Editor's note: This article uses only initials to identify the people interviewed, and their hospital systems are not being named. The goal is to share their stories without putting their jobs at risk.
W.T., a registered nurse, used to be invigorated by the appreciation his patients showered him with because of the care he gave.
"The immense waves of gratitude and fulfillment. … I'm glad it was my shoulder that they cried on, not anyone else's," W.T. said.
But after five years, critical care nursing began taking a toll.
"Those moments (of gratitude), they were outweighing all the bad (in nursing), but now the weight is starting to shift," he said.
This past week was National Nurses Week, when hospitals and other healthcare facilities promote all the good nurses do. Many provided gifts of company clothing or meals and sweets. But speaking to nurses one-on-one, many do not feel appreciated as they say more and more is being asked of them.
There are a lot of reasons, from low pay to dealing with high patient-to-nurse ratios and understaffing.
A 2021 study by the Florida Hospital Association estimates a nursing shortage of 60,000 positions by 2035 due to the state's growing population. Since 2020, the state has added 65,000 positions.
A 2024 FHA study found the state was short 16,000 positions. Florida nursing schools are addressing the shortage as the number of graduates increases.
However, nurses are still reporting "burnout" in large numbers. Since 2022, nurses nationwide have reported an increase in burnout from 39% to 67%, according to the results of a recently published survey by Florida Atlantic University.
Central Florida Public Media spoke with nurses at a local hangout to get a better understanding of how they are feeling about their chosen professions.
"Crazy"
K.G. has been a registered nurse working in an emergency room for two years. After three particularly hard nights, she and two fellow nurses destress by meeting up at a bar that opens early for those workers ending their day as many others are just getting started.
K.G. orders a tequila, soda and lime. The friends reflect on the massive influx of patients they all saw the night before.
"I'm drained," she said. "It's really hard for me to be compassionate and continue to do my job at the same time."
At 3 a.m. the previous night, she says her hospital had 16 holds, meaning there were no free inpatient beds and 16 admitted patients remained in the ER waiting for placement.
K.G. said the ideal ratio is one nurse taking care of two patients. Three is manageable. The max is four.
The night before it was five.
When that happens, "we're not able to do adequate care because it's kind of like rushing," K.G. said.
K.G. said high patient-nursing ratios are more common because of the nursing shortage. Schools and hospitals are trying to fill more openings, but the high turnover rate and Florida's fast growth are keeping the patient ratio high.
What makes it even more difficult is the level of patient "acuity" or the intensity of care a patient requires. If a nurse is managing three patients, it can be difficult to provide equal care for a flu patient, someone with abdominal pain and someone who has had a stroke, K.G. said.
W.T. has experienced the same in critical care. He often finds patients don't have sympathy for the juggling act nurses are tasked with keeping up. What gets to him is when he is trying to save a patient, and another is upset with him for not bringing a box of juice fast enough.
"They're like, 'Where's my cup of ice?' And I'm like, 'If you could only see what's happening 10 feet in front of you on the other side of this wall,' " he said. "There are 39 other patients who are fighting for their lives, just as much as they are. I'm one person. I can only be in one place at once. They don't understand it."
K.G. said it's the same in the emergency department, and sometimes she's harassed for how she looks.
"Patients will say, 'You're so beautiful. How old are you?' I said, 'Old enough to be your nurse," K.G. said. "I had a patient complain because I said that. She called my manager and told my manager that she didn't like that answer."
That's something else they have to consider: patient reviews.
"With a smile. Don't forget patient satisfaction," K.G. said. "You have to be crazy to do this job."
"Exhausted"
Working 12-hour shifts for three days may not sound like a lot compared to the typical 40-hour, 9-to-5 work schedule, but it takes a toll.
"The average person is not gonna see a person dying in front of them. We do," K.G. said. "I have to go to the next room, not even go home, the next room, and just keep working."
Nurses compartmentalize for the sake of patients, but many say the pain of seeing someone suffer or die eventually bears itself.
"There have been times when I don't even make it to my car. I'll be walking across the bridge (to the garage), and I just break down," W.T. said. "It just sucks the life out of you, but it's like, 'Who's taking care of me?' "
Many hospitals offer mental health resources for employees, but some nurses don't use them. They don't want to be in the hospital any longer than necessary.
"I don't have the capacity right now to, like, go walk myself to the admin office and say, 'Oh, I really want to speak with a therapist,' " said O.D., an RN in an intensive care unit for four years.
"I try to disassociate from the shift and leave it at work, run out of this building as fast as I can. But I'm not the type of person to just stop thinking about it. I go home and think about it for like three days."
