‘I felt like I was drowning’: Exhausted and exhausted, nurses quit their jobs in droves


“I felt like I was drowning,” Sullivan said, “and I couldn’t do it anymore.”

After 17 years caring for patients at Heywood Hospital – a job that at first was so exciting that she would come to work eager to see what the day would bring – she walked into her supervisor’s office and resigned.

Sullivan, 56, is among a growing number of nurses who, amid the unprecedented challenges of the COVID-19 pandemic, are quitting jobs they once loved. The rising level of burnout is exacerbating staff shortages as hospitals struggle to keep up with demand from sick patients.

In interviews, a dozen nurses described staffing crises at New England hospitals that left them too exhausted and unable to think critically or meet all of their patients’ needs. They fear making mistakes. And when they return home at the end of a shift, the stress and trauma of their work often stays with them.

During the peaks of the pandemic, nurses have witnessed the suffering and death that COVID can bring. They held the hands of dying patients. They feared they would get sick themselves or bring the virus back to their families. And sometimes, instead of gratitude, sick patients would respond with name-calling.

At first the nurses said, the adrenaline kept them going. But when COVID receded, other sick patients flooded hospitals. Healthcare workers had no time to rest.

With each successive outbreak of the virus, more experienced nurses chose to leave. And conditions for those who stayed have worsened further.

Massachusetts hospitals are struggling to fill thousands of nursing jobs. Some offer bonuses and new perks and benefits to attract talent, but there are no easy solutions to build the pool of highly skilled workers. And departures should continue.

When hospitals are understaffed, patients wait longer for care.

“There are vacancies in every position and in every area of ​​the hospital,” said Steve Walsh, president of the Massachusetts Health & Hospital Association. “It was a challenge before the pandemic; it’s only worse now.

In a McKinsey survey of nurses nationwide, 32% said they planned to quit patient care, citing staff, pay and lack of support – a 10 percentage point increase in less than a year, from the beginning of 2021 to the end of 2021.

Last fall, before the Omicron wave destroyed hospitals, 18% of healthcare workers across the country had already left their jobs since the start of the pandemic, according to a Morning Consult poll.

Some nurses quit high pressure hospital environment for less stressful healthcare jobs. Others are retiring or turning to new careers.

Sullivan had no back-up plan when she quit her job in January; she just knew she couldn’t stay in the hospital. Within weeks, she found a new position preparing patients for eye surgery at an outpatient clinic in Worcester. His days are no longer hectic.

“I had to take a pay cut, but I didn’t care, if that meant I was going to be less anxious,” she said, referring to the risk of fatigue and stress leading to mistakes in care. “I don’t feel like I’m going to kill anyone, like in the hospital.”

* * *

Haley Fiske, 32, came to nursing after working in public health. She graduated in 2019 and was just two months away from her first nursing job at a hospital in Rhode Island when the pandemic began.

Night after night, his medical-surgical floor was understaffed. Patients asked her questions, and she tried to answer. Corn she didn’t have enough time deal with whatever happens to him; sweat ran down her back as she thought about the next person who needed her, and the next.

“We worked 12:30 p.m., 1:30 p.m. without taking a break, without going to the toilet. Then you realize you didn’t need to go to the bathroom because you hadn’t had a drink during your shift. We couldn’t take care of ourselves in the most basic way,” Fiske said.

She felt like a “work bunny” – check vital signs, give medicine and rush.

One night in the winter of 2021 sticks in Fiske’s mind. She was struggling to care for three unstable patients at the same time. Then, when she was already inundated, her colleagues needed her help to revive an unconscious patient in another room.

“I would walk away and think, ‘Thank God none of my patients died,'” she said. “The standard shouldn’t be that they didn’t die, the standard should be that they got good care.”

Fiske became a nurse to help patients, but she couldn’t help but think that under so much pressure, she might make a mistake and hurt them. Anxiety gnawed at her. She contemplated suicide. She spoke to a therapist. Eventually, she realized she had to make a change – her health depended on it.

Last spring, Fiske moved into an administrative role in health care. She still uses her nursing skills but no longer cares for patients. “I can’t believe how much better I am now,” she said.

* * *

Amy Smith usually worked in the emergency department at Brockton Hospital, but at the start of the pandemic she volunteered to work in the COVID ICU. Twenty-five years as a nurse did not prepare her for the amount of pain and death she saw there.

“I guess I forgot I was human too,” Smith said, his voice cracking. “When I threw myself on the breaking wave, I did not realize what it was going to do to me afterwards.”

Even at home, more than a year after the start of the pandemic, rest was hard to find.

“I would start sobbing. It happened all the time,” she said. “I was walking around with tears streaming down my face with the idea that I have to go to work.”

Smith, 48, spoke to her husband and found they could manage their expenses without his salary.

“I can’t continue to give poor care and go home with a clean conscience,” she said.

Smith went out in her canoe to write a letter of resignation, in blue ink on white lined paper, and delivered it to her boss the next day. In November, she quit breastfeeding.

Smith’s prospects of working with patients again are slim — she opted out of getting a COVID shot, a requirement for employment in most health care settings. But she and her husband started roasting and selling their own brand of coffee beans. She dreams of a new life at the head of a café.

“I still have days where I’m like, ‘What have I done?’ “Smith said. But she sleeps through the night now, and she doesn’t cry when she thinks about work.

* * *

Lisa Mancuso had 37 years of nursing experience when the pandemic started, so in the early days of COVID she too volunteered to help in the ICU, at St. Elizabeth’s Medical Center in Brighton. But as she and her colleagues dealt with the new virus, stocks of personal protective equipment ran out and they were forced to reuse face masks.

To limit exposure to infectious patients and preserve PPE, few people were allowed in COVID patient rooms. Mancuso was one of them. She remembers once checking on a critically ill patient, wearing head-to-toe PPE, while doctors outside the room shouted instructions through the window.

“I remember turning around and saying, ‘I only have two hands,'” she said.

Mancuso was so busy during her 12-hour shifts that she had no time to eat. By the time she got home, she just wanted a hot shower and a tall glass of wine.

In May 2020, Mancuso fell ill with COVID. She is certain that she contracted the virus at work.

“You’re in intensive care in your patient’s room, pretty much marinating in the virus,” she said. “And I didn’t do anything else during that time.”

For three weeks, Mancuso was out of breath. She lost her appetite and 10 lbs. As she recovered, she realized she didn’t want to return to a workplace where she felt unsafe. She left her job in June 2020, when she was 57, several years before she had originally planned.

Mancuso was fortunate to have another source of income as a consultant for attorneys working on medical malpractice cases. After leaving the hospital, she made counseling her full-time job.

Now she works from home, a cup of hot tea on her desk, music playing in the background. She has time to exercise and eat regular meals. She is not exhausted.

Mancuso bristles at the term burnout. It involves a personal failure to cope with difficult circumstances, she said, when the reality is far more complex.

“People were having the worst days of their lives, and all we could do was walk in and out,” she said. “I just wasn’t willing to do it anymore.”

Priyanka Dayal McCluskey can be reached at [email protected]. Follow her on Twitter @priyanka_dayal.


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