Nurse’s Leaving Direct Patient Care – Where Will They Go?

A recent study from McKinsey & Company offers few surprises about the state of the nursing profession. The study highlights what many in healthcare have known for a long time: registered nurse jobs are plentiful because nurses are leaving direct patient care and there are not enough new nurses coming in to take their spots. However, the study does raise an interesting question.

If as many as one-third of all currently employed nurses plan to leave direct patient care, where will they go? There are non-clinical opportunities out there, but there may not be enough to keep all of them employed in nursing. More non-clinical jobs could be created, which could possibly help boost the number of new nurses being trained in the years to come.

Planning to Leave Soon

The McKinsey & Company survey questioned both registered nurses (RNs) and licensed practical nurses (LPNs) about their plans for the future. Researchers noted that prior to the start of the COVID pandemic, new nursing licenses were up roughly 4% year-on-year. That probably would not have helped ease the nursing shortage even if the pandemic hadn’t reared its ugly head. But now, with the pandemic largely over, so few new nurses seeking licensing will barely make a dent in the problem.

That is because the pandemic has left some 30% of currently employed nurses reconsidering the commitment to remain in clinical care. By 2025, they expect to be in non-clinical positions or out of nursing altogether. That is a significant number by any measure. Any other industry losing 30% of its workforce would find itself in big trouble in short order. Healthcare already has its problems. Losing one-third of its nursing staff cannot be good.

Non-Clinical Job Options

So, what does the job market look like for nurses hoping to leave clinical work? LPNs are probably going to find it tougher to remain in nursing after a decision to leave direct patient care. RNs should have an easier time. Creating more registered nurse jobs in education would be a start.

According to McKinsey & Company, one of the reasons nursing schools are not producing enough new nurses is that there aren’t enough spots for all the students looking for an education. Expanding nursing programs is the obvious solution here. To do that, schools need to create more educator spots. The study also suggests creating more mentor programs whereby experienced RNs mentor smaller numbers of students as they work through the later stages of education.

Another suggestion in the McKinsey & Company report is that both government and the private sector find ways to make more use of registered nurses. What that would look like, in terms of job creation, is unclear. But if keeping RNs employed in nursing after leaving clinical work is the goal, jobs need to be created somewhere.

Rethinking Healthcare Profits

There is no arguing that RN and LPN jobs or readily available. Employers cannot fill them fast enough. But with more nurses planning to leave clinical work within the next few years, something must be done to keep hospitals, clinics, and doctor’s offices operating. Perhaps it is time to rethink profit. Maybe it is time for the industry to accept lower profits in exchange for more nurses who really just want lighter workloads, more flexible schedules, and a bump in pay.

We have been talking about the nurse shortage for some time now. Continuing to talk about it will not change anything. If we really want to prevent one-third of our nurses from leaving clinical work, we need to get serious about addressing their motivations for doing so.

Why America Needs Nurses Now More than Ever

It’s 2022 and COVID-19 and its variants still represent a massive threat to public health. At the same time, however, a nursing shortage threatens the effectiveness of healthcare solutions for the general public. Now, estimates suggest that 1.2 million more registered nurses (RNs) will be needed by 2030 to adequately serve the populace.

This flood of demand has made RNs America’s most wanted healthcare worker. Now, we need nurses more than ever. And yet, the causes of the nursing shortage continue to rage, limiting our ability to replace retiring nursing staff.

Facing major implications for public health, evaluating and solving these causes is essential. Understanding is the first step in a healthcare environment more inviting for professional nurses.

What is Causing the Nursing Shortage?

