By Melissa Rudy 

With nearly two-thirds of nurses in the United States experiencing burnout — including 69% of those under 25 years of age, many in the industry are calling for change.

A recent survey by a health care workforce solutions company based in Texas, found that most nurses aren’t optimistic about improvements, with 80% saying they think the year 2024 will be either "no better or worse" than last year and 38% of nurses expecting it to be worse.

"The concerns that many nurses have about their profession were not created by COVID-19 and have not gone away now that the crisis has passed," said Robin Johnson, group president of nursing solutions, who administered the survey.

"Many nurses still feel overworked and undercompensated," she said.

"What they want to see is a change in their daily working conditions — better hours, fair compensation and more time with their patients."

Amid the ongoing challenges faced by today’s nurses, six people in the profession shared what they wish they’d known before they decided to enter the field — and what advice they'd give to newcomers.

Lisbeth Votruba: ‘Nurses don’t have enough influence'

Lisbeth Votruba, a third-generation registered nurse in Belmont, Michigan, is also the chief clinical officer of AvaSure, a virtual health care platform.

"When I first entered the profession in the 1990s, I was surprised to learn that although nurses are held to high ethical and legal standards, they do not have the influence to match that level of accountability," said Votruba.

"I see trends to show this is changing, and I am doing what I can as a member of the senior leadership team of a technology company to make sure the voice of nurses is heard as health care technology is being designed," she said.

"Nurses must be at the table for every discussion about technology that impacts the patient," she said.

Mat Wellnitz: ‘Wish I'd known the stress involved'

Mat Wellnitz, a registered nurse in Big Rapids, Michigan, recently retired from a rural hospital after more than 34 years, most of them spent in critical care.

"I wish I’d known the amount of stress that's involved in nursing," said Wellnitz.

"I would have taken more time off for myself. It wasn't until about a week after I retired that I realized how much stress I was blinded to."

He added, "I used to lie down and instantly could feel my heart pounding, always thinking about work. But not anymore — and I sleep better."

Larry Williams: ‘Your work impacts your overall health’

Larry Williams worked as a registered nurse at California’s Stanford Hospital in the intensive care unit before retiring in 2021.

"I went into nursing with my eyes wide open … There were no surprises because I worked in two different hospitals while going to school," said Williams.

"My advice to anyone considering nursing and health care in general is to find a way to actually work in a hospital prior to graduating. Pay attention to your strengths and weaknesses and choose an area that fits you as a person."

He also said, "While you are working, pay attention to how your work is impacting your overall health. Not everyone is cut out to work in the ICU. I still have occasional work dreams, and I remember the names and faces of people I cared for who did not survive."

Said Williams, "That is balanced by the happy memories of my peers as well as lives that I have touched … It is not the career for everyone, but it was for me."

Karie Ryan: ‘Bedside nursing is not the only option’

Karie Ryan, currently the chief nursing officer at health tech firm Artisight, spent 27 years as a nurse in Florida, with a specialty in medical/surgical/orthopedics.

"I wish I had known that bedside nursing is not the only option available in order to make an impact," she said.

"There are so many specialty opportunities, including nursing informatics."

She added, "If nursing schools offered exploration in nursing informatics and other subspecialties, it would open a new world of possibilities not only to those entering the field, but as a consideration for nurses later in their career who may want to transition but remain in the profession."

Katelynn Blackburn: ‘Constant pressure took a toll’

Katelynn Blackburn, a former nurse who is now an entrepreneur, worked 12-hour night shifts for parent access care in Chico, California, for over two years before leaving the field.

"I wish I would have known more about how my personality would affect my profession in the medical field," said Katelynn Blackburn.

"I am empathetic and caring; however, the field itself comes with a lot of pain and anxiety for patients and their families," she said.

"The constant exposure to hardships, on top of the pressure of providing comfort and support to patients and their families, definitely took its toll on me."

She added, "I wish I had thought less about the income and salary and more about what the actual job entails. You must find something you are passionate about and ensure that it will secure your family financially."

Noted Blackburn, "I have always had an entrepreneurial mindset and a personality driven to achieve more — so I decided to leave to pursue something I felt more aligned with."

Michele Acito: ‘Emotional bond is deep'

Michele Acito is executive vice president and chief nursing officer at Holy Name Medical Center in New Jersey. She joined Holy Name in 1989 as a telemetry nurse, working in the cardiovascular and intensive care units before she was promoted. Earlier in her career, she worked as a staff nurse in orthopedics at St. Joseph’s University Medical Center.

"I wish I’d known about the emotional commitment I was making," said Acito.

"We know we will be committed to providing the best care … but the emotional bond and commitment you make to patients and families as they navigate through life-changing events is deep. As a nurse, you quickly learn how to comfort, celebrate, support and educate patients and families through the good and the difficult times."

She added, "Today, nearly 40 years into my career, I am able to reflect on how my training as a nurse helped me to help patients and families during their most vulnerable moments. It is what makes me proud to be a nurse."

"Another thing I wish I had known before entering the profession," said Acito, "was how complex it would be to blend a career, a young family and a household."

But "what I realized was that nursing was the perfect career for someone striving to manage it all and find fulfillment and purpose on a personal and professional level. It requires thoughtful prioritization, planning and support."

Other insights: ‘A nurse is a career learner'

Acito also shared the importance of ongoing education to set up nurses for success.

"Having graduated from a BSN program, I thought I was educationally set for my entire career," she said. "I quickly realized that was not true."

She noted, "A nurse is a career learner. Obtaining degrees is very important to remain current with theory — but learning through continuing education is paramount to staying current in practice."

"Technologically, nothing remains the same in health care," said Acito. "It’s an ever-evolving field. Pursuing a nursing career in hospitals and health systems that are committed to investing in innovation and technological advancements is critically important."

Acito also pointed out, "What I did not know then, but I know today, is that I made the best career choice when I decided to be a nurse. The hours are difficult, the stress intense, the emotional commitment deep — but the rewards are innumerable."