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An off-shoot of Kalipso's "poor standards of care" thread


Hi all! I am a student who peruses the boards, and I came across Kalipso's thread about her new job. Oh my! :eek:

So, my question is this: who changes that toxic and unsafe environment? While it seems, at least in her particular situation, that pretty much the entire system is less-than-stellar (nicest way I could put it!), change has to start with SOMEONE. So how DO you go about making a better and safer environment for patients without everyone making your work life a living hot spot?? And CYA in the process?

I just found that thread particularly interesting. So say, hypothetically, this is the only place of employment and you NEED that job. What would you do in that situation? Just keep up YOUR standards of care and keep your head out of target range? Or do you work to get change rolling?

I am just curious :D And as an aside, I love reading everyone's stories on here :)

emtb2rn, BSN, RN, EMT-B

Specializes in Emergency. Has 21 years experience.

The only way a toxic environment will change is management driven. The toxic staff needs to be purged. Sometimes this also means replacing the immediate management.

If it's the only job available, well, sometimes you just gotta do whatcha gotta do. That's a personal decision.


Specializes in retired from healthcare. Has 25 years experience.

The only way a toxic environment will change is management driven. The toxic staff needs to be purged. Sometimes this also means replacing the immediate management.

Sometimes, it's a matter of making them see that there actually is a toxic environment.

Well, in my situation I wrote a lengthy letter to the director, manager, and educator of the department. I described all the things that I felt both staff and policy were lacking. After writing out all the issues I described some of the methods that were use that ran my last department so smoothly. One was called a GEMBA board, which is an annoying thing to have to fill out on a daily basis if you are a nurse, but my previous manager had been religious about making us do it and it really helped. Along with mandatory staff meetings to discuss changes and get the staff's opinion on what changes are working and what isn't. The response I got from my manger was "I don't really understand why you are having all these problems suddenly now, do you think you need more training?" I asked her if any of the examples I gave her made her feel like I had a lack of understanding of patient care guidelines? She didn't have a response. She then stated "I don't really like GEMBA boards, do you?" I told her that I didn't 'like' doing them but that they were effective and effectiveness is what matters. Then she says "Well we use to have staff meetings but no one ever came to them so I quit doing them. I now send out emails, but everyone says they don't have time to check their email." I said that at my last job 10 out of 12 monthly staff meetings were required to be attended in a year. If the nurse did not comply it was a write up. But each of these statements by my new manager made me realize that nothing is going to change because she doesn't want to do the work. So now I'm looking for another job. But if I really needed this job, like it was the only job in driving distance, then I probably wouldn't have said anything to start with and because I did say something and the other staff know it I do have a target on my back. This is a dangerous situation for any nurse at any facility because now it is a race for me to find other employment before they find something to start writing me up for so they can fire me. Getting fired would make it more difficult to find another job. I'm also trying to find other employment without my new job knowing....could be an issue in an area with 2 hospitals because people talk. So to answer your question, things don't normally change because people need to make a living more than they need to make waves.

icuRNmaggie, BSN, RN

Specializes in MICU, SICU, CICU. Has 24 years experience.

Just dont use anyone at this jo for a reference. Leave quietly. Do not discuss your opinions with anyone at this position. When interviewing just say something like I am looking for more experience with trauma.