First, let’s look at some of the measurable causes of the nursing shortage. These are observed patterns in the data that reflect bottlenecks and challenges that may come to affect the way most of us receive care in the future, should the situation not improve. These causes include:

  1. The aging population. Lifespans, birthrates, and advancing medicine have all contributed to a changing demographic. By 2030, it’s estimated that one in five people will be a senior. This is an age group that requires more care and more nurses to care for them.
  2. Retiring nurses. Similarly, healthcare workers themselves are aging up. With one-third of the workforce age 50 or older, retirements are occurring faster than nursing staff can be replaced. This is a problem exacerbated by the next cause of the worsening nursing shortage.
  3. Limited newcomers. Nursing schools can only train so many people. Meanwhile, the COVID-19 pandemic has been challenging on many learning institutions. The rate of new to retiring nurses isn’t enough to make up for lost workers, and patients are the worse for it.

All these causal factors were present in the healthcare industry even before the pandemic emerged, but COVID drove the shortage to new depths. That’s because pandemic conditions have redoubled our reliance on nursing staff and overburdened them to the point of frequent burnout.

In a survey of 6,500 critical care nurses, 66% said they were considering leaving their careers because of their COVID experiences. Meanwhile, 92% said that nurses at their hospitals had cut their careers short as a result of burnout. These numbers represent vital healthcare staff that we cannot afford to lose. And yet, the shortage is a looming threat impacting us all.

America is in desperate need of nurses but the conditions of the job as well as larger social factors make it exceptionally difficult to fill the gaps. Incentives and workloads have to be adjusted if we are to change these circumstances in the future.

In the meantime, what exactly are the implications of not enough nurses in our hospitals and care facilities? These will be the effects we’ll see play out unless this negative trend is disrupted.

The Effects of Not Enough Nurses

A world with too few nurses is a world in which no one should want to live. These care professionals fulfill many of the most important functions within a care institution. Without their work, being seen and treated for any and all health conditions would take longer and would be less effective. The consequences of such a reality would be negative for everyone involved — from the average patient to the doctor who would then have to take on a much greater burden.

As you explore the question of America’s nursing shortages, keep in mind the associated effects. These include:

  1. Longer care wait times and expenses. Nurses take care of just about all the care-related tasks that don’t require a doctor’s training to legally treat. This includes record-keeping and administrative functions. The fewer nurses available to check in with patients, move them along, and conduct vital care processes, the longer patients will have to wait for care. Meanwhile, relying on more highly trained medical staff for every procedure all but guarantees higher costs for patients.
  2. A lack of empathy in care. Empathy is essential to care. There is something healing in the simple act of a human being listening and being friendly, and nurses provide this empathy in heaps. Where it is applied in healthcare, empathy has been found to improve care satisfaction and even reduce burnout rates in hospital staff. However, human professionals are needed to practice empathy.
  3. A greater reliance on tech. Amidst nursing shortages, care practices are increasingly turning to tech to fill labor gaps. The implications of these tools are enormous. Chatbots, for instance, are taking down patient symptomsand computing diagnoses, sometimes with even greater efficiency than human workers. As these tools improve, some healthcare roles may even be automated out of existence.

A world with too few nurses presents too many challenges for society to accept. Instead, the industry looks to potential solutions for staffing and supporting care facilities while inspiring new generations of nurses. With a need this desperate, the healthcare industry must apply all the tools and tricks necessary to reduce nursing labor gaps.

A Life-Threatening Need

When it comes to healthcare, labor shortages present real risks to life and well-being. That’s why the 1.2 million nurses needed within the next eight years is a scary number. Without nurses, care is longer, worse, and more robotic. However, this last point may also be part of the solution.

Just as artificial intelligence presents certain risks to human workers (such as displacement), it can produce benefitsas well. Through automated data collection, chatbot interfaces, personal medical AI, and more, healthcare work is changing for the better. This means reduced workloads for nurses and potentially less-stressful work environments in which to care for patients.

The causes of the nursing shortage may be too widespread and human to fully correct. However, supportive technology may help to reduce the negative implications of this shortage and even encourage up-and-coming talent. Perhaps when nurses all have personal AIs to make the job easier, nursing schools won’t be able to handle the flood of compassionate individuals wanting to save lives and make a difference.

