Retaliation for voicing concern over unsafe pratices - page 6

Hi, I am looking for some insight into retaliation acts by employers.I am a RN in a ICU setting at a major teaching hospital.I have been a resource to my entire unit.I received a promotion only... Read More

  1. by   Keysnurse2008
    maybe..you guys are right. i may very well be naive.i probably am to a certain degree...and i admit it.
    i have already been the victim of a preemptive strike. i hate that i even had to "learn" what that term - preemptive strike means.the nm got rid of me so that my formal reports on this nurses incompetent/unsafe acts would be discredited.thereafter...all complaints by myself would be labeled as just a "disgruntled fired employee". i "would have " been effectively discredited.however,...my case is a lil different.these 2 really didnt think it through very well...and they cant keep their lies straight .first of all i wasnt the only one who was being very very verbal about this nurses lack of acceptable skills.numerous nurses went to the nm...and she gave them lipservice and never took care of the problem of ensuring this nurses actions were stopped.i wasnt even in the top 10.so..they can not label it as a isolated incident that they had received numerous complaints. secondly,...these same outta control pair...actually wrote formal letters/evaluations along with a few coworkers requesting that i be promoted only like a month before i was fired...so nothing makes sense!!!first they say i am an incredible , highly skilled nurses...then i complain of the nurses unsafe practices and now ...i suck????.the jest of these letters/evaluations is that basically i am a highly experienced ccrn and function with such a high level of skill that i should be promoted.i was then presented to a central committe of this hospital.....and these unbiased central committe rns evaluated my level of function and said " yes....she functions with a level of skill and experience that she meets all of our hospitals strict criteria for this promotion.". i was then promoted...got a raise...and then apx 4 weeks later received a email from my nm thanking me for my "dedication" to all the nsg staff.the next night i complained of her friends incompetence...notified rm and the next day i was gone!so...they can read the nurse managers version of what "level of functioning" i was. straight from the horses ( ass) oops,.. sorry,.. i meant to say mouth.so..numerous employees had complained about this nurses lack of skills and knowledge before me.it should have been stopped there.....but it wasnt...that nm turned a deaf ear to numerous nurses complaints over various things.so...i filed complaints.... then...i am fired like the next day(apx 24hrs later).my work record is impeccable.it is spotless,..glowing.while texas is an at will employment state...they are many exceptions to that law....and retaliatory discharge is one of them.
    when i was terminated.....this nm actually lied about what day of the week it occurred on.i have it on audiotape.so they can hear that straight from the horses ass...oops...sorry again.horses mouth too.i am going to be very interested in seeing how this administrative committee wrestles with a nm who is so deceitful...that she cant even tell you truthfully what day of the week it is.can you imagine my atty having afield day with that? so..on one hand....you have a model employee...who just got a promotion at the written request of this nm. that nm stated that i was functioning as an incredible resource to my coowrkers and was a huge patient advocate.i then had to pass the scrutiny of a central committe for the hospital who interviewed me and evaluated my level of skill. they too agreed i was a highly skilled ccrn. i was then promoted. numerous coworkers are fine with admitting they had voiced concerns over this nurses lack of skills too and all they got was lip service from the nm.i have other things too...and people too...that can substansiate what actually happened. again....i wouldnt dare put all the proof/info i have on this web site...and have changed some years/dates/circumstances/things to avoid being identifiedi intend to be strictly factual.i...unlike them....intend to only tell the actual events that occurred. i only have to tell the truth.my record at that hospital is great,..nothing but raises and promotions in the last 4 years i have worked there. to tell you how well i functioned and gave 110%...look at my salary.when i started there 4 years ago...my base salary was a tad over 18$ an hour. my base salary is now over 30$ an hr. 12 dollars an hour hike in pay in less than 4 years. they dont give out raises like that unless you have gone above and beyond and have been functioning at a perfect level with strong loyalties to that hospital. like i said...i was a model employee. it is clear cut an etics violation, a code of conduct violation, a nurse pratice act violation, a pt protection act violation...it is illegal. i am still in hopes ...that these 2 ( nurse and nm) were acting without the hospitals administrators and legal depts knowledge. i still...want to believe that this hospital...would never have condoned their behavior if they had knowledge of it.my work hx at that hospital speaks for itself.so i am not worried about it. what i am worried about...is that perhaps...this hospital that i have dedicated so much of myself to in these last few years.....has all these really great "compliance policies/code of ethics/code of conduct/nsg bylaws/antiretaliation policies etc etc etc......and that they are merely words on paper.....that sound really great on paper...but are utterly useless...bc they never intend to ever enforce them. thats my only worry. i will meet with them...and do as you guys say...stick to the facts. unlike those 2....all i have to do is tell what truthfully happened.then its up to them to do the right thing.and...that is my hope.my hope is that they have these policies there for employees like me and that they are not " meaningless words" on a peice of paper.see...i guess you guys are right.i am hopelessly niave.but ya know...if they dont do the right thing...well....thats what they make courts for. thats why these antiretaliation and public protection acts are on the books for. these people in these icu beds....they are not peices of equipment.they are people.with families, friends. they are " someone" to "somebody".they are someones mother, brother, father, sister, child, friend, neighbor.their is someone hoping and praying that they will recover. they place alot of trust in the icu nurses....and when you have someone who is not functioning at a safe and competent level for whatever reason...then we have a duty to speak out. to keep talking until someone listens...bc.....what if that were youre mother, brother, father, sister or child that was lying in that icu bed?
    Last edit by Keysnurse2008 on Mar 1, '06
  2. by   LadyCharge
    Quote from ZZTopRN
    These situations are horrible and hold us as non-humans, and what the hospitals and management do to destroy your career. Nursing in big corporate owned hospitals are absolutely dangerous. Before I returned to nursing in the summer, I had volunteered in one of the "corporate" owned psych hospitals for a year and was encouraged every day to renew my license and go to work there. I did get my license and enrolled in a refresher class.

    While I was still at the "corporate psych hospital" I had seen abuse by a certain CNA that that belonged to a union and although nurses complained about it nothing could be done. One evening when I was seeing not only abuse from this CNA, but the first time I met the Nurse Manager of this unit, she was socializing, taking smoke breaks and not monitoring patients. Nothing dangerous just ignoring patients, but she was abusive of me. I have glowing reports at that hospital as a volunteer and I decided that I would just resign. Of course the volunteer coordinator urged me not to, the day nurse manager urged me not to resign, but would I please give them something about it in writing and told me I was doing the right thing. I did the wrong thing and trusted them. Of course, I could not go back to that unit and found I paid a big price.

