Anyone ever feel like there license is in jeopardy?

heart queen · Oct 12, 2004

First time, in a "new" facility last night. Unionized to boot! Told the charge RN, when she told me I'd get an admit upper and lower GI bleed. I'm in a unit and this was #3. This was an ACTIVE, throw up buckets of blood, with another active lower GI bleed getting 4 units of blood and a one day ruptured appendectomy who had just gone into new onset rapid afib. I said "no way", as ER was running through the doors with my patient, whom the charge had taken report on, and accepted.

Mind you, team work made this a semi-do able. but my gi bleed sat in crap for three hours, minus a CBC at midnight, late ABX, while my afib with the low urine output and compromised resp. status patient needing Q1 hr. IS and bp monitoring was ignored for too long while I had two IV's wide open and 6 units PRBC's and scoping my admit.

I'm filing a grievence with the union, told the manager this am.. this was beyond unsafe and basic, basic care was not met and I was filling an incident report, listing all the late meds, dressing changes not done as well as basic ICU monitoring that had not occurred (four hours without vital signs diespite two nurses drowning in their own mess and helping me).

Now, it's too soon to tell if they will use this information and "discipline" me, or if the union will stand behind me. My grievance being I refused the admit due to patient safety and the charge never called the manager for guidance. However upper administration, higher than the manager insisted upon the admit, as well as two additional patients into the unit who we were unequiped to handle.

Must be a full moon soon.

so long story short, I can tell you about the past, but Dorthy isn't in OZ anymore. I did fill out an incident report on every bit of lacking nursing care and sent it to everyone, first being risk managemet. Second.. I WILL file a "grievence", which I think will amount to nothing.... but in a court of law, these documents can and will be called upon if a patient files charges or suffers from the neglect that DID occur.

These two processes are the only way to try to prevent future situations and cover myself for the current one.

If I had been given the time (no patient rolling through the door as I was told of the admit) I would have refused the patient, refused report and been willing to face disciniplinary actions. The state board requires and demands it of us.

The charge nurses response to my question of how in the hell can you justify this was... "I have a mortage and a new car payment"..... unacceptable to me.

did what I had to do, but will prevent the blind siding again and con't the fight.

good luck with yours. Will let you know..... when nothing comes of this!

Apologize if I hijacked your excellent thread to vent... yet I appreciate the ears too.

RN123456789 · Oct 12, 2004

First time, in a "new" facility last night. Unionized to boot! Told the charge RN, when she told me I'd get an admit upper and lower GI bleed. I'm in a unit and this was #3. This was an ACTIVE, throw up buckets of blood, with another active lower GI bleed getting 4 units of blood and a one day ruptured appendectomy who had just gone into new onset rapid afib. I said "no way", as ER was running through the doors with my patient, whom the charge had taken report on, and accepted.
Mind you, team work made this a semi-do able. but my gi bleed sat in crap for three hours, minus a CBC at midnight, late ABX, while my afib with the low urine output and compromised resp. status patient needing Q1 hr. IS and bp monitoring was ignored for too long while I had two IV's wide open and 6 units PRBC's and scoping my admit.
I'm filing a grievence with the union, told the manager this am.. this was beyond unsafe and basic, basic care was not met and I was filling an incident report, listing all the late meds, dressing changes not done as well as basic ICU monitoring that had not occurred (four hours without vital signs diespite two nurses drowning in their own mess and helping me).
Now, it's too soon to tell if they will use this information and "discipline" me, or if the union will stand behind me. My grievance being I refused the admit due to patient safety and the charge never called the manager for guidance. However upper administration, higher than the manager insisted upon the admit, as well as two additional patients into the unit who we were unequiped to handle.
Must be a full moon soon.
so long story short, I can tell you about the past, but Dorthy isn't in OZ anymore. I did fill out an incident report on every bit of lacking nursing care and sent it to everyone, first being risk managemet. Second.. I WILL file a "grievence", which I think will amount to nothing.... but in a court of law, these documents can and will be called upon if a patient files charges or suffers from the neglect that DID occur.
These two processes are the only way to try to prevent future situations and cover myself for the current one.
If I had been given the time (no patient rolling through the door as I was told of the admit) I would have refused the patient, refused report and been willing to face disciniplinary actions. The state board requires and demands it of us.
The charge nurses response to my question of how in the hell can you justify this was... "I have a mortage and a new car payment"..... unacceptable to me.
did what I had to do, but will prevent the blind siding again and con't the fight.
good luck with yours. Will let you know..... when nothing comes of this!
Apologize if I hijacked your excellent thread to vent... yet I appreciate the ears too.

