Unsafe agency, unsafe case. Need advice please!

[SDALPN]

ok, so I posted recently about working a case where the patient was living in poor conditions. I have only worked there a few times for orientation. I have worked a few shifts "on my own". I'm still not comfortable with a procedure and have been shown once and talked through it once. I think it may not be as much about being comfortable with the procedure as it is what I need to know. Knowing and doing are 2 different things!!

So 2 days ago I was told I would be receiving a call about scheduling a nurse to come in and work with me on my next shift. The call never came. So I called the scheduler about having someone come in and had to leave a message. I also sent an e-mail (CYA in writing) explaining that if I don't have a nurse there that it will be an unsafe assignment and that I can't accept it.

I finally got in touch with the scheduler this evening. She started yelling at me and telling me how unprofessional it was to wait til the last minute. I didn't wait til the last minute. I was told I'd receive a call and was being patient. But since I had not received a call this evening I decided to follow up to make sure a nurse was coming. I explained to her that if I didn't have a nurse that it would be an unsafe assignment. She yelled at me, telling me that it wouldn't be unsafe. I explained that I would protect my license and won't be accepting any unsafe assignments in order to protect my license. She yelled back that my license wouldn't be in danger (shes not a nurse). She yelled, telling me she didn't appreciate being threatened not to show up. I explained that it wasn't a threat and that I was doing what I could to be there. But that I couldn't accept an unsafe assignment. Then she hung up on me. She barely let me get a word in. Shes one of those people that has lots to say (even if its wrong) but never hears a thing that is said.

This same scheduler told me the other day to run to the office as soon as a nurse I was orienting to the case showed up. I found it rediculous that they had me orienting someone when I'm still learning the case. But she had experience with the procedure and was showing me some of that. We both were teaching each other....scary. I explained that meds would be due before the nurse to orient would arrive and that I would have to do those first. The scheduler told me the meds could wait until I got back. I ended up giving meds and getting the patient taken care of and getting the orienting nurse to a point where it was only necessary to monitor the patient while I was gone. Then I was comfortable leaving. It was a new nurse I was orienting. She was only being oriented to the case. But still, my concern was this scheduler telling me not to worry about giving meds!! When I told her I wouldn't leave the patient until the meds were given and blood sugar checked, the scheduler told me those were excuses.

What can I / should I do? This scheduler is out of control! I'm scheduled to be at work in the morning. But I don't feel comfortable accepting the assignment without a nurse being there during the one procedure.

[BrookeeLou_RN]

Your situation must be very confusing.. I re-read your post 3 times and still do not really get it!! Are you the RN? What procedure do you need help with? Why have you not taken this need for more training to someone of authority Director or Supervisor.. Like you said scheduler is not a nurse!

I think you are saying you are doing private duty both for an agency and on your own.. On you own could get your license in much trouble if you admittedly do not know the correct procedure.. so be careful there, plus can get you terminated in most places.

Blind teaching the blind is very scary but unfortunately exists in many fields.

perhaps you could clarify more of the problem so someone could help?

In general.. my gut.. says to get away way far away of this agency..but without all the details I could be wrong.

[SDALPN]

Sorry its confusing. I'm still kinda shaking from being yelled at and having to stand my ground. I don't like confrontations and avoid them at all costs. But I also will stand my ground. I was trying to make it make sense, but like I said I'm a little shaky right now.

I'm an LPN on the case. I have informed my DON that I'm not comfortable with the procedure and have asked for further training. I'm avoiding discussing which procedure so I don't identify too much. I'm not doing private duty on my own at all. I'm working for a private duty agency.

[carolmaccas66, BSN, RN]

You did right. I worked for one agency where, I swear on God's holy word, that the manager running the show was psychotic/bi-polar/shizophrenic or all three. She used to send me abusive emails, yell over the phone, and (like you) if I said an assignment was unsafe or she hadn't left me enough time to get there (she used to call at all hours and DEMAND I leave for work at once), I would get abused over the phone. I refused to go work in a locked psychiatric ward once (I'd told her the story when I joined up) that one time I got punched in the head and partially strangled by a psych patient on one of these wards, and I flat out refused to take the assignment. She screamed at me and I hung up on her. The only reason I put up with it 4 a while was cos I needed the money. She eventually rung back and told me to quit, and I agreed, then I told her she needed help, badly (I was serious). Of course, she abused me for that as well!