    So when I started my clinicals, from the very beginning, the instructor who was quite old, began the task of breaking me down by telling me I shouldn't apply for these fast paced jobs, I wouldn't be able to keep up with the younger nurses. Every point of my enthusiam I was brought down by this instructor. I was even asked to apply on a certain floor. But the sweet, grandmotherly instructer said, "they were only being nice." Little did I realize that this sweet, motherly, sympathic person, was an act to gain your trust and to get all she could to use against you, I innocently told her about the experience in the other corporate hospital, she indeed used it.

    I had reported near the end of my clinicals, the harassment I was experiencing with a certain nurse, realizing it was part of the plan to get me out and she told me that every unit I had been in I was "incompetint" and all my work had to be done over etc. I am assuming that she used the fact that I had made the complaint at the same corporate sister hospital to alert the staff that I was a danger to the hospital or a whistleblower or something of that kind to get the hospital personnel to cooperate with her demise of me.

    What others of you are experiencing is all too common. The thing that bothers me the most about nurses, is how they willingly, and cruely, do such things to try completely destroy you. I am very aware of this, but I just don't understand the cruelty. And even though I have been a victim, I understand that this is widespread, but it still hurts.

    I have also been working at a psych residental facility part-time where, can I say, "I am loved?" And just got a part-time job that fits me perfectly for the part-time job and hours I want, with RN wages, and only passing meds and doing IVs. So I feel like I have the perfect jobs and pay and hours I want, without the abuse, the stress and backbreaking 12 hour shifts.

    I am going to file a discrimination complaint against the instructor with the school I did the refresher program with, even if it results in no disciplinary action for her. I at least want it documented, because this is how they get away with things like this. Many nurses or other employees are not willing to undergo the stress of the horrible emotional impact it takes on one. Or some might not be able to afford to hire an attorney. And as someone stated, if you win, you life will be made a hell.

    The bottom line, is extreme profit driven greed by the corporate hospitals and their competion with other "hospital chains." No longer a profession, but an industry. But you know what, I am very happy with my part-time jobs, and I know they have to make a profit, but they are HUMANS.

    My best wishes to you. You apparently are a very strong person and I wish you the most and very best. Although, you can be persecuted for something that you have not done, it can be extremely painful and traumatic.
    This was a good post I enjoyed reading as well. Its interesting to see how many nurses are going through this or have been. And you are right on target when you say hospitals are an 'Industry' now. Indeed they are...capitalization is a good thing but not at the expense of human beings! Like you, I just dont understand what motivates other nurses to do these cruel things. I have some theories however. And for the most part, I do not think these nurses have any financial kickbacks/gains from this so the motives must be some sort of emotional need; or they are just plain witches! lol! For some NM its power driven aimed at a career goal in higher management if not CEO of Nursing Administration. I know one NM in particular who is the most disgusting brown-noser I have ever witnessed in any job I have had, including the military! However, for those who are not motivated to advance their careers in administration, I really believe they have a deep-seated emotional need that they crave. Just a theory from observation of many, many nurses who are attention seekers and the reasons why. Its really very sad that people do not care who they hurt from the nurse to the patient...that they would be so selfish to say or do anything for an unethical NM or administrator just to get their approval. I have seen it! They are the spies in the hospital...if not henchman.

    And so it goes with human nature. I have seen it all and I am sure you have too in psych nursing...though we do get a few of those incidentally in Med-Surg as well.
  3. by   panhandler
    Lady Charge, surely you must be aware of the prison-camp studies. It is human nature to immitate the captors. "Trustees" ie pets of the bad guys treat fellow prisoners worse than the guards do. Not exactly your enlightened behavior, but built into the wetware of homo-sapiens.

    I wonder if it is time yet for a national nurses' strike. PRobably not. I wonder if I will see it in my lifetime. Teachers also get majorly f-ed over as a matter of routine. All of us, women.

    Bawk bawk bawk, says my dh. All hen-house doo-doo. Women working together ... sure trouble. The cliques and cabals also exist among men co-workers in the corpo world... anyhwhere you go. Just an extension of sandbox antics.

    To TNNurse..... darlin, do not go in there alone. You must have a lawyer advise you before you do. You probably have a wrongful termination suit. I wouldn't even set foot in the g/d place. Just see a good employment lawyer. BEFORE you take them on.

    If you cant or don't want legal advice, please strip your mind of ANY EMOTIONAL JABBERING. Everyone knows how crappy they treated you. They know it better than you do, and are probably laughing at how they "got" you. You EXPECTED otherwise and you are FURIOUS. Do you realize you cannot win an argument with an irrational opponent? The best you can do is a "draw." You cannot go back to your job as if it never happened. The only thing you can build a case with, a case that will get you $$$ with which to salve your wounds, is FACTS.

    FACTS means neither innuendo, mood, ambiance, tradition, education, intention, assessment nor outcome: FACTS can be used as weapons, by professional FACT-USERS. They are called LAWYERS. I wouldn't begin to do my own dentistry, and you should not begin to do your own legal work.

    If you insist on going to this Platinum Level Kangaroo Court, Do not lay EVERYTHING on the table. A lawyer will know what to reveal, what to withhold. Your "proof" your "judgement" your "findings" and your "conclusions" will be fine annecdotal material to give to your Attorney. Give him everything, after you strip out the emotions. (Lawyers love for you to jabber on, while the meter is running, of course, and you are paying, they will listen until the next ice age.)

    An employment lawyer is your best bet. You obviously have beaten this "defective person" to a pulp. "They" told you to stop, when they did NOT fire her with your "proof." You didn't stop. They were embarrassed. They weren't doing their jobs, documenting incompetence. They don't want (or didn't want) you to do YOUR job. They only want to have POWER over OTHERS, this power is the heroin of the corporate mind.

    In the corporate medical industry, it is ALWAYS, ONLY, and ALL about money.