OH HOW AWFUL FOR YOU! IT IS OKAY, WE ALL NEED TO VENT SOMETIMES. I HOPE IT ALL WORKS OUT FOR YOU :)

cannoli · Oct 12, 2004

First time, in a "new" facility last night. Unionized to boot! Told the charge RN, when she told me I'd get an admit upper and lower GI bleed. I'm in a unit and this was #3. This was an ACTIVE, throw up buckets of blood, with another active lower GI bleed getting 4 units of blood and a one day ruptured appendectomy who had just gone into new onset rapid afib. I said "no way", as ER was running through the doors with my patient, whom the charge had taken report on, and accepted.
Mind you, team work made this a semi-do able. but my gi bleed sat in crap for three hours, minus a CBC at midnight, late ABX, while my afib with the low urine output and compromised resp. status patient needing Q1 hr. IS and bp monitoring was ignored for too long while I had two IV's wide open and 6 units PRBC's and scoping my admit.
I'm filing a grievence with the union, told the manager this am.. this was beyond unsafe and basic, basic care was not met and I was filling an incident report, listing all the late meds, dressing changes not done as well as basic ICU monitoring that had not occurred (four hours without vital signs diespite two nurses drowning in their own mess and helping me).
Now, it's too soon to tell if they will use this information and "discipline" me, or if the union will stand behind me. My grievance being I refused the admit due to patient safety and the charge never called the manager for guidance. However upper administration, higher than the manager insisted upon the admit, as well as two additional patients into the unit who we were unequiped to handle.
Must be a full moon soon.
so long story short, I can tell you about the past, but Dorthy isn't in OZ anymore. I did fill out an incident report on every bit of lacking nursing care and sent it to everyone, first being risk managemet. Second.. I WILL file a "grievence", which I think will amount to nothing.... but in a court of law, these documents can and will be called upon if a patient files charges or suffers from the neglect that DID occur.
These two processes are the only way to try to prevent future situations and cover myself for the current one.
If I had been given the time (no patient rolling through the door as I was told of the admit) I would have refused the patient, refused report and been willing to face disciniplinary actions. The state board requires and demands it of us.
The charge nurses response to my question of how in the hell can you justify this was... "I have a mortage and a new car payment"..... unacceptable to me.
did what I had to do, but will prevent the blind siding again and con't the fight.
good luck with yours. Will let you know..... when nothing comes of this!
Apologize if I hijacked your excellent thread to vent... yet I appreciate the ears too.

Sorry you had such a night from hell. I think I would have gone over the charge nurse's head and called the supervisor, I've done it before.

Please let us know what happens, maybe we can learn something from your experience.

Good luck!

Sadie04 · Oct 12, 2004

I just left a unit a month ago due to 8 or 9:1 ratio on day shift. Yes, I felt like my license was in jeopardy at times.

Tweety, BSN, RN · Oct 12, 2004

I feel like that sometimes. I also worry more about being sued or fired than actually loosing my license. I take a little (mind you a little) comfort in that in the 13 years I've been in this hospital, no one has lost their license due to high ratios. There's been a few who have over drug diversion, and one who committed a felony unrelated to nursing.

Long Term Care Columnist / Guide · Oct 13, 2004

I felt in constant danger when I was a nurse consultant/acting administrator for several assisted-living facilities, and Corporate didn't want me in any of my three buildings more than 15 hours a week! I was responsible for over 160 residents, all told. That was 15 hours in which resident assessments must be done for service plan meetings, staff trained and delegated for such tasks as trach care and insulin administration, charting checked, new orders gone through and noted, meetings attended, and reports written. Not to mention: going to hospitals, nursing facilities, and private homes to perform pre-admission screening and functional assessments.......supervising staff.......dealing with salespeople........getting ready for survey.......well, you get the idea. :uhoh3:

anndoodle · Oct 13, 2004

i went through this just recently!!!

worked 11-7 at ltc, where they kept putting me in the position of being the only lpn in the building on the night shift for periods of time....with a census of 88 residents. (one lpn - me, and perhaps 4 or 5 cna's) i discussed this with my don, she said that state allowed them to only have 1 lpn for up to 100 residents on 11-7 shift. i said i was totally uncomfortable being put in this position and would resign if it happened again. guess what. yep. :angryfire then i rethought my resignation because if i could have held out until november 12, i would be there for 3 years and get my 2 weeks vacation due. so i agreed to work 11-7 until then - provided - they did not put me in that position again.

