Becker's Clinical Quality & Infection Control

36 NURSING SPOTLIGHT Side hustle or exit path? How COVID-19 shifted the side gig landscape for nurses By Erica Carbajal and Cailey Gleeson P re-pandemic, it wasn't uncommon for hospital nurses to have side gigs on their days off, be it paid or volunteer work. "Because of the way their [schedules] are set up, they have always felt compelled to do something else," said Katie Boston-Leary, PhD, RN, referring to the typical three 12-hour shift weekly schedule for a nurse in the hospital setting. Dr. Leary is the director of nursing programs at the American Nurses Association and former chief nursing officer at the University of Maryland Capital Region Medical Center in Cheverly. During her time as a CNO before the pandemic, Dr. Leary would make rounds to check in with nurses in the intensive care unit. "That's when I started to hear from almost everyone that they had other things that they do outside of work," she told Becker's. At the time, side gigs mostly included volunteer work at places like the local women's shelter or pet shelter, as well as hobbies like improv. Now, the side gig landscape has changed, with nurses using days away from the hospital to work on entrepreneurial endeavors. Part of that shift is, of course, inflation, and the need for additional sources of income. Data from the St. Louis Federal Reserve shows the percentage of employed people in the U.S. working multiple jobs has steadily increased from 4 percent in April 2020 to 4.8 percent in June 2022. In some states, nurse salaries fall close to what the livable wages are, Dr. Leary said, citing the "2020 National Nursing Workforce Survey" from the National Council of State Boards of Nursing and the National Forum of State Nursing Workforce Centers. This leaves little room for saving, especially for nurses who are the primary household breadwinners, and is traditionally why many have felt compelled to get secondary jobs, she said. In today's landscape, however, finance is hardly the sole element factoring into nurses' decisions to take on side hustles. Becker's heard from at least a dozen nurses who since the onset of the pandemic have taken on side hustles in hopes of reducing their hours at the bedside or eventually developing a revenue stream large enough to leave hospital nursing altogether. And the nurses we heard from are just the tip of the iceberg. A survey of more than 2,500 nurses published in May by Trusted Health found nearly 60 percent of respondents reported they were actively looking for a job away from the bedside or outside of nursing completely (34 percent), had plans to do so within the next year (21 percent), or were planning to retire from the workforce (3 percent). Over the last 13 years, Lorie Brown, RN, has helped hundreds of nurses start their own business. She worked as a nurse in hospitals for 12 years across California and Indiana and has since become an attorney. "With your own business, unlike nursing where patients come with the room, nurses need to market their services to get clients," Ms. Brown said. "I say once a nurse, always a nurse. We just have a different kind of patient." Staffing and patient safety Several nurses Becker's heard from mentioned unsafe nurse-to-patient ratios as a contributor to reducing their hours or planning to leave the Nebraska system's hair policy for nurses sparks backlash on social media By Mackenzie Bean N urses flooded social media with posts using the hashtag "showmeyourbuns" in late July in response to a photo of Bryan Health's personal appearance policy, which was widely circulated online. While the policy is not new, the Lincoln, Neb.-based system updated it this summer it to allow nurses to have unnatural hair colors. The widely circulated image depicts a written memo to nursing unit staff about the update, which includes the following language: "There is emphasis on hair being clean, neatly managed, therefore no 'messy buns.'" The text is accompanied by images of nurses with various bun hairstyles that do not meet appearance standards. Many nurses took to social media to call out this part of the memo, arguing that the health system should be less concerned about nurses' appearance and more focused on serious issues such as staffing shortages and staff well- being. "You realize most hospitals are dealing with severely understaffed units and nurse burn out. How about you worry about your staff ratios, not your nurses' hair," one Twitter user wrote July 28. The health system said the social media account that first shared the screenshotted memo "grossly misrepresented a long standing Bryan Health policy" and that the official policy "includes no mention of messy buns." "The policy does and will continue to reference clean, neatly managed hair, appropriately secured out of the face. Appropriately secured hair is important for a myriad of safety reasons," a spokesperson for the system told Becker's. n

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