Why Nurses are Leaving the Bedside

August 25, 2023 Bridget Montes

In 2022, the U.S. Bureau of Labor Statistics estimated there is about 3,072,200 employed registered nurses in the U.S. workforce.

Since there are 3 million of us, I know I’m not the only nurse out there who got to the bedside and realized that nursing is not what you thought it would be and is not what you wanted when you decided to be a nurse.

Luckily, the nursing field has all kinds of different career opportunities and allows nurses to change positions without changing careers.

Nurses leave the bedside for many reasons, and all are viable reasons to leave any job, especially if the job is unsafe or unsuited for the life they want to live.

Why Nurses are Leaving the Bedside

1 | COMPASSION FATIGUE

Many individuals looking into becoming a nurse do so because of a sense of purpose and wanting to help people in need. The demands of the job warp a good-intentioned nurse into a burnt-out, dissatisfied one.

A combination of what it means to work for big corporations (aka hospitals) and compassion fatigue significantly impacts feelings of fulfillment and overall job satisfaction. As a result, bedside nurses must learn how to compartmentalize and suppress feelings to sustain an outward appearance that will allow them to continue doing their jobs, even when they have emotionally taxing experiences. This experience, called ‘emotional labor,’ takes a toll on the nurse’s overall emotional well-being.

Nurses working in acute care hospital settings and long-term care facilities experience the highest levels of job dissatisfaction, in part due to compassion fatigue, disenfranchisement, and lack of fulfillment. If a nurse’s job is taxing to their overall emotional and mental health, they may choose themselves over their jobs, and I don’t think that’s selfish.

2 | NEW OPPORTUNITIES & HIGHER EDUCATION

The nursing profession has so much variety that the field never really gets old, allowing a nurse to leave a position guilt-free. If a nurse is unhappy with their current position, wants something new, or wants to advance their career, they can try a new specialty with or without returning to school or changing careers.

If a nurse does want to go back to school and earn a master’s or doctoral degree to continue to advance their career, they can do that too. Higher education will likely mean the nurse leaves the bedside altogether.

Nurses have over 100 different specialties to choose from and try something new (and there’s probably more than that too). With burnout rising in bedside nurses and the opportunity for a new specialty, higher education offers a way to break away from the increasing demands of bedside acute care. It may mean nurses leave the bedside for good to move into a less stress-filled work environment.

3 | RETIREMENT

The Health Resources and Services Administration (HRSA) found that the average age of nurses in the U.S. is 50 years old. While this is a relatively high number, it is even more alarming considering that almost half of nurses in the U.S. are 50 years old or older (47%). Having an older generation of nurses like this is a cause for concern since they become more susceptible to injury and illness as they age and will eventually retire.

When this happens, it will leave even more significant gaps in the nursing workforce, putting added pressure on the nurses who remain at understaffed facilities across the U.S. This is an especially serious problem because it can potentially lead to an even greater shortage of nurses in the future, which could put both the nurse and their patients at risk.

4 | TELEHEALTH

With new technology comes new healthcare practices. With the COVID pandemic, we’ve all seen a rise in remote health care, and as technology continues to develop, we will continue to see this trend moving upwards.

HRSA studies show 32.9% of nurses report having telehealth technologies in the workplace, and of those nurses, 50.3% use some form of telehealth in their primary nursing position. This is a remarkably high level of adoption, which suggests that technology and remote telehealth care practices will continue to become even more widely available and accepted, allowing more nurses to leave bedside patient care and focus on other aspects of their profession.

This shift in nursing could profoundly impact the healthcare field, potentially leading to better access to care and improved patient outcomes. However, whether this will lead to a noticeable difference in traditional bedside patient care is yet to be seen. Only time will tell how the healthcare industry will continue to evolve as technology advances.

5 | UNSAFE STAFFING

Unsafe staffing persists in job dissatisfaction among nurses and is shown as one of the most common reasons nurses leave their current positions.

