It wasn’t until the moment that I stopped romanticizing my role in healthcare, that I reclaimed my power. There is a long-standing notion that in order to be great at anything, you must be deliriously passionate in its pursuit. I used to believe this about my role as a nurse and in healthcare in general: how could I possibly reach the pinnacle of my profession, if I didn’t give it my all? How would I ever succeed in my role, without sacrificing myself in return? As it turns out, learning to create firm boundaries in my role as a practitioner not only made me a better provider; it made me happier, healthier, and more well-rounded in return.
Every day, we are bombarded with the false narrative that saying “no” makes us difficult to work with. When we are asked to come in for overtime; pick up that extra shift; stay the extra few hours…and we agree…we are proclaimed team players. But when we don’t do these things – when we make up excuses for not “going the extra mile,” or worse, say no without reason or explanation – we are made to feel as though the plight of patient care rests on our shoulders. How dare we shrug? How dare we place our needs or wants above the necessity of patient care? Well, here's why:
Pay more. Provide salaries contingent with the corporatized landscape you’ve built this new age of healthcare upon. If you can charge exorbitant fees to patients, you can pay increased salaries to providers.
Provide better staffing. More bodies in the hospital, means improved morbidity and mortality for patients. It’s not just convenience: it’s evidence-based practice.
Ensure adequate resources. That doesn’t mean a concierge service or fancy coffee shop in the lobby: it means access to the basic necessities to ensure safe and effective practice at every level of care.
Encourage work-life balance. Stop harassing your staff day after day, shift after shift for more. You cannot incessantly take without giving something in return. Stop treating resident physicians and unpaid students like cheap labor: they are struggling; they are human; and this system is archaic. Cut off the mindset that “because we once suffered, so you must too.”
Set realistic expectations. Stop encouraging patients to rate hospitals like they are hotels.
Trim the fat. Stop paying top hospital administrators millions of dollars in salaries and bonuses, only to tell staff that tough economic times mean tightening belts.
Stop having it both ways. You can’t deem healthcare a not-for-profit sector, and purely focus on financial gain. If you’re going to corporatize medicine, level the playing field.
Drop the rose-colored lenses. Stop calling healthcare providers “healthcare heroes” when so many never signed up for that level of sacrifice. Some of us just want to do a job; go home; and have a happy life.
If patients and their families truly understood the house of cards upon which the US healthcare system is built, they would demand reform at every level. We are faced with a crisis that will only prove more damning as more and more brilliant, compassionate providers walk away from hospitals first, and healthcare as a whole eventually. We are no longer “quiet quitting:” we are walking away entirely…and that should speak volumes. We are on the cusp of a second pandemic, and one that will lead to the loss of human life in a very different way.
Do you understand that there is not a single hospital across the country that doesn’t depend exclusively on begging, pleading, and cajoling staff to stay just another hour? Take just one more patient? Cover just one more shift? Do you understand that the only reason you or a loved one have any care at all, is because providers are guilted by a sense of obligation, or cannot afford a sustainable living wage otherwise? Do you understand that even the most prestigious surgeons in the country graduate riddled with debt and without recourse except to be worked to the bone? Do you understand how this is amplified for women and minorities? Do you understand that I have hardly ever met a nurse with only one job? Do you understand that a patient care technician makes a lower wage than many in the retail industry? Do you understand the physical and mental toll that comes from caring for patients at baseline? Now amplify that by a nation that focuses on damage control over preventative medicine; that refuses to believe that universal healthcare is a right; and that relies on staffing a hospital based on a text message, whim, and a prayer.
I have been a nurse for nearly twelve years – with most of that time in critical care. I spent thankless shifts caring for the most acutely ill patients in the hospital. I sacrificed my time; my mental health; my most basic physical needs. And then, I attended graduate school as a nurse anesthesia student, and learned to provide safe anesthesia care at every level…for free. And today, as a practicing nurse anesthetist, I am grateful to only have one person at a time to care for…but this does not eliminate the stress; the physical burden; and the overarching theme of provider efficiency in the name of fiscal economy.
After years of trial and error, I finally learned how to say no. I learned how to leverage my skills and talents in a way that provides me with a sense of balance. But make no mistake about it: the long-standing damage caused by working as a healthcare provider in the United States is permanent. It’s chronic. It will never leave me, until I someday decide it’s time to leave it all behind. We are a nation filled with brilliant minds and bleeding hearts…and we are one patient; one shift; one incident away from leaving it all behind. Stop romanticizing healthcare and see it for what it is: an exchange of fees for services. It’s the only way to sustain in a marketplace that leverages human empathy as capital. I will always dedicate myself to provide the best possible care to my patient…but I will no longer throw myself into the fire. I have been burned before: I will no longer ignite myself and choke on the fumes to keep a broken system warm. I will say no. I will scale back. I will stand up. I will walk away. Bruised and beaten, perhaps…but never broken. Because when part two of this pandemic strikes – the one that’s plagued with post-traumatic stress; burnout; and exhaustion…the only one out there to protect me, is me. And I hope you will stand up for you, too.
** You can read about why I left bedside nursing in more detail here: https://www.amazon.com/dp/B09ZRSGB1W?ref=myi_title_dp