**Article Image Source: Pexels

         

      Katie Brenneman is a passionate writer specializing in lifestyle, mental health, activism-related content. When she isn’t writing, you can find her with her nose buried in a book or hiking with her dog, Charlie. To connect with Katie, you can follow her on Twitter. 


Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Where Nurse Salaries Are Highest & Lowest

Over the past year, nurses were highly-praised, often being called heroes for their efforts during the pandemic. But were they being paid hero-type wages?

Nurses were, without a doubt, one of the most talked about professions over the last year. As the COVID-19 pandemic swept across the nation, nurses dashed to the frontlines, and were called heroes time and time again for doing so. But were they being paid hero-level wages?

Below are the 10 states where nurses earned the most and the least, on average, according to 2020 salary data from the U.S. Bureau of Labor Statistics.

Registered Nurses – Highest Paying States

  1. California – $120,560
  2. Hawaii – $104,830
  3. Massachusetts – $96,250
  4. Oregon – $96,230
  5. Alaska – $95,270
  6. Washington – $91,310
  7. District of Columbia – $90,050
  8. New York – $89,760
  9. Nevada – $89,750
  10. New Jersey – $85,720

Registered Nurses – Lowest Paying States

  1. Alabama – $60,230
  2. South Dakota – $60,960
  3. Mississippi – $61,250
  4. Iowa – $62,570
  5. Arkansas – $63,640
  6. Tennessee – $64,120
  7. Kansas – $64,200
  8. Kentucky – $64,730
  9. West Virginia – $65,130
  10. Missouri – $65,900

Ready to start your search for a higher paying nursing job? Click here.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

5 Tips for Nurses Working in Hot Weather

Summer is here, bringing with it record temps in parts of the country. If you’re a nurse working in a hot climate, try these 5 tips to help you keep your cool.

by Deborah Swanson

While more than half of all registered nurses work in a hospital, there are many other roles available to an RN with a nursing degree. Occupational health nurses, public health nurses and even traveling nurses are just some of the careers that could have you working outdoors or in hot weather. Since your role is to assist others and care for patients, you must make sure you are comfortable and healthy while working in a warm environment. In addition to wearing lightweight cotton scrubs and taking plenty of breaks, the following tips will help you feel great while you fulfill your healthcare duties.

1. Stay Hydrated

It is always important to stay hydrated as a nurse, but it is even more critical to keep track of your water intake when you spend time working in warm temperatures. The average adult needs between 11.5 and 15.5 cups of water per day, but more may be necessary when you are hot or sweating. To avoid dehydration, nurses who work in hot weather should drink at least 16-20 ounces of fluids in the one to two hours before they start work. After their shift starts, especially if they are outside and active, it is recommended to consume between six and 12 ounces of fluid every 10-15 minutes to prevent dehydration.

Since you will need to consume a lot of fluids each day, it is helpful to carry a reusable water bottle. A flexible, lightweight bottle or flask will fit into a backpack, pocket or fanny pack. Some nurses like to wear the water bottle waist packs sold at sporting goods stores and athletic supply shops. When you want to mix things up, eat fruit with a high water content or drink a healthy beverage.

2. Recall the Signs of Heat-Related Illness

Nurses are trained to know the signs of a heat-related illness such as heat exhaustion or heat stroke. Before you start your new role outdoors, give yourself a refresher of the most common symptoms. A heat rash may start to sting and make your skin red, while heat cramps feel like painful spasms in your muscles.

Common signs of heat exhaustion include excessive sweating, rapid breathing and a weak pulse. If you feel any of these symptoms, be sure to alert a fellow nurse or call 911 in the event of an emergency. It does not matter how trained a healthcare professional you are because it is essential to receive care before the condition turns into a life-threatening heatstroke. Prevent heat cramps and heat exhaustion by drinking fluids, staying physically fit and checking with your doctor about how prescription medications can affect your health outdoors.