Yes, you have to protect your license that is so true. If you accept an unsafe assignment and you KNOW it is unsafe and goes wrong, your BON will only smile if you make excuses - so will the lawyers. And how on earth can she judge what is safe/unsafe when she is not a nurse? Goodness these people!! Some of them are so arrogant. Stand your ground re nursing procedures - meds for example are important -lifesaving in many cases, so you need to explain why they need to be done at certain times.

Can you not go through a different agency? I'd be brushing up on my CV (resume) and applying everywhere and anywhere. I myself am never putting up with that BS again. Life is too short, and I am too old.

[SDALPN]

Well there is a good side to that. I am in the process of getting hired on with another agency :-). Still waiting to hear officially though. Going to go do their testing next week. But nothing set in stone yet. So I can't count on the other agency. Plus the other agency doesn't have f/t work available for me. Only call outs and p/t shifts available with them for now.

[netglow, ASN, RN]

Yeah, agency. Not really. Lots of them popping up without anybody clinically experienced in command. VERY DANGEROUS for you to continue if you want your license. These people just do not care. It's happening in home health and hospice too. Makes me want to puke. I was put in a bad situation and I did call in and have "the talk" with an "assistant" who was a new grad RN at one short agency stint I had. I yelled at her while driving to a "mystery" visit at night, and when she asked me if I was threatening her, I said yes I was threatening her and she better get her **** together, that we are talking serious business, this isn't a game!!!!! I also told her to stop sniffling and to grow a pair! I quit soon afterward.

Go online with your state licensing site. Take out your employee list if you got one you can get hold of from that agency. Start looking people up. See how many are new grads. Heck look up your so called clinical management and see how much experience people have. I would bet that you have mostly new grads.

[SDALPN]

From my understanding, the DON is quite experienced and on some boards (not state board though). But the scheduler isn't a nurse and has no business telling me what is/isn't safe for my license. She also has no business making nursing judgments for me either. I don't know what her qualifications are. My impression is she is a secretary who also does scheduling and probably has no more education than a high school diploma at best.

[BrookeeLou_RN]

Okay.. first off, I want to share something I learned in nursing school years ago before dirt was invented.....Do not let anyone yell at you! You are a human being and be it boss, doctor or scheduler.. they all put their pants on one leg at a time.. I was taught to politely say"I will not be yelled at by you.. I will be happy to continue this conversation when you are able to speak to me as a human."

I used it as a new grad and Doctor called me back and apologized. Now I am not saying if you are in a CODE to do this if someone is yelling!

If DON knows you are uncomfortable with this procedure..has she provided any instruction for you ..be it written or another nurse? If yes.. are you scared to preform it or simply do not get it(no o0ffense intended)? If no and what more do you feel you need? Since you will not share what procedure this is.. I can not really say yeah that one is really tough or??????

I am not sure why not saying what procedure will mean you are breaking HIPPA or whatever way it would identify the patient?

Have you done cases for this agency before? Were things like this? If so.. may be time to job hunt.

If you'd feel better you can PM me.

[SDALPN]

Nlmoore, I PM'd you. Thanks!

[highlandlass1592, BSN, RN]

Without more details, an informed reply is a challenge. Suffice to say, no matter where you are working, you have a chain of command. Your agency has to have someone on call for practice issues..whether they be yours or the client's. If your scheduler is giving you that much grief, stop the call and contact the on call administrator, DON, whomever. Explain the situation professionally and stand your ground. You need to realize you could be terminated but if things are as bad you are trying lead us to believe, you may be willing to pay that price.

Have I had to do this? Yes. It was at a hospital, being asked to take 8 patients on a telemetery unit, no clerk (so I was responsible for my own orders and order entry and helping with the desk), no techs-so that's primary care, and no telemetery techs-so I was responsible for watching the monitors of my patients who were spread all over the hall. We won't begin to talk about the fact that 3 patients were confused on fall precautions. I refused the assignment. Yes, it caused a stink but it was the right thing to do. I never went back to that facility. No problems, had plenty of other work.

[caliotter3]

Your entire post was about the scheduler's behavior. I would be having a talk with the nursing supervisor/Director of Patient Care Services about both the situation at hand and the behavior of the scheduler. Never let a scheduler bully you into doing something you do not want to do.

[SDALPN]

I tried calling the "RN on call". Every time I have ever called her, she never answers. That has been another concern of mine and another story.

I don't want to be terminated. I'd rather quit if possible. I may be getting hired on with another agency...pending paperwork and stuff. But I don't want to quit until I know I have work available. The current agency doesn't have any other cases available right now. I need to work, but I'm not risking a patients safety/health for a check.

What other details would help?