The Plight of Nurses: Essential Yet Overworked, and Underpaid

Nurses are a vital part of the healthcare community. From being the first person patients encounter in the hospital to being the only member of the hospital staff that the patient spends most of their time with, nurses play an important role in patient care. In fact, without nurses, a hospital wouldn’t be able to run efficiently.



Nurses often put their patients above their own needs to ensure great patient care and to provide their patients with comfort. They work for long hours, mostly standing on their feet, without taking lunch or toilet breaks, just for the smooth stay of their patients. They provide a calm environment for their patients to feel better despite their own physical and emotional exhaustion.

Are nurses suffering from burnout?

Many nurses experience exhaustion to the point of burnout at some point in their careers. Furthermore, this burnout leads some nurses to either quit their job or quit their nursing careers entirely. Taking care of multiple sick people with little to no support can take a toll on a person’s well-being. Nurses do this for almost 80 hours a week, and then go on to work their second jobs.

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Burnout in American nurses is extremely prevalent, affecting around 35-45% of all nurses. This burnout in hospital nurses has created what scientists have dubbed an American epidemic.

Why are nurses so exhausted?

There is a serious shortage of nurses in the United States. This has led to the overworking of the very few nurses, resulting in one nurse taking care of multiple patients. This, along with the lack of nursing supervisors, assistants, and the administration’s blatant disregard for the well-being of nurses, has led to extremely tired nurses who have become cynical towards their job and with no will to go on.

Furthermore, the salary for a nurse is barely enough to help them survive, with most nurses living from paycheck to paycheck. This dismal pay from their day job has resulted in most nurses working dual jobs.

Based on US Labor Stats, approximately 6.3% of female nurses have multiple jobs and 9.5% of male nurses work at least two jobs to make ends meet. Some of the nursing staff also take on multiple, consecutive shifts to be able to afford the bare necessities.

Considering the importance of nurses in the smooth sailing of a hospital, it’s about time pay raises were considered for these essential workers.

Why are nurses working in multiple jobs?

A 2009 survey conducted by AMN, a healthcare staffing company, on approximately 19,000 nurses found that 22% of them have a full-time second job. This means 1 in 5 nurses work two full-time jobs.

According to Janine Kalbach, a 34-year-old registered nurse in Cleveland who also works as a freelance healthcare writer: “Every nurse I know who gets a second job? It’s always about money.”

Nursing is one of the most in-demand jobs in the United States and is almost always associated with dismal pay, more work, burnout, and piles of debt.

The student loans are taken by students to put themselves through nursing school but then become the reason for nurses to take up other jobs.

According to Katherine McCusker, a registered nurse from Seattle, she works 24 to 36 extra hours every month in the critical care unit just to be able to pay off her student loans. In her own words, “If I didn’t have the loans I have, I certainly wouldn’t be per diem.”

When she was asked about the fear of burnout and exhaustion, she says, “I worry about burnout, not necessarily from the hours, but the emotional toll it takes to work in these intense environments.”

This crushing debt, which averages about $30,000, is a major reason for moonlighting. However, it is not the sole reason.

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An associate professor at New York University and a registered nurse, Amy Witkoski Stimpfel conducted a survey between 2006 to 2016 and found that 1 in every 15 nurses applies for a second job within 18 months of working as a nurse.

According to Stimpfel, nurses who work dual jobs—and both of them in the healthcare community—affect their own physical and mental health severely. “Nurses who are working two jobs, with two different schedules—there’s no opportunity for self-care,” she said. “They are working back-to-back in these demanding environments.” This can take a massive toll on their own health, requiring treatment that only puts them in more debt.

The United States has been suffering from a nursing shortage for decades. This has caused nurses to be overworked in their first, main job, but has not resulted in a pay increase. In fact, most nurses would agree that nursing is a profession with stagnant pay.

Sara Choi, an emergency room (ER) nurse from New York, initially started off with an annual salary of $98,000. In the 13 years that she has worked—or overworked—her pay has only been increased to $110,000. This is just a $12,000 increase in 13 years and more than half of her paycheck goes to her rent and bills, while the rest goes into repaying her student loans. This barely leaves anything behind for her own expenses.

Doing all the work and jobs that they do, many nurses end up missing out on quality time with their families. However, to them, it’s the price to pay to be able to provide their families with a good life financially. For some nurses, taking care of their children and families is the motivation behind working double jobs.

Some nurses have taken up dual jobs to try and fulfill their responsibility as young adults. To be able to buy their first home or to buy a car—these are the milestones of a young adult that most nurses are trying to reach, albeit by taking multiple jobs and working themselves to the bone.

To overcome the stress of needing to work multiple jobs, some nurses have chosen to work a second job in a non-healthcare environment. Most of them work for Uber as it provides them with quiet time without the constant noise of a hospital floor.

A pediatric nurse from Chicago took up a side job as a driver for UberEats. According to her, she likes this job as she isn’t required to do much. “I deliver groceries, get quiet time, and there are no monitors beeping,” she said when speaking to the Stimpfel.

Some nurses take up freelance work like writing, some sell crafts on Etsy, and some drive for Uber. Among the healthcare-associated jobs that nurses take up are nursing home assistants, medical transcriptionists, and caregiving jobs.

And each nurse might have their own reason for getting a second job, but what they can all agree on is that it’s for extra money—the money they need to make ends meet—and that this is taking a toll on them, and affecting their ability to perform their jobs efficiently.

Are multiple jobs making nurses less efficient?

In a 2012 study of approximately 22,000 nurses, the researchers aimed to associate long shift hours (12-hour shifts) with three major outcomes: burnout, job dissatisfaction, and intention to quit. An important point to note is that long shifts are supposed to be only 12 hours, but a 12-hour shift is never that. These shifts usually run up to 13-14 hours instead.

As mentioned above, long hours of work almost always result in burnout, quitting, and cynicism toward the job. However, something that isn’t often discussed is the fact that this cynicism and thoughts of quitting can affect the nurses’ ability to provide for their patients.

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According to their study, seven out of ten times, the long shifts that nurses were made to do significantly and adversely affected patient satisfaction. Nurses are not to be blamed for this discrepancy but rather the hospital administration that organizes the shifts.

Understaffed, underpaid, and fighting a pandemic

Nurses have been moonlighting, a term for having another job, mostly at night, for decades now. Salary crisis and nurse shortage issues aren’t new issues. However, they are issues that have been put under more strain due to the recent pandemic. Nurses and healthcare staff are now expected to put their lives on the line every day with minimal resources, pay, and support.

During the COVID-19 pandemic, nurses have not been provided with the necessary personal protective equipment (PPE) and are overworked in the ICU, taking care of multiple patients for long shifts. They also have to distance themselves from their families since they work on the front lines of this pandemic and carry a huge risk of contracting the SARS-Cov-2 virus and transmitting it to their loved ones.

They have been hung out to dry while they overwork and risk their lives, and still barely make enough to make ends meet. It’s high time the plight of nurses be considered and provided with a better working environment and better pay. The burnout faced by nurses is beyond abnormal and it’s time we took care of those who take care of us.

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