    "They"are lazy. They want to get paid for doing as little as possible. They lack initiative, personal ethics, and plain old gumption. "They" can find fault with anything they chose to pick apart! They're real good at it. They abuse and neglect patients as a matter of course. They get paid for it. The hospital doesn't give a crap about the patients:

    It is ALWAYS, ONLY and ALL about money!!

    "The hospital" is only brick and mortar. It is run by robots. Robots in groups are known to behave very very badly.

    You are not automatic. YOu are not a robot. YOu feel betrayed because you did 110% better than people who get raises and have tenure. You used your education, intellect and physical strength to grind out invention after genius invention in the everyday of nursing care. True, you were rewarded, but you didn't have any POWER.... and now you are being punished.... because they DO have POWER. The rewards and the punishment are meted out by IRRATIONAL robots who are addicted to POWER and CONTROL. YOu mean nothing to them. They spit on you. They wreck your life. They are confident in the belief that you LET THEM.

    Take some time.
    Don't go back there.
    Get a lawyer.
    Please listen to an old gray-hair diploma grad from the Cretaceous: this is the tricky part.
    When you solve the problem, the root of the problem, you will have changed and outgrown this mess.
    You will amaze yourself!
  4. by   Keysnurse2008
    Dear Panhandler....thank you. It is hard for me to keep my emotions in check...bc....I truly got f****d in this whole deal. I hadnt thought about it till you brought it up...This NM was probably in fear that my voice would shine the limelight on her inactions. She had been contacted by numerous nurses re: this nurses lack of competency and opted to turn a deaf ear. I was one of the nurses who had a strong enough personality and ethical core to go above and beyond her with my complaints. Straight to the risk mgmt dept. So...she eliminated the problem....me.But...it still doesnt erase the facts.
    I am working with a very good atty...who is actually scheduling this meeting. I have a ton of strictly factual proof that I am not posting on this thread to verify my acct of the events. he has provided a fraction of what " I have" to them...and has advised me on what info he wants to "keep under raps" until court..."IF" they dont do the right thing.I have no intention of laying ALL my cards on the table.I can prove...others complained of this nurse.I can prove that she removed certain articles from the patients medical record.I can prove the NM gave me a promotion only weeks before. I can prove that this NM was very proud of having such a highly skilled pt advocate nurse working on her unit(me!)...bc....I have a copy of the letters she wrote to the central committee asking for them to promote me.I can prove less than 48 hrs before she fired me she wrote an email to me thanking me for my dedication. I can prove that she is so deceitful that she lied about what day this alledgedly occurred on ( her own voice- I recorded it). I can prove I was treated far differently than numerous other employees charged with the same thing.Most of them were not even written up...yet...I was fired. I can prove alot more....concrete factual info too.This is just the basics here too.But...yeah...I have no intention of even telling my best friends ALL the info I have. Any other advice?
  5. by   gauge14iv
    You know - the tape doesn't HAVE to be admissable to be useful. Sometimes just dropping the bomb of "Oh btw - I have a TAPE of that conversation" is enough to make the other party change their entire attitude. So admissable or not - it's still useful.

    In some states only ONE party has to give consent for a convo to be taped - and that one party can be you.
  6. by   Keysnurse2008
    Guage14IV,
    TX,TN,SC,AL,NC,WV and the state in which I now currently live is one of those states.....that states as long as ONE of the 2 parties knows a conversation is being taped...then it is legal and admissable."I" happen to be one of the two parties.So taping my termination meeting is completly legal.I am very much sure the hospital's atty will object when it is introduced into court as evidence. I mean...if I were their atty I wouldnt want to be left hung out to defend a NM that is so deceitful that she cant even tell an employee what day of the week it is without lying.There are many many items on that tape that will be very very damaging to the hospital.She has treated numerous employees accused of the same alleged act that I was fired for ,..so very very differently than me.None were fired....most were never written up.Some of these employees had a lengthy performance problems....unlike me...who has nothing but raises, promotions, excellent evaluations, and letters of praise for going above and beyond for my pts and coworkers. Couple that....with a lying NM....and....how would you like to be the atty left to defend her?
    See....this is where I have a problem. I still am hoping that this hospital...when made fully aware of the situation...will rectify it. I am "in hopes" that their policies are not merely meaningless words. I would hate to think I had worked for years in a place that would condone the type of behavior this NM and incompetent nurse has exhibited. That may well be the reality I am left with though...so....no....I have no intention of "giving away" over 30 % of the proof I have.I will provide them with enough info and proof to do their job.But...as far as the great majority of my facts/evidence I have....I wouldnt post them on this thread,...wouldnt tell my bestest friend.....wouldnt even tell my momma....only my atty and god.I might be niave.....but I wasnt born yesterday. I would love to hear from anyone who has ever been involved in any dispute resolution meetings...or administrative review hearings. Id like to hear the good and bad. The more I hear...the more I am inclined to possibly believe it may well be a "kangaroo court".If it is a "kangaroo court"...then....that hospital is in a very ...very...bad position.
    Last edit by Keysnurse2008 on Jan 9, '06
  7. by   TsunamiKim
    another thought:

