"It's so bad to be a patient right now." These were the words from a healthcare provider I was speaking with a few months ago, days after a family member had been admitted to a local community hospital for trouble breathing, dizziness, and fatigue. The "care" they received over the next two weeks was nothing short of jaw-dropping and concerning. 

But if it is bad to be a patient right now, it is equally as hard to be a clinician. The problem in healthcare is multifaceted, as burnout and dissatisfaction are rampant in a healthcare system that has notoriously been one of the worst in the developing world, even though we spend the most money on it. 

COVID consequences

Coming out of COVID, the 2022 National Nursing Workforce Survey found that 51% of nurses who responded felt emotionally drained, 45% felt burned out, and 56% felt "used up." As burnout increases, nurses leave the bedside in droves. 

The survey found that 100,000 RNs left the workforce during the pandemic, and another 610,388 expressed an "intent to leave" by 2027 due to stress, burnout, and retirement. 

Nurses aren’t sticking around

Even more concerning, the nurses at the bedside generally have just 2.8 years of experience, down from 3.5 years in 2022. My colleagues say new nurses give themselves 90 days at the bedside to decide if they will stay. Almost 18% of new nurses leave the profession within the first year. This leads to a shortage of experienced nurses to support, teach, and mentor the newer nurses — causing subpar and stressful work environments and, ultimately, care.

My firsthand experience

This became clear as I spent time with a family member, first in the emergency room ,  and then a few days later after admission. It was apparent from the ER visit through admittance to the hospital that the medical team was not communicating with each other—no one knew what was going on or why specific tests were being run. 

They diagnosed my family member with congestive heart failure, a heart attack, and other things that, in the end, they did not have. I never saw a nurse while visiting my family member in the ER.

The nurse caring on the floor my family member was on at times was no better — the nurse caring for them while I was visiting was inexperienced, overwhelmed, underprepared, and floundering. When I asked about a specific precaution my family member was on, the nurse couldn't explain it and kept saying, "I'm only a nurse." 

We received the same reply to every question asked about their care: "I'm only a nurse." Finally, I had to tell them to stop saying that — and that I, too, was a nurse, and that they were this patient's nurse, and it was their responsibility to know about the patient and their care. 

At that point, the nurse looked as though they were going to cry. None of this instilled confidence in the patient—my family member, or me — a nurse educator and leader advocating for this profession.

A systemic problem

This was not all the nurse's fault. It’s a systemic problem not just in a local community hospital in Philly but in hospitals all around the country. Some say these issues are remnants of the COVID generation. During COVID, students were not permitted in the clinical settings and were doing much of their clinical "care" virtually or through simulations. 

Now, these students are clinicians out in the real world, and it is nothing like what they thought it would be or were prepared and trained to do.

The shortage of nurses at the bedside contributes to this. Per McKinsey, the pandemic accelerated the nursing shortage and now experts predict an absence of close to 400,000 nurses by 2025; compounding this, there aren't enough new nurses graduating to fill this gap.

Coming solutions

Healthcare leaders at every level are trying to solve these workforce problems, though. Not long after that experience with my family member, I spent a week with nurse leaders from around the country, teaching them how to think innovatively about the problems they face in healthcare at their institutions. 

We must use a human-centered approach that centers on the needs of the end-users, whether that is the patients or clinical nurses. Many of the nurse leaders focused on staffing issues, nurse burnout, and new-to-practice nurses and how to keep them at the bedside — all the things they are struggling with at their institutions. 

I was inspired by the commitment of these nurse leaders to try to fix these enormously complex problems, but our healthcare system is broken on a more significant level — and it has been for a long time.  COVID just shone a light on the cracks. It will take a commitment from the entire national healthcare system to take a hard look at the problem: the system as it is today. 

From how we educate nursing students and clinicians to the hospital work environment , we have to work together with new and seasoned nurses, other clinicians, administrators, and patients to really fix it. So the next time my family member or yours is in the hospital—say from the influenza outbreak that is straining hospitals around the country currently—they receive the quality care I know our clinicians can provide.

Marion Leary PhD, MPH, RN is a nurse leader, public health advocate, and activist.