Character Letter safe to write in this situation?

[SE_BSN_RN, BSN]

We have an issue at work where 2 nurses were terminated yesterday due to not wrapping a residen'ts legs. The hosp. reported to the state the wraps were not changed in a month. The guy got septic due to cellulitis. Before he went to the hospital, I asked him if they were changing his dressings and he said no. I asked him if he wanted me to change them, and he said no. The treatment orders for this pt were frequently changed, and the nurse who forgot to transcribe the order to the MAR said s/he didn't have time. The halls that are in question are very, very heavy. 30 residents to 1 nurse, a bear of a med pass and 2 residents with decub ulcers that require dressing changes BID, and they take at least a half an hour if not more to change EACH! I have told work over and over that no one can do all of that in 8 hours. I have asked if we can switch that cart to 12 hours and have been told no. I have asked for a treatment nurse and have been told no because our census is at 89 and it needs to be at 94/95. The regional nurse manager of our building was there yesterday and wanted suggestions, and shot down everything I had asked for....so what gives? Can I make an anonymous call to OSHA? We are told that if we don't get it all done, and treatments aren't done, we could possibly lose our license for neglect, but we can't tell anyone we don't have time or are working short staffed as we frequently do. She said because of federal guidelines, nursing homes are all this way. We have a unit manager who is new but she goes to meetings all day so she's not there to help out, but we are told "They are here to help if you ask for help." Yesterday I had 6-7 charts stacked on my desk that the unit manager was writing orders in. She wrote her last order, left the chart OPEN on the desk, and then said "Well since I was here late last night I think I'll go ahead and take off." ...I said nothing, just kept my mouth shut. No matter what shift you work on that cart, you don't have time to take a lunch or your state mandated 15 minuted breaks. I take 15 min breaks every 3 hours or so to pump because I am breastfeeding but I don't get to take a lunch....ever. The management said they'll take a look at these halls and see if they can change anything but I can almost guarantee they won't.

Now, the nurses that were termed want us to write them letters of character. Can we do this without our jobs being jeapordized? Would you write one in this situation? I am so furious right now that the $4 pay cut to go over to the brand new rehab hospital where I'll have 6 patients just sounds better and better! I worked pool there so I am familiar with the routine.

[caliotter3]

I would scoot out of there and take that pay cut to work in a place where the answer is possibly not always "no". By all means, write the character references if you feel so inclined. Nothing changes your personal or professional opinion of the work performance of these nurses just because they were terminated in a questionable situation. Do not feel intimidated about this. The employer may not even become aware of it and you would want someone to do this for you if you needed it.

[CapeCodMermaid, RN]

Why in the world would you call OSHA? They don't care that you have 30 patients. They care that the facility maintains a safe working environment..that's it.

[noc4senuf]

Instead of calling OSHA... why not put in a call to the state? You don't have to say who you are. As for writing a letter of reference, if you are not management, then it is possible that a prospective employer would only think that the nurses have their froends giving the letter.

[achot chavi]

It is unclear to me if you are writing this letter of character as a friend, a co-worker or as a manager. If as a friend,or co-worker than it is clear, you may write a letter and specify in the letter what your connection is to those nurses. You dont have the authority to write on facility stationary or to represent anyone other than yourself.

I dont know how that letter can help but I would be careful what I write in it as it can hurt you in the future if used inappropriately such as: if the nurses say that you are the unit manager or DONor a representative of the facility. Usually letters of character come from management and not peers for obvious reasons. You might have to defend that letter in the future.

I agree with CCM, there is no reason to call OSHA . I know it sounds terrible but they only care about the bottom line and not how the facility makes that happen.

Regarding unit managers help, if you are supposed to turn to her for help and you have asked her to help you in a reasonable capacity and she refuses, I would respectfully approach her.

If you have not asked for her help because you are intimidated, then you cant blame her. Not every unit manager can empathize with your situation and I dont know her side of it and what she has on her plate.

The bottom line is to protect your patients and the quality of care in your facility. If you use those things as guiding lights than your decisions will be clearer.

If you feel that you can not continue to safely work where you are, then...go fish. I am not saying that I dont empathize with your situation and it sounds like you are burnt out and need a vacation, but if you are so unhappy, you might end up doing something you will regret that can jeopardize your license or career.

[CapeCodMermaid, RN]

If you called the DPH they would most likely so "so what"...the regs in my state are that you have 'sufficient staff' to care for the residents. Most of the time 1 nurse to 30 is sufficient...not ideal, not easy, but sufficient. WE can complain all we want but until the residents and their families complain....again.....it's all a question of economics. Most of our residents are on Medicaid and the reimbursement nowhere near covers the cost of the care. Don't blame the facility...we all have to stay with in our budgets. We're not like the Federal Government which can spend more than they have.

