I have been an RN since 2002. I worked on a med-surg unit in a hospital for over a yr and a half which was my first RN job out of school, but left because of wanting a job closer to home. I took a job in a NH. During the three months and one week that I was employed there, I felt more overwhelmed and frustrated than I ever did at the hospital, and I had made these concerns known to the DON and ADON on three different occassions, in which they gave a few suggestions that offered either little or no help for me. On the last day that I worked at the NH, I was thirty to forty minutes past due time to be getting the am med pass completed, due to several resident requests, phone calls from family members and doctors, phone calls to family members or doctors concerning various residents' status'. The DON approaches me while I am at the med cart and asks me if I need anything, and at that point in time I was feeling very overwhelmed and frustrated, and stated to her that yes I would like to talk to her and the ADON at some point that day to find out what I need to do to be able to quit because I didn't feel that I was the right person for this job and that this job was right for me. She said that here afterwhile we'd talk about it. I also ask her if she was aware that the front and back hall assignment divisions weren't evenly divided up (I the back hall nurse had 24-25 residents with 2 to possibly 3 admissions expected admissions that day, and the front hall nurse had only 17-18 residents with only one expected admission). Her reply to this was that she wasn't aware of how the assignments were divided but that she was aware of the admissions, and that her and the ADON would redivide the assignments here afterwhile. The conversations about my wanting to quit and the assignment redivisions never occured. The rest of the day went on as usual, drowning under more and more paper work, getting further behind. Then evening time rolls around, about one half hour before the night shift comes in. I am standing at the med cart reviewing the MAR's, trying to compile my end of shift report, and work on one of the admissions paperwork. During all of this a CNA approaches me and says that two of the residents didn't get their hamburgers for dinner. I then told her that she could call the kitchen and reorder them. She then stated that she'd done that and the kitchen staff replied that they were out of hamburgers but that she could come down and get 2 big dinner salads in place of the hamburgers for them, and that when she went to pick them up she saw that all of the kitchen staff were eating hamburgers. So now I have this info and I'm sure that there's another form or paperwork that I have to write up on about this, but I didn't know what or where it would be, but it just so happened that the admissions counselor who was an LPN who had worked the floor there for 5 or so years prior to getting this position, was standing at the nurses station having a conversation about her new home with an orienting nurse, whose only task for the past 4 to 5 hours of the shift was to be completing one of my admissions. I began to try to explain to her what had been told to me by the CNA when a resident, who is known and documented for making several repetitive requests for Tylenol daily, approaches me at the med cart and begins making the repetitive request for Tylenol. I then looked at their MAR to see when it was due and saw that it was not yet time for them to get it. I then explained to the resident that it was not yet time for it and also explained how long it would be and what the time on the clock would look like as to when they could get it. The resident then began to repetitively say okay. I then began where I had left off, explaining to the admissions counselor, about the hamburger situation, when only 30 seconds to a minute had passed and the same resident began to make the repetitive request for Tylenol again. I then re-explained, verbatim, to the resident, what I had told them before, and again their response was repetitively, okay. I then again began to try to begin where I had left off with the admissions counselor, when again another 30 seconds to a minute passes and the resident begins to again make the repetitive request for Tylenol. At this point, my head was pounding with a headache, because of everything I still had yet to finish (ie. admissions paperwork, paperwork for the hamburger situation, reviewing the MAR's, and compilation of my end of shift report). I then became frustrated because I wasn't getting anywhere. I slammed my fists down on the med cart (in which the resident was nowhere near), and loudly said to the resident, would you please stop being rude and interupting me when I am trying to explain something to someone else, I already explained to you that it is not yet time for your Tylenol. Then about 15 minutes later the admissions counselor approaches me behind the nurses station and asks me how much more stuff I have to finish. I told her that I still had about 75 to 80% of my paperwork left to finish and some phone calls to make to some doctors and family members. She then said to me that she was sending me home (granted it was time to go home anyway, by this time). I then said okay, but I still have paperwork and stuff to finish. She then said that it didn't matter, she was still sending me home. I then began to think that something bad had happened at home and that she wasn't wanting to tell me because she was afraid that I may have an accident on the way home, so I ask her if someone had called from my house. She then said no. I then ask her why she was sending me home even though I still had things to finish. She then said that the way that I had talked to the resident was completely out of line and she had recieved the okay to send me home from the DON over the phone. I then, replied okay. During this situation nobody offered me any help, nobody even attempted to redirect the resident. They either thought that the whatever conversation they were having or that picking up dinner trays was more important than redirecting a resident or helping out.
So, now after all that, my RN license is under investigation for verbal abuse. Nobody will hire while I am under investigation by the state RN board and are even more reluctant to hire me if I am given probation as my reprimand. This has been under investigation for seven months now by the state board and can still take another eleven months before they render a decision on my reprimand, even though I admitted what I said and how I said it. My state board also tells me that hypothetically, if I were to recieve a 3, 6, or 12 month or so probationary license, that it is not uncommon for someone in that type of situation to spend 2 or 3 years trying to find someplace to employ them to be able to work out their probationary status. I am at a complete hardship financially. My previous employer at the hospital, with who I left in good standing and told me that if I ever wanted to come back there that they'd definitely rehire me, won't hire me back now. I presently work 2 six dollar an hour jobs. The state board says that I can work as an RN now because presently I have a fully valid unemcumbered license, but that if a prospective employer were to ask a question of there being anything pending against my license, they would tell them yes, which I understand.
I would like someone to talk with who may have some insight to this type of situation. I would also like to hear some opinions about this. I admit that I was loud. But I didn't utter a curse word or belittle the resident. I have been told by other healthcare professionals that they don't see where I was verbally abusive, and that I shouldn't have ever made my desire to quit known to the DON earlier that day.