top of page

The House Always Wins

Ever been to Vegas?

I had a conversation recently where I described the current state of working in healthcare as toxic. It’s not about blame; it’s a tough environment to work in even in the best of times. We all know that things have gotten significantly worse in the past few years. The statistics tell me that more than half of you reading this are burnt out.

Your feet hurt; your back hurts. Your soul hurts.

Working in healthcare can feel like being in a casino. You go in with some kind of hopes, which may be guarded, conservative, realistic. You know better. You realize that while there are always the lucky few who win a ton of money playing blackjack, they are just that – lucky and few.

You plan to have a little fun, and not go beyond your budget. If you happen to get lucky and win a few thousand dollars while only betting a few hundred, great. But you know that the house always wins.

Does working in healthcare feel like that for you? Like a casino?

Think about it: you go into work and all of a sudden there is stimulation coming at you from all different angles. Only instead of the sound of slot machines, cocktail waitresses with complimentary drinks, and the free entertainment in the lounge, you get a swirl of staff members coming at you with a million questions. Patients that are double booked and sicker than they should be. Meetings that eat up your entire lunch break or what precious little admin time you might get.

And the house always wins.

Before you know it, you’ve been there for – hours? Days? Who knows. It’s after dark, you’re done with patients, and you have a mountain of work waiting for you in your inbox. You start going into a sort of time debt, so far over the line of normal working hours that you’re basically volunteering at this point. You’re salaried, so you get paid the same amount of money if you work 40 hours or 400.

What happened to not going beyond your budget?

The house always wins.

When you are finally tapped and have nothing left to give, you gather your things. The exam rooms are dark. The waiting room is silent. Everyone else is long gone. It’s just you and the cleaning crew.

You step outside, drag yourself home. You eat something, anything, and stare at a screen for a little while longer. You finally fall asleep for a few hours, only to wake up and do it all over again.

The house always wins.

How did we collectively go so far beyond our “budget” when it comes to time and boundaries? How did we get so indebted and have the balance so far out of whack for so long?

I know that the quick response is that the patients need us, and that is true.

But we need us. Our loved ones need us. Our pets need us. Our plants need us.

Our patients need us to maintain our boundaries. Providers maintaining that boundary between work and not-work is the foundation to good patient care.

Who benefits if we stick to our “budget” and our boundaries? Us. Our loved ones. All of the aspects of our life outside of the walls of the clinic.

Ask yourself this: who benefits if we let those lines blur to the point of being unrecognizable? Who wins?

Take care,

originally published February 10, 2023


Did You See This?

A group of nurses in Texas, part of National Nurses United, are speaking out about nursing shortages and the toll that they take on both nurses and patients.

“Lindsay Spinney, also in NNU, and a NICU nurse says she adapts as best as she can to struggles caused by short staffing. ‘I am responsible for these tiny, fragile beings. And I can’t really see all of their needs, if I’m taking care of four of them at once,’ said Spinney. Patient and nurse safety remain the true heart of the ongoing nurse’s shortage.”

When the nurses put their concerns in writing and presented them to the administration, this happened:

“Ascension Seton responded to the rally with the following statement: …The union event being held Jan. 26 is a bargaining tactic initiated by National Nurses United in the midst of contract negotiations. We respect the right of our associates to hold an informational assembly outside our facility and we will continue to negotiate in good faith. We look forward to a collaborative dialogue at the bargaining table.

Wow. If only it were that simple.

1 view0 comments

Recent Posts

See All


Post: Blog2_Post
bottom of page