Some nurses try to rely on family to destress. T.G. is an RN in an ICU who will wrap up her first year of nursing in July. She's also the first in her family to graduate from college. She's proud to be a nurse, but the burnout is already affecting her.
"I'll try and talk to my father about it, and he's like, 'Oh, you only work three days a week.' But what he doesn't understand is that – three days a week – I just body-bagged someone at my young age." she said.
Underappreciated
According to a report by Nurses.org, Florida ranks 31st for registered nurse salaries. The average RN makes about $88,000. California is ranked No. 1 at an average of $148,000.
Although T.G. is relatively new in her career, she feels like she's already underpaid. That's because the hospital is tasking her with taking classes to earn a certification in pulmonary hypertension.
She said pulmonary hypertension doesn't have enough qualified nurses to fill the floor. It has several nurses who don't have the certification. They were moved to the floor during the COVID-19 pandemic to make up for a shortage. That was a strategy many hospitals implemented during the pandemic, when patient-nursing ratios were at a high.
It bothers T.G. that the other nurses are making the same money she is despite her being required to get the certification.
"Instead of signing up experienced nurses on the floor, they're making me take these classes," she said. "I think being compensated fairly for all the certifications that we do would be a fair start (to appreciation)."
At the start of the National Nurses Week, K.G. and fellow ER nurses were presented with company apparel sporting their hospital's logo to show appreciation. It made her laugh.
"We deal with things that the average person really doesn't understand. They can try to sympathize, but they will never get it, and we don't want you to get it, but it's like, 'Really? Can we get something else? More pay?' " she said.
On W.T.'s floor, his co-workers were given sweet treats.
"It's kind of insulting, right? Like, I'm not a child," he said. For him, there's a much easier way for hospital administrations to show appreciation.
"Set aside 30 minutes of your busy day and ask me my name. Ask me why I got into nursing. Ask me my favorite things about nursing, my least favorite things about nursing, and connect with us," he said.
"Love"
When O.D. was a kid, she thought she was going to be a doctor. Then, in her senior year of high school, two of grandparents received cancer diagnoses months apart. When O.D. finish school, she'd come home and help her mom take care of them. She would bathe them and drain their catheters.
"It made me realize that I really was more of a nurturer at heart," she said.
Her grandparents' hospice nurse noted she was pretty good at taking care of people and told her that she would make a great nurse. At first, O.D. resisted that idea, still set on being a physician.
"I was like, 'No, I'm gonna be a doctor, babe. I'm gonna tell you what to do.' And she was like, 'Are you sure?' "O.D. said.
A year later, both grandparents died. It was hard taking care of them, but she got to connect with them on a deeper level. They were vulnerable with her. She was grateful for the opportunity to care for them like that. That's when she knew the hospice nurse was right.
"I wanted a more intimate relationship with my patients. Our doctors don't get to know them and their families, and that made me switch to nursing," she said.
Today, she's been a nurse for four years. It's harder than she imagined it would be. But the opportunity to help patients when they are at their most scared is something she's still grateful for.
"Every hard day where I'm crying, and I hate my job, I really couldn't imagine myself doing anything else. It's so rewarding at the same time," O.D. said.
K.G. comes from a line of nurses – her mother and a grandmother were nurses. Her mom is a manager on a hospital floor who tried to deter K.G. from the profession because of the demands.
"She told me that that was the worst mistake I ever made in my life," K.G. said.
Despite not following the advice, her mom is proud of her, especially for the way she's been able to create a better economic life for herself, something that inspires younger members of her family.
"Nursing has created a pathway for a lot of people to, like, I'm not gonna lie, to get them out of the hood," she said. "Now, I do this for my family. I do it for my younger siblings and cousins that are coming up, and they're watching me do the unimaginable."
She describes herself as a nurturer, too. K.G. said her favorite part of the job is translating medical talk for a patient.
"When the doctor goes into the room and starts talking jibber jabber, and then the patient says, 'What did they just say?' And you're like, 'This is basically what happened, girl,' " she said.
And sometimes, that's when something special happens between her and the patient.
"When that patient pulls your arm and holds your arm, and says 'thank you.' That's not a feeling that everybody understands. She's gonna remember that for the rest of her life," K.G. said.
K.G. has a complex relationship with nursing, and so do the other nurses interviewed for this article. They all agreed that they mostly don't feel appreciated, and the job could be better with more resources, but they all love what they do.
"It's like a toxic relationship. You know, you shouldn't be going back to that man, but I'm still gonna go back, because I love them. OK, I'm here. I made it for the long haul," K.G. said.
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