Nurses quite literally have their fingers on the pulse of patient care — and we’re sounding the alarm: There are not nearly enough of us at the bedside. What this means in ERs and on hospital floors in our area, throughout the state and even across the nation, is that nurses, already physically and emotionally drained from a year and a half on the front lines of a pandemic, are being asked to care for more patients than is safe for either the patient or the nurse.

When this happens — when nurses are routinely required to care for more patients than is safe — it’s called chronic nurse short-staffing, and care suffers. Nurses suffer, too. These are our stories.

I see someone quit every day

We are experiencing a turnover rate now that I’ve never seen in the 30 years I’ve been at Einstein. Every day, someone leaves. Nurses used to be here for three or four years before moving on; now, it’s three or four months. It’s scary on so many levels.

Nurses who are brand-new, just coming out of school, are being thrust into assignments with high acuity even as they’re forced to handle more patients because the units are short-staffed. Experienced resource nurses are just not available to help, and these new nurses are getting burned out very quickly due to the lack of support and great demand put on their shoulders.

“When there are no nurses, who is going to take care of these patients?”

Peg Lawson

There was an incident recently where a nurse with just three months’ experience was forced to take on the charge-nurse role because she was the most senior nurse working that day. She called the supervisor to tell her that she was uncomfortable. She said, “I meet zero of the requirements for being charge nurse.” She was told she couldn’t refuse the assignment.

How long do you think that nurse is going to stay? Can you blame her if she doesn’t?

We are getting to a point where there will be no nurses. And when there are no nurses, who is going to take care of these patients?

Peg Lawson, R.N., has worked as an ER nurse at Einstein Hospital for 30 years. She is co-president of Einstein Nurses United.

» READ MORE: Coronavirus nursing shortage? Three ways to get more nurses — now. | Expert Opinion

I was punished for pushing back

I worked on the floor for more than 20 years before moving to the operating room four years ago as a way to stay in the profession I love but one that had changed dramatically since I entered it. In the OR, if we don’t have enough nurses, surgeries get canceled. We aren’t asked to double up on patients. We aren’t expected to split our attention into teeny little pieces.

Today, nurses have more patients, more paperwork, more policies, and more procedures than ever, which means they have less time to devote to any single patient, less time to care. And if you push back even the littlest bit against that model of care, you’re ignored or belittled or even written up.

“Today, nurses have more patients, more paperwork, more policies and more procedures than ever.”

Leslie Heygood

I remember the incident that precipitated my move to the OR like it was yesterday: I was asked to accept yet another patient. I had just received a very sick patient who needed immediate attention, and I asked if I could have a few minutes to devote to my crashing patient before I accepted another one. My nursing supervisor at the time became indignant and asked me in a harsh tone, Are you refusing a patient? That question, which was designed to put me in my place, convinced me I was in the wrong place. I knew it was time to go.

Leslie Heygood is an OR nurse at Crozer-Chester Medical Center in Delaware County and the president of the Crozer-Chester Nurses Association there.

I retired because my heart would break if I stayed

I was a nurse for 42 years before I retired in June 2020. For all that time, when people would ask me to describe myself, I would say, “I’m a wife, a mother, and a nurse.” Being a nurse was a part of me, as much as my heart and soul. I agonized over the decision to retire. Ultimately, however, I had to. I felt like I would break into a million pieces if I stayed.

When the pandemic first hit our area, I was a discharge nurse at Mercy Fitzgerald Hospital in Upper Darby. But I had been an ICU nurse for 24 years earlier in my career and had extensive experience caring for patients with ventilators. As the hospital was flooded with COVID patients and we desperately needed more staff, I volunteered to go back to the ICU and work the shift where they needed the most help, which, at the time, was the night shift. It was the most devastating experience of my life.

