Recently a discussion started on a list server which focused on care issues, specifically quality of life. Oftentimes healthcare providers become so focused on curing an ailment that the patient’s wants and desires are not questioned or addressed. Is it possible that some patients might just not want to go through extensive treatment which could lead to deterioration of some other body system?
Similar to the assessment of pain, quality of life is subjective. One person’s expectation or definition of quality of life is most likely different than another’s. Most nurses agree that when a patient enters the hospital, one of the goals is to receive adequate treatment for the health care problem or illness. The treatment however could lead to additional problems such as side effects from medications or changes in previously stable body areas. At what point was the patient asked if these additional problems fit into the patient’s life expectations?
Quality of life is not just an issue with patients – it is also an issue for care providers. Over the last weeks and months many issues have been raised on list servers and Facebook posts that focused on changes in the health care industry which affect the nurse. Some nurses have had hours reduced while others are expected to pick up the slack. Other nurses have had work hours changed which deviate considerably from that which was negotiated upon hire. Some organizations have altered benefits which impact the nurse’s take home pay. All of these changes and issues impact the nurse’s quality of life.
During one discussion on a list server a nurse was hired to staff an out-patient ambulatory care center. For the first several months there were no issues with the work or the hours however once a new leadership team which oversees the center was brought on board, the hours of work changed. Surgical hours were expanded and staff with the most experience was shifted to work the later hours. The nurse argued that if she had known that her hours of work were going to change, the position would not have been accepted. This change negatively impacted the time she needed to spend with her family since her spouse was already working the later afternoon shift. Babysitting fees were not calculated into the average monthly salary needs.
Another nurse became quite vocal with this argument and berated the nurse for complaining. After all, the nurse did have a job in a part of the industry that was desirable and a change in hours should not be a major concern. And if it really was an issue, the nurse should just leave and let someone else who was looking for a job have a chance.
This comment raised an issue that many found quite interesting – when should a nurse decide that an employment arrangement is just not working out anymore? At what time should the nurse focus on individual needs, over those of an employer, and determine that personal quality of life is more important?
Since the responses to this question were numerous, I’ll consolidate them here. Several nurses believe that whenever an employer changes the conditions of employment, the nurse should plan to leave. Others believe that employers have the right to alter conditions of employment, based upon market needs, and the nurse should be happy to have a job. However the vast majority commented that the nurse needs to stop putting everyone else’s needs first and focus on what will support the nurse’s quality of life.
Little has been written or studied about the nurse’s quality of life. There are many quotations and beliefs that state nursing is a thankless profession and if personal gain and accolades are desired, find another career. Others believe that if a person desires to become wealthy, forget nursing. However little has been written about the sacrifices that nurses make when putting the needs of others first.
Nursing has had a long tradition, or misconception, of being a handmaiden. Many in the profession have tried to eradicate this perception with little success. Relationships with physicians remain adversarial. Relationships with leadership are condescending. And relationships with each other are combative. None of this is positive or adds to the nurse’s quality of life.
Thankfully for the profession most nurses overlook these indiscretions and forge forth to provide care to those who are infirmed and seek other avenues to support personal needs. But then there are some who decide that the best option is to let go and move on. Moving on is not giving up or admitting defeat. Moving on might be the only option for the nurse to achieve balance.
So to those who decide to remain in situations that are less than ideal, best wishes for finding peace. And to those who have decided to move on, prepare for an adventure into the unknown. As always, the only time we have is now. Make the most of it.
Dawna Martich, MSN, RN
Director of Education