By Vickie Milazzo

A recent American Nursing Association (ANA) poll indicates that 18.8 percent of nurses in the U.S. do not work in nursing. A study by the Center for Health Outcomes and Policy Research reveals that 22.7 percent of nurses plan to leave their hospital jobs in the next 12 months. Despite record-breaking salaries and bonuses, nurses are leaving hospital jobs in droves, resulting in the nursing shortage that has captured the attention of the American public.

As a nurses, you know this shortage is not a new trend. Since the average nurse is 46, I’m sure many of you remember the “bonus” days of the early 1980s when a nursing degree and a pair of clean white shoes got you a job anywhere. Today we’ve come full circle – a nursing degree and some brain activity will do: “Thank you for the emailed resume. Can you start today?”

The reasons nurses are leaving the profession today are equally familiar. The complaints from two decades ago still apply: nurses are understaffed, underpaid, under-appreciated, under-insured and under-you-name-it. On top of all that, nurses must work 26 weekends and at least five holidays a year and endure nightmarish schedules.

In addition, today’s nursing shortage is being intensified by three new phenomena: managed care, on-the-job health risks and alternative careers for nurses.

Managed Care Compromises Nursing Care

In spite of giving more than they have to give every day, nurses in all settings can no longer deliver the level of care of which they are capable. Nurses who remember the “good old days” battle the shame of knowing they’re partially responsible for the deaths of 98,000 patients in hospitals every year. That death toll is equivalent to a jumbo jet crash every other day, yet the number doesn’t even include patients who become victims of injury and illness while in the hospital.

Why are patients dying unnecessarily? Nurses have less time to see more patients. They have more to do and fewer tools to do it with. They must contend with increasingly complex equipment and less trained staff. LVNs/LPNs, nurse’s aides and nursing assistants are replacing skilled nurses at the bedside. Yet nurses still get little respect and face more responsibility when everything turns sour. In this “dark age” of medicine the words “quality of care” are becoming an oxymoron.


This trend goes against our education and against our very nature as nurses. Certainly some people get into nursing solely to make a living and don’t progress beyond that stage. They’re part of the problem. For most of us, though, nursing is more than a profession – it’s a calling that attracts the “best and the brightest” who want to make a difference in people’s lives.

You won’t find a more caring group than nurses. Try having an anaphylactic reaction at a lawyers’ conference and see how many people come to your aid without a business card in hand.

Yet today, despite all our caring, we’re denied the ability to provide quality care. With the exception of a few great facilities around the country, we can no longer find jobs that allow us to fulfill the mission we defined for ourselves when we entered this profession. No wonder so many nurses are quitting.

Nurse Healers Fear For Their Own Health

Not only are nurses exhausted – we the healers fear for our own health. On-the-job health risks for nurses range far beyond bloodborne pathogens and latex allergies (not to mention feeling like aliens dressed in our goggles, masks and gloves). We face obvious occupational hazards, such as back injuries from long shifts pounding hospital halls and doing more lifting with less help.

We also face the less obvious hazards that aren’t just physical. Sheer exhaustion from our overwhelming schedules and our unsupportive work environment take a heavy toll.

Look around you at how many nurses smoke, drink and are overweight. These are signs of deep unhappiness and of not having time to take proper care of ourselves. Between juggling life, family and jobs, nurses often find it far easier to wolf down fast food on our 10-minute lunch break than to prepare a healthy brown-bag meal.

Isn’t it ironic that the injured and disabled are treating the sick? No wonder the nurses dangerous workplace is yet another reason for the flight of such talented caregivers.

Nurses Choose a New Career and a New Life

The bright spot in this grim scenario – and the most distinctive aspect of today’s nursing shortage – is that we can enjoy better, more satisfying careers as nurses elsewhere. Admit it, you know nurses who’ve left traditional nursing and are prospering and much happier in their new positions. Today, we’re leaving younger, smarter and better qualified than ever before. We are creating our future rather than being victims of it.

Without even leaving the hospital setting, we are using our skills and training in areas we never thought possible: risk management, utilization review, accreditation and research. Beyond the hospital we’re experiencing success selling medical- and nursing-related products, such as equipment, instruments, drugs and blood products. We’re starting companies selling our own products and services, running our own agencies and working for insurance companies and major corporations.

Many of us are becoming legal nurse consultants, both in-house and independent. Most importantly, legal nurse consultants have just begun to penetrate the legal industry. I look forward to the day when it’s considered legal malpractice for an attorney to work on a medical-related case without a legal nurse consultant on the team.

Wonder-Working Nurses Can Do Anything

Why am I confident that no nurse must be a victim of poor working conditions? Because nurses are trained to do three things simultaneously. For example, nurses make rapid, informed life-saving decisions while listening to the physician’s orders and at the same time they console the patient and family members.

The average ICU has more complex instruments and monitors than the bridge of the Starship Enterprise, and a nurse operates every one of them! Forget Superman, Spiderman and Wonder Woman. I’ll take a wonder-working nurse any day.

A career outside of traditional nursing can provide a nurse with a new purpose, a new attitude, new challenges, new rewards, new wealth and new respect. One place to find all these pluses and much more is in legal nurse consulting. If this field is not for you, look farther – the sky’s the limit these days. The only way you’ll find your star is by reaching for it.

About the Author: Inc. Top 10 Entrepreneur Vickie L. Milazzo, RN, MSN, JD is the founder and president of Vickie Milazzo Institute, the oldest and largest legal nurse consultant training and certification company ( She is the author of the bestselling book, Inside Every Woman(


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