3. Eat and Drink Smart

To avoid fatigue or nausea in hot weather, eat smaller meals. A modest-sized salad consisting of hydrating foods like lettuce, cucumbers and strawberries can help you to stay full and energized. Other smart choices include kale, broccoli and cantaloupe. A handful of almonds or a spoonful of peanut butter can give you the energy you need without making you feel weighed down. Mix things up by infusing your water bottle with mint leaves, lemon or pineapple. You can also freeze a full water bottle before you leave for the day so it will defrost as you work.

At the same time, you should steer clear of dehydrating beverages like coffee, alcohol and protein shakes. Soda and sports drinks may taste good, but they will not help you cool off and stay hydrated. A healthy diet at home will keep your body fit, which will make it easier to work outdoors, no matter the temperature.

4. Carry Helpful Accessories

Other helpful accessories for nurses who work in hot weather include a hat and sunglasses. A hat with a wide brim and some neck protection is always best for sunny outdoor worksites and avoiding sunburn. It is also essential to wear sunscreen on your body and face. Dermatologists recommend using SPF 30 and above, which helps to block up to 97 percent of harmful UVB rays from the sun.

A smartwatch or smartphone can help you keep track of the outdoor temperature or locate a place to get a drink. A medical bag or tote helps to keep stethoscopes, protective gear and medical devices secure while you examine a patient or enjoy some shade. Along with these tools, athletic shoes and moisture-wicking socks will help to keep your feet cool and comfortable while you are on the job. The best footwear for nurses working outside combines a slip-resistant grip with breathable material and a flexible feel.

5. Wear the Right Scrubs

Now that you have the right accessories and footwear, it is time to complete your look with stylish nursing scrubs. Outdoor nurses and traveling nurses tend to prefer cotton scrubs over other materials because cotton is breathable, soft and durable. It also tends to soak up sweat, which allows for heat to escape the body and keep you cooler. Cotton uniforms are available from the top scrub brands, so you will easily find the patterns and colors that you like best.

Some of the most popular styles for warm weather include short-sleeved, V-neck cotton scrub tops and cotton print scrub hats. Wrap tops, drawstring pants and jogger scrub pants are also popular. When cotton scrubs are impractical or unavailable, it is fine to choose a cotton/polyester blend.

You may not be able to control the environment in which you serve the public or care for patients, but you can take steps to stay healthy and cool. Think about your clothing, nursing accessories, meals and fluid intake to make your day more productive and focused. The habits you adopt while working outdoors will be beneficial for serving your patients.


Deborah Swanson is a Coordinator for the Real Caregivers Program at allheart.com, a site dedicated to celebrating medical professionals and their journeys. When she isn’t interviewing caregivers and writing about them, she’s gardening.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

3 States with the Most Demand for Nurses

Healthcare added back more than a quarter million jobs over the past three months. Here are the top three states where demand for nurses is the greatest.

The nursing workforce, like virtually every other industry, was greatly impacted by the COVID-19 pandemic, seeing staggering job losses as the virus—and the economic fallout associated with it—swept the nation. However, nurses are essential in a way that most other professions are not at the moment, and hiring remains steady, with the healthcare industry adding back more than 250,000 jobs during July, August, and September.

Where is the demand for nurses the greatest, though? We analyzed data from our jobs website to determine what states currently have the highest inventory of openings. Here are the top three states where nurses are needed most.

1. California

Average Annual Registered Nurse Salary in California: $113,240

Noteworthy Openings in California:

Click Here to Search Registered Nurse Jobs in California →

2. Texas

Average Annual Registered Nurse Salary in Texas: $74,540

Noteworthy Openings in Texas:

Click Here to Search Registered Nurse Jobs in Texas →

3. Virginia

Average Annual Registered Nurse Salary in Virginia: $71,870

Noteworthy Openings in Virginia:

Click Here to Search Registered Nurse Jobs in Virginia →

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

The Top 10 Pandemic-Proof Healthcare Jobs

Healthcare is often touted as a recession-proof industry. But is it pandemic-proof? Given the number of available jobs, it seems so. See the most in-demand position types here.

