I’m a nurse. I’m also tired, overworked and close to burning out.
I was twenty years old when I graduated nursing school. I chose to study nursing because I knew I wanted to help people and it was a practical hands-on profession that afforded me that privilege. Twenty-two years later, I still believe that I’m privileged to be able to work in a job that helps people. I strive to treat my patients not only with professionalism but with a smile and compassion as well. Yet as much as I like making a difference in this world and being there to care for and support people when they need it the most, I am very close to burning out.
It’s not because of my nursing related responsibilities. It’s not because of the tremendous responsibility of making split second judgment calls as to which patient needs more urgent attention. It’s not due to the pressure of hoping you haven’t missed a symptom you should have caught. It’s not because of the vast bank of knowledge you’re expected to know and use regarding diseases, medications and procedures. Yes, all of the above have been a heavy burden to carry during my many years working in the ER and now as a nurse in outpatient Oncology. Those concerns are all a huge responsibility and often times a stressful weight on my shoulders. But they are not the reason I’m close to burning out.
The nature of nursing work itself is not the problem. The problem is the unrealistic workload and the sometimes disrespectful conditions in which I am expected to care for my patients. The workload and the number of patients I am expected to care for each shift at times borders on being unsafe and at times is downright reckless. At the minimum I have the huge responsibility of making sure that the chemotherapy I give my patients is correct and that I have not missed any red flags that might mean that I need to consult first with a doctor before treating them. But is there anyone out there who wants to be treated with the minimum? I sure as heck don’t want to treat my patients with the minimum. I don’t want to hastily ask them a few questions, hook them up to their treatment and not even have time to check up on them. I don’t want to treat them while my stomach is rumbling and I’m dizzy because I haven’t had a chance to eat. I don’t want to have to choose between making a patient who feels physically lousy wait or going to the bathroom. I don’t want to hook someone up to chemotherapy when they don’t have a private place to sit. I don’t want to have to fill up supplies because there are not enough nursing aides. I don’t want to have so much work that I have to stay late almost every day. I definitely don’t want to be so exhausted at the end of the day that I collapse on the couch when I get home and have no energy for my kids.
The sad part is that nurses work so hard and yet our patients are still frustrated. They are irritated at the amount of waiting time, resentful of the lack of attention they receive and they are annoyed that we have no time for them. They understand it’s not our fault but all too often that doesn’t stop them from lashing out at us in frustration and anger. I can’t say I blame them but we too suffer. I want to be able to give each and every one of my patients the time they not only deserve but also need. I want to make sure they have time to ask all the questions they have. I want to make sure that I have time to speak to someone who is crying or sad. I want to hear about the successes and the moments of hope. I want to make sure I do everything I can to give my patients the information, tools and the support they need and deserve in order to have the energy to get through their treatments. I want to do all that while still taking care of myself. I deserve it and my patients deserve it.
Then there are the days where I question how I can go on. The days when what is expected from me is too much for me to handle. The days when my calm, cheerful facade cracks and breaks. Those moments when my irritation for the situation sadly gets taken out on a patient who just needs to feel taken care of and comfortable with their level of care. On those days when I can’t put my patients first I question whether I am too burned out to continue doing my job. I question whether it is time to make a change.
So why is the situation here in Israel the way it is? According to the OECD statistics for 2011 there are 4.85 practicing nurses in Israel per thousand people in the population. That is a very slight rise from 4.76 nurses per thousand people in 2010, but a decline from 5.28 nurses in 2005. The OECD average worldwide is 8.7 nurses per thousand people.
Why are there not enough nurses in Israel? I believe that one of the main answers to that question is that salaries for nurses are too low. If I compare my salary to the salary of someone my age with my years of experience who is working in hi-tech the discrepancy is huge. I recently spoke to a nurse who just came on aliyah to Israel from the United States. She opted out of hands-on nursing and is working for a private company because the salary she is able to make here as a nurse is less than a quarter of what she had been making in America. While she would love to go back to caring for patients hands-on, she can’t afford to.
Why is that? Why is the work that nurses do not deemed important enough to command higher wages? Are we being taken advantage of? Why is there no money in the government budget to raise nursing salaries to a respectful level without nurses having to resort to a strike that crippled the health care system causing inconvenience and worse to a population who depends on their healthcare. Why did the government let nurses strike for over two weeks with an estimated tens of millions of shekels of income lost during the strike when they could have reached the deal made with the nurses without it.
At this point I don’t think the answer to why really matters. What I do know is that unless something is done to raise nurses’ wages enough to make a nursing career an attractive proposition, a decade from now we will not have enough nurses to care for the population. The younger generation is financially savvy and they know what it takes to live a comfortable life. They also know that a nurses’ salary is not enough to make ends meet. Most nurses work shifts and weekends. They work hard both physically and emotionally and they get paid peanuts. Why wear yourself out, have it take a toll on your own health and on your family life and not even make a decent salary?
It’s no surprise that people are choosing more lucrative professions. It’s no surprise that many nurses are leaving nursing for higher paying jobs. Can you blame them when the hourly rate for a cleaning person is higher than the hourly rate a nurse receives? (Yes, there are other benefits so that’s not exactly comparing apples with apples but it’s close.) Right now, the salary of a new nurse working full time in a hospital (nurses in clinics make less) is between 60,000-70,000 shekels ($16,000 to $19,000) gross per year (without the additions for shift work).
Something has to be done. Whether the salary increase achieved with this last nursing strike is enough to raise salaries to a level that will attract more students to learn nursing is yet to be seen. I hope so. Even so, the physical conditions nurses work in need to be improved and their workload needs to be lightened. Nurses deserve that and their patients deserve that.
In the meantime, until that happens, please remember to at least pay the nurses in your life with kindness. A word of thanks, a heartfelt compliment, an acknowledgment of the heavy workload are all appreciated. They help us remember why we became nurses. And if you could remember to be patient when we are doing our best that would be really helpful too. I’m a nurse, I care and I don’t want to burn out.