    i believe you said they bought the incompetent nurse onboard without orientation? not normal practice, different treatment and possibly a violation of the standard regulations? approach this with your concern not only for the patients, but also for the nurse involved. she was set up for failure, may feel overwhelmed, doesn't want to fail the nurse manager who has shown such confidence in hiring her without requiring the normal orientation. she has no proper support or backup; what is the management going to do to help her move to a more appropriate role commensurate with her experience.
    even if through witnessing her incompetence you may have grown to detest this nurse do not let them know any of your personal feeling just your professional opinion as a well respected tenure nurse. considering past accolades from the manager you had assumed that she would understand and fully support your views in speaking out about the level of competence shown by the unsatisfactory nurse.
    at your hearing expect to be ambushed by a number of managers all berating you at once. this is the tactic, if you hear insults from several people you may just be persuaded to doubt yourself and buy into their crap. the tape record is like another person in the room, but definitely on your side. the other nurse is right it does have an affect on how managers speak to you when they know you are recording everything.
    expect it to be demeaning and completely irrational. i was falsely accused of making one of my harassing phone calls during a time that i was documented as being scrubbed into surgery. nope i could not get the circulator to hold the phone while i disturbed the surgeon with my screaming in the middle of his case; i couldn't get her to smash the phone down for me either. the problem is although i am listed on a patient record as the scrub with no access to a phone, it doesn't matter because they have records and i have zip. they have to prove nothing, but i was not permitted to disprove anything. fair right?
    to make my life hell my nurse manager reinvented my schedule and reassigned me to a completely different or a full ten minutes walk from my normal work area. there was no orientation to the new or, no mail slot, no hill rom locator and no locker for me in the locker room. why would i need a locker if i was scheduled to me fired as soon as they could coble together a reason? my nurse manager had her office in the new ors and under my old schedule i was rarely in the hospital when she was at work let alone anywhere near her or suites. however once she changed my schedule she was confronted by me every day. so here is this crazy nurse manager at my grievance hearing trying to convince hr that sometimes my harassing phone calls to her would total five hours a day, but for some inexplicable reason she wants to have me closer to hand in her ors on days when she is at work.
    i told hr that if i had spent five hours a day tying up the or phones someone would have noticed our complete inability to get any work done, duh! i also said her decision to relocate me under such intimidating conditions was equivalent to inviting your stalker to dinner! were her false accusations incredulous, unsubstantiated garbage, obviously they were. however that didn't really matter as they had me outnumbered they weren't interested in rational explanations; they had come only to wield the rubber stamp. everything that will transpire on that day will make your head spin. as long as you know that this is merely a sordid formality so that the hospital can pretend that they are following procedural guidelines; go humor them, but don't go alone or you may feel devastated.
    i asked that the manager to show me one of the supposed "letters of outrage" from the "intimidated" employees; she wouldn't even give me a direct quote of what was written. hr defended her right to suppress this evidence to "protect" the employees who wrote them; like anonymously quoting what they had written placed them in some danger, ********! when my union asked the manager for a copy of these letters she said that when she had interviewed the staff she had scribbled her own interview notes in the margins and wanted me to have a clean copy, how considerate. that hospital really needs to front for more stationary it's pathetic! it took me another eight months to get the union to have the labor board force hr to hand over copies of those three letters. meanwhile they were grossly misinterpreted to me with impunity. at my arbitration one of the "outraged" letter writers said she felt threatened by me because i had my "arms folded in an aggressive manor" and my "hands on my hips in an aggressive posture." i was fired for "aggressive" posturing!
    there are so many out there with stories as ludicrous as mine and a whole lot worse. they will not have to prove anything, whatever they say is written in stone until they need to change it. they will try and brush off every bit of evidence you produce as if it were a small childs refrigerator art. if you have that tape recorder document this verbally for the record. it goes like this: "for the record management have not entered any documentation to support the validity of their accusation made in that last statement." "for the record, i am entering x paperwork showing..., y letter of recommendation and z memo commending (your name) for outstanding job performance, all in support of my contention here." or something to that effect. do not forget to put together that detailed log of relevant events documenting dates that everything occurred. you will need this as disputes like this go on for years and you must keep your facts straight. let them supply all the inconsistencies with their lies; oh they will lie and lie and lie......
    here are some useful sites to check out; contact the whistleblower site asap and follow their advice. also i will have other links and important info i can share when i finally finish my petition. i am still wading through the links that will be imbedded in the petition; in this way i can make the document a genuine resource for people facing similar circumstances. i will let you know when it is up and running. this is a difficult time of year for me, now the five year anniversary of being marched out of the or by security like a criminal. that memory will haunt me for the rest of my life; we show more dignity and respect for people arrested by the police in the uk. it is also coming up for two years since i lost my house in baltimore; christmas will never be a happy time for me again. vindication would start the healing process. hope all goes well and keep your spirits up.

    http://www.whistleblowers.org/html/sarbanes-oxley.htm national whistleblower center on sox

    [color=#333333]american rights at work 1100 17th street nw, suite 950, washington, dc 20036[color=#333333]
    phone: 202-822-2127 fax: 202-822-2168

    http://www.laborlawtalk.com/articles_list-target-3.html labor law hotline can tell story ask about protections?

    http://www.semmelweis.org/articles/s...20failure.pdfb bad faith pier review of md semmelweis society international, contact info from their site: 6335 river downs road, alexandria, va 22312 tel: (703) 981-3492 fax: (703) 997-5674
    bad faith pier review: http://semmelweissociety2.tripod.com/id387.html
    http://semmelweissociety2.tripod.com/id334.html become a member

    this is just a few i can pass on, fair winds & following seas, kim.
  8. by   Keysnurse2008
    tsunamikim,
    were you as shocked as i...to find out how widespread this type of thing is?i mean...i have been contacted by tons of nurses who complained over patient safety issues ranging from ...unsafe staffing to incompetent pratictioners.the sad common factor in all of these situations is that.....the nurses suffered retaliatory acts/retaliatory discharge......and the other sad common factor is that patients were placed at risk.think about it...these patients are soooo sick now just to meet admit criteria......and then you introduce them into a environment where the nurses are complaining that the environment is not acceptable/unsafe.when you complain.....you are effectively silenced by management.there is just nothing about this whole situation thats ethically right, not to mention legally. i am shocked.i feel an obligation to become more invested in assisting the ana in any way possible.
    on your situation....am i understanding you correctly?that they have accused you of making harassing phone calls simultaneously while you were physcially in the or as scrub?maybe.....you should ask if these messages(phone calls) they received were telepathic?...bc....otherwise you cant be doing both.thats an outrage.do they track the infection rates?since you were obviously touching the phone(fomite)?do they have reports from the surgeon complaining that you were placing his patient at risk by breaking sterility to go "scream" on the phone?.......i bet......they dont have jack from that surgeon...do they? i am just in awe.i feel like i have been so sheltered....bc....before this happened to me i never knew all these type of retaliatory acts occurred.want to know something sad? my facility lost so many experienced nurses ....that after i left they had no one to do charge one night. on this particular night...in one of the areas largest icus....a new grad nurse was left to be in charge of a very large level 1 icu.this new grad( nurse less than a year)...was the "most experienced" nurse on the unit that night.she...nor any of the other new grads were even acls certified. this nurse...is a great little nurse...who tries to do such a good job.but what would....that hospital have done to her and her nsg liscence if their had been a code that night...or if any negative event had happened?that was not fair to her....and i hate the fact that i now know what they would have done to her if they even heard a whisper that anything negative had occurred.she would have lost her nsg liscnece...they would have hung her out to dry.it makes me sick to think they placed her in a situation...bc...she is a good nurse...she is just trying to gain experience.lets play devils advocate....what do you think wouldve happened to her if she had refused to do charge?care to take any bets on it?
  9. by   TsunamiKim
    tnnurse,

