It's unusual for Emma Cooper, a nurse who cares for women after they've given birth, to be proud of the work she does every day.
"To have a patient sitting in front of me crying because they feel that they haven't been taught how to feed their baby is so upsetting," Cooper, of Portland, Maine, said.
The explanation for the lapse in guidance is simple: "None of us had time." Cooper and her nursing colleagues at Maine Medical Center have so many patients that they are unable to focus appropriately on any single one, she said.
Nurses nationwide are overworked, overloaded with patients and, quite frankly, over it all. There are not enough nurses in the workforce to ease the problem.
And it's younger nurses, like Cooper, 27, who are sounding the alarm.
"Imagine trying your hardest every day at work, and you're barely scratching the surface of usefulness," Cooper said. "Then you get in your car and cry."
Physically and emotionally drained
Cooper's frustrations mirror the findings of a survey published last week of more than 18,200 registered nurses. The survey from AMN Healthcare, a health care staffing agency, was riddled with evidence of a stressed out, burned out nursing population.
"Our survey data illustrates the growing dissatisfaction and wellbeing struggles among nurses — and the workforce challenges that this is escalating," Landry Seedig, AMN Healthcare's chief operating officer, said in an email to NBC News.
The findings show a recent drop in job satisfaction that had remained over 80% for a decade. In 2023, 71% of survey respondents said they were satisfied with their nursing career.
Younger nurses were much less satisfied with their careers and jobs compared to older generations, and were least likely to recommend the job to others. Just 42% of Gen Zers and 43% of millennials said they would encourage their peers to pursue nursing as a career, compared with 62% of baby boomers.
But signs of dissatisfaction were apparent in the majority of nurses surveyed.
More than three-quarters said they felt emotionally drained, up from 62% in 2021. And 70% of respondents in 2023 said they worried that their job is hazardous to their health, compared with 51% during the height of the pandemic in 2021.
The latest survey also showed that more than half of surveyed nurses felt unappreciated and often felt like quitting.
Among the biggest issues, nurses say, is the large number of patients they must care for each day.
Spencer Paddyaker, 28, is an emergency room nurse in the Dallas area. A typical shift has him caring for at least six patients at once.
Each of those patients may need help at the same time. One needs assistance getting to the bathroom. Another is having chest pain and is frightened about what it means. Another patient has questions about the medications they've been prescribed.
"All these things, piece by piece, are fine. It's when they start to happen all at once that it becomes cumbersome," Paddyaker said. "While you're addressing the person who is very sick or demands your attention immediately, your other patients start to feel a little blown off and neglected."
Last week, Cooper urged the Legislature in her home state of Maine to pass a bill that would set minimum requirements for nurse-to-patient ratios. Cooper is involved with National Nurses United, a union that represents registered nurses.
The state does not have a law limiting the number of patients each nurse can care for during each shift. Only California has passed a law mandating a minimum nurse-to-patient ratio.
"We need more nurses at the bedside," Cooper said. "My patients deserve better."
Jennifer Mensik Kennedy, a 26-year nursing veteran and president of American Nurses Association, remembers "working 12 hour shifts and not going to the bathroom or getting anything to drink."
"That should have never been accepted as normal," she said, adding that she is proud of this generation "for not putting up with what I put up with."
"They're holding us accountable for an environment that we allowed to happen for a very long time," Kennedy said.
Bernadette Melnyk, dean of the College of Nursing at The Ohio State University, said that "nurses have a huge long history of taking great care of everybody else, but they often don't prioritize their own self care."
"We've got a population of about 5 million nurses that overall isn't so healthy," she said.
'Nurses didn't get a break'
Job satisfaction among nurses was higher during the height of the pandemic than it is now. In 2021, 48% of nurses said they were "extremely satisfied" with their job, compared to 33% in 2023, the AMN Healthcare survey showed.
"As Covid patients started to decrease, we started to get people coming back to the hospital who held off their medical treatments" during the pandemic, Kennedy said. "Now they're even sicker than they would have normally been. Nurses didn't get a break."
Nearly 9 in 10 nurses said the nursing shortage is worse than it was five years ago, the survey found. Nearly all respondents — 94% — said there is a severe or moderate shortage of nurses in their area.
National Nurses United balks at the idea of a true shortage.
"There is only a shortage of nurses willing to work in environments that risk their licenses and the safety of their patients," the Union wrote in a media statement.
In January, thousands of nurses in New York City went on strike, demanding in part an increase in staffing to ease a shortage that's being felt nationwide.
Cooper, who is part of a union, said that while she has the deepest admiration for her health care co-workers, she and her peers deserve time and flexibility to focus on their patients.
She has advice for other nurses frustrated by their workload.
"Stand up, use your voice," Cooper said. "You know how to be an advocate already; you do it everyday for your patients. It's time for you to do it for yourself."
Follow NBC HEALTH on Twitter & Facebook.