Healthy Start Stories |
Mariska Wildschut-De Heer

Dropout rate among nurses: ‘How do pediatric nurses continue to enjoy going to work?’

We want the best care for our children. Whether it’s a one-time procedure or the treatment of a long-term condition. In order to be able to provide sick children with the best possible care, the deployment of nurses is crucial. However, the pressure on this profession is steadily increasing while a growing number of nurses are dropping out prematurely. How do we ensure that nurses, and in particular pediatric nurses, keep their heads above water and continue to enjoy going to work? This is what Mariska de Heer, ICU Pediatric nurse at Erasmus MC Sophia Children’s Hospital and Convergence Nurse within Healthy Start’s ambition ‘Children’s hospital of the future’, explains.

“As an PICU nurse, I know first-hand how intense the work is in the PICU. This is where children with complex health problems are cared for. These include, for example, a congenital heart defect, severe brain damage or the RS virus. Although the ICU is designed for children between the ages of 0 and 18, the majority of the patients are younger than two years old. Not only are the health problems of these children challenging, we are increasingly struggling with a shortage of staff and time. Many colleagues run and fly and often feel that they cannot provide the care they would like to provide. That has to change. The pressure on healthcare is only expected to increase in the coming years. I want to know why there is so much absenteeism among nurses and what we can do to prevent it.”

Passion for my profession

“As far as I know, I have always had a drive to make a meaningful contribution to people’s lives and especially to that of children. At the same time, I am at my best when I am allowed to unravel and solve a complex situation. That’s why the nursing profession appealed to me at a young age. After I completed my nursing study, I did an internship at the Children’s Intensive Care Unit (ICK) for a while. That was a golden move. After this internship, I knew what I wanted to become: PICU nurse.”

As far as I know, I've always had a drive to make a meaningful contribution to people's lives

“After 15 years, the passion for my profession has still not disappeared. This is also because I perform many other tasks in addition to the hands-on work in the department. For example, I am a member of the executive board of the Nursing Advisory Council (VAR) of Erasmus MC. In that role, I contribute to the deployment of pediatric nursing within the hospital. In addition, I am involved in scientific studies. Under the supervision of a nursing scientist, we regularly conduct research on the ward. For example, we recently investigated how we can stimulate the mobility of children in the ICU. These kinds of studies help us to take a critical look at the way we work. Is it evidence-based? It is very valuable to conduct small-scale research and to apply the results directly in practice.”

The future of nursing

”Recently, I started as a Convergence Nurse at Healthy Start, together with Anne Heijboer, who is a nurse at the Children’s Thorax Center and a nursing scientist. Together, we are given a lot of freedom to think about how we can relieve the pressure on nurses and prevent absenteeism. At the moment, we are exploring exactly what is needed for this. That depends on the needs of nurses. To gain more insight into this, we recently organized a brainstorming session from the VAR together with Healthy Start. Various healthcare providers, including nurses but also a physiotherapist and nurse specialist, discussed the bottlenecks they experience in the workplace. This session shows, among other things, that nurses find direct contact with patients very important and valuable. This indicates that workload relief cannot be achieved simply by outsourcing patient-related tasks.

Research into job satisfaction among our profession is not new. However, we still don’t know exactly why the dropout rate is so high. Only when we have an answer to that can we find out what nurses need to enjoy going to work. To gain more insight into this, we will be monitoring a large group of pedriatic nurses in the coming years. By means of questionnaires and diary research, we hope to gain more insight into the aspects of the work that generate energy or require a lot of energy.”

In the coming years, we will explore which aspects of the work generate energy and which require a lot of energy

“But even in the short term, there are already opportunities to reduce the workload and increase job satisfaction. I am thinking, for example, of the hospital robot that is already driving around Erasmus MC at the moment. We sometimes spend a long time trying to find the right materials for certain procedures, such as placing a catheter. It would be nice if the hospital robot could be used to collect the right items quickly. Incidentally, it is not a question of making our work more efficient. Above all, I advocate that it be more fun.”

Room for personal development

“I find it very valuable to be part of Healthy Start and look forward to working in the coming years to increase the job satisfaction of nurses. That is desperately needed. I see around me that there is often too little time to have lunch or catch up with a colleague. Moreover, there is not always enough room for every nurse to work on personal development and it is often difficult to combine other roles within healthcare with work as a nurse. If we want to prevent absenteeism among nurses, that really needs to change.”

My ultimate ambition is for nurses to acquire a greater degree of ownership and participation in the practice of their profession

”At the same time, I notice that our profession still too often struggles with the ‘Calimero complex’. Especially with doctors and scientists around us, the feeling can arise that we know too little. Of course, that’s not the case, but it sometimes stops us from coming up with new ideas or solutions. That’s why I think it’s so great that two Convergence Nurses have been hired within Healthy Start, so that the perspective of nurses is included.

My ultimate ambition is for nurses to acquire a greater degree of ownership and participation in the practice of their profession. This is not only about the practical care provided at the patient’s bedside, but also about personal professional growth. Are you aspiring to a managerial position? Or are you interested in scientific research? It would be fantastic if nurses were given more freedom to shape their own work. I am convinced that this will result in more enjoyment of nurses’ work and contribute to a more sustainable future of healthcare.”

Mariska Wildschut-De Heer’s Healthy Start perspective
“When I was approached at the beginning of this year by Vincent Jaddoe (Erasmus MC and academic lead Healthy Start) to contribute to the future of child care as a Convergence Nurse, I didn’t hesitate for a moment. Healthy Start offers me the opportunity to form a link between science and practice. I think it’s really important that nurses are heard. Because far too often it is about our profession and solutions come from ‘above’. But nurses themselves know very well what they are up against and what they need. I really hope that together we will find solutions to relieve the pressure on nurses.”

Mariska Wildschut-de Heer is Convergence Nurse at the ambition ‘Children’s hospital of the future’.

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