I, too, have worked at a small rural, critical access hospital ER. I know what it is like to work codes with a less than ideal number of staff. I have worked in a larger General Medical hospital, too. I understand your tendency to feel loyal to a facility for allowing you the opportunity to get your feet wet.
Keep this foremost in your mind. Keep your integrity. Once you lose it, it's hard to get it back. Conduct yourself professionally. Look out for YOUR patients and YOUR VERY OWN safety and well-being. Understand that no matter how diligent you are and how noble your intentions are, there will ALWAYS be somebody who will find some reason to put you down. That's just a given in most aspects of life.
Realize this: though many nurses have a true calling to care for people, health care is a business, and business people pretty much call the shots. Most business people are most concerned with a bottom line and with not being bothered and hassled. They will not lose a wink of sleep over nurses working short staffed, without proper supplies, or without basic security in place. Human Resources are the cheapest resource that they have. Business will very often use you up, risk your safety, or even destroy your health and NOT care about you or the diligent special care you provide your patients.
It is not my intention to paint a dismal discouraging picture for you or any other nurse. PLEASE realize that you must always do what is best and safe for your patients AND yourself. If a situation is unsafe or untenable, and the facility is unwilling to properly address it to ensure the best possible patient outcome or staff safety, then end your association with that facility.
If someone should make a job jumping comment during an interview, you say to them, "The casual observer making a superficial review of my application may call me a job jumper. It is my experience that some facilities don't share my patient care values. If you'd like to know more, I'd be more than happy to clarify for you my patient care and safety concerns and priorities. Then you can make an informed evaluation of my work history."
Though I've only been out of nursing school about 2 years, I am a middle aged gal who investigated medical malpractice cases for the State of Louisiana before I ever became a nurse. Rest assured, there are all sorts of perfectly good and admirable reasons for leaving a facility or agency.
*Being scolded by a preceptor for refusing to give a bolus dosage of a vasopressor when there was NO order for it. "We always give a bolus before starting the low dose continuous infusion. No, we don't have a standing order or protocol for it. I just always do it that way." (Well, this nurse isn't giving it without an order!)
*Being scolded by a preceptor for getting a doppler when a patient returned from the cath lab with a COLD foot with NO palpable pulse. "Don't bother with that, just assume that it's ok." (My patient came in walking on two good feet,and I intend for him to leave here walking on two good feet.)
*Being scolded by a preceptor for spending time looking for an intermittent wall suction fitting. Having to explain to a preceptor that there is a difference between continuous and intermittent suction and how continuous pressure could erode the gastric mucosa and having to point out that the order is for INTERMITTENT suction for the patient's NG. (The doctor ordered intermittent, and that's what my patient is going to get.)
*Being instructed by a QA Nurse to falsify a medical record. Having to explain legal and ethical consequences of falsifying a record to this person who also works as a nursing instructor.
Ignorant, incompetent, manipulative, or jealous people can readily attempt to apply the stigma of job jumping to a nurse when what the nurse actually has is a badge of honor and integrity. As tough as it is to say, there are many many folks who simply are not COMFORTABLE even being in the same room with integrity and competence. Do the right thing and at some point, in some way, it may result in your having to leave a facility or agency. When it all comes out in the wash, you will NEVER regret doing the right thing--what YOU KNOW to be the right thing. You may face some personal difficulties or hard times for doing the right thing, but it will ALWAYS be the best thing in the big scheme of things. The only person you have to sleep with is yourself. Do the right thing and you will be able to sleep like a baby.
Last, and not least: Get your own individual professional liability insurance policy.
This gal with the silver streaks in her hair knows what she's talking about, for sure and for certain.
Feb 23, '11 by TinashimkoCongrats on finding a new job, and do not for a single moment feel as though you owe them any sort of loyalty. Take care of you forst. There is nothing as miserable as dreading the idea of having to go to work. Be happy!
Feb 23, '11 by janhetheringtonYes, it will be a hard two weeks. One thing you HAVE to get over is thinking that a boss or a hospital is going to "be happy for me" because you're moving on up. That's like expecting an ex-husband to be glad you're getting remarried, to a rich hunk. Not very realistic.
Feb 24, '11 by gonzo1Where do I begin. I have worked in good ERs and bad ERs. There are way more bad ones. You are right to leave since you are not getting the orientation that you should have and were promised. Administration is always cutting corners and trying to get away with less and less. And they try to pull the guilt card all the time.