.

I just, it was just so wonderful to me.

I was so happy there.

. But tell me, tell me about you, tell me about how you worked with,

how you, why you stayed so long in your area in pediatrics initially.

think, cuz I did so much travel internationally and I worked with a lot

of different organizations . with the impoverished, um, communities around the

world, like in Africa and India and stuff.

And I saw so much devastation with the children that I, I wanted to learn more so

that I could be more useful in the world.

Right?

Yes.

And San Antonio is very diverse with population and we have a lot of indigenous

and , There's a huge underserved population here in San Antonio.

Now, or it's like the surrounding counties that we bring in where I

think we cover like 58 counties.

We do.

We do like all the way in South Texas.

And even in crossing the border.

Yes.

And so we get a high influx of,

. Geary Lynn: We, a high influx of

really, that cross down, even though they're crossing the border in Mexico,

they're coming from all over the world because we have lots of refugees as well.

So the, the hospital that I picked was, you know, a county

hospital that serves, that, serves all that, serves these populations.

Right.

And so you see just a little bit more diverse diversity in the type of

medicine that you're getting to practice.

Mm-hmm.

and then also where trauma and.

When I started, I thought, this is gonna be such a good learning opportunity that

I can take with me all over the world,

And then I just fell in love with.

Also, obviously the people that I work with, you know, you have so many nurses

that have been there for forever and they just teach you all the tricks and

you see how much, how much of their heart and soul and their blood and

sweat has gone into work that they do.

And you just idolize them and wanna be just like them.

. I work night shift, so being with these little kids when

their parents can't stay Oh yes.

At night because they have to go to work the next day and they have other

kids that they have to take care of.

And being able to be the one that holds them at night and takes care of them

and, you know, tells them stories and changes their dressings and with real

tenderness, you know, and compassion.

I think I just fell in love with doing that.

And then you grow your skills at the same time, not.

As an independent, as an independent woman.

Right.

Be or a person, man, man or woman.

Right.

Being able to walk into just random people's rooms and getting to know

them in their most deepest, like Yes.

Worst experiences of their lives.

Right, Right.

Cause you're getting all up in their personal business.

Mm-hmm.

and, and then being confident and being able to do that and

show love and compassion and, and be good at what you do.

The biggest thing is how much I cared about my patients and I just

didn't have the heart to leave my patients, even if I was so tired at

the end of the shift, if there were still things that needed to be done.

And that's what I mean about the physicality.

If it was the end of the shift and they needed, the nurses

needed help with a patient.

Moving them in bed or helping them to the bathroom or any

of those things I would try.

And I think all nurses are this way.

We have this mentality that we wanna help each other.

We'll go the extra mile.

We'll stay, we'll and then we'll go back and we will help lift the

patient or move the patient and, um, help take care of put in that last IV.

Yeah.

Put in that last IV.

Yes.

There'll be someone who will say, Hey, can you help me start an IV on this patient?

He just lost his line or working in oncology, the port, if there was any

type of an issue and we needed to.

clear the line, then we'd have to put in an IV.

And so someone would say, Hey, can you put in a line because our, uh,

specialty services who normally would do that, they're busy right now, right?

Or the charge nurse in the ICU, who would, who would normally be

able to come do that for nurse?

For our, for our unit, was busy.

She was in a code so we would, so we would have to.

either do it ourselves, or you wanna get someone on your floor who was the best

person to go ahead and start the IV.

So that's something that we would stay and start the IV.

So I think that that's an ongoing, we it's the physicality putting

in IV isn't necessarily doesn't involve the physicality as much.

Working on the floor is a very physical job.

You're going back and forth.

And with hospitals as big as they are these days, the units are pretty big.

think it's important that we stay organic.

When we talk about these things, we're talking about nursing retention,

something that everyone is quiet about.

No one wants to say up front.

If you look at so many different websites and reports and articles,

uh, they will give you a list of what's going on and they always list

pay as the last concern of nurses.

So they'll list.

Nursing workload nurse to patient ratios as, uh, top concerns of nurses,

safety, , nurse to patient ratio.

And then at the very bottom pay rate is what they'll say, but I

think pay should be at the top.

Yeah

I think that's a load of hog wash.

That's a nice way of putting it as if money isn't on

the top of everybody's mind.

Right now, it is at the very top of the list we are in such high inflation.

As a society.

Food is not nearly as cheap as it was even two years ago, and they wanna put

finances at the bottom as if we're more worried about nurse to patient ratios.

Not that that's not a valid concern, we all are.

How many of these nurses are jet setting across the country for $4,000 a week

on a travel contract, willing to be in an unfamiliar environment, set up

on a new computer system of chart.

work with all new coworkers.

