by AFT President Sandra Feldman
May 2001

Poor working conditions
for nurses endanger
their patients.

Recently, I spent a day in a large urban teaching hospital watching nurses and other health professionals save lives. In a neonatal intensive care unit with 28 struggling premature newborns, I saw miraculous modern technology and nurses doing miraculous work. But wherever I went, I heard stories of understaffing, low pay, exhausting hours and mandatory overtime, and most alarmingly, nurses who love their profession but are planning to leave it.

That we have a shortage of nurses isn’t news anymore. Our critical need will rise to almost half a million by 2008. Like teachers, nurses are opting for other professions previously unavailable to women. But disturbing new numbers highlight even greater threats to the nursing profession and the overall quality of our nation’s health care.

A new poll commissioned by AFT’s health care division and conducted by Peter Hart Associates shows that fully one fifth of the nation’s nurses are ready to leave right now because they’re fed up with their horrendous working conditions and the lack of support and training they receive. Equally alarming, the study found that more than half of current nurses age 18-39 have thought about leaving. Imagine the crisis we would face if this came to pass.

Nursing has always been a demanding profession. Those who go into it--like those who go into teaching--do so out of commitment. That’s why these new poll numbers are especially dismaying. Harsh decisions by the health care industry have made it virtually impossible for nurses to fulfill that commitment and so they are leaving in droves to pursue other careers.

Cutting costs has led to cutbacks in staffing, which has led to the hiring of unqualified new workers and mandatory overtime for nurses. The bottom line of this shortsighted approach is that the burdens on nurses are increased and patient care is compromised. It’s frustrating to a nurse who wants to do her job and dangerous to her patients.

Competence suffers

Here’s how one nurse describes what she faces at work: "At 42 years old, I ache all over after a 16-hour shift, I go home tired, and then I’m up again in 4½ hours to do another 8- or 16-hour shift. How competent can a nurse be in these conditions?" The current system has also cut back on support for new nurses as well. As a result, one veteran nurse says she can no longer recommend nursing. "They plop you on a floor and don’t give you the training anymore. It’s terrifying for someone new." I’ve heard this from teachers, too, who are "plopped" into overcrowded classrooms without adequate support.

These stories are not aberrations--they are the result of business as usual. When dedication is exploited, you get the kind of blind exhaustion that leads to horrific stories like one about the nurse who was forced to work the night shift, fell asleep at the wheel of her car on the way home, and hit a telephone pole.

But there is a silver lining. According to our poll, nearly three fourths of the nurses thinking about leaving would stay if improvements were made. And we know what needs to be done. First, ban mandatory overtime--for the good of patients and those professionals who care for them. Second, raise salaries and improve benefits. Third, enact federal standards for health care staffing levels. Fourth, encourage more people to enter the profession, particularly minorities and men, by adopting student-loan forgiveness programs and encouraging health care systems to offer tuition and stipends to employees who return to school. We need more nurses to increase the attention care-givers can provide patients. Just as a lower teacher-to-student ratio improves learning, so too does a lower nurse-to-patient ratio improve health care.

Ending a vicious cycle

Acting responsibly now can end the vicious cycle in which increasingly unattractive jobs become more difficult to fill, causing more understaffing and even less personalized patient care, and leaving nurses feeling more used up, worn down, and burned out. One nurse I recently learned about would go out to the parking lot and get sick after finishing her shift each night because of the stressful conditions. You won’t be surprised to hear that she has since left nursing.

It is ludicrous to recruit people into a profession, prepare them to uphold its standards, and then make their work environment so poor it sends them running from that profession at high speed. Yet that is what’s happening in nursing today. If you’ve ever been hospitalized, or worried about someone who was, you know what a difference quality nursing care can make. It’s time to make sure that hard-working nurses get the support they deserve--so they can provide us and our loved ones with the care we need.