A letter to new nurses (and to my past self).

A note from 2024 Sarah: this is a letter I wrote “to new nurses,” in May 2020, right after I volunteered to work indefinitely on the first covid cohort unit in my hospital.  Read within this context if you are just coming across this blog post.

This is not a “normal” time to start your career in nursing. This is not a “normal” time to be in nursing school.

⁣⁣⁣⁣Some aspects of what you may be experiencing are practices we have normalized in our profession:⁣⁣

Short Staffing⁣⁣- Limited Breaks⁣⁣

Lower Acuity Floors Assuming Care of High Acuity Patients⁣⁣

Lack of Support from Leadership⁣⁣

PTO Denied⁣⁣ due to lack of “projected staffing needs.”

An all around “Out of sight, Out of mind” attitude from corporate level staff.

Breaks are not protected. Common to go 12 hours without time to eat, drink water or use the restroom. 

We have allowed these practices to be “normal” in this profession. This crisis has combined these toxic practices & compounded upon them. What you are experiencing is not “normal” but it is an extension of decades of complacency from our institutions. So what can you do?

LEAN ON YOUR PEERS

Find support in each other, those you graduate with or start this journey with at the bedside. Talk to each other after each shift & lean on one another when things feel impossible. Debrief after difficult moments & unexpected or unwanted outcomes. Find the leaders you know will support you, who you can learn from, they’re on every unit. They may be exhausted but they will always be willing to answer questions and teach. Ask “stupid” questions. If your gut tells you something isn’t right or you aren’t sure on what to do next, ask. Your patients need you to be sure of each step you take.

REMEMBER, THIS IS NOT OKAY

You have been thrown into a world of unbridled chaos. ⁣⁣⁣⁣Where does the new grad find support when every nurse is putting out their own fires? Who does the new grad turn to in a sea of new grads? ⁣⁣⁣⁣When you burn every experienced nurse on a unit, who is left to provide knowledge & expertise to the future of nursing? ⁣⁣⁣⁣I know you don’t feel supported. ⁣⁣I know you don’t feel heard.⁣⁣I know you are not being heard. ⁣⁣I know you’re scared for your license.⁣⁣ I know you’re scared for your patients. I know this is not what you signed up for. ⁣⁣⁣This is not okay. It’s important that we recognize that. It’s important that we speak up for you. I have cried in my car after work because of how frustrating it is & how powerless I feel, I can’t imagine what you’re going through. You are allowed to be upset, you are allowed to be angry. This crisis did not begin with this pandemic but it must end here. It’s important that we protect & preserve what little hope you have left for this profession.⁣⁣⁣ ⁣

BE BOLD

Challenge the notion that this perpetual state of chaos and cycle of abuse is “okay.” Have conversations with your leadership when you feel frustrated or concerned. Keep a running list of dates in your phone when staffing is particularly bad. Write down each day you had to skip a lunch and ALWAYS SAY NO IF YOU DIDN’T TAKE A BREAK. 

Talk to your coworkers about how you’re feeling. Seasoned nurses are most likely experiencing similar levels of stress, exhaustion and frustration. The first step in creating real change is recognizing that this is a problem and the only way forward is eliminating abusive practice. We must make it clear that until things change, we won’t be “picking up shifts,” outside of pure necessity to “help out.” We have to express to our leaders that they need to assist in moving up our concerns to those “in charge.” If they don’t have the capacity or resources to improve the situation, they need to delegate and shift the responsibility to someone who can.

HOLD ON TO HOPE

Remember that the crisis we are in is temporary. Things will get better in regards to the pandemic. What we must do going forward however is ensure that this never happens again. We must make it clear that pre-pandemic standards were just as unacceptable as what we are going through now. New nurses, you started in the depths of a pandemic & one of the worst staffing crises this country has ever faced, you will grow faster than you may have anticipated. What is the cost of that growth? The cost is the trauma you are sifting through each day. I know that you will have a fire in your hearts to impact actionable change in our profession.

That is where my hope lies.