By: Chris Warren.
Late night phone calls almost never bring good news. Everyone has experienced being whacked out of a dead sleep by a ringing phone, and the first thought is, someone died. In a best-case scenario, it’s a wrong number. My blood pressure drops to pre-freak out levels and I roll over and go back to sleep. As a group, my circle of friends and family are emotionally stable and seldom require a late night consultation with anyone, much less the likes of me. So when the phone rings in the darkness and they are not calling with a death or serious injury notification, it’s not vanity. They’ve got my undivided attention.
When my foggy eyes focused on a squawking cellphone and I saw it was my friend Phil, I initially did not think much of it. Phil works odd hours and it’s not unusual for him to be up at 2:00 am. I thought he might be messing with me. I’ll be a good sport and play along. Instead of making me the victim of a prank, Phil was clearly upset and went into a no-limits explanation about how stressed out and unhappy he was at his job. The lack of management support, workplace politics, the weird schedule, physical demands, and the overload of work assignments were pulling him apart. This was not about one bad day. I could hear the hurt in his voice. Phil is not used to needing help. He’s always the guy giving it, usually to people who are very sick and suffering. Phil is a nurse.
When I was researching for this blog article and googled “job stress among…” the auto-fill listed “nurses” in second and fifth place. Google does nothing randomly. The more popular a search term is, the higher it lands on the list of suggested search options. That “nurses” claimed two of the top five results is not just evidence of it being a hot topic a lot of other people are interested in, it’s a symptom of a bigger problem.
Times are tough, jobs are hard to get, and everyone who is lucky enough to be employed is feeling the squeeze. So why should we care about nurses and their problems? Because job stress among them is so severe and widespread that it threatens patient care. This very thoroughly annotated article from 2013 documents a direct relationship between nurse job satisfaction and patient outcomes.
Most medical professionals have contact with a patient for a short amount of time and are focused on one aspect of treatment. Doctors, x-ray techs, therapists, and all the rest busily come and go, but nurses are there all the time, day and night. They face suffering, confrontational family members, uncooperative patients, juggling attention between several patients, making sure medications are administered and lab tests are completed. They deal with puke, blood, urine, crap (both kinds) and more and more often are physically assaulted by the people they are trying to help.
Nurses are the only constant human presence in what is usually a chaotic and frightening patient experience. It’s not nearly enough for a nurse to be technically skilled. They must also be gentle and have a cool head while giving hope to very sick people who are at a low point in their lives and may not be in a frame of mind to show gratitude. How are nurses supposed to do all that when they themselves are depressed and drained?
Unfortunately, not only is there is no Easy Street ahead, things are expected to get more difficult. Politics notwithstanding, no one on any side of the argument rationally believes the Affordable Care Act (Obamacare) will make life better for healthcare workers. The new reality of “passing a law to find out what’s in it” is that a lot of what used to be done by doctors, such as basic exams and checkups, will now be delegated others, particularly nurses.
My sister in law is also a nurse and works full time traveling all over the country doing nothing but health screenings and wellness checks. I don’t think she has any idea how often she’s detected an early-stage, treatable condition and sent the patient to the doctor in time to save them from some horrible disease. I am certain there are many people who are alive and healthy today because they took her advice; there are probably also a few who are dead because they didn’t. She does her thing, then folds up her kit and jets off to the next stop. Her home life and personal free time is compromised because of the constant travel; the complete strangers she deals with every day may never appreciate what she gives up to help them avoid hurt and misery.
As upset as he is, Phil does not talk of leaving nursing. For the short term he is reaching out to other nurses for ad hoc group therapy. I wish I could be more supportive, but with no personal insight about the medical field or direct knowledge of his specific concerns, I’m of limited usefulness. I am close enough to the situation to understand why nurses do what they do. Even with all the job pressures, there are a lot of bright spots, perhaps the most meaningful is actually making a difference in a patient’s life. The satisfaction of being a key player in relieving suffering and helping someone recover and move on is priceless. Of course nurses have to earn a paycheck like all the rest of us, but believe me, if it was only about money, no one would ever become a nurse. There are a zillion easier ways to earn a living.
Since that late night phone call over a week ago, I’ve had daily conversations with Phil and am happy to report that he is feeling better and his outlook has improved. Through all this his desire to treat the sick was never even vaguely in doubt. We outsiders seldom if ever see the behind the scenes forces that drive nurses’ anguish. It’s not drama and they are not making it up. Their pain is as real as the high ranking google searches suggest.
Phil is the kind of nurse who will call into work on his off days to check up on “his” patients. He is the kind of nurse who will stay after his midnight shift ends because the emergency room sent up a late admission. He is the kind of nurse who, with his own time and money, reads medical books and attends training courses that are not required by his employer. Phil is the kind of nurse who prays to God for the welfare of sick people and those who care for them. I’m not exaggerating any of this to make a point; it all really happened and I’ve personally witnessed it. But here’s the kicker: Phil and my sister in law are not outliers. Nearly all nurses go twice past normal. This behavior is easy to find in a humanitarian profession where being above average is average.