I work in an outpatient surgery center on the night shift for the PACU. Our nurse / pt ratio for PACU is 2:1. Ext Care on the 7p-7a shift is supposed to carry the same ratio. We've never had more than 4 pts / 2 nurses in the past w/o bringing on another RN. Our Ext Care is set up for 3 over-night pts (1 semi-pvt rm & 1 pvt rm). If more than 3 pts stay the night, they stick them in a back corner of the PACU unit. The problem with that is that if you are in the Ext Care unit, you cannot hear the monitors or call bells coming from the PACU unit. When in the PACU unit, you can hear the call bells from Ext Care, but not the monitors.
This particular night, we originally had 3 EC pts sched'd for the night, found out they added another, but then added an 83 y/o partial thyroid lobectomy (which we had never done this case at our facility before) that morning as well. As soon as I found out about the pt case load (5 pts), I called my charge nurse (which was approx 2:30-3p) and asked for another body so I could have an extra set of ears for the monitors for the night. Apparently, according to the administrator, we were being ridiculous, and after refusing to come in if they didn't give us at least a tech in order to make sure the pts were safe, they finally got us an LVN to help us for the night. I told them up front that we could handle the work load, but that it was a pt safety issue and neither of us RN's wkng that night felt comfortable. We were all three very busy that night, but everything turned out find.
In a mtg they requested w/ me the next Mon (charge nurse, DON, & administrator present), they were not happy saying that I was "refusing / threatening abandonment of my scheduled shift". I told them that I was refusing to come in if they didn't give me safe and proper staffing according to the situation and that I felt that my pt's safety and my license could be at risk if I came in w/o another person for the night. I re-explained the monitor and call bell situation and why it was not a safe scenario. I told them that if one of the pts in PACU, mainly the 83 y/o partial thyroidectomy pt, happened to stop breathing while we were dealing w/ pts in the EC unit, we would not know until it was too late. Their response: "it happens all the time in the hospital, you go in and the pt's fine, go back in & they're not breathing. It happens and there's nothing you can do about it." I told them that should not be something that could happen in an surgery center where there are only two RN's in the whole facility all night and that this is not a hospital, these are not "sick" or critical pts. They then told me that as long as I do my scheduled rounds, that my license would be safe if I went back and the pt had stopped breathing and died w/o my knowledge. Of course I then told them that would not make me feel better and I would not be able to live w/ knowing that a pt of mine died simply b/c I could not hear a monitor, which I made them aware of in the first place.
I did not claim "safe harbor" to my employer, but that's basically what I did.
Two days later, I got a call from my charge nurse asking if I would be willing to work the same shift situation in the future, but with their original decision for staffing. I told him that it would depend if they fixed the monitor / call bell situation to make it safer. He reiterated that nothing would change, & would I work it. I stated that I would have to push my case for my pt's safety again if nothing changed. He asked me one last time and said "their decision would remain the same, without any changes, are you saying that you would refuse to work the shift if this were the case". My response: "I guess so b/c I could not in good conscience work in a situation that I know puts my pt's safety at risk".
I was a PRN employee (who had wk'd anywhere from 20-40 hrs/wk for over 2.5 yrs in mult. units of the surgery center), so apparently, they didn't have to tell me that they were firing me. I didn't know for sure for almost over a mth. On my separation form, they wrote that it was a "voluntary separation" (which I did not do voluntarily) and wrote "mutual consent, mgmt/employee unable to come to agreement on pt to employee ratios. Not eligible for rehire at this facility." It was NOT a mutual consent, I was not even made aware that I was no longer to be employed w/ them or that I was not going to ever be able to work there again. I also couldn't believe that they made it sound as if I always disagreed w/ pt to employee ratio(s) rather than just for this situation.
This all happened approx 4.5 mths ago. The big problem is that this surgery center had a parent company in which I used to be a shared employee, but no longer able to work for any of them as such since I got fired. And since they put that I'm not eligible for rehire at that facility, it makes it seem as though I really did something awful rather than just stand up for my pt's safety. Doesn't look good to future potential employers...
Is there anything I can do to get them to retract that from my employee file since I was basically acting from a "safe harbor" stand point? Were they justified in firing me and I'm just being bitter? Just not really sure if there's anything I can do. I've never been fired before in my life for anything, much less for trying to do the right thing....