Rates of burnout, job dissatisfaction, poor patient outcome, and patient mortality rates increase when one nurse is required to care for more than 4 patients.

Additionally, this study found “36 percent of nurses in hospitals and 47 percent of nurses in nursing homes, compared to only 21 percent of nurses in other settings, reported that their workload caused them to miss important changes in their patients’ condition.”

High nurse-to-patient ratios are dangerous and only exacerbates the potential for errors, poor patient outcome, and maybe even litigation. So it’s only natural for nurses to want to protect themselves and their license, which may mean resigning from a position or facility with unsafe staffing.

6 | HIGHER ACUITY PATIENTS

We’ve also seen a rise in patient acuity and patients who require higher levels of care from nurses. In addition, the U.S. senior population (those 65+ years old) is expected to grow 49.5% by 2030. In a comparison between older adults in 1999 versus 2014, evidence shows the older population has an increased prevalence of diabetes and obesity by 55% and 25%, respectively.

The Baby Boomer population has seen a 9% decrease in reports of ‘good’ or ‘excellent’ health. With the aging population getting older and sicker, these patients’ acuity rises and will inevitably strain current healthcare systems and staff.

Bedside nurses are often in an acute care setting with intense stress, high risk, and unpredictable outcomes. You add patients who are only getting sicker to the mix, and you have the perfect recipe for burnout and nurses choosing to leave these bedside nurse positions for greener grass, as they say.

7 | STRESS & ANXIETY

I have gone through waves of stress-induced anxiety because of direct patient care. But I found it interesting how most of my research on nurses’ anxiety has correlated this symptom primarily with newer nurses.

New nurses AND seasoned nurses can experience stress and anxiety.

Even as an experienced nurse with 6 years of bedside care, I absolutely still experience workplace anxiety. But, as I said, the anxiety has come and gone in waves over the years, and in my experience, it directly correlates with the acuity of the patients.

Higher acuity equates to a higher risk for poor patient outcomes, which of course, equates to higher levels of stress and anxiety for the nurse. The higher stress levels, pressure, and anxiety will eventually lead to burnout and the nurse deciding to look for less volatile work environments.

8 | BURNOUT & SELF-PRESERVATION

Job dissatisfaction and burnout run rampant among nurses, specifically for those nurses in direct patient care.

According to this study, “Nurses providing direct patient care and working in hospitals and nursing homes were statistically significantly more likely than nurses in other settings to express dissatisfaction with their jobs and to report feeling burned out.”

Additionally, as more and more nurses leave the bedside, there will continue to be a more significant strain on the already prevalent nursing shortages across the country. These understaffed units will cause even more stress and emotional exhaustion on already stressed and burnt-out nurses.

Protecting one’s mental and emotional health may culminate in MORE nurses leaving the bedside and, for some, could mean leaving the profession altogether.

9 | WORKPLACE VIOLENCE

The American Nurses Association (ANA) states that 1 in 4 nurses have been assaulted. Still, only a fraction of victims will report the incident. At the same time, the U.S. Bureau of Labor Statistics finds that healthcare workers are 5 times more likely to experience workplace violence than any other profession.

In a review of 253 eligible studies, among 331,544 participants who worked in healthcare, 61.9% experienced some form of workplace violence. Of this percentage, 24.4% experienced physical violence, and 42.5% experienced non-physical violence, including verbal abuse, threats, and sexual harassment.

Violence, regardless of cause, can accelerate the need for the nurse to remove themselves from poor working environments to protect their own mental, emotional, and physical well-being.

10 | SEVERELY UNDERVALUED

There’s this idea that a nurse is “just a nurse” and completely undervalues all a nurse deals with daily. It’s not only this ideology because studies have shown that nurses largely don’t have the health or retirement benefits packages they need compared to other white-collar professions.

The HRSA has shown the average age of an employed nurse is 50 years old.

