Nurses face tough conditions despite an abundance of jobs.
Jade, a 24-year-old nurse in Georgia, worked in a small emergency room when the pandemic hit.
She left for something more stable but had to take a pay cut and doesn’t have great benefits.
She thinks that nurses don’t have power despite the Great Resignation and need unions.
Jade, a 24-year-old nurse, always said she’d leave the ER if she ever lost her compassion. That was before the pandemic made her job too difficult to stay, making her one of the many front-line workers who quit their roles — but still remained powerless if they stayed in their fields.
Jade, whose real name and employer are known to Insider but withheld for privacy, has been working as a nurse since she was 20. She was drawn to the pace of the small-town Georgia emergency room she joined prior to the pandemic.
“It’s kind of a balance of high chaos, and then you recover,” she said.
That all went out the window when the pandemic hit. Like millions of workers, Jade’s job changed dramatically in March 2020. But instead of working from home and doing Zoom happy hours, she was contending with a full-to-the-brim ER in an area with few virus mitigation or masking measures.
“We got overrun pretty quickly, and there was no sign of it stopping,” Jade said.
“It was really hard to not simultaneously be angry with people who didn’t take the pandemic seriously and would question us as we tried to care for them,” Jade said.
It weighed on her and took the joy out of nursing. She quit to try out an ER at another hospital, but found many of the same problems. It was a conundrum that revealed how quitting for a different role wouldn’t necessarily change the issues dragging her down — they were widespread and systemic. One day, she found herself balancing two patients in the ICU, another patient with COVID-19, and a fourth coming in from an ambulance.
“I had to take a moment in the supply room that day to cry, honestly, because it’s really hard to find out where you should split your attention when you have four patients, two of whom are critically ill,” she said. “That’s when I decided I needed to find a less stressful job.”
Last August, she left emergency-room nursing altogether. Jade became one of the near-record number of Americans quitting their jobs for a better deal, but she also came up against the constraints of how much a job switch can change the material conditions of work, as her new job still came with difficult concessions. The power of quitting your job is often the only power a worker can wield, and even that isn’t available to everyone. In nursing, where shortages abound, it may not be hard to get a new offer — but systemic issues are harder to escape.
‘There’s nowhere else to go’
In the fall, Jade began working as a primary nurse for a cardiologist. She was drawn to the hours — a steady 8 a.m. to 5 p.m., instead of the 12-hour shifts expected at the ER. She wouldn’t have to work nights, weekends, or holidays.
“I enjoy the work that I do,” she said. “I’ve learned a lot more about cardiology, and I like nursing. So learning about it is a plus in my book.”
But there were trade-offs. She had to take a $5-an-hour pay cut. She’s the only nurse in the office. She also doesn’t have a bank of sick days, and instead has to use paid time off, which she accrues over time.
“When I first started this job, I didn’t know I had asthma at the time, but I got pretty sick and I had to be out for a week before I had started accruing PTO,” she said. That mean she started with a negative balance of PTO. When she got COVID earlier this year, she also had to take PTO for the five days she had to quarantine.
While Jade would “love” to get another job, she needs the health insurance her current role provides, especially as she deals with her own medical issues. Jade is coming up against just how much the Great Resignation — and job switching — can change an individual’s circumstances. Her current role offers conditions and experiences that are better than weathering the ER during the pandemic, but that doesn’t mean the underlying factors have changed.
“A lot of folks tossed around the idea that workers, especially nurses and other healthcare workers, would have a lot of power right now because we are in such high demand. That is absolutely not true,” she said.
For instance, she gets emails and calls from people offering travel contracts that would pay her twice as much an hour as she’d earn at a hospital.
“If workers’ power is having as many job offers as you could want, then yes we do” have power, Jade said. “But if that means being able to have more time off than I do on shift if I want to work in the ER, or being able to be sick without being worried about being fired, then we do not have that.”
That’s likely due to the fact that companies wield what’s called monopsony power, where they have the ability to dictate wages and working conditions because there’s a lack of competition. The Department of Treasury has found that workers make 15% to 20% less than they would in a “perfectly competitive market.” Solutions to reducing monopsony could include raising the minimum wage and stricter antitrust measures, according to Treasury.
She’s had a lot of people tell her to try her hand at lucrative travel nursing, because “there’s nowhere else to go.” It seems like the only option where if it’s “shitty,” at least “you’ll get paid a lot.”
“I either have one place where I have solid 12-hour shifts, don’t have to worry about staying late — but also you don’t have a lunch break. You eat if you have time and if you don’t, well, you don’t,” Jade said. “Or I can go to another place where you do have a lunch break, but you’re gonna have to try and balance the job of two people for 12, maybe 13, hours.”
The only thing that could bring workers in nursing actual power, she said, is unionizing. Her mind was blown when she heard that some unionized nurses have a protected lunch break and safe patient ratios — things that nascent doctors unions have also been pushing for on the job.
“We talk, we know that this sucks, we all bitch about it to each other, but we all know that there’s nothing that we can do,” she said. “So that collective action, I think, seems to be pretty powerful in places where it works.”