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In all my years of nursing, even when I was working with very sick patients in the ICU, I always felt that if I worked really hard and did everything I knew and was trained to do, I could make a difference. It was the reason I became a nurse, and it was the opposite during the pandemic. My first night in the ICU, we had no deaths, and my coworkers were calling me a good-luck charm. The next night, in the first three hours of my shift, we had three patients code and die, and that happened every single night afterward. I carried their faces home with me. I carried the voices of their family members, whom I spoke to on the phone. I carried with me overwhelming sadness mixed with intense fear for my coworkers, who were immersed in the same hell I was, and for my family and friends, whom I worried I would infect. I isolated myself. And I stopped sleeping. I couldn’t shut my eyes without seeing my patients’ faces.

“I couldn’t shut my eyes without seeing my patients’ faces.”

Marci Keating

As our COVID numbers started to trail off a little bit late in the spring, I was floated from the ICU to the step-down unit. But although I was incredibly torn about abandoning my coworkers, my spirit was broken. I retired in June of that year.

All the nurses who have worked through the pandemic — who risked their own lives to care for their communities — are truly suffering. Hospitals never staff with any sort of cushion, they never plan for the what-ifs. And as a result, nurses are burned out. They feel unappreciated by hospital management. And they’re either leaving the hospital or the profession, as I did.

Marci Keating, R.N., a former longtime Mercy Fitzgerald Hospital nurse, retired from nursing in June after 42 years.

» READ MORE: Philly-area hospitals are paying nurses big bonuses to stave off shortage

I’m only six years in and already exhausted

A patient’s nurse is their fiercest, most informed advocate because, even when we’re short-staffed, we spend more time with our patients than any other caregiver. So if nurses aren’t heard, our patients’ needs aren’t being acknowledged either.

With staffing shortages, charge nurses now take full patient assignments, along with their host of other responsibilities, and we have fewer and fewer nurse’s aides and unit clerks on the floor, sometimes none at all.

“Bedside nursing is no longer sustainable for me. I’m just 33.”

Claire Swanson

I work with heart patients who are very sick and often unstable. When a patient uses their call button, they may be having chest pain, or be unable to breathe, or just have a question. I won’t know what they need until I’m in their room, but that might mean leaving an unsteady patient to walk to the bathroom by themselves or hanging up on a distraught family member on the phone. I can’t clone myself to be in two places at once. There’s no more safety net. The worst feeling is going home after a hard shift knowing there were things you could not get to and wondering what you may have missed.

I’m currently in Temple’s Doctor of Nursing Practice program. I’m thinking about the next 30 years of my career, because bedside nursing is no longer sustainable for me. I’m just 33, just six years into my career, and I’m exhausted.

Claire Swanson, R.N. B.S.N., has been a nurse in Temple University Hospital’s Heart and Vascular Pavilion for the last four years and is a student in the Doctor of Nursing Practice program there.

I’m asked to give better care to management than my patients

It’s awful to walk into a room with a new mother who needs help with nursing and have too little time to give her. She isn’t emergent, but it is a momentous time in her life; she needs caring support. When our management team and executives and their loved ones are in the hospital, they don’t experience this. We will be alerted to their presence, and they will receive more attentive care. They may believe all patients receive the same type of care they do; I’m here to tell you, they don’t. It’s impossible when we’re so short-staffed.

Management wants us to do more with less. They say this all the time, and it’s an approach that can work in the corporate arena. I went to Wharton, I understand. But it doesn’t work in the human realm. And it doesn’t work for me.

“Being asked to give less to people who already have less is counter to everything I believe in.”

Carla Le’coin

My heart doesn’t go to catering to those who have plenty. I entered nursing to give more to those who have less. It’s why I chose to be at Einstein, a safety-net hospital that serves the largely Black and brown community surrounding it and those who have less. Being asked to give less to people who already have less is counter to everything I believe in.

Many moms don’t realize it, but long after they’ve left the hospital, we think about them. We think about their children. We care so much. We want more for them, not less.

Carla Le’coin has spent all 33 of her years in nursing in maternal health at Albert Einstein Medical Center. She is the Political and Community Outreach Chair for Einstein Nurses United.

Maureen May, R.N., is a longtime Temple University Hospital nurse and president of the Pennsylvania Association of Staff Nurses and Allied Professionals, which represents 9,500 nurses and health-care professionals across the commonwealth. She has worked at the bedside for more than 35 years.