This situation is weighing quite heavily on me so I'd like to get some advice. All responses, no matter how brutally honest, are much appreciated. Sorry for the long post. Here goes....
My evening consisted of 5 patients of my own (2 vents & 1 on 3 critical gtts). I was also responsible for covering the LPN's 3 patients that all required frequent IVP narcotics, IV antibiotics, am labs, and 1 of hers was on a vent. So I'm responsible for 8 patients.
Charge nurse had 7 patients. Several vents/critical gtts. LPN had 7, 3 of which I was essentially responsible for. 1 aide that spent the entire shift in the restroom, breakroom, anywhere but the floor.
Administration was called several times. No one returned our calls.
We barely make it through the night. I check the schedule for the next night & realize that myself, the same charge nurse, and a LPN are on the schedule. No attempts have been made to contact agency even though scheduling has known for 4 weeks we were short on this night. While leaving the charge nurse informs me that she will not be coming in the next night due to the awful night we had just had. So that leaves myself and the LPN tomorrow that would be responsible for the 19 patients.
I call the next day to see what staffing is like. I'm told it's me & the LPN. The charge nurse called off. They left messages for agencies but none have called back. They also left several messages for administration, but they haven't called back either. So I call back 2 hours before shift starts & it's the same situation. So knowing the ridiculously unsafe night ahead of me, I too called off. I've been a nurse for 18 months & the previous night was my worst night. I never let things get to me, but I allowed myself to lose control and cry. I just felt so overwhelmed...I felt I couldn't give my patients the care that they deserve. I couldn't knowingly walk in to the same situation again the next night, especially being a new grad and not having a resource.
Am I wrong for calling off? Am I not a team player? I feel sick stressing about this? Please advise.
You made the right decision for you. Whatever the consequences, and you know that there may be consequences, you have the secure knowledge that you did not harm or provide substandard care to a patient because of the working conditions.
I hope that this forces your institution's hand regarding staffing.
Personally, I would have not called out because I would have felt AWFUL for the patients and the LPN. I would also start my shift with a protest of assignment and continue my shift with the understanding that patients will only get ESSENTIAL things done (and no charting, a few notes). I'd' figure I have been left with no choice and I will do the best that I can for these patients because they don't deserve to be in this position. ......Then I'm sure I'd totally not prioritize and run myself ragged.
It sounds about right that calling out may possibly create the situation which would finally wake up the admins but... I would never have come to that conclusion on my own nor would I have the balls to bring it to that point.
In school our instructors have told us about a process/regulation we have in Texas (may also be in other states, I don't know) called "Safe Harbor". So I don't know where the OP hails from, or if they have something similar, but it apparently protects your license and raises a HUGE red flag for the employer that they have to fix the issue, and quick because invoking the process starts some sort of peer review process and the BON is involved. So we're taught in this sort of situation to take the assignment, but only after informing the appropriate administrative personnel that we are invoking Safe Harbor. I wouldn't have been able to in good conscience call off, but this post makes me wonder what I would do if the same thing happened in a state without a Safe Harbor process, and I just don't know.
Tough call. If I read your story accurately than I can't blame you for calling off. Too much responsibility and not enough resources. The only fault I can find (and yes, I'm callous and cynical) is that you didn't give a "heads up" to the LPN about what was about to happen.
You were placed in a position of having to put out a house fire from the inside armed with a water pistol. You go in-you lose. You call off-you lose. At least with calling off, the monkey is now on management's back and they get to scramble for a change.
Don't worry about that team player stuff. Sounds like you didn't have a team to play with.
I too wouldn't worry about being a team player, this organization has a breakdown somewhere is not doing enough to safeguard its patients or its employees. I probably wouldn't have called off 2 hours before my shift. If the charge nurse had told me she was calling in, I would have informed her and my manager (or whomever else) that I would not be coming in unless more help was brought in. I would state very clearly why, and if a resolution was not decided right then and there, I would have let them know I was quiting at that point. In the long run, it is more important to take care of your license than worry about consequences from an employer you should probably part ways with anyhow. You have not put those patients in that unsafe position; the blame is entirely on the hospital administration. SHAME ON THEM!
This sounds like a very unsafe situation. I don't think calling in sick for one shift is the answer I'd say quitting this place altogether is! I don't know what state you are in to be given such a crazy load. Good luck too you
Is this an ICU? This doesn't even make sense to me!