Healthcare is often touted as a recession-proof industry. This is typically believed, because, even in the worst economic times, people still require medical care. However, it is proving not to be entirely pandemic-proof, with more than 40,000 healthcare professionals being laid off in March, when COVID-19 began to significantly impact nearly every industry in the United States.

Healthcare is still hiring for a surprisingly large number of positions, though, despite the pandemic continuing on, and not all of them are related to COVID-19, either.

Here are the top ten most in-demand positions right now, according to data from our job board.

1. Registered Nurse

Number of Available Jobs: 7,761
States with the Most Available Jobs: California, New York, Massachusetts
View All Registered Nurse Jobs →

2. Physician

Number of Available Jobs: 4,141
States with the Most Available Jobs: California, New York, Pennsylvania
View All Physician Jobs →

3. Speech Language Pathologist

Number of Available Jobs: 3,462
States with the Most Available Jobs: California, Texas, Illinois
View All Speech Language Pathologist Jobs →

4. Physical Therapist

Number of Available Jobs: 2,840
States with the Most Available Jobs: California, Texas, Illinois
View All Physical Therapist Jobs →

5. Nurse Practitioner

Number of Available Jobs: 2,222
States with the Most Available Jobs: New York, California, Connecticut
View All Nurse Practitioner Jobs →

5. Occupational Therapist

Number of Available Jobs: 2,222
States with the Most Available Jobs: California, Texas, Illinois
View All Occupational Therapist Jobs →

7. Physical Therapist Assistant

Number of Available Jobs: 1,833
States with the Most Available Jobs: California, Texas, Illinois
View All Physical Therapist Assistant Jobs →

8. Certified Occupational Therapy Assistant

Number of Available Jobs: 1,725
States with the Most Available Jobs: California, Texas, Illinois
View All Certified Occupational Therapy Assistant Jobs →

9. Respiratory Therapist

Number of Available Jobs: 1,703
States with the Most Available Jobs: Pennsylvania, Alaska, Florida
View All Respiratory Therapist Jobs →

10. Certified Registered Nurse Anesthetist

Number of Available Jobs: 1,346
States with the Most Available Jobs: Texas, California, Virginia
View All Certified Registered Nurse Anesthetist Jobs →

Don’t see your position listed? That doesn’t mean it isn’t hiring. Search for it on our job board by clicking here.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

The 3 States with the Most Nursing Jobs

Hiring in healthcare is booming in 2020, adding more than 35,000 jobs in January alone. So, where are the nursing jobs? We break it down for you.

So far, hiring in healthcare is booming in 2020, adding more than 35,000 jobs in January alone, according to the U.S. Bureau of Labor and Statistics. So, where are the jobs? We analyzed data on our site and came up with the top three states with the most available openings for nurses right now, as well as a selection of noteworthy positions in each state.

1. California

Average Annual Registered Nurse Salary in California: $106,950

Noteworthy Openings in California:

Click Here to Search Registered Nurse Jobs in California →

2. Texas

Average Annual Registered Nurse Salary in Texas: $72,890

Noteworthy Openings in Texas:

Click Here to Search Registered Nurse Jobs in Texas →

3. Virginia

Average Annual Registered Nurse Salary in Virginia: $69,790

Noteworthy Openings in Virginia:

Click Here to Search Registered Nurse Jobs in Virginia →

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

5 Shoes Nurses Swear By

On average, nurses walk 4-5 miles during a 12-hour shift. If your feet are aching, it might be time to consider these five pairs that other nurses swear by.

It’s no secret that nurses spend a lot of time on their feet. Studies have found that a nurse will walk between four and five miles over the course of the average 12-hour shift—that adds up to between 728 and 910 miles per year, on average. Needless to say, if you are on your feet that much, you are going to need a comfortable pair of shoes. If your feet are aching, it might be time to consider these five pairs that other nurses swear by.

