Was reprimanded and told to resign. Advice or thoughts would be appreciated.

[nurse20011]

Hi there, I work on a general medical/surgical floor and had an incident come up the other day. I was given a large patient load without a nurse tech for help. Usually on our unit we have a tech assigned to a nurse if that nurse is looking after more than five patients. Anyways, several hours into the shift I was already drowning. I told my supervisor that I was having troubles and she told me to try and handle it and if I needed help to ask for it. I had a patient who soiled the bed and took some time to clean him up and the mess. As soon as I got him back in bed he soiled it again almost immediately. I stepped out of the room for a moment to ask my supervisor if she could check on my other patients and she said she would. I finished cleaning up my patient, went down the hall, and they were doing a rapid response on one of my patients. A rapid response is called when a patient is having chest pain. I went in and helped and afterwards I thanked my supervisor for the help. The patient was fine. He was having some indigestion.

Yesterday I was called to have a meeting with my director and chief nursing officer. The patient that had the rapid response told my supervisor and the rapid response team that he had been having the chest pain for almost an hour. I was then told that I was neglecting my patient and that I "knowingly put the patient in harm" because a rapid response was not called sooner. I responded by telling them about my day and how I was drowning but it had no effect. The chief nursing officer then said that the papers would be passed up the chain of command and that this is very very serious and she doesn't think the turnout will be good for me or my future. She then recommended that I resign. I was terrified and so I resigned.

What are your thoughts on these events? I feel like the whole situation was extremely unfair. Or am I just a terrible nurse? Will this effect me in the future in any way? I'm terribly worried and depressed about all of this. Any advice or thoughts would be really appreciated.

Thank you

[BlueDevil,DNP, DNP, RN]

I think every nurse needs to put themselves into this scenario and have an idea about what they would do before it happens. I won't tell you you were wrong, because the "right" answer is going to vary for every person. However, I would have made them fire me, complete with thorough documentation of the events, including my rebuttal response.

[KelRN215, BSN, RN]

It's definitely better for the employer to coerce you in to resigning. No unemployment benefits to pay, and they don't need to back up their decision with a good paper trail to protect themselves from wrongful termination lawsuits. Chances are this job is going to be a black mark on your job history with prospective employers now no matter what ("Oh, we can't call them for a reference? Hmmmmm...."). It's an unfair and bad position to be in no matter what, and I think I'd want unemployment while job hunting.

Agree. I would have made them fire me as well so I could collect unemployment. Resigning under those conditions is no better than being fired. When a future job calls for a reference, they ask dates of employment and eligibility for rehire. Someone forced to resign will probably be marked ineligible for rehire, just as someone who was terminated would be. There's no changing what's done, but I think it's always better for the employee (benefits wise) to be fired than it is to forcibly resign.

[DeLana_RN, BSN, RN]

OP, so you had to do primary with 6 or more med/surg patients? That's an unreasonable assignment for anyone. That you would drown was totally predictable. And how can you be held accountable if a pt supposedly reported CP but no one told you?! In addition, your charge nurse also was aware that you were in over your head (as anyone would have been), and probably threw you under the bus to take the attention away from her role in this disaster.

So, you were the sacrificial lamb. It happens so much in nursing it's not even funny. Coercing you into resigning is the easiest way for them to do damage control. However, unlike pp I believe that you did the right thing by giving them what they wanted. You do not want to have a termination on your record, no matter what. In the future, every decent job you ever apply for (except for he|| holes who take anyone) will have the "Were you ever terminated?" question on the application, and many would automatically dismiss your application without ever giving you a chance to explain. Forfeiting some unemployment is a good trade-off for not having to deal with this for years to come. Besides, you have med/surg experience and it shouldn't be too hard to find another, better job.

All the best to you!

[Esme12, ASN, BSN, RN]

Just becasue you resigned doesn't mean you absolutely can't get unemployment. Rules vary check with them.

As per the Terms of Service we cannot offer legal advice. If you have malpractice insurance I would call thema ask them to talk to a lawyer. You cannot be in two places at one time and becasue of their lack of staff and unsafe conditions they have placed pateint at risk and wrongfully terminated you.

I am so sorry you are going through this and that you have become another sacrificial "corrective action" in this ever malignant envioment that is nursing today.

((HUGS))

[Vishwamitr]

Dear nurse20011,

An old wisdom dictates, "everything happens for a reason". What happened to you may traumatize you for a while but down the road you'll be glad that it happened sooner than later.

First of all, you were working under untenable conditions. Unwittingly, you let yourself be set up right there. I would have declined to take that assignment. There is no law against declining an assignment if you feel that your patients' safety will be jeopardized. But once you accept it, there is no deserting the shift.

You did the right thing by resigning rather than trying to fight the city-hall, so to speak. It could have become a prestige issue and the administration could have haulded you to the Nursing Board under some flimsy pretext. As I see it, it will not affect you in the future in any way except that you might not be able to use that God-forsaken place as a reference.