    there are certain employees who are more likely to become the target of a campaign for removal: you are in one of those two groups: tenure nurses. the second group comprises innovative or outspoken employees in any job category; i am in the latter. the relentless drive to remove experienced tenure nurses is purely financially motivated. however, new grads are not only cheaper they are more compliant with breaches in patient care through lack of coverage. they are not yet secure in their job or bold enough to speak up. they may also fear not being taken seriously or being ridiculed for their inability to cope. sometime the more experience we gain the more we come to realize the potential for disaster; i have faced many disasters at sea and i became a very conscientious captain.
    the toxic nurse manager is key to this process and very valuable to the hospital. don't be fooled your hospital will defend their toxic manager with a tenacity beyond belief. she is laterally worth her weight in gold with the money she saves; the dirty money of dangerous understaffing cut backs. the hospital can distance itself by pretending that the nurse exodus has nothing to do with them, but it was precipitated and supported by them. the toxic manager will help to transform her clinical area into a less desirable working environment and worse. as the situation deteriorates the tenure nurses are the first to leave as they do not have to put up with abuse they can find another job. policies that make the tenure nurses feel demeaned and undervalued are instituted and their benefits package meets a few budgetary constraints. as more nurses leave the working situation becomes more oppressive with mandated overtime and excessive call to cover the staff losses. you are left with the least experienced personnel trying to cope as they scramble to gain basic experience. this is happening all over the us so that we can maximize hospital profits. it is unsafe to the point of criminal negligence and we must expose this corruption to public scrutiny.
    people like me are dangerous because we dare to rock the boat; i even broached the subject of the "nursing exodus." i am an ideas person and i was vocal right from the very start. as a new tech i considered myself still in training when after less than a year on the job i made my mark. a surgeon became frustrated during a case and humiliated me with a reckless tirade during surgery. i wrote a letter to him admitting that i was still learning, but making a point about how his conduct had intimidated those in the or and thereby endangered the patient when we could no longer function as a team. it was a long letter, very cathartic in the writing, but then i questioned giving it to the surgeon. an anesthesiologist friend read it and wanted to share it with her boss as she felt it really struck a cord. i removed all the names and it went from rooky tech to the new dean in one leap. the dean called a meeting of all the heads of surgery and made them read the lengthy two page letter; he said "this behavior has to stop and it has to stop now." i thought "the letter," as it was now called, might shake a few trees; it napalmed the forest!
    i was really pleased with the hospital's swift response. they set up six separate multidisciplinary teams to look into various issues in the or and i was on one of them. we were all committed to the new goal: creating a "perfect day in the or." the frustrations that precipitated the outburst i experienced were finally going to be addressed and dealt with, i was impressed. due to the vintage of our prestigious institution's general or suite the challenge was tremendous, an antiquated facility had not kept pace with new technologies and the frustrations were numerous. these committees met once a week for almost six months. this culminated in an or retreat at the inner harbor, a grand event that took place on my birthday the 28th of march with over 200 or employees attending. the dean while never publicly acknowledging me as "the letter" writer wrote a letter of commendation that was placed in my file. the outgoing director of surgical nursing also wrote a letter, but more to the point we were making progress.
    the new director of surgical nursing bought these efforts to a screeching halt. we didn't even see her in the or for the first 8 months that she was there. this is the same top level or manager who lied under oath at my arbitration hearing and she remains there to this day: enter toxic management all of the recommendations in the one inch thick book we had generated through the diligence of our committees was swept under the rug. we returned to our old fatalistic, "nothing changes" mindset, employees felt jaded and used. the "perfect day in the or" became an elaborate wall exhibit to fool jcaho during one of their perfectly choreographed scheduled visits where as usual the or was transformed to deliberately deceive them. filthy overflowing trash dumpsters were only kept in the hopper room during jcaho visits. if challenged in a future hearing the hospital will have to count on more than a hundred or employees all lying to cover up the sordid facts of this negligent practice and deliberate deception: i don't think so.
    the entire or retreat project was abandoned in favor of toxic managerial policies to trim down the work force by getting tenure nurses to leave, and they left in droves. the pto (paid time off) that trimmed their paid leave benefit, the "occurrence policy" that discouraged use of sick time: calling in more than three times a year put you in the disciplinary process. then there was the final insult big fat bonuses paid to travelers for signing on for a few more weeks while regular staff shouldered the burden of excessive call. in my ignorance i, a non-nurse, tried to suggest strategies for nurse retention as i was deeply concerned about patient care. i had failed to grasp the deceitful concept of understaffing through toxic management policies. i also tried approaching the dean again to suggest a follow up that used a computerized system to channel ideas from ordinary employees to the management, but it was of course ignored. i now call that idea the "kaleidoscope of innovative momentum," but it was an outgrowth of the or retreat.
    however, my hospital now had a far more important focus, they were right on track to sop up all those profits from understaffing. toxic management was the key and input from the staff was unwelcome. i was warned by many, "nothing ever changes around here, don't rock the boat." my evaluations were astoundingly mediocre while they did not reflect the duties i was entrusted to. i started reorganizing the instrument trays on the insistence of my nurse manager. however, after devoting hours of my personal time to this project when it was finished she stalled me with "there's a lot of change going on right now." i was selected as one of the techs who would work with our most difficult and demanding surgeon the other was a far more experienced older tech. at first i used to tremble in his cases; at the end of the first one he shook my hand and said: "you survived." it was working with this surgeon that made me so fanatical about the way i did my job in the or. i was fastidious to the point of being a tad neurotic and this did not endear me to all of the nurses, but i could live with that. i tried not to let surgeons "dump and grab" from my mayo stand with impunity and that annoyed a few. however, when management tried to delete their most effective skin stapler i alerted the doctors by circulating a petition and the decision was reversed to meet their needs.
    although all of the staff were free to attend surgical grand rounds, no one ever did except me. perhaps i gained the respect of my surgeons through hard work and that dedication to further learning i demonstrated by attending their grand rounds every saturday without fail for three years. later i became one of the techs trained to work with the operative robot used in our living related donor nephrectomies. i joined the or education committee, submitting a quiz on ecmo. i was able to change my shift assignment to work several of the most challenging and severely understaffed weekend shifts which i continued to cover for nearly two years until my untimely departure. i did a lot of trauma and transplant cases; i had to be able to do literally any type of surgery that came to the or, even opening for the cardiac team until they arrived. this level of functioning wasn't the hallmark of an incompetent tech, but my evaluations remained alarmingly noncommittal as i was already identified as a risk to managers. knowing they would look downright negligent assigning an incompetent person to cover such demanding shifts the or managers chose to paint me as a "troublemaker," abusive, threatening and even mentally disturbed. the hard earned respect of surgeons was almost certainly destroyed when they saw me escorted out by security like a common criminal.
    my hospital was a level one trauma center and as such under comar we had to be able to man a trauma or in 15minutes or less. comar didn't say we could abandon another patient already in surgery just to man a trauma room. however on a saturday night after 11:00pm our coverage dropped to just one nurse and two techs with an assistant for room turnovers. if we started a case we were supposed to call in a call person to stand by for trauma because at that point we only had half an or team. however, if we didn't call in that call person it saved the department money. so if we had a lengthy case under way and a trauma came up to the or then the one nurse would split her services between two ors that were technically not even in the same building let alone next to one another. there was no spare person to even call the call team for backup if they came to the or stat. it seriously compromised the care of or patients, but it saved the department money and the toxic manager who condoned it would profit from that with a bigger, fatter bonus for doing her part in helping to make the unit unsafe. when the compliance line questioned managers about not calling in the call team they blamed it on the "nursing shortage." this was bs because we had people standing by on call and the obligation to cover that call had no bearing on the "nursing shortage" as it was always covered. we were just saving money by leaving out call people at home.
    the night that i was left stranded for 12hours was one such occasion when they should have called in a call team person to stand by for trauma. the charge nurse on duty was the hospital's most notoriously abusive or nurse manager and after 11:00pm that night there was a fairly new nurse on duty instead of another tech. this nurse manager was so abusive that droves of nurses left her shift and she could barely get new nurses though orientation before there was no one there experienced enough to orient them, that's how toxic this manager was and how bad the situation got! new grads assigned to her had to learn very quickly as they were needed to train even more inexperienced new grads replacing the tenure nurses. working under this abusive nurse manager employees talked about dealing with the "s....factor" (her name); no one tolerated it for long. when i told upper management about this they appeared genuinely shocked, as if it was something they had absolutely no knowledge of. there is no possible way that they could not have noticed how many staff especially tenure nurses left her shift: it was a lie.
