Nurse Lisa Sullivan was in the hall at her community hospital in Gardner during the peak of the Omicron wave as the calls from patients kept coming. One patient had a stroke. Another needed a blood transfusion. The family of a third patient was on the phone, waiting for updates.
She was overwhelmed, and none of the other staff had time to help her.
“I felt like I was drowning,” Sullivan said, “and I couldn’t do it anymore.”
After 17 years taking care of patients at Heywood Hospital — a job that at first was so thrilling that she drove to work eager to see what the day would bring — she marched into her supervisor’s office and quit.
Sullivan, 56, is among a growing number of nurses who, amid the unprecedented challenges of the COVID-19 pandemic, are leaving jobs they once loved. The rising level of burnout is worsening staffing shortages as hospitals struggle to keep up with demand from sick patients.
In interviews, a dozen nurses described staffing crises at hospitals across New England that have left them feeling stretched too thin and unable to think critically or tend to all their patients’ needs. They fear they will make mistakes. And when they go 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 witnessed the suffering and death that COVID can bring. They held the hands of dying patients. They worried about becoming sick themselves, or bringing the virus home to their families. And sometimes, instead of gratitude, patients in the throes of illness responded with abuse.
At first, nurses said, adrenaline kept them going. But when COVID receded, other sick patients flooded hospitals. There was no time for health care workers to rest.
With each successive surge of the virus, more experienced nurses have opted to leave. And the conditions for those who remained have become even worse.
Massachusetts hospitals are working to fill thousands of nursing jobs. Some are offering bonuses and new perks and benefits to attract talent, but there are no simple solutions for building the pipeline of highly skilled workers. And departures are likely to continue.
When hospitals are short-staffed, patients wait longer for care.
“There are vacancies in every single job and every single area of the hospital,” said Steve Walsh, president of the Massachusetts Health & Hospital Association. “That was a challenge prior to the pandemic; it’s only worse now.”
In a McKinsey survey of nurses nationwide, 32 percent said they were planning to leave patient care, citing staffing, pay, and lack of support — an increase of 10 percentage points in less than a year, from early 2021 to late 2021.
By last fall, before the Omicron wave pummeled hospitals, 18 percent of health care workers across the country had already quit their jobs since the start of the pandemic, according to a Morning Consult poll.
Some nurses are leaving the high-pressure hospital environment for less stressful health care jobs. Others are retiring or pivoting to new careers.
Sullivan had no backup plan when she left her job in January; she only knew she couldn’t stay at the hospital. Within weeks, she found a new position prepping patients for eye surgery at an outpatient clinic in Worcester. Her days are no longer hectic.
“I did have to take a pay cut, but I didn’t care, if it meant that I was going to be less anxious,” she said, referring to the risk of fatigue and stress leading to errors in care. “I don’t feel like I’m going to kill somebody, like at the hospital.”
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Haley Fiske, 32, came to nursing after working in public health. She completed her degree in 2019 and was only two months into her first nursing job at a Rhode Island hospital when the pandemic began.
Night after night, her medical-surgical floor was short-staffed. Patients asked her questions, and she tried to respond. But she didn’t have enough time to deal with everything coming at her; sweat trickled down her back as she thought of the next person who needed her, and the next.
“We would work 12½, 13½ hours without taking a break, without using the restroom. Then you realize you didn’t have to go to the restroom because you also didn’t drink anything at your shift. We couldn’t take care of ourselves in the most basic ways,” Fiske said.
She felt like a “task rabbit” — checking vital signs, giving medications, and rushing on.
One night during the winter of 2021 stays in Fiske’s mind. She was scrambling to tend to three unstable patients at the same time. Then, when she was already inundated, colleagues needed her help reviving an unconscious patient in another room.
“I would leave 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 they got good care.”
Fiske became a nurse to help patients, but she couldn’t shake the thought that under so much pressure, she could make a mistake and hurt them. The anxiety gnawed at her. She contemplated suicide. She talked to a therapist. Eventually, she realized she needed to make a change — her health depended on it.
Last spring, Fiske transitioned to an administrative job in health care. She still uses her nursing skills but no longer takes care of patients. “I can’t believe how much better I am now,” she said.
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Amy Smith usually worked in the emergency department at Brockton Hospital, but in the early days of the pandemic, she volunteered to work in the COVID ICU. Twenty-five years as a nurse didn’t prepare her for the amount of pain and death she saw there.
“I guess I forgot that I was also human,” Smith said, her voice breaking. “When I threw myself at the surge, I didn’t realize what it was going to do to me afterward.”
Even at home, more than a year into the pandemic, rest was hard to find.
“I would start sobbing. It was happening all the time,” she said. “I would walk around with tears streaming down my face with the idea that I have to go to work.”
Smith, 48, talked to her husband and realized they could manage their expenses without her salary.
“I can’t keep giving subpar care and come home with a clean conscience,” she said.
Smith went out in her canoe to write a resignation letter, blue ink on white lined paper, and gave it to her boss the next day. In November, she left nursing.
Smith’s prospects of working with patients again are slim — she has opted not to get a COVID vaccine, a requirement for employment in most health care settings. But she and her husband have started roasting and selling their own brand of coffee beans. She dreams of a new life running a coffee shop.
“I still have days when I think to myself, ‘What have I done?’ ” Smith said. But she’s sleeping through the night now, and she doesn’t cry when she thinks about work.
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Lisa Mancuso had 37 years of nursing experience when the pandemic began, 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 faced the new virus, supplies of personal protective equipment were running low, and they were forced to reuse face masks.
To limit exposure to infectious patients and preserve PPE, few people were allowed in the rooms of COVID patients. Mancuso was one of them. She remembers checking on a critically ill patient one day, wearing PPE from head to toe, 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 didn’t have time to eat. By the time she got home, she just wanted a hot shower and a big glass of wine.
In May 2020, Mancuso became sick with COVID. She feels certain she contracted the virus at work.
“You’re in the ICU in your patient’s room, you’re pretty much marinating in the virus,” she said. “And I didn’t do anything else in that period of time.”
For three weeks, Mancuso was short of breath. She lost her appetite, and 10 pounds. 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 initially 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 consulting her full-time job.
Now she works from home, a hot cup of tea on her desk, music playing in the background. She has time to exercise and eat regular meals. She isn’t exhausted.
Mancuso bristles at the term burnout. It implies a personal failure to cope with hard circumstances, she said, when the reality is far more complex.
“People were having the worst days of their lives, and all we could do is run in and run out,” she said. “I was just not willing to do it anymore.”
Priyanka Dayal McCluskey can be reached at firstname.lastname@example.org. Follow her on Twitter @priyanka_dayal.