I wasn’t supposed 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: ICU nursing. After 33 years as an ICU nurse, I knew it was time to go.
I used to feel like I had a purpose. I used to think I was a dynamic part of saving lives in the ICU. I lived and breathed ICU. I was a charge nurse, a mentor, and a preceptor. I attended the AACN meetings, was the leader of the shared governance committee, was on the rapid response team (RRT), and 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 I listened to the family members scream at us nurses and doctors: “Do everything.” 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 chests, 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 master’s 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 why the budget was so important. She slowly eliminated our care techs, secretaries, and CNAs, often 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 was a gasping moment for me. Like how could any manager be okay 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,” but so are our patients.
Top CEOs 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 grand 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, and Vasopressin; add a central line and an arterial line, maybe a Swan-Ganz line, CT scans, and Code Cools and proning, ECMO. Our duties were endless. And it would be 12 to 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, then nobody would protect it. Not even my ICU Nurse manager.
So I turned in my resignation. I said goodbye to my true love, ICU nursing. I could no longer bear to treat patients with haphazard nursing practice 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 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 America. Two for the price of one.
Debbie Moore-Black is a nurse who blogs at Do Not Resuscitate.
