In 1993, I was working at a hospital on a twenty bed Cardiac Stepdown Unit. I worked four 8 hour 11-7 night shifts per week making 20.00/hour. I enjoyed working the unit until staffing no longer met the needs of the patients.
On night shift, they usually had two to three RNs with one or two CNA's. We managed, but could have used another RN as all 20 beds were filled; half with serious fresh cardiac patients, some of which had multiple issues wrong with them including a few mental problems that got out of hand each night. As that particular week went on, our third nurse called in sick, leaving 2 RNs and 1 CNA on duty for twenty patients. As the night went on, alarms were going off constantly, more than five patients were complaining of chest pain that had to be monitored frequently while giving the NTG tabs, etc, taking vital signs every five minutes, and so forth. One combative patient pulled loose from his restraints, pulled off his tele monitor, patches and all, and we found him stumbling down the hall towards the nurses station with blood splattering everywhere since he dislodged his IV. His NGT was dangling from his nose/taped by a thread, foley bag dragging on the floor.... need I go on???
The entire floor was in chaos! I called for the supervisor who told me "We just had to do the best we could because there weren't any nurses in the house that she could send to help us out." WELL, EXCUSE ME, but that wasn't good enough for me. I asked her to come to the floor to help out, and she declined stating "That wasn't her job to help us out." COME AGAIN???
I told her she had better find us a nurse, and find her/him fast or I was going to call the police for backup.... OKAY, I was ******, okay????
She sent us a pediatric LPN agency nurse who had never taken care of an adult patient in her life! God bless her for trying her best to help us out, but it just wasn't enough for the kind of patients we had to deal with. The other RN and I were pulling out our hair, to put it mildly. I called the Nurse Manager (Head Nurse) and the main Charge/Preceptor Nurse at home and asked them to come in. They refused. The supervisor eventually sent us someone from ER to put in the old man's IV again, and help us get the floor settled down as much as humanly possible.
At the end of that shift, I made it known that I would NOT be returning that night UNLESS they had sufficient staffing on that floor, or transfer some patients back to CCU or to a unit that could help us deal with the serious cases. I went home, got a few hours sleep, woke up and called the Dayshift Nursing Supervisor and asked her how things looked for the nightshift, and she said she was afraid they weren't going to get any better. I said, "I hate to leave you hanging tonight, but if you don't staff that floor, or move patients around so that they are "safely" cared for, I will not be reporting to duty because I knew I would be held accountable for any patient assignment I came to work and took report on. She said, they would call me back if things changed. By nine thirty that evening, I called them back, and nothing had changed; not even an agency nurse. So, I told them with much regret, I would not return because it was putting the patients lives at risk as well as my nursing license.
The following morning, I went to the hospital and handed them my resignation letter, apologizing for not giving them the two week notice, but under the circumstances in which they expected their nurses to work, they left me with no other alternative but to resign.
The hospital gave me an excellent evaluation to my next employer, but when asked if they would ever rehire me they said "No, because the employee did not give her two week notice." They at least acknowledged that I was an excellent nurse, but stuck to their policy of needing a two week notice when an employee resigns.
Can you imagine what those two weeks would have been like for me? I wasn't stupid! At least the evaluation left nothing negative against my nursing skills, just my timing of leaving their facility.
I would never abandon a patient assignment that I had already accepted, but I would not accept an assignment if I knew beforehand that the patients would be inadequately staffed.
I learned to call in two shifts before my next assigned shift to find out how the staffing versus patient ratio was for the nightshift. If it sounded too unsafe, this gal let them know not to expect her. If the entire shift refused to do this when there are unsafe conditions, I bet they would find some nurses in a heart beat.
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Accept or refuse an assignment
