I Put In My Notice!!!...Now what???

  1. I could really use some help here!
    I am an Rn graduate of 8 months now...I started straight out of school on a cardiac/telemetry floor...THEY do not label this floor a step down floor, but we have post op day 1 CABG pt,Cath pt,Fem-Pop,pacemaker placement...lots of copd,chf,renal failure...you get the picture.Our floor has 16 beds.I work 7p-7a.We have 2 RN on this shift and if full 2 CNA...1 CNA if less than 15..sometimes unit secretary.I have never been comfortable with this ratio 8:1 on this floor and was told upon hiring that we would have 3 nurses at night.I have been there 8 months and I can could on 1 hand the number of times there have been 3 nurses on this shift....So after many sleepless nights and many mornings leaving there just thankful that they are all alive..I put in my 2 wk notice.I don't have another job lined up but I felt my license was in jeopardy......So now what do I do...Everyone wants 1yr experience...I have 8 months...any suggestions?

    Thanks
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  2. 27 Comments

  3. by   maryshome8
    I'm a pre-nursing student...but I have over 20 years of Corporate working experience, and hospitals are a business like any other, complete with their corporate and administrative headaches.

    I'll be brutally honest here, I think you pulled the plug too soon.

    As a new graduate, even though your current situation is very difficult, future hospitals may look at it as you 'can't handle' the stress of nursing.

    It is always, always better to look for a job when you already have one. This is no matter what profession you are working in.

    I don't think your license is in jeapardy because 8/1 ratio in post-op is ridiculous, and it's the hospital that is responsible for staffing, not you. Let's say you had two life-threatening situations to occur with your patients in two different rooms at once...do you feel a license review board would think you could be at two places at the same time, or would they take a good hard look at the staffing?

    The hospital is CLEARLY cutting the staffing cord too short with only 2 RN's for 16 patients.

    There is a serious difference between not being adequately staffed (for comfort) and being critically short staffed (before patient care starts to suffer).

    I feel sorry for the patients at this hospital, because they are not getting the care they deserve, and with post-op, I think their lives are at risk.
  4. by   Ruthiegal
    Quote from msmel321
    I could really use some help here!
    I am an Rn graduate of 8 months now...I started straight out of school on a cardiac/telemetry floor...THEY do not label this floor a step down floor, but we have post op day 1 CABG pt,Cath pt,Fem-Pop,pacemaker placement...lots of copd,chf,renal failure...you get the picture.Our floor has 16 beds.I work 7p-7a.We have 2 RN on this shift and if full 2 CNA...1 CNA if less than 15..sometimes unit secretary.I have never been comfortable with this ratio 8:1 on this floor and was told upon hiring that we would have 3 nurses at night.I have been there 8 months and I can could on 1 hand the number of times there have been 3 nurses on this shift....So after many sleepless nights and many mornings leaving there just thankful that they are all alive..I put in my 2 wk notice.I don't have another job lined up but I felt my license was in jeopardy......So now what do I do...Everyone wants 1yr experience...I have 8 months...any suggestions?

    Thanks

    Take a deep breath, and start applying for new jobs. I've seen so many nurses who go from job to job and they never seem to have a problem getting one. So put this behind you and hold your head up high and keep going! I won't sugar coat the profession you will find problems most places you go and staffing is usually a big one but if your heart is in the profession you will find your niche. Don't give up!

    Good luck,
    Mydnightnurse
    AKA Ruthiegal
    36 yrs in the profession and counting.
  5. by   cookie102
    here's my 30+ years of nursing experience cents---you have to be comfortable with the situation you are working in, if you exhausted all your resources in the chain of command, then giving your 2 week notice was the right thing to do. yes, it is true it is always better to have a job to go to before leaving one, but there are times when you have to do just what you are doing. you can completely honest when applying for a new positon, and with your skills from the unit you were on, you can look into most any area, consider home health. best of luck
  6. by   NurseCard
    I have to disagree with a lot of what the second poster said. First of all, your license IS in jeopardy when you are in a situation like that, UNLESS you speak up. You speak up and tell your house supervisor, your nurse manager, or your charge nurse, that you are being put into a situation that you feel very uncomfortable and unsafe in. Now, I've always been somewhat unclear how a complaint like that gets documented, but I know that it NEEDS to be documented somehow. Perhaps you could have your own personal log book and in it, make notes of the situation on a given night, date it, note that you complained, and sign it.

