Stop calling nurses superheroes

by Clara Yim Bolduc

This article was first published in Medscape Nurses in July 2022

Imagine walking into work, and your boss says, "Today, you're going to take a test. The test will last for your entire 12-hour shift. There are 24 questions on the test. Each question will take approximately 1 hour to complete."

"Wait a minute," you say, doing some quick mental math, "That's 24 hours' worth of work. There's no way I can do that in 12 hours."

"Sure, you can! You just need to have a better attitude," your boss says. "Lean on your coworkers. Learn to work collaboratively, like a finely tuned machine, or an unrealistically functional family. But don't talk to each other too much. If I see you laughing or chatting or sharing a picture of your grandkids for 8 seconds in the hall, I'll know you aren't working hard enough and I'll give you more questions."

"Good teamwork requires camaraderie," you say.

"I'm not paying you to make friends. I'm paying you to take a 24-hour exam in 12 hours."

"You know this is impossible, right?" you ask.

"Nothing is impossible!" your boss tells you. "See? It says so on that motivational poster in the breakroom, right next to the vase of wilted flowers that old lady's family sent to the nurse's station, after she died. You know, I bought that poster. With my own money. No need to thank me. It's just a little gift to show how much I appreciate you. You're like a superhero without a cape! Don't forget to punch out on time! We're depending on you!"

Welcome to the world of bedside nursing, where the hours are long, the stakes are high, and the institutional gaslighting is unrelenting.

One day, early in my training as a medical-surgical nurse, my preceptor said to me, "Helping people in their time of need is a privilege. Always remember that." She's right, and I think most nurses would agree. But it's a privilege we pay for dearly, too often with our lives, our bodies, and our mental health.

This painful truth was brought home to me after my third day at my new job, when I found myself reaching for my Ativan prescription for the first time since I left my last nursing job, more than a year ago. I couldn't fall asleep, because I couldn't stop reviewing and second-guessing every decision I'd made throughout the day:

If I'd just been a little more organized, could I have gotten those meds to all my patients on time? Did I remember to chart that Foley I removed? How long was that patient sitting in his own poop before we got to him? Will he get a bedsore as a result? I should have notified the doctor when that patient didn't tolerate that NG tube. Will whatever errors I made today, or whatever errors I will inevitably make tomorrow, cause my patients any harm?

The day would go smoother if I went in half an hour before my shift starts, to read up on my patients' charts. Should I go in early tomorrow, even though the hospital prohibits it and I won't be paid for that time?

The common cost-saving measure of forbidding nurses from clocking in more than a few minutes before their shift strikes me as incredibly short-sighted. How can we be expected to safely care for our patients when we arrive on the floor, knowing no more information about them than can be squeezed into a 5-minute verbal report? "Don't code at shift change!" I hear from nurses. They say it jokingly, but the danger is real.

Administrators acknowledge that we've got it tough. They call us "superheroes," like it's a compliment. I appreciate the sentiment, but I can't help but hear the subtle implication that we shouldn't be asking for money to do our jobs. After all, most of us are women, and "caring" is just part of our DNA, right? But more than that, I think calling us "superheroes" supports the false narrative that nurses should be capable of doing the impossible — and a reminder that the failure to do so is ours and ours alone.

When your job demands the impossible, failure is inevitable. Mistakes and medical errors are unavoidable. We're forced to cut corners on patient care, because we simply aren't given enough time to do our jobs. There are 24 hour-long problems to complete, and we are given 12 hours in which to complete them.

Hospitals need to stop pretending that nurses are superheroes. They need to acknowledge that we're humans with normal, human limitations. Until then, the job of nursing will continue to become more and more untenable, and there will be fewer and fewer people willing to continue doing it.

What most nurses want is pretty simple:  We want to provide safe, quality care to our patients. We don't want appreciation awards; we don't want free sandwiches, or posters in the breakroom. We definitely don't want to be called superheroes. We simply want to do our jobs, safely.

And that requires that our patient numbers be limited; that if and when those limits are — by necessity — exceeded, there are crisis-staffing policies in place to guide and protect us so we can legally adjust and prioritize our care accordingly and that policies and procedures be changed to fit the reality of day-to-day patient care in the specific environments in which we work.

What's that you say? There's a nursing shortage? A budget shortfall? A patient surplus? Limiting our patient loads to safe levels right now is impossible?

As a motivational poster once said to me, "Nothing is impossible!" You can do it. We're depending on you. 

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