I mean, we all know how important it is to work with nurses and staff

that we feel comfortable with.

Yes.

Meeting all new people in a completely unfamiliar place.

And yes, it's fun and it's exotic and it's an experience,

but it's exhausting as well.

And taking whatever patient load we're given.

It doesn't even matter for more money.

Why?

Because of the money, not because we're getting, you know,

That's exactly right.

I do think when it comes to retention, I think one of the things that any

employer can learn, and I know it's 60% of nurses work in hospitals.

So, I don't know if you're aware, but in 2020, when all this crazy business

happened with COVID nursing, traveling grew up or grew 35% compared to the

previous year, and it's expected to grow another 40% in the future.

Here we are seeing all these issues with monkeypox pop up, and

there's a potential for a polio outbreak . So there's a lot going on.

so travel nursing is gonna spike again.

So how the question remains, how can we retain nurses in

their own cities where they are?

Right.

and I think that most nurses, we talked about this before that no

one wants to leave their home.

Mm-hmm no one wants to leave their families for three to

six months, their dogs, their.

Who's gonna watch 'em who's gonna watch the dog.

Who's gonna water my plants.

I mean, this is a problem.

what are we gonna do?

What are we gonna get?

How this is making us go crazy.

You having to be travel nurses, but, um, when they're offering,

how much were they offering?

4,000 to $5,000 a week?

You can't compete with that.

That's somebody's monthly salary.

Exactly.

Depending on what area of the country you're living in.

So people are evaluating, I'm evaluating, you're evaluating what sacrifice

does my family need to make, right.

In order for me to make this kind of money, because it might not come around

again, as we see, it's probably not going away, but what can the facilities do now?

Okay.

Decrease infection.

Minimize, um, the risk of infection in the facility.

Okay.

I think that, yeah, maybe that's somewhere in there, but safeguarding staff,

I mean, bullying is a huge problem.

And from management down to, you know, coworker from what is

it, your, your parallel line and then your horizontal line, right?

Mm-hmm so your vertical and horizontal.

I mean, that's a big issue for a lot of people.

Nobody wants to deal with being bullied and made fun of at work, right.

Or having a hard time you know, the motive for advancement, the opportunity

for advancement, all these things.

I think that contribute hospitals really need to work on that.

Yes.

And with hospitals being one of the largest, well, the largest employer

of nurses right now, 60%, I think we said earlier that 60% of the

registered nurses work for hospitals.

And, uh, how can hospitals increase their retention.

I mean, do you think a bonus would work like a quarterly bonus for, I

do think a bonus would work because one of the things I've been speaking

to a lot nurses I've been trying to survey nurses wherever I go.

I try to talk to the nurses, whether it's in a clinic and I have been following

different people, um, in clinics or hospitals and asking the nurses.

So what would keep you.

What would keep you from leaving?

And a lot of them have cited.

The fact that the hospital is offering five, 10, $20,000 sign on bonuses to new

nurses coming into the system, new grads.

Yes mm-hmm . And then there's staff.

Who's been with them who have been with them for five, 10 years and longer.

Right.

What are they getting?

Exactly.

And how hard was it for them to pay back their student loans on the, I

have to work for a county hospital for 10 years and make the minimum

payment on my student loan in order to get any kind of loan forgiveness.

Yes.

Meanwhile, working at county working with the people that nobody wants to

work with for the money that nobody wants to make, because it's not good money.

Maybe good opportunities for learning, building your skills.

You become amazing at your job, but I'm making hundred $20 less an hour than the

person working at the private facility.

That's up the street.

That's just not right.

So maybe a bonus, but then what about, okay.

Um, we're gonna pay back your student loans.

I do think, and I do see some hospitals starting to do that.

I know at university hospital , that was a program they were starting,

that was becoming very popular.

Mm-hmm so to get loan forgiveness, right?

Yes.

I think.

So there it's, it's a multipronged subject and there's a multipronged

solution to this problem.

Uh, and I think for me, I think this starting out, I think it's a good

start that hospitals are helping nurses pay back their student loans.

I think that would be a huge incentive and I think it segues

us into a really good topic.

Discussion, which is how the medical community is pushing nurses

to higher education, but they're not paying us more to do it.

That's exactly right.

And on that note, that's gonna be part of our go crazy conversation

about nursing education requirements.

All right.

That's all the time we have for today.

We'll continue to have our discussions here at the round table with Karen, Gary.

Catch us next time.

. And remember whatever life

So email us, drop us a line at gokrazy@thenursesroundtable.com.

That's go krazy and remember crazy with a k@.