I honestly don't know what I would have done in this situation...are there other units they could pull nurses from, even if just for tasking? I don't blame you for calling off, I might have gone in and refused the unsafe assignment...that is always an option. No worries of abandonment or anything else if you haven't accepted the patients! Good luck:redpinkhe
I am curious to see if they were able to get in one or two, or more, nurses to replace you and the charge nurse? I mean if they weren't really able to get anyone in before what would they do without you and the charge there? Not sayng what you did was wrong or right just curious to see if under preasure they were able to materialize some nurses
I am also curious to see if they found coverage for your shift. My best advice is to start looking for a new job and get yourself out of there. But you have to leave on good terms, so move fast and give your appropriate notice.
Personally, I would have not called out because I would have felt AWFUL for the patients and the LPN. I would also start my shift with a protest of assignment and continue my shift with the understanding that patients will only get ESSENTIAL things done (and no charting, a few notes). I'd' figure I have been left with no choice and I will do the best that I can for these patients because they don't deserve to be in this position. ......Then I'm sure I'd totally not prioritize and run myself ragged.
It sounds about right that calling out may possibly create the situation which would finally wake up the admins but... I would never have come to that conclusion on my own nor would I have the balls to bring it to that point.
Please keep us updated on the outcome.
One LPN and one RN for 15 critically ill patients, some on vents? That's a recipe for death and disaster and license losing. And believe me, TPTB will find staffing. They filled the beds, they can fill the staffing roster. And my patoot they tried agency. The only possibility, if they did, is that no traveller will accept assignment there because the place is a disaster. And there is no nursing shortage. There's a shortage of facilities willing to hire enough of us.
And it isn't her responsibility to protect anyone before she's accepted the assignment. And I totally would not accept that one.
this situation is weighing quite heavily on me so i'd like to get some advice. all responses, no matter how brutally honest, are much appreciated. sorry for the long post. here goes....
my evening consisted of 5 patients of my own (2 vents & 1 on 3 critical gtts). i was also responsible for covering the lpn's 3 patients that all required frequent ivp narcotics, iv antibiotics, am labs, and 1 of hers was on a vent. so i'm responsible for 8 patients.
charge nurse had 7 patients. several vents/critical gtts. lpn had 7, 3 of which i was essentially responsible for. 1 aide that spent the entire shift in the restroom, breakroom, anywhere but the floor.
administration was called several times. no one returned our calls.
we barely make it through the night. i check the schedule for the next night & realize that myself, the same charge nurse, and a lpn are on the schedule. no attempts have been made to contact agency even though scheduling has known for 4 weeks we were short on this night. while leaving the charge nurse informs me that she will not be coming in the next night due to the awful night we had just had. so that leaves myself and the lpn tomorrow that would be responsible for the 19 patients.
i call the next day to see what staffing is like. i'm told it's me & the lpn. the charge nurse called off. they left messages for agencies but none have called back. they also left several messages for administration, but they haven't called back either. so i call back 2 hours before shift starts & it's the same situation. so knowing the ridiculously unsafe night ahead of me, i too called off. i've been a nurse for 18 months & the previous night was my worst night. i never let things get to me, but i allowed myself to lose control and cry. i just felt so overwhelmed...i felt i couldn't give my patients the care that they deserve. i couldn't knowingly walk in to the same situation again the next night, especially being a new grad and not having a resource.
am i wrong for calling off? am i not a team player? i feel sick stressing about this? please advise.
thanks in advance
wow crazy management! what were they thinking? if i were you, i would have called off myself but do it right after the last shift and not wait until the next day. they would know why you called out. i hope this incident works out for the better-for you and your floor!
Where the H E double hockey sticks do you work. Is this an ICU, step down, or low acuity ICU? Good lord. I woulda quit!!!!! Admin should be coming in to help this. This is not SAFE what so ever. Id be going elsewhere and fast. Thats impossible to manage!
But that being said, personally I probably would have given them an ultimatum. I would have told them right after that shift was done, knowing that they would be even more short staffed when your charge said she wasn't coming in, that I would quit if something wasn't figured out. Theres no way in hell thats manageable. Does your state have that safe harbour act? I still probably would have gone in for the one more shift, but that would be it.
Altra, BSN, RN
6,255 Posts
You made the right decision for you. Whatever the consequences, and you know that there may be consequences, you have the secure knowledge that you did not harm or provide substandard care to a patient because of the working conditions.
I hope that this forces your institution's hand regarding staffing.