Nurse Mates Align™ Velocity

Source: Nurse Mates

Featured Review:
I’ve been an RN for 20 years and this is by far the most comfortable, practical shoe I’ve ever worn! I have no aches or pains after 12 hours on my feet. I recently had hip surgery and this has helped in the alignment of my leg and into my back for sure!! Will definitely purchase again!

Dansko Women’s Professional Clog

Source: Dansko

Featured Review:
As a generally practical soul, I’m not one to rave about footwear. However, these shoes deserve all of the accolades and more. As a nurse, I work a combination of 8 and 12 hour shifts, the occasional 16 hour, and the VERY occasional 20 hour when staffing gets really hairy. I recently worked one such 20 hour shift; I came in 4 hours early, stayed 4 hours late, and then when they couldn’t find anyone to relieve me, stayed until the next shift showed up… [A]t the end of that 20 hours, my feet were still singing the Hallelujah Chorus rather than Get Off On The Pain. And that, in my little world of long-suffering, racing from bed alarm to bed alarm, and hoisting hundreds of pounds of human flesh on and off of the bedside commode, is worth its weight in gold.

Crocs Women’s Neria Pro II Clog

Source: Crocs

Featured Review:
I’m a nurse and on my feet all day long. I bought two pairs of the Women’s Neria Pro II Clog, one black and one white. They fit snug because they were pushing down on the top of my feet. but I did the trick of putting them in hot boiling water for 45 seconds and then wearing thick socks with them until it cool down and formed big enough for my liking. They are so comfortable!! And perfect! I work in a plasma center, and I’m telling all my co-workers about them. Nobody like fluids getting stuck on my feet. Easily washed. I will be ordering again next summer for sandals.

Brooks Ghost 12

Source: Amazon

Featured Review:
I had been wearing Asics for years because they were recommended by my podiatrist. Actually just bought a pair before purchasing these. All I have to say is , wow. I immediately noticed the difference in comfort as soon as I put them on and realized what the Asics have always lacked. The arch support on these are perfect for me. Not too much, but just enough. The toe box is perfect for me in the wide and they don’t rub anywhere the wrong way. I m also pretty heavy on my heels when I I walk and these made me instantly feel like I had a new pep in my step and my heels haven’t been hitting since. I’m a nurse on my feet for hours and I wore these without having to break them in. And the colors are great too!

New Balance Women’s FuelCore Nergize V1 Cross Trainer

Source: New Balance

Featured Review:
Okay, so let me just start off my saying I am an Emergency Department nurse at a trauma center where we always have lines out the door, and I love these shoes! I am on my feet for 12+ hours at a time, and most of that is walking and moving. I rarely stand for long periods of time like some other nurses, but for moving constantly at a steady pace these are great. I originally got these to switch from day to day with a pair of more colorful under armor shoes to give my feet some relief thinking that I would wear these when the other ones hurt my feet but I find myself wearing these more and more!

Please note: HealthJobsNationwide.com receives no compensation for recommending these items and makes no warranties regarding their safety. Items listed above should be evaluated individually for potential risks and hazards.

When The Nurse Is Stretched Too Thin

Nurses can be pushed to the breaking point, driven to the precipice of burnout, compassion fatigue, and utter defeat. But there is another way.

From Nurse Keith’s Digital Doorway

In all likelihood, we can all readily agree that nursing is not for the faint of heart. Nurses in many different settings can be pushed to the breaking point, driven to the precipice of burnout, compassion fatigue, and utter defeat. But there is indeed another way.

Nurses are often seen as strong figures who can tend to the sick, stand on their feet for hours on end, simultaneously care for multiple critical patients, and document it all like a pro. Many years ago, I wrote about the Sisyphean nature of nursing, a topic I should probably revisit sooner than later.

We can think of the nurse as Sisyphus, pushing a boulder uphill with no hopes of tomorrow being any different. We can also consider the metaphor of the elastic band stretched beyond its capacity. Our breaking points are individual, as are the events or circumstances that will trigger our breakdown or moment of snapping.

What’s Your Capacity?