[SE_BSN_RN, BSN]

I would be writing as a friend/co-worker. I am no longer in management. I don't know what all the unit manager has to do, I just know what I did as SDC, and if the UM position is like SDC, it's too much for one person.....or too much for only 40 hour weeks....and I have no problems whatsoever asking for help when I need it....getting it is another issue.

I'm not burned out, I only work 2 days a week, doubles on S/S. I just feel we are understaffed-which we frequently are...and too much is expected out of one nurse in an 8 hour shift...does that not count as a safe work environment? I guess I should develop an I-don't-care attitude and not get so frustrated about it. Since the state probably wouldn't care, I guess I shouldn't either.

Every suggestion I make-AFTER management asks for some ways to improve-are all shot down. Don't ask for a suggestion or a way to make things better if all you are going to say is "No!"

Our facility is in the "federal watch list" whatever that is....we've been loosing residents to other facilities because they don't like the care they get, because we don't have enough staff. We had 2 RN's quit becasue they are afraid of losing their licenses.

I understand we have to stay in our budget, but I also understand the administrator gets a big bonus.....twice a year. Is that also in our budget? Does the money we save from the budget get given to the administrator for a "job well done?" Because it sure isn't given to the staff!

IDK maybe i have unrealistic expectations about my facility because it isn't that bad of a place. I have worked in worse ones, and better ones. I'm not planning on finding a new place to work until I get my RN. My DON is terrified that I'll quit, so, again, IDK. Unrealistic of me, I guess, to think that I can make a difference and want a change of culture and ethics in the workplace. Maybe as an RN a different facility will value my opinion more.

[Dixiecup]

It is unclear to me if you are writing this letter of character as a friend, a co-worker or as a manager. If as a friend,or co-worker than it is clear, you may write a letter and specify in the letter what your connection is to those nurses. You dont have the authority to write on facility stationary or to represent anyone other than yourself.

I dont know how that letter can help but I would be careful what I write in it as it can hurt you in the future if used inappropriately such as: if the nurses say that you are the unit manager or DONor a representative of the facility. Usually letters of character come from management and not peers for obvious reasons. You might have to defend that letter in the future.

I agree with CCM, there is no reason to call OSHA . I know it sounds terrible but they only care about the bottom line and not how the facility makes that happen.

Regarding unit managers help, if you are supposed to turn to her for help and you have asked her to help you in a reasonable capacity and she refuses, I would respectfully approach her.

If you have not asked for her help because you are intimidated, then you cant blame her. Not every unit manager can empathize with your situation and I dont know her side of it and what she has on her plate.

The bottom line is to protect your patients and the quality of care in your facility. If you use those things as guiding lights than your decisions will be clearer.

If you feel that you can not continue to safely work where you are, then...go fish. I am not saying that I dont empathize with your situation and it sounds like you are burnt out and need a vacation, but if you are so unhappy, you might end up doing something you will regret that can jeopardize your license or career.

I disagree here. Character letters ARE usually written by friends or co- workers where letters of REFERENCE are written by management.

And no, all nursing homes are NOT like this. I work in an excellent facility. It may not be the norm but we have enough staff assigned for every department for all the work to be completed without people feeling like they are losing their mind.

[achot chavi]

I disagree here. Character letters ARE usually written by friends or co- workers where letters of REFERENCE are written by management.

And no, all nursing homes are NOT like this. I work in an excellent facility. It may not be the norm but we have enough staff assigned for every department for all the work to be completed without people feeling like they are losing their mind.

That's great,because we always feel so understaffed!! I usually tell nurses that feel that they are working in unsafe numbers to vote with their feet and find a facility that has better staffing if possible. If they choose for other reasons to stay with the poorly staffed facility not to grumble about it but do the best you can and document any requests for help. Grumbling wont help and will only kill morale which will make your job harder not easier. Sometimes staff who work together and efficiently are better than more staff who dont.

Regarding character letters- I would be very cautious as you dont really know your co-workers. One sweet nurses aide got 4 co workers (including one nurse) to co-sign her mortgage. A year later the sheeps clothing came off and she was found stealing from patients, she was fired and you guessed it, stopped paying her mortgage so the bank just took the money from her cosigners!!! The staff were shocked as they thought she was so nice etc....

[CapeCodMermaid, RN]

As someone who does most of the hiring, I can tell you from my perspective a 'character letter' is a waste of time. You wouldn't ask someone to write one unless you knew they would be positive. It won't help you get a job. We have to call references. I used to think that no one would give the name of a reference unless you knew they would be positive, but I've had people I've fired give me as a reference!

[noc4senuf]

I agree with CCM. Many people I have fired or left in poor standing have me listed as a reference. When I get a call, I tell the prospective employer that I am not the one to give a positive report and they should ask the person for another name. I also never look at friends that they have listed as references and only use previous employers (in management).

[caliotter3]

People who list supervisors who have fired them are at a loss for listing a good reference so they list the people they worked for, regardless of the manner in which they left the organization.