    this rouge nurse manager was responsible for the decision to keep so few staff on duty on weekend nights, she could have stated that she needed more staff: negligent in itself.. she taught the trauma courses, but she was also responsible for teaching new grads that if they took charge on saturday night it was simply unnecessary to call in a call team to stand by for trauma. the hospital had confidence that these raw recruits barely out of orientation would cope ok if there was an emergency. they could just wing it covering two ors until a call person drove in from home after they got a chance to call them in. luckily there was no trauma on the night i was stranded for 12hours in that liver transplant because my patient was on bypass and that case was very challenging to say the least.
    the abusive nurse manager entered the room once to relieve the circulating nurse who had come on duty at 11:00; she was told to "run to the bathroom quickly" as if some major emergency was pending. she returned in less than 10minutes, but i was really absorbed in a critical part of the case and had barely looked at miss abusive while she was in the room let alone spoken to her. this nurse manager did not believe techs were worthy of being given a break at all anyway, so she left and didn't return until the end of the case at 6:00am. because of her comment to my circulating nurse we refrained from calling the desk thinking some emergency was about to come to the or. i was convinced this was the case and since calling the desk would tie up one of the only people able to call out to bring in call people we refrained from doing this. it was becoming an increasingly more harrowing task to call in people with the staffing shortages. there were no overhead calls, but there was only one other person free in the or to hear it.
    i think the abusive nurse manager spent the entire night surfing the internet in her office. when she came to my or i tried telling her i was about to pass out and she might have to take over from me so i could get something to eat. i had to repeat myself three times and when she finally heard me she gave me another task to complete before breaking scrub: "just suction out all the fluids before you leave." to avoid getting written up by miss abusive for disobedience i suctioned out all the saline, slush and ice despite feeling as if i was about to pass out. after 12hours without food, water or a pee it was little short of cruel and inhumane punishment. i was shocked to find out there had been no pending emergency, but she claimed she wasn't "just sitting around eating bonbons" that she was preparing instrument trays. this task would in no way preclude her from giving me a break. i was later expected to explain why i had not pestered the desk with calls requesting a break as i had to prove i had asked for a break. i feel that the nurse manager's single most important duty that night was to my patient; she should have ordered me to break scrub to protect his safety. however, not only did hr condone this abuse, the compliance line and several regulatory agencies i contacted all thought that leaving me stranded for 12hours straight was perfectly ok.
    this is an interesting reprint from a document that those who work under similar unreasonable, torturous or downright inhumane circumstances in the us should take careful note of:
    [font='arial narrow']43. hours of work are interspersed with one or more eating and rest periods of not less than half an hour. continuous work may not exceed five hours. the rest period in jobs which span two meal times ranges between one and four hours (labour act in force, art. 58).
    unhcr is helping to legislate more humane working regulations in iraq than are afforded to us workers even in critical jobs like healthcare! the "labor act" is a un document, please visit this site: [font='times new roman']http://www.unhchr.ch/tbs/doc.nsf/(symbol)/e.1994.104.add.9.en?opendocument
    in my case the comar violation was a "smoking gun." which my complaint about the situations where i was left without relief had inadvertently uncovered. their dirty little secret was out: not calling in call people to stand by for trauma when another case was running was against their own policy, not to mention comar regulations, but it saved them money. all these little infractions, changes in policy, leaving toxic managers in place to help trim down the work force: it is all about the money. just one month after i left they started calling in their call people to stand by for trauma/ for me there was no stronger indication that what i said was absolutly right. when i contacted miemss the maryland trauma agency i told them that quite possibly all of the baltimore level one trauma facilities were misinterpreting their comar policy on or coverage in exactly the same way and perhaps they should consider altering the wording to close this loophole. i was never thanked for this input, instead i was treated as a nuisance.
    i made sworn statements to the meimss attorney about several violations of the comar regulations at my facility that i, in good faith, believed endangered trauma patients. another issue was not expecting or insisting that our or techs maintained any basic cpr certification. it was the hospital's way of discounting our role in the or as "idiot work" at the expense of demanding that we were better prepared for trauma. as you all know good cpr quickly becomes exhausting so in minimally staffed off-shifts it was doubly important for the or team to all be able to take turns maintaining cpr in an emergency. i was acls trained at my previous hospital and was adamant about at least keeping current with cpr. but it was if you feel like it, on your own time. they wouldn't even allow use of the title surgical technologist as it implied that we were trained. this is the big trend towards minimally trained staff. some hospitals have or techs doing the circulator role which is grossly inappropriate as it does not match the absence of documentation training that we receive as techs. and just provides a cheap scapegoat when things go wrong.
    meimss did not bother to investigate, but informed me over the phone that the issues i had raised "did not specifically endanger trauma patients." obviously it was ok to endanger other or patients to drop everything to offer timely care to or trauma patients: presumably those "other" patients weren't in their remit! miemss never put anything in writing to me, as that would have acknowledged that there was indeed a problem and that i had reported it. i had tried to deal with this issue in-house by going up the chain of command, but after i was fired i was not prepared to let the matter go. then i contacted the compliance line to give my hospital another opportunity to handle things internally, but that too was ignored. only then did i contact outside agencies. unfortunately, those agencies were easily fooled by the "disgruntled former employee with an axe to grind" hype. added to which i was going up against the single largest employer in the state of maryland, the most prestigious well revered hospital in the nation; it was like squashing a gnat! this lack of oversight may still endanger patients in baltimore even five years on.
    the important thing here is that it was documented and i did absolutely everything i could do to end the negligent practices; my conscience is clear. it may take a patient death to expose the issues i bought forward, but if and when that happens my documentation of the danger will surface at last. what continues to drive me five years on is that it is not necessary for anyone to die to correct these problems, so i feel compelled to continue speaking out even from exile on the other side of the atlantic. this is what you must keep in mind: document the danger and do not allow them to silence you, hopefully no one has to die from this negligence before the truth is revealed. it is easy to imagine that if there is no written reply from them it was not very important; be governed by your conscience human life is important. they think that by ignoring your letters of complaint and reports on negligence that the situation will go away and the big bucks from understaffing will keep rolling in. understaffing is a form of fraud and you are bearing testament to the truth. do not let their inaction persuade you to abandon this important paper trail of evidence; this is really vital. if something adverse happens in the future it will be hard for them to deny any knowledge of past reported negligence when there is a stack of ignored letters of warning from you documenting everything.
    even as i parted with so many personal possessions when i was forced to abandon my baltimore home i got one file of paperwork out to be carefully preserved with a trusted friend in the us so it will always be ready to go to court. there were so many other treasured items i left behind, but it was my solemn duty to protect that one file. i hope that one day we may be called upon to testify before an inquiry. i live for that day. i will beg and borrow the money to return to the us to testify with all of my british family and american friends in full support of my stand for justice. that will perhaps be my last duty of us citizenship as i have been totally trashed and abandoned by the us in every possible way. please keep speaking out!
    although i know that some things have changed for the better at my old hospital i am sure many have not. they rely on their iconic status to avoid scrutiny and bend a few rules to maximize profits. they have been caught a few times recently, but no one seems to recognize the pattern of "we are above the law;" they think regulation are made for lesser institutions and do not apply to them. meanwhile their spin doctors are busy building on this aura of squeaky clean respectability, honesty, integrity and transparency. have you been overwhelmed by the honesty, integrity and transparency of their actions in the accounts i have posted? my former hospital is still wining accolades for their innovative patient safety initiatives while refusing to explain why they have not bothered to investigate my allegations or the retaliation used to silence me. they should really take the prize for hypocrisy!
    when my petition is posted on thepetitionsite.com you will know the name of this hospital; it will be there soon enough. i do not know how effective this tactic will be in demanding an investigation into my case. my petition appeal will only call for their compliance line to do a proper investigation; it appeals to that same dean who wrote a letter of commendation for me so long ago to insist on this being done. the compliance line say that they looked into things, but i just didn't like the outcome. they can hardly have looked into my case very thoroughly if they did not need to review anything from me or call me in for an interview. besides a legitimate investigation would result in a written conclusion sent to me, but there was nothing, just vague reassurances over the phone to fob me off. this is not transparency it is deceit. the real importance of opening my case is to expose the faulty dismissal process as it is used to silence patient advocates: that must stop. if i can keep going after five years and loosing everything then please tell me you will stick to your guns. the internet is a great equalizer, it may give us all recourse to justice. i hope you contacted the whistleblower hot line: don't give up,