Nurses, it’s up to you to determine for yourself what your capacity for stress and unhappiness really is. No one on the outside can really tell you what you should or shouldn’t be feeling on the inside. Your ability to determine your own capacity is part of your emotional intelligence and your personal insight into the workings of your own psyche.

The nurse who brags that she can face any challenge or work any number of shifts without blinking an eye is probably lying — either to you, or to herself. We’ve all probably encountered those highly seasoned nurses — some would derogatorily label them as “Old Battle Axes” — who, for all intents and purposes, seem impervious to all negativity or stress. Their jaded outward personalities probably belie what may be going on inside of them; they may actually so far gone, they can’t even feel their own feelings. This is the opposite of emotional intelligence.

Nurse, you need to determine your own capacity for every aspect of your work environment and professional experience:

  • How many hours can you work in any given week and still feel somewhat functional and human at home?
  • How much bullying and aberrant behavior are you willing to tolerate without taking action?
  • Is there a type of negative workplace culture that you feel you could actually work in without it impacting you in damaging ways?
  • What level of dysfunctional management is permissible?
  • How little teamwork and collaboration is accepted in your workplace?
  • What other areas of your work life are you able or unable to tolerate?

Why Do You Stay?

If your workplace leaves much to be desired, one of the initial questions to ask yourself is, “Why do I stay?” If you’re only staying because of the money, that’s probably not going to seem like enough as symptoms of stress-based illness begin to arise, or you’re just too depressed and despondent to take any action whatsoever.

You may be caught in a moment of simply feeling too beaten up by your work to even consider making a change. This type of ennui and loss of energy to create change in your life can have dire consequences, especially if you’re tolerating bullying, the sabotaging of your patient care by colleagues (we know this happens, folks), or other behaviors that put your license — and your patients — at risk.

Remaining in a job that’s killing you is not recommended, nor is it mentally, physically, or emotionally healthy. Some might even say it can be spiritually damaging to stay in work that doesn’t feed your heart and soul and/or detracts from your self-esteem and self-worth.

Determining why you’re choosing to stay may reveal very clearly that you have every reason to leave. How much are you willing to take? When will you put your foot down and say, “no more”?

Cultivating Nurse Resilience

Nurse resilience comes in many forms. Your resilience may come from cultivating the courage and ability to speak up to managers and executive and share your opinions about your workplace, or stand up for nurses on the receiving end of bullying and aggression.

Resilience may come from a variety of sources, including but not limited to:

  • Engaging the services of a counselor or therapist to help you navigate the challenges of your professional life
  • Using career coaching as a means to discover what you love about your career and how to instigate healthy change
  • Speaking with supportive colleagues, friends, or family
  • Studying meditation, yoga, mindfulness, Reiki, or other modalities
  • Take a course on cultivating emotional intelligence
  • Guard your time off and use it wisely in the interest of self-care and personal wellness
  • Turn to faith leaders for support and wise counsel
  • Focus on your physical health and well-being
  • Allow yourself to explore new career paths and professional options
  • Finding and strengthening your most resilient self is essential to counteracting those moments, days, weeks, months, or even years when you’re stretched too thin and come dangerously close to reaching your breaking point.

Why allow yourself to get to the point of snapping from the strain? Why not cultivate resilience, as well as strategies for surviving and thriving rather than tolerating what’s unhealthy? No one can do this work for you, but you can enlist the help of those who can make the journey easier.

Push Back

If your work is like pushing a rock uphill day after day, something has to give. Are you going to push back against unsafe staffing and high nurse-patient ratios? Will you join the union and seek greater protection from poor management? Will you speak up and call the unit bully on her horrible behavior? Are you going to say “no” the next time you’re asked to cover yet another extra shift?

How you push back is up to you, but push back you must. When the going gets tough, your job is to build up your resilience, take action, and push back against what is making your miserable. The ultimate push back may be giving your notice, and that is sometimes the only way. However, if you’re dedicated to your workplace and want to fight the good fight, enlist courageous colleagues willing to stand by your side.

