Career Changes in the Covid Era — A Nurse’s Dilemma

Based on two real stories

Let me tell you a little bit about this woman named Sarah.

Sarah was the person who always was there for you and would constantly be found lending a helping hand. You could remember her loving friendship that lasted way longer than you could have imagined because of her dedication and loyalty to you. Many of you might know Sarah.

This particular Sarah though is very special.

Not a stranger to challenge, Sarah had battled her way through middle and high school facing many hurdles. Growing up in a chaotic family had not been easy on her and she really struggled with knowing the balance between achieving accomplishments vs. proving her worth through her accomplishments. Her resilience deepened though as she went through college, dealing with a hard loss and the stress of nursing school. This girl had become a woman and a woman who was a fighter.

Where did she end up?

Four Years Later

“Sarah, you have a new admit in 24B who is male and presents with CHF. He has a history of alcohol and tobacco use with an overdose hospitalization three months ago. He is 57 years old and has no family of which we know,” added the charge nurse. “Will you be able to admit him prior to the end of your shift or should I pass this on to the night shift?”

Sarah, already exhausted from her other two admits today said, “No, I can take him. Can you send an aide to help me prepare the room?”

“You got it!” replied the charge as she hung up her call.

Sarah sighed as she realized she’d be getting out later than she already would today. However, she always wanted to prove to herself and her boss that she could handle any workload so she took it anyway. As she made her way back to the nursing station, she saw that all the chairs were empty. Where had all the nurses gone? She looked towards her boss’s chair and saw her bent over with a face of anxiety. Sarah looked closer at the paper her boss was holding and it saw that it was the staffing to patient ratio. Close to the margins, she read 1–6 and the following four names listed next to it: Michael, Denise, Michelle and Sarah. Sarah knew then that her entire team of nurses was loaded down with 6 patients each and therefore decided not to blame others, but take the responsibility assigned to her. She looked back at her boss and finally realized how exhausted she must be. Carrying the burden of ensuring adequate staff to high acuity patients was no easy feat.

Not normally a physically affectionate person, Sarah moved toward her boss and gave her a pat on the shoulder. “It’s going to be okay Joyce,” Sarah thoughtfully stated. Joyce smiled up at her and said a quick thank you before returning to her computer. Feeling like she had done the most she could do, Sarah turned and called the aide as they prepared to admit her new patient.

That night as Sarah went to sleep, she thought about her job and the work she was doing. She knew it was extremely valuable to her community as there was so much sickness. She also had patients that lit up her life as she cared for the most vulnerable with grace and poise. She tried to assure herself that today was just a really hard day and that not all days felt like this. However, they were becoming more frequent and she wondered how long she could carry on.

Sarah is in a similar boat as Kelly was in our last article. She is in an extremely well paying job, has been promoted to a sub- charge nurse when needed, is getting time and a half for overtime pay, and gets to do meaningful work. However, she is not feeling supported by those running the hospital and is scared of future burnout.

Which Role(s) do you think Sarah could employ less of and more of to help her move forward with staying in the position or leaving?

Sarah ranks as a high Team Builder and therefore wants her whole nursing staff to be supported and heard. She sees the pain her boss is experiencing and wants to alleviate it. However at what cost to herself? If she keeps trying to carry a load too heavy for her to bear, will she emotionally thrive? Our recommendation would be for Sarah to value the role she plays in carrying for her team and her patients, but play the Team Builder Role a little less in order to take care of herself. If she is unable to take less patients and set those boundaries, maybe finding a different unit that is better staffed could lighten this load on her. Sarah’s voice needs to be heard or the hospital could lose another staff member that is vital to their success.

Sarah also ranks high as an Implementor which means she loves accomplishing tasks and is known for getting things done. This however can lead to burnout as she has the potential to take on too many. You can see that in her willingness to take another patient when she honestly is too busy with her other patients to give adequate time to the new admit. If Sarah played that Role less, then she could utilize the Investor Role to set boundaries for herself.

The Investor Role believes in the importance of time, money and partnerships. If Sarah valued herself more, she would value her time more as well and set up boundaries to keep herself in better physical and emotional control. Even though saying no to her boss could be challenging, it is protecting herself from taking on too much. And in fact, her saying no to her boss can demonstrate to Joyce that she needs to escalate the staffing problem.

And if Sarah wants to be even more bold, she could implement the Luminary Role to engage with the higher ups and speak about hiring more staff. There obviously seems to be a staffing crisis and therefore something needs to change for her unit to survive.

Sarah could also leave.

But as she is not at burnout yet, we would recommend she advocates for change from the inside out first before moving on.

An aside

We know that this past year, particularly for healthcare professionals or #frontlineworkers, has tested every ounce of their strength. It might seem impossible to change a company so large, and it could be at the expense of your wellbeing if you stay to fight it out. We commend you for your continued effort, but ask that you take the proper steps to take care of yourself first. A great article we suggest is titled “Hiding in Plain Sight: Compassion as an Antidote to Burnout in the Post-COVID Era” if you want to stay awhile longer. If not, remember there is no shame in moving on… often it takes the bravest of us to do that as well.