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A survey conducted by the American Nurses Association says the multiple pressures associated with nursing responsibilities and the health-care setting translate into significant stress levels among nurses.

The job can include overtime (and you don't have a choice) and, since your base pay isn't always that high, overtime may not mean that much extra money.

You're on your feet for hours on end, running from place to place, being asked to handle task after task, so physical exhaustion is a problem.

And almost every customer you meet is on-edge and scared. And why not? There's a chance some of them could die. Literally die.

Welcome to the world of nursing.

"Hospital nurses are overworked, even in primary care," says a local 31-year-old registered nurse who wants to remain anonymous for fear of being fired. "I am expected to do the job of three full-time registered nurses — mandatory overtime, long shifts with little pay, poor benefits, not to mention the compassion-exhaustion effect. It is back-breaking and emotionally draining work. That's why there's lots of burnout."

Her statements are not unusual. A group of local nurses, some of whom would only be interviewed anonymously for fear of losing their jobs, say the same thing.

A survey conducted by the American Nurses Association says the multiple pressures associated with nursing responsibilities and the health-care setting translate into significant stress levels among nurses. Over the past decade, nurses have consistently reported the highest levels of job stress of all health-care professionals with surveys consistently finding that they identify stress and overwork as their major safety and health concerns.

A 2014 study at the University of Akron in Ohio surveyed more than 700 registered nurses and found those who are motivated primarily by the desire to help others, rather than by enjoyment of the work, were more likely to burn out.

"I have been a nurse for 15 years at the bedside and absolutely love caring for my patients," says a local registered nurse who asked to remain anonymous but is easing out of the profession because of the stress. "I wouldn't take back one single minute of my time with so many amazing patients over the years; however, the atmosphere in medicine has changed.

"Changes with insurance deductibles created great stress for patients, decreased reimbursement created stress and frustration for hospital administrators, and physicians and nursing seemed to be the place where cutbacks were made," she says. "The stress of someone's life being in your hands is bad enough, but then add frustrated patients, administrators and physicians on top of it and that makes for a miserable situation."

Yet in a 2014 Gallup poll asking Americans to rate the honesty and ethics of various professions, nurses ranked highest for the 13th straight year. Still, the American Journal of Medical Quality has projected a shortage of registered nurses to spread across the country by 2030, mostly due to heavy work schedules and insufficient staffing.

Former Chattanoogan Emily Meeks, 39, a nurse anesthetist who now lives in Nashville, agrees that nurses are overworked and underpaid.

"Most nurses work 12 or more hours a day, three or more days per week, and are grossly underpaid for the level of care expected from them," she says.

According to the U.S. Bureau of Labor Statistics, the average salary nationwide for a registered nurse is about $69,000 a year, but that figure doesn't include nurse anesthetists, nurse midwives or nurse practitioners. However, salaries for registered nurses are significantly lower in the most Southeastern states. In Tennessee, Alabama, South Carolina and Mississippi, the average salary runs between $56,000 and $57,000; in Georgia and North Carolina, it's between $60,000 and $62,000, the bureau reports.

Nurse's pay, especially in Chattanooga, is very poor, says the registered nurse who's planning to leave the profession. According to payscale.com, a registered nurse in Chattanooga averages $23.83 an hour which, in a normal 40-hour week, would be about $49,000 a year.

The lower salaries around here are, in part, because there's a glut of nurses, the retiring nurse says.

"The Chattanooga area has many nursing schools producing new graduates that can replace more- experienced nurses at a lower rate and no one seems to be alarmed by that other than the nurses and physicians," she says. "We have to adequately compensate nurses for their time and skill set in order to keep great nurses at the bedside because, currently, most are returning to school for nurse practitioner or nurse anesthesia programs for more money."

But Erlanger spokesman Pat Charles says Erlanger's five campuses in the Chattanooga area are always looking for nurses and trying to treat them well.

"We have a nurse residency program at Erlanger in which we bring in nursing students from various nursing schools in the region, for classroom and clinical training/rotation for 12 to 13 weeks. They then give us their top three choices of where they would like to work and we try to match them with one of those specific areas at the end of their residency programs when they graduate," she says.

"We have more nurses than CNAs (certified nursing assistants) or patient care technicians, which is very similar to CNAs. We've held two major career fairs in recent months to recruit nurses and there is absolutely no truth to any budget cuts at Erlanger. Quite the opposite."

But the health-care industry, as whole, is a stressful work environment, whether you are a nurse, respiratory therapist, lab tech, physical therapy tech or other jobs, Charles acknowledges.

"There is no other industry where every customer you deal with is vulnerable and anxious, where everything you do on a daily basis revolves around treating, healing and saving people's lives," she says. "Working in health care, in and of itself, is more difficult and certainly more stressful than most other occupations."

Retired registered nurse Gwen Tant, 74, agrees that stress levels are high and draining.

"Every patient's health and life is in your hands, and that is a stressful responsibility," Tant says.

But Tant says she didn't have much choice about entering the profession because she was "born to be a nurse."

"I grew up in the country in Tellico Plains, Tenn., and I'd always find hurt animals that I would try to nurse back to health," she says.

Like most in her profession, Meeks says she became a nurse because she cares about people.

"I have always been a caretaker. Growing up, my mother was sick a lot and I was in and out of hospitals with her. Being in that environment allowed me to see what nurses did and helped me make the decision to become a nurse," she says.

Her biggest frustration in the profession has been "the lack of kindness and willingness of older nurses to help teach the younger nurses."

"Instead of taking them under their wing, they tend to eat their young," she says. "This is probably due to the fact that older nurses are burned out, overworked and underpaid.

"Older nurses need to remember that they were students and new nurses once before also. They should be eager to teach them the right ways to do things."

But she admits that, for that to happen, there need to be more nurses on staff, and there should be ongoing programs to instill the idea of mentorship in longtime nurses.

"And older nurses need to realize that one day they may be lying in a bed in a hospital with one of their former students being in charge of his or her care."

Many of the nurses interviewed agree that hospitals push for registered nurses to delegate responsibilities among all the nurses, but that it's not always done. It's cheaper, they say, to have one nurse "running the show" and lesser-paid CNAs to do most of the actual patient care.

But there will always be problems with staffing, Tant says.

"It's just a part of life, no matter where you go. It got better before I retired, though," she says. "Of course, higher pay would be great. But in the South, our pay isn't as good as it is in other parts of the country.

"Solving those two big problems — staffing and pay — would go a long way in making nursing better," she says. "Part of that includes training more nurses to give good-quality patient care. That means giving nursing schools the funding to attract quality teachers in greater numbers to train the additional new nurses we will need soon."

Meeks says that, despite the frustrations, she's never regretted becoming a nurse.

"I chose this profession because I genuinely care for people and I believed the world needed more people like me to take care of the sick," she says. "I knew I would be able to go anywhere in the world to work and that, if I wanted to further my career, there were many different routes to take.

"I never second-guess my decision to become a nurse. Even though we are overworked and underpaid, the true reward comes in the form of appreciation from my patients and knowing that I helped them in some way."

Contact Karen Nazor Hill at khill@timesfreepress.com or 423-757-6396.

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