If it is any consolation to you, I want to assure you that you are not a terrible nurse but a good nurse who was subjected to terrible working conditions. Nursing is not a calling anymore but a summon lurking in the shadow.

[chinacatRN]

I didn't get a chance to read all the responses, but I can tell you I know how you feel. Something very similar happened to me.

I worked as an RN charge nurse at a LTC and rehab SNF facility for almost 2 years with nearly perfect attendance. I nave had any write ups or reprimands. Then, a couple weeks ago, a resident fell in his bathroom. The CNA who was transferring him off the toilet only used a 1 person assist instead of a 2 person assist. They also got him off the floor before I could assess him and take his VS. By the time I was able to assess him, he was so angry that he would absolutely NOT allow a full head to toe assessment. I was able to look over his extremities, his back, and his butt. No skin tears, lacerations, bruises, swelling, redness. No c/o pain except generalized achiness which is normal for him. He wouldn't do ROM for me but from what I observed throughout the day, his ROM seemed wnl for him. I documented everything. Incident report completed. MD notified. Message left for family/POA d/t no answer when called. Nothing new noted overnight per the night nurse either. The next day, his right leg was slightly swollen and he had c/o pain. They sent him to ER and he ended up having a hairline fracture of the femur.

I come in to work a couple days after the incident (it was my weekend off) and I am told by corporate personnel (who were there investigating) that I failed to fill out the incident report correctly. I informed her that I have been filling them out the same way for 2 years and never have been informed that they were completed incorrectly. Later, I am called into the DON's office and written up because I didn't complete a head to toe assessment on the resident even though I documented on EVERYTHING (nurses notes, incident report, fax to MD) that he refused the complete assessment. They also write me up because the CNAs complained that I "don't help out enough". Hard to help out when your patient load is so high that you can barely complete all nursing tasks that need done. I complete the work week without incident. Come in next monday and am informed I am terminated d/t writing the incorrect date on a bandaid - thus "falsifying documentation" because they didn't know if I was the one who actually changed it, even though my initials were on it.

Anyway - there are many facilities out there who know they can find another nurse and if they think they're in trouble will stop at nothing to get rid of the source. In my case, state will come in to investigate and the facility will tell them that they fired me and the CNA who were the "cause" of the incident and state might give them a flag or something. In your case, having you resign will hopefully mollify the persons in charge, the lawyers, and the patient. No, it's not right that you were given such a huge patient load and expected to sink or swim. Your supervisor should have helped out more and in my opinion, who should at least be reprimanded. It sounds to me like they used scare tactics to force you to resign because they didn't want you telling the truth about your patient load and the rest. At least you didn't sign anything. Sorry this happened to you and I hope you find a better job!

I also agree that you should "make them" fire you. It's more work for them and you'll get benefits. I don't know where you live, but I've filled out TONS of applications and not one has asked me if I've ever been terminated. And legally, they can not give any info as a reference that can not be proven in a court of law - at least where I live. For example, a potential employer could call my work and ask for a reference and if my prev. employer stated I was fired for falsifying documentation, I could sue them because it's never been proven in a court of law, nor did I sign anything that stated I falsified documentation.

[07302003, ASN, RN]

I'm so sorry that happened to you. Med surg is very hard.

My only thought, which hindsight is 20/20, and it comes with experience, is that when working med-surg I would, before I get involved in anything else, go into each room, eyeball each patient (are they breathing?), introduce myself (are they responsive? at their baseline?), see if they have any immediate needs (pain meds?) and tell them when I'll be back. Because you can't always believe the report you've been given, and patient's conditions change.

Poop and incontinence can wait until you make sure the rest of your patients are breathing. If the patient is alert, just let them know you'll be back after you've briefly checked on your other patients. It sounds awful, and callous, but poop can wait - you want to make sure no one is circling the drain or having respiratory distress first.

[Kyrshamarks, BSN, RN]

You do not always get unemployment with firing. All the company has to do when the unemployment office calls to verify the reason for firing is to say it wsd negligence of duty, which is what they are calling it by the sounds of it, and unemployment will ne denied.

[Orange Tree]

I might be missing something, but you don't specifically say that you had not been informed of the patient's chest pain. If you were aware of the chest pain for one hour, I think you need help with prioritization. If you were not, then this whole situation is very unfair.

[hiddencatRN, BSN, RN]

You do not always get unemployment with firing. All the company has to do when the unemployment office calls to verify the reason for firing is to say it wsd negligence of duty, which is what they are calling it by the sounds of it, and unemployment will ne denied.

And you can challenge them on that front by filing an appeal.

[SionainnRN]

And you can challenge them on that front by filing an appeal.

But if you're fired for cause they usually won't investigate and you're going that whole time without any income. Sometimes it is better to resign.

[hiddencatRN, BSN, RN]

But if you're fired for cause they usually won't investigate and you're going that whole time without any income. Sometimes it is better to resign.

Not true. If you appeal you have the opportunity to present your case at a hearing. They don't simply take the employers word for it if you challenge with an appeal.