so....guess what. they did it to me, yet again. :angryfire i wrote the don another note, along with filing a complaint to the administrator, about being put in this position again - even after talking with the admin! i told them to consider my prior resignation "continued in force". (i had one day left in the 2 weeks notice period, and was scheduled off!!) that was it, i walked out that morning and never looked back. i told them i had contacted someone from the office of long term care and that they told me it was 1 lpn for 80 residents - 81 and they had to require 2 lpns. the admin still looked me in the face and said, "well, they're wrong..." (this is his first job as an administrator) sorry, folks, but from where i see it, the oltc is not wrong, and i will abide by their rules and regulations...and continue to value my license and not put it in jeopardy by continuing to work for someone who apparently doesn't care if i work there or not.:angryfire

by the way, 2 days later i applied/interviewed for a geri/psych job at a local hospital and got it!!!! yay!!! now i get the same pay i was getting at the ltc on nights for daytime shift (7a-7p) plus insurance, 401k, vision, dental, and the list goes on. did i mention the $2500 sign on bonus for agreeing to work for just a year??? i am seeking long term employment here, i'm a hometown gal not planning on going anywhere! and with 2 kids in college i'm dedicated to receiving the pay! thanks for all the support i've gotten here at this board - i've mentioned my situation here before, and the response was great!!!

:balloons: :balloons: woo-hoo!!! who's a happy camper?!?!?! and i even have a week before i start work to relax and get used to being "awake" during the day and "asleep" at night!!

RN123456789 · Oct 13, 2004

WOW!!!!!!! GOOD FOR YOU!!!!!!!! Hat's off to you for standing up to the MAN!!!!!!!!!!! :balloons: :balloons:

anndoodle · Oct 13, 2004

It's mostly all the support and good thoughts I received from this website that help me make my decision. It really helps when you've got other nurses to "back you up" in your decisions... means more than some people know. Many of them told me to "RUN!" and that's close.....but I left in a slow walk with the administrator watching as I went out the door, knowing he just lost another GOOD nurse. Now, I do feel bad for some of the nurses who I had been "acquaintances" with there, some of them are having to work more hours and one in particular was pulled from her long-awaited day shift job and told she "HAD" to go back to the night shift, because I quit. She's not a happy camper right now, I'm sure. But to this date, I STILL have not seen a "help wanted" ad in our local paper for this facility. I think they prefer to have less nurses/less people to pay rather than employ new nurses and new salaries. Once again, it all goes back to the almighty dollar bill.

WOW!!!!!!! GOOD FOR YOU!!!!!!!! Hat's off to you for standing up to the MAN!!!!!!!!!!! :balloons: :balloons:

ERNurse752, RN · Oct 13, 2004

I don't know what her situation is, but maybe she should take a page from your book as well, and walk out!

It's mostly all the support and good thoughts I received from this website that help me make my decision. It really helps when you've got other nurses to "back you up" in your decisions... means more than some people know. Many of them told me to "RUN!" and that's close.....but I left in a slow walk with the administrator watching as I went out the door, knowing he just lost another GOOD nurse. Now, I do feel bad for some of the nurses who I had been "acquaintances" with there, some of them are having to work more hours and one in particular was pulled from her long-awaited day shift job and told she "HAD" to go back to the night shift, because I quit. She's not a happy camper right now, I'm sure. But to this date, I STILL have not seen a "help wanted" ad in our local paper for this facility. I think they prefer to have less nurses/less people to pay rather than employ new nurses and new salaries. Once again, it all goes back to the almighty dollar bill.

heart queen · Oct 25, 2004

thank you all, the manager pleaded innocent and swore she would have backed me up "If only I was notified". The supervisor stated she was under direct orders from the VP of nursing and the charge, although stated we would be over census, never refused or alerted her that patient care WAS being compromised. The charge stated that her only defense was that YEARS of refusing and calling the manager only amounted to a patient rolling in the door regardless.

The union held a meeting, in which I was the bad guy for not updating the charge RN in advance and accepting a patient (which I never did, the charge did and took my report without even checking to see if I could manage it, plus I had sudden changes in my patients condition.. which I was actively treating).

So here it is, as expected wasted union dues and all, It's so easy to lay blame on the bedside nurse as any reprocussions that could come from me are simply my resignation.

I have started now telling each charge that I will not accept any patient without notice and will not accept them unless I take report myself and validate if it is a safe assignment. I have done this the last four nights and will continue it... as it seems to be my only solution.

I've had no reprocussions from the staff, who rotate charge as I say that nightly. But several have mentioned that "It won't make a difference anyway". Yep, I respond, next time anyone tries to blind side me with an admit, without accepting my own report I won't EVER appear in the room and you (the charge) will take care of the patient.

So thank you all for the support. Why can't we see that we can work together to fix this?

Sincere thanks for the ears

KacyLynnRN · Oct 25, 2004

YES I DO and have felt my license was in jeopardy, many times!! I just try to chart, chart, chart as much as I can and if something very odd or something I consider 'high risk' happens, such as a MD's bad call or a pt. calling a lawyer (both of which I've seen) I will go home and jot down a page or so about it in my journal, just in case I'm ever called into court and need to remember details. Also...I would never be without malpractice insurance. If I'm ever in court, at least I know I'll have a lawyer and won't be going broke to pay them.

Kacy