When you’re stretched too thin, it’s time for action. When you’re pushed beyond your limit, recognize what those limits really are and how to protect them from ever being threatened again.

Staying may work, or it may be impossible. Leaving may be the only way out, or there may be other solutions. If you’re experiencing the cognitive dissonance of workplace demands beyond your capacity to meet those demands, it’s time to consider your options.

Don’t allow your well-being, health, and happiness to be compromised by your work. This profession of nursing should feed your soul, pay your bills, and bring you fulfillment and positive self regard. If something else is happening in your work life and career, it’s time for a new plan and a new lease on life.


Keith Carlson, RN, BSN, NC-BC, is the Board Certified Nurse Coach behind NurseKeith.com and the well-known nursing blog, Digital Doorway. Please visit his online platforms and reach out for his support when you need it most.

Keith is the host of The Nurse Keith Show, his solo podcast focused on career advice and inspiration for nurses. From 2012 until its sunset in 2017, Keith co-hosted RNFMRadio, a groundbreaking nursing podcast.

A widely published nurse writer, Keith is the author of Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century and Aspire to be Inspired: Creating a Nursing Career That Matters. He has contributed chapters to a number of books related to the nursing profession. Keith has written for Nurse.com, Nurse.org, MultiBriefs News Service, LPNtoBSNOnline, StaffGarden, AUSMed, American Sentinel University, Black Doctor, Diabetes Lifestyle, the ANA blog, American Nurse Today, NursingCE.com, Working Nurse Magazine, and other online and print publications.

Mr. Carlson brings a plethora of experience as a nurse thought leader, keynote speaker, online nurse personality, social media influencer, podcaster, holistic career coach, writer, and well-known nurse entrepreneur. He lives in Santa Fe, New Mexico with his lovely and talented wife, Mary Rives, and their adorable and remarkably intelligent cat, George. (You can find George on Instagram by using the hashtag #georgethecatsantafe.)

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

The Highest Paying U.S. Metro Areas for Nurses

If your 2020 job search has you considering a change of scenery, you may want to consider these metro areas offering top pay for nurses.

If your 2020 job search has you thinking of a change of scenery, you may want to consider taking a job in California. While the cost of living in some areas of the state can be above the national average, all of the top ten highest paying metro areas happen to be located within the state lines, as well. In fact, out of more than 500 metro locations, nineteen of the top twenty are located there—the only non-California area to rank that high was Honolulu, Hawaii in 16th place.

Take a look at the top ten metro areas offering the highest average annual salaries for nurses as determined by the U.S. Bureau of Labor and Statistics—as well as some high-ranking cities not in California, all offering above the national average annual RN salary of $71,730.

Highest Paying Metro Areas for Nurses

1. Salinas, CA – $131,710
2. San Francisco-Oakland-Hayward, CA – $128,990
3. San Jose-Sunnyvale-Santa Clara, CA – $128,610
4. Santa Cruz-Watsonville, CA – $127,440
5. Sacramento-Roseville-Arden-Arcade, CA – $120,530
6. Vallejo-Fairfield, CA – $115,900
7. Stockton-Lodi, CA – $111,140
8. Napa, CA – $106,060
9. Modesto, CA – $106,040
10. Santa Maria-Santa Barbara, CA – $104,680

Honorable Mentions (Not In California)

16. Urban Honolulu, HI – $99,600
22. Boston-Cambridge-Nashua, MA-NH – $95,270
24. Portland-Vancouver-Hillsboro, OR-WA – $93,570
29. Danbury, CT – $91,680
30. New York-Newark-Jersey City, NY-NJ-PA – $91,160
31. Eugene, OR – $90,850
32. Kahului-Wailuku-Lahaina, HI – $89,290
35. Salem, OR – $88,460
36. Anchorage, AK – $88,170
37. Bend-Redmond, OR – $88,100

Thinking of relocating? Start your job search now by clicking here.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.