'Exhausted and fatigued': Nurses lift their voices and demand to be heard

Nurses say they aren’t being protected at work from both the pandemic and threats of violence. They also said healthcare leaders must do more to show nurses are valued.

Nurses have been on the front lines during the COVID-19 pandemic, but many nurses say they aren’t being heard.

They say they're utterly exhausted. They don’t feel protected or respected. They want a bigger voice in patient care and to see potential for advancement. Some say they feel unsafe.

Nurses around the country rallied on Twitter Wednesday, using the social media platform to speak out. Using the hashtag “#ANursesVoice”, nurses called for change. IntelyCare, a nursing agency based in Massachusetts, helped organize the effort.

Monique Cano, an emergency room nurse, said the term “living vicariously” has a different meaning in her world.

“We are not OK,” she wrote. She said there needs to be more conversations about the impact of staff shortages and burnout, which were problems even before the arrival of the coronavirus.

David Mancini, a registered nurse, said nurses are experiencing more than burnout, but compassion fatigue or “vicarious trauma.”

Nurses “are exhausted and fatigued as a whole, resulting from being overworked, underpaid, and chronically understaffed,” he wrote on Twitter.

Later, he wrote, “Every nurse I know has been assaulted, used as literal punching bags. We’re told ‘you signed up for this.’ If we are ALLOWED to report it to the police, most of the time, they don’t even make a report. We deserve more security and support!”

Rhonda Collins, chief nursing officer of Vocera Communications, agreed. Collins said there must be a culture change in healthcare providers when it comes to nurses being threatened or assaulted.

“Provide nurses with immediate response technologies to call for help!! Remove stigma, lateral bullying. Crisis issue for nurses,” she wrote.

Recent studies have shown nurses are exhausted and willing to walk away for other careers. A study published in Mayo Clinic Proceedings found that 40% of nurses said they are planning to walk away within two years. The study also found that nurses and other healthcare professionals who felt highly valued were less likely to leave.

Healthcare organizations across the country have said they’re seeing a shortage of nurses. Hospitals said they are losing some for family reasons but said some are taking more lucrative positions as traveling nurses.

Kelley Muldoon Rieger, a pediatric nurse practitioner, wrote that some would say there isn’t a nursing shortage.

“Rather there is a shortage of nurses willing to work in these environments and accept the current situation,” she wrote.

Toby Bressler, an oncology nurse leader, wrote, “It shouldn't take a pandemic to eliminate barriers to practice and #nurses practicing at full scope.”

National Nurses United, a union representing nurses, is holding a day of action across the country Thursday. The union is calling for greater protections from the federal government and healthcare providers.

Many nurses have been frustrated at revised isolation guidelines for healthcare workers from the Centers for Disease Control and Prevenion. Under the new guidelines, state healthcare organizations can bring infected healthcare workers back to work after shorter periods if they have staffing shortages.

With some nurses leaving their jobs, some hospitals have offered hefty signing bonuses of $10,000 or more to hire more nurses. Debra Graham suggested a different approach.

“Pay for performance and longevity,” she wrote. “Don’t pay sign-on bonus but 'stayed-on' bonus. After 5 years there is no financial reward for extended service.”

Another nurse, Olga Kagan, said healthcare providers should be reaching out to their nursing staff.

“Asking nurses what they need to be effective in their work and giving it to them is one of many ways to show that they are being heard and seen,” she wrote.

Nurses said they can play a vital role in the transformation of the healthcare industry, but they remain an untapped resource, said Michelle Acorn, chief nurse of the International Council of Nurses.

“Nurses are central to lead, innovate, design and drive global health systems,” she said on Twitter. “A professional knowledgeable workforce of 27 million nurses are untapped to advance access, safety, quality caring and career satisfaction to support the world.”

Mary Lou Ackerman, vice president of innovation at Saint Elizabeth Health Care in Ontario, Canada, said universities should be accepting more nursing students.

“We need a way to increase the capacity within universities to accept, train and graduate nurses,” she wrote. “It would be interesting to hear what percentage of nursing applicants were accepted into their program. This could be a huge lost opportunity.”

Healthcare providers must offer nurses lifelong learning opportunities throughout their careers, said Peter Preziosi, an analyst for the World Health Organization who is also a registered nurse.

“Nurses face daily health system challenges, aging and chronic care needs, complex social situations, changing healthcare tech tools, care delivery complexity, fiscal constraints,” he wrote. “Invest in lifelong learning structures to upskill nurses to alleviate this pressure gap.”

Sarah Warren, a registered nurse, implored healthcare leaders to pay attention to nurses.

#ANursesVoice is missing in conversations related to direct patient care in both inpatient & outpatient settings, public health, the art of caregiving & so much more,” Warren wrote. “We have the skills & knowledge to be amplified across all forms of media. Our perspectives are vital, hear us.”