Two for the price of one

By Debbie Moore-Black, RN

I wasn’t suppose to hear this. But I did. It sealed the deal for me.
It was one of the reasons I had to finally leave my true love. My passion.
ICU nursing.

After 33 years as an ICU nurse, I sadly knew it was time to go.

I use to feel like I was purposeful. I use to think I was a dynamic part in saving lives in the ICU.
I lived and breathed ICU.
I was a charge nurse, a mentor, a preceptor. I attended the AACN meetings, I was the leader of the Shared Governance Committee, I was on the Rapid Response Team (RRT) and I obtained Level 4 RN which was the highest attribute you could earn as an ICU nurse.

But as the years passed, I watched patients with multi system organ failure come through our doors, usually the aged population, many with their own DNR/DNI papers and listen to the family members scream at us nurses and doctors: “Do everything.”

And unfortunately, the theory was that we had to honor the family members regardless of the legal DNR papers…. Because families can sue, dead people cannot.
And so we did.
We did “everything.”

The vigorous and fast CPR pounding on their brittle chest, hearing and feeling their ribs crack. The inhumanity and brutality I felt as we dishonored these poor souls.
But we were forced to do so.

The patients lay motionless on the ventilator, wrist restrained, turned and repositioned to prevent decubitus ulcers. Their vacant stare of what truly was their hell on earth.
Because this was not living.

This new manager had her masters degree. She had no ICU experience but apparently was a “good fit.”
She knew the “corporate commandments” and she knew them well.
She also rattled off reasons for why the budget was so important.
She slowly eliminated our care techs, secretaries and CNA’s, many times leaving us with skeletal staff.
And then came what I perceived as ageism.
Some of the older nurses with incredible experience were being put under the microscope, upper management second guessing us.

At first I didn’t comprehend what was going on until I overheard: “We can get two inexperienced young nurses for the price of one vintaged experienced nurse”.
It truly was a gasping moment for me.
Like how could any manager be ok with attempting to eliminate the experienced nurses?
But we soon learned that Corporate hospital America had sold their souls.
Not only are the nurses a “number” so are our patients.

Top CEO’s for “for- profit hospitals” can make yearly salaries into the millions even for non-profit hospitals. And their incentive pay and perks which add several millions.

My Grande finale was when we were told we would have a 3:1 assignment in ICU.
We were a high acuity ICU. 25 beds strong. Many patients were on ventilators and life saving IV drips like Nipride, Levophed, Vasopressin, add a central line and an arterial line, maybe a swan ganz line (PA or Pulmonary artery line), CT scans, and Code Cools and proning, ECMO, our duties were endless. And it would be 12-13 grueling hours non-stop without a break.

A 3:1 assignment was the end for me as I truly felt that if I did not protect my nursing license that I worked hard for… than nobody would protect it. Not even my ICU Nurse manager.

So I turned in my resignation.
I said good bye to my true love. ICU Nursing.
I could no longer bare to treat patients with haphazard nursing practice that was forced upon us by management.

I have those flashes of memories, the patients that were triumphs, the tragedies and sadness, the nurse camaraderie.
Memories to last me a lifetime.

The corporation. They may never know what we as nurses do relentlessly to save a life.
Would they ever look in the mirror and come to terms with greed becoming their god.
My prayer is to have a mandatory
safe nurse:patient ratio across our America.

Two for the price of one!!

(Photo: Getty Images Stock Photo)

6 thoughts on “Two for the price of one

  1. Heartbreaking for you and your patients. It’s a similar situation in hospice. Corporate greed had taken over and corners are cut; timed visits, fewer visits from nurses and other team members, doctors rarely see any patients except on a chart, pain meds reduced.

    Liked by 1 person

    1. Thank you for writing this. I am a retired nurse, having graduated in 1972. This has been an ongoing problem for as long as I can remember. I had to leave, my nightly nightmares, made it impossible to continue working in a profession I loved. Your not alone.

      Liked by 1 person

      1. Thank you Lorraine!!! I wrote this recently due to a random flashback of this situation. I use to love working in the ER but had to leave, the child abuse was too unbearable. ICU was easier to handle emotionally…. I just couldn’t handle the child abuse in the ER. As I had my flashback of this baby recently, I realized she’s probably 11 years old now…. I’ll always wonder if she is having a decent childhood. Take care💖


      2. We have so much in common! I also worked in a pediatric unit, and had to leave because the child abuse was unbearable. It’s now 45 years later and I think about, my kids, as I called them, and wonder how they are! I also, transferred to an ICU unit. When I left bedside nursing in 2002, it was due to lax standards, that allowed patients to walk out on the streets with their IV poles. The neighborhood was a haven for drug abuse, I didn’t want my name on my patients chart.
        I’m enjoying retirement, still have nightmares at least once a month!

        Liked by 1 person

  2. I feel your pain and I too quit the hospital nursing/respiratory care 1975 to 2022 after witnessing this happening. Bless you Debbie for putting a lot of our feelings into words. I hope this site will help more of us heal.

    Liked by 1 person

  3. Physician burn out is increasing. you can likely guess the top reasons.

    Physician burnout and depression continue to climb: Medscape

    Reasons physicians pointed to for their burnout:
    Volume of bureaucratic demands — 61 percent
    Lack of respect from coworkers — 38 percent
    Their personalities, i.e. perfectionism, being overly empathetic — 33 percent
    Stress of treating COVID-19 patients — 8 percent

    Liked by 1 person

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