    Secondly, you CAN find a better job and situation, and better staffing ratios. The unfortunate thing is that it make take some research on your part, and since you only have two weeks you may not have the time to do the researching you need to do to find a good job.

    DID you follow the chain of command? Did you let your immediate supervisor know how uncomfortable you were with the staffing ratios? If not, it's something you do need to do next time around because nothing is going to get done if no one complains, and furthermore, like I said, you ARE putting your license in jeopardy if you don't say something. When you don't say something, everyone assumes that you feel like you can handle the load you've been given... and with that, you assume full responsibility.
  7. by   imenid37
    Quote from maryshome8
    I'm a pre-nursing student...
    I don't mean to be rude, but you don't fully "get it". When you are actually responsible for these patients and a NURSE, not a student, not a pre-nursing student, but a licensed NURSE who is legally responsible for these patients, you will get it. Places that cut corners every night, night in, night out are places you need to get out of. 8 cardiac step down pts. is too many. I worked on the same type of unit. I hung in for three years. We had 9-13 patients. That was almost 17 years ago when I switched to ob.To the OP... Find something better. It is out there. By all means be very vocal about why you are leaving to management when you have your exit interview. Not obnoxious, but honest and firm.
    Last edit by imenid37 on Aug 26, '06
  8. by   Jennerizer
    You did the right thing...those ratios are ridiculous for a step-down unit. At my hospital the staffing ratio is 4 to 5 to 1 nurse in PCU. Every once in awhile they may ask us to take a 6th patient if a nurse is running late, but 99% of us refuse, so the clinical leader is left responsible for that patient. We know that if we start accepting a 6th patient, it won't be long before that's the norm. It's much better to speak up. Even our med-surg floor at night has a max load of 6 patients to 1 nurse and they always have techs. I don't see how you could even do your job properly with 8 patients to assess, medicate & chart on...much less if you have a patient or two not doing well that need closer monitoring.

    Just start applying for other positions, I'm sure it will work out for you.
  9. by   catlady
    Quote from maryshome8
    I'm a pre-nursing student...but I have over 20 years of Corporate working experience, and hospitals are a business like any other, complete with their corporate and administrative headaches.

    I'll be brutally honest here, I think you pulled the plug too soon.

    As a new graduate, even though your current situation is very difficult, future hospitals may look at it as you 'can't handle' the stress of nursing.

    It is always, always better to look for a job when you already have one. This is no matter what profession you are working in.

    I don't think your license is in jeapardy because 8/1 ratio in post-op is ridiculous, and it's the hospital that is responsible for staffing, not you. Let's say you had two life-threatening situations to occur with your patients in two different rooms at once...do you feel a license review board would think you could be at two places at the same time, or would they take a good hard look at the staffing?

    The hospital is CLEARLY cutting the staffing cord too short with only 2 RN's for 16 patients.

    There is a serious difference between not being adequately staffed (for comfort) and being critically short staffed (before patient care starts to suffer).

    I feel sorry for the patients at this hospital, because they are not getting the care they deserve, and with post-op, I think their lives are at risk.
    I'll be brutally honest--you aren't a nurse and you don't know what you're talking about. This nurse has an unsafe assignment, and regardless of the corporate decision not to correct that situation, she is risking her nursing license by accepting the situation. The legal standard of care for all patients is what a reasonably prudent nurse would do in a given situation--not what a nurse would do if she had too many patients. The nurse/patient ratio is irrelevant.