    fair winds & following seas, kim.

  10. by   Haunted
    After reviewing all your informative and thoughful posts on this thread I am overwhelmed with the multitude of abuse, physical, emotional and professional inflicted upon healthcare workers!!! I am astonsihed that we get buried, discredited, defamed, villified for our compassion and ethics.

    True, I am a California agency nurse and am delighted that our nurse association, the CNA was able to effectively push for ratios but this was very costly and many nurses were unfairly painted with a broad brush by hospital administrators , the California Hospital Association, as lazy and unprofessional special interest groups.

    Our media focused on horror stories like King/Drew Medical Center and attempted to panic the citizens with screaming headlines about the horrific "nursing shortage" in an effort to turn the public against us. I personally have been blackballed and branded by facilities and felt the sting of low self esteem and confidence shattered by being out gunned.

    I have much to learn. My State BRN is working with a skeleton crew due to funding issues and laws and policies are being sheparded in the back door in the middle of the night, under the nurses radar and we are left to trust the facilities interpretation of these as gospel.

    The fulcrum of justice will currently side with the big business and deep pockets of hospitals, ironic that they offer free legal representation as part of the attractive benefit incentives to newly hired MD's !!!

    I submitted a thread about a year ago "I got canned" which was the first step on this journey towards truth , justice and patient advocacy and cannot see the light at the end of this tunnel. Just last month I was DNR'd from a facility that I had been going to for over a year and observed some of the most horrific acts and blatant disregard for patient safety, still have nightmares. I have submitted the documentation to every authority I could and have been ignored entirely.