However, healthcare benefit structures for nurses are designed for the younger nurse and are inconsistent and outdated compared to the changing demographics and employment histories of nurses in today’s workforce.

To keep experienced nurses at the bedside, healthcare institutions overall need to review and implement nurses’ benefits packages to align with other white-collar professions.

11 | MANIPULATIVE EXECUTIVES

All of us have likely had a bad experience with a boss. The nursing profession, especially when short-staffed, is extremely demanding. Healthcare institutions provide 24-hour patient care that requires nursing staff around the clock.

I’ve learned in my career that it’s crucial for the nurse to remember it’s not their job to staff the facility. This responsibility lies solely on the facility executives and managers.

Nurses have every right to leave a position for their health and well-being. Demanding and manipulative executives or managers that don’t care about their staff is a ‘good enough’ reason for a nurse to leave their position.

12 | WORK SCHEDULES

One of the benefits of nursing is having flexible schedules. However, flexible schedules depend on the specialty and often contribute to the paradox of nurses wanting longer shifts for more freedom in their personal lives while also experiencing higher levels of job dissatisfaction because of those long shifts.

Working 12-hour shifts isn’t a choice for some settings because of the necessity for 24-hour care. While only having to work 3 days a week sounds great in theory, those long 12-hour shifts can be emotionally draining and physically exhausting. Studies have also shown working 12-hour shifts has adverse effects on general well-being, mental health, sleep quality, stress levels, musculoskeletal disorders, and overall job satisfaction.

Additionally, new grads are often forced to choose night shift schedules before qualifying for the experience needed for the day shift. However, studies have proven that night shift nurses have higher levels of anxiety, emotional exhaustion, sleep disorders, general fatigue, and reports of lower critical thinking performance.

A nurse may or not choose a position specifically for the schedule. Since scheduling comes down to personal preference and lifestyle choices, this may mean a nurse leaves a job simply for an opportunity that has a schedule more suited to the life they want to live.

13 | INJURY

A 2016 U.S. Bureau of Labor Statistics report states, “74.1 percent of all injuries and illnesses experienced by RNs occurred in a hospital setting.” Of all the injuries nurses experience on the job, falls, slips, and trips represent 25%, and violence caused by persons or animals represents 12.2%. In contrast, most other causes include excessive force or repetitive motion in bending, twisting, lifting, or pulling.

Nursing has a higher injury and illness rate than other professions, and nurses experience the highest injury rate within the healthcare industry. Injuries also occur more often in nurses aged 45 to 54, which becomes a problem for the workforce because the average age of an employed nurse is 50.

Work-related injuries persist in bedside nursing due to the job’s physical demands and lead to nurses being unable to work. Nurses need to be able to bend, twist, lift, and pull without causing themselves injuries. Unfortunately, some injuries happen regardless of how careful or physically capable the nurse is, and any injury (regardless of cause) can lead to nurses leaving the bedside.

Need I say anymore?

Nurses may leave the bedside for their mental, emotional, or physical well-being, benefits packages or compensation, or unsafe work environments. They may choose to leave because of their schedule or demanding, out-of-touch executives who don’t care about their employees. If a nurse decides to leave a job, it is within their right to do so — no matter the reason.

SDN

Why Nurses are Leaving the Bedside

Why Nurses are Leaving the Bedside

1 | COMPASSION FATIGUE

2 | NEW OPPORTUNITIES & HIGHER EDUCATION

3 | RETIREMENT

4 | TELEHEALTH

5 | UNSAFE STAFFING

6 | HIGHER ACUITY PATIENTS

7 | STRESS & ANXIETY

8 | BURNOUT & SELF-PRESERVATION

9 | WORKPLACE VIOLENCE

10 | SEVERELY UNDERVALUED

11 | MANIPULATIVE EXECUTIVES

12 | WORK SCHEDULES

13 | INJURY

Need I say anymore?

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