    "Future hospitals" will either have adequate staffing, or they won't have the benefit of the OP's services. We are more than a corporate commodity, and this young lady won't have any trouble getting another job.
  10. by   cathlab1
    I have been in your situation before and I admire the way you maintain your standard however, unfortunatly this is the practice that exist in the nursing world. IT IS NOT PERFECT nor is it close. Most other units will probably be the same way. ... On the up side of that, you will have no problem getting another job, assuming no bridges were burned where you are now. When I was in nursing school, the instructors warned of this. Our standards and expectations of deliverying care are not always the standards of others, and it makes you somehow desensatized to administration. You will find your niche, but even working on a unit that has a strict ratio(like ICU) , has its own problems such as the acuity of each patient etc.
    Good Luck, and Keep your head up !
  11. by   MrsMommaRN
    i wish you the best in finding a new position. i am sure you will have no problem finding a job as an rn. as one of the posters mentioned be sure to be honest about why you are leaving express your concern for the safety of your patients and your sanity.
  12. by   Elisheva
    Nursing school is a WORLD away from reality nursing. Just wait.

    I stuck it out for two years on a busy med-surg floor. I wish I'd just admitted that it wasn't for me sooner and looked for something else. As a result, I stayed out of nursing for many years. I'm taking a refresher course to return soon.

    Nursing is the one career where changing jobs is completely acceptable, although I think staying a year is probably preferable. However, I won't put myself or my patients in an unsafe situation just to finish out a year.

    Althought medicine is definitely a business, there's no comparision to a job in nursing and a job in the "corporate" world. I know because I've done both.

    Hang on to your hat, Maryshome
  13. by   traumaRUs
    The rules in the business world do not always adequately cross over to the nursing world. In the ideal world, a nurse or group of nurses would verbalized patient care concerns and they would be addressed. However, it is specifically the reason that hospitals have gone to a business model that these concerns aren't always addressed. I have left positions when I have felt that my license was in jeopardy and that I couldn't meet the minimum standards of care.
  14. by   ZASHAGALKA
    I do agree with several things mentioned in this thread:

    1. Ultimately you are responsible for assignments you accept. That's a fundamental notion of most BON's NPAs. Your standard of care is neither reduced nor mediated because you were 'too busy'. Someone mentioned they didn't know how to document complaining about assignments. Send an interoffice email to your manager and to the house supervisor stating the date and time and that you object to the assignment given on the basis of safety. Do so BEFORE you accept the assignment and print it off and keep it in a file at home.

    2. 8:1 on a stepdown unit is too many. You are right to question such a consistent assignment. It's unconscionable in all cases, and especially so to put a new nurse through such a steep learning curve. It speaks volumes to how your administration views its most precious commodity.

    3. In the future, you are better off securing new employment prior to leaving a job. It just puts you in the position of negotiating from strength. First, if you are actively employed, you can request that prospective employers not contact and alert your current manager about your plans. This is a reasonable request and much more effective then having a manager that you just left from give feedback on you. Yes, there are limits to what they can say. But, you can say LOTS without saying it, if you know what I mean. Also, it puts you in a position to negotiate for salary, etc. A potential employer that knows you need a job can negotiate differently then one that knows they have to 'pull' you away from a current job. For example, if you were making 22/hr, and the new job offers 20.50, you CAN say, 'Well, can you match my current salary?' - but only if you have a current salary.

    Now what? Go get you a job. Ask the NM about expected ratios and expectations in advance. Ask about what resources you have to call upon if you need help. Ask what recourse you have if you feel the assn is unsafe.

    Ultimately this is a Nurse's market. The sooner we collectively realize that, the sooner 8:1 ratios will be a thing of the past.

    Remember this: being a good nurse is NOT always the same as being a good employee. And you - you are a nurse first.

    ~faith,
    Timothy.

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