    I'm not going away but neither is this problem.
  11. by   Arden2
    when i first read about your whistleblowing incident, i was angry with the administration - just as the other responders are. retaliation for whistleblowing is reprehensible. you are not alone - most whistleblowers experience personal stress and loss as a result of speaking out. you know all too well the personal pain involved in doing so.

    this being the case, i hope you don't mind if i suggest another angle that may shed light on your supervisor's reaction (however unjustified it may be) and a consideration the members of the resolution committee may voice.

    many nursing codes of conduct indicate that "nurses must strive to prevent and minimize adverse events in collaboration with colleagues on the health care team." collaboration entails working with the team in a congenial way to resolve the area of concern. in your situation, you quickly reported the unsafe practices to the risk management department because "you had no other choice." an alternative would have been to first speak with your supervisor about the incident in a congenial manner - implying a degree of uncertainty regarding the accusation. this tentativeness is a good strategy to get people to work alongside with you rather than being definite and forcing them to work in a competing role with you. remember the seriousness of your claim - you are declaring a team member incompetent without going through the normal channels. how would outsiders view your intentions? maybe malicious in which case they wouldn't want you on their team anymore due to the injury to morale etc.

    if after speaking with your supervisor no positive change results, then, depending upon the circumstances, a report to the risk management department would be in order.

    of course, if you truly believe that in the interim patients are being harmed, you may need to speed-up the whole process but how much time does it take to speak with a supervisor about your concern? she can act promptly to take corrective action.

    your intentions are good. but can you effect a positive change without harming your own career and causing all this stress in your life?
  12. by   Keysnurse2008
    haunted....i have been a nurse for many years...and am now realizing the magnitude of this problem.i know that readers digest did an article a few years back about the nsg shortage....but....people are not fully understanding "what"is going on here. it is like.....we are talking about a peice of equipment.....but we are not! these are people....with lives, emotions, thoughts, memories, personalities, children.these are human beings...and when a nurse is not praticing at a safe competent level .....and that facility allows that nurse to gain competency thru trial and error then the public should know. these are not mere peices of equipment we are talking about.we are talking about the most vulnerable in our society.we are talking about patients that are lying in icu beds relying on the icu nurses to have enough expereince and strong enough assessment skills to pick up on the small subtle differences in their assessment that can literally mean the difference between life and death for these patients. when tenured nurses are driven out of their jobs by a nm that is more concerned over her budget versus patient safety then it borders on criminal.at my hospital....i had a long flawless work history. in apx 4 years i went from a base salary of 18$ an hr to a base salary of over 30$ an hr +shift diff.i didnt get those kinda raises for the heck of it. i am an excellent clinical critical care nurse and am a strong verbal patient advocate. i was my nm's "prize child" until i complained about her best friends lack of competency.she sent me an email "thanking me for all my dedication " only hours before i complained about her best friends perfornmance issues. then ...."poof" i was gone .i didnt even know what hit me!!!!i am still in shock. the "alledged documentation error" i was accused of is ridiculous.that same facility....had another nurse in a level 1 icu that failed to document an assessment or vital signs on a critical care -icu patient for the entire shift...this nurses didnt document jack! would you like to know what happened to that employee?was she fired?no! was she written up...suspended?nope!she wasnt...and she has a hx of being on performance improvement.unlike myself...who has a spotless work record for this hospital...nothing but promotions and raises and email after email after email from mgmt stating "what a great leader you are".."excellent nurse"..."role model"..."leader in positive change"....then i tell them i am going to risk mgmt bc they arent doing jack with this nurse...and "poof".i am gone. ......i am gone.....but the problem is still there. that raises yet another concern.....these surgeons are left "wide open for liability" when nurses dont speak up and deal with nurses that are not functioning at a competent level.
    you know.....eventually this nurse will have / has gained competency. but...she is being allowed to gain competency thru trial and error. these are people in those icu beds.they are some to "somebody".they are someones mother, father, brother, sister, child, spouse friend...neighbor. there is "someone" out there...that is hoping and praying that they will recover.and when a hospital allows a nurse to "gain competency" thru trial and error it is ethically , morally,...and legally wrong.it is also a violation of that physicians trust.how would youlike to be the family member of one of the ones she "learned from"...the one that she was allowed to say "oops...that didnt work"...gee maybe i will not do that again. it is an outrage. when my fellow nurses started complaining about this lady...i was determined to find out for myself how this nurse functioned. i was on vacation....on vacation now.....my vacation had been granted and i was suppost to be off the last night i worked......but i had seen enough "things" to make me worried.so i actually volunteered to come in.....on my day off........while i was on vacation to really just watch her.i was sick of all the complaints and i was going to see for myself what she was/was not doing. i got to see allright...and when i was had seen enough to validate their concerns...i ...as a tenure nurse....was determined to make sure risk mgmt knew what was going on. i followed the ana standards and informed this nurse i was going to risk mgmt bc of my concerns.do you want to know what following the ana standards got me?it got me fired.it got me fired. fired for doing the right thing. i have a family...kids that depend on my income.....and i feel so abandoned by my hospital. i followed their policies.i followed the nurse pratice act.i followed my hospitals nsg bylaws.i did the right thing...and for that both my family and i paid dearly.
  13. by   Keysnurse2008
    arden 2i know you didnt just ask me if i couldnt effect a positive change with """causing"""" all this stree in my life. first of all....i didnt "cause " this. my nm's inactions caused this. you may have overlooked where i posted that i wasnt even in the top 10 of nurses who had went to this nm c/o this nurses poor performance.this was her best friend whom she refused to "allow" her to have to "be oriented" to a new job.her mind was closed. she had proven she was going to "do nada".and according to my facilities policies i am not obliged to consult with my nm when it is a patient safety issue.i am only obligated to notify risk mgmt...and tell the nurse about my plan and my concern over her pratices. but....i was professional.....i actually attempted to schedule a meeting with the nm to inform her ....and i was met with a date to come in for my termination. i was "upfront" with this nurse regarding my concerns...and followed the hospitals policy.i didnt "ask" for any of this.i didnt ask to be the victim of an illegal retaliatory discharge.offhand comments like that are "why" so many nurses feel pressured to remain silent.perhaps i read your text/post wrong and you didnt mean it...how i interpreted it.

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