Are Incentives Enough to Save Nursing? A Q&A with Michigan Nurse Lizzy Kay

By JOSEPH GORAL, Solutions News Bureau

Lizzy Kay, a Nurse Intern at Beaumont Health in Southfield Michigan, entered the healthcare field for the opportunities a nursing degree creates, and because “helping people is good for the soul.” But with 47% of U.S. nurses planning to leave their positions within the next three years, nurses around the country are receiving higher workloads. Kay tells us about her experience, and what might help.

What is a major challenge you face in your position?

The patient load nurses can have because your day is so unpredictable. Managers try to prevent it by seeing how much care [each patient] will require, but it’s hard when you have five patients, and [one] could have a stroke in the middle of the day. They could have been known as a really easy patient, and all of a sudden they have a stroke and you’re in there for hours, but you still have four other patients to take care of.

We think it’s because the emergency room can get so packed that they need to send patients to different floors. So even though my floor is an orthopedic floor, we end up with cardiac patients because there isn’t enough space on the cardiac floor. But the emergency room can’t get backed up because it’s open for everyone. So it’s an overflow and the emergency room will never really shut down.

Who do you turn to when this problem happens?

Usually, I’ll find a nurse that I know is smart and will know what to do, or you contact a doctor because there are some that can spot things that are abnormal. Or you can ask the patient “is this normal for you,” or “what has been done in the past?” It’s critical thinking in the moment.

How do hospitals respond to this?

At Beaumont, they’ve been offering incentives called critical stacking pay. If you pick up [a shift] they’ll offer a nice amount of money on top of that, so I think that’s what’s keeping some people there. But some people definitely quit because of the workload. I think it just depends on how long you’ve been a nurse and how much you’re willing to put up with it.

Are the incentives for people who have been working there or is there a signing bonus?

They do offer a signing bonus, but they also offer [more]. If [you work] full time as a nurse, you work three 12-hour shifts per week. If you pick up any hours on top of that you could get $30, or $40 extra per hour.

It used to be a lot higher when COVID was going on. Now it’s not great. I think that’s definitely an effort to keep the hospital staffed, but also to keep nurses on board. [Still] I think they’re burnt out for sure. They just go work at inpatient places like doctor’s offices.

How effective do you think the responses are? Is there more the hospitals could be doing?

I think they should be hiring managers that are just as good as the ones on the floor that I’m on. I used to be in the resource pool, so I got to work on every floor for at least one shift. One of the few reasons I picked this floor is because the managers are so good.

Something with the numbers needs to change. They need to limit how many people they let in without hurting other people’s feelings, but that sounds like an unrealistic ask.

So limiting the number of patients they admit?

Yeah because then, in the end, it would prevent burnout, and it would create a healthier and safer environment for the patients. So then it’s a win-win for almost everyone.

Do you think that would hurt people who need care?

I think it would make people upset and I think one of the reasons why that isn’t happening right now is because the government wants money. So if they set a limit, then the government won’t get as much money.

Is there anything that makes it hard to get help from managers when there is an overflow?

They’re [also overworked] so sometimes you feel bad for asking and you just got to do it on your own. But I guess that’s just how you grow as a nurse. You have to figure it out and then you’ll know how to do it next time.

What do you want people to know about yourself and other caregivers?

It’s hard when you want to do so much for these patients, but you mentally and physically can come to a breaking point where you need to take a break yourself as a healthcare worker. But then it is easy to feel guilty for that because we’re the ones who signed up for this, went to school for this. It was our decision, but in the end, it should all work out and you’re trying to make a difference, and change people’s lives for the better.