I think I just felt the straw that broke the camel's back. This is going to take some time to unpack.
TLDR version is: I'm frustrated with my hospital's continued disregard for nurse and patient safety and want to leave this hospital system for the local competitor, but I want to tie up some loose ends and I'm worried that the next job won't be any better.
When Covid started, the Other hospital system in town started testing all admits for any reason for Covid. My hospital did not. On my floor, patients often discharge to a rehab facility, and all require a Covid test to be done before transfer. Many, many times we have had patients Surprise! test positive for Covid when we are doing this test right before setting up transport.
Edit: I wanted to add that I don't mind caring for Covid patients. We've seen less than the other floors but we have had many. I am happy to do my part in caring for these patients. However, we must know their Covid+ status to protect ourselves and our other patients.
So this month, as we are now 2 years into the pandemic, we all got an email from corporate headquarters that all patients admitted to the hospital will be tested "so they can be treated appropriately". No mention of avoiding cross-contamination or protecting direct patient care staff, but I'll take it.
We saw this policy go into effect last week, but it was ugly. All patients admitted from the ED were tested, but not patients admitted under observation status, even though these patients are roomed on the same floors as general admission patients. Patients were also being tested only on admission to the hospital, which meant that this test was the last thing that was done in PACU as surgical patients were to be admitted. We had 4 surgical patients to our floor that afternoon after this policy went into effect and 3 were surprise positives.
So instead of moving the Covid test to before surgery (wouldn't the surgical team want to know a patient was positive?) the hospital panicked because PACU can't isolate patients. They required that PACU testing be stopped immediately. It doesn't exist if we don't see it, I suppose.
I found out about this a few days ago when I admitted a surgical patient from PACU and a warning came up on my computer that this patient had not been tested. I ordered a test per protocol and let my charge nurse know that a patient had come up without being tested. I was then told to cancel the order and there's no protocol (despite the email from corporate headquarters?!), so it was an inappropriate order. My manager then let me know the changes to PACU not testing. So we are not even testing these patients after they arrive to the floor. Again, it doesn't exist if we don't know about it.
I have posted many times about being dissatisfied with this job. I'm still a fairly new nurse, so I've stuck it out, the devil you know and all that. I am so close to being fully vested in my 401K, which will be this August. I'm also close to finishing my BSN, which I am getting partial tuition reimbursement. I wanted to finish those before moving on. On some level, I feel like the hospital owes me after the BS I've dealt with here, so I want to get all I can get from them.
I'm also a little scared of looking for another job. I hate, hate, hate the job search and would rather just be settled. I don't expect the Other hospital system to be perfect or even better, but I know that they are better in at least the specific areas that I am frustrated with in my current hospital. I've had a horrible manager and a better manager, so I know that my next one could be either.
I think I'm also a little psyched out from the last time I thought about jumping ship. I did land an interview in my preferred area of nursing at the Other hospital, but I did the interview while sick with Covid at home isolating and did the interview online. I didn't get the job but I did get the "we still liked you so feel free to apply again sometime" letter. That was over a year ago, so my nursing skills have improved and I now have a bit of charge experience, but I don't think my confidence has improved.
I have also thought of just quitting now. If I did that, then I would finish the BSN then start applying to the other hospital. My family finances can take it, though it would delay some of our goals this year. This option "feels" better, but it leaves me even more anxious about actually landing a job I want.
I'm also afraid that the next place will be worse in some other way. I know nowhere is perfect, but what if I have a good thing and don't realize it. Well except for the blatant avoidance of Covid testing. I think this worry comes from when I was floated to a more medically oriented floor and I felt way out of my depth. I have an interest in oncology, but I know that the learning curve there will be steep after working with mostly surgical patients. This may be exhaustion and anxiety of the unknown talking.
In the past it seemed like you should keep your job until you get another one. The shortage of qualified nurses is clear where I am in California. I think you can do either.... wait or go.
Also don't be afraid to not take the first job you are offered. I recently accepted a new job, and for the first time in my life told them the offer was too low. I was diplomatic. I was honest. I asked for what I needed to make the job even be a starter for me.
The pandemic has changed everything for nurses, hiring, recruitment, and retention. Somehow I was raised in the Midwest to believe if I had to leave a job it was my fault. Now I know that there are many different jobs and situations out there. I don't think they will be able to screen candidates the same way they did 3-5 years ago. Some had to leave for family, illness, and stress.
I think your awareness shows you know what you need. If you don't ask for it, you definitely might not get it.
I read an article on Raw Story, yes, it's a legit news outlet, that a judge in Wisconsin, a right to work state, issued an injunction that nurses can't quit their job without notice to go somewhere else. This is an act of desperation from hospitals. For those of you who don't know right to work is a euphemism for at will. This means an employer can fire you without notice or reason. By the same token as an employee you don't have to give 2 weeks... until now. RTW was nothing but a union busting tactic which in many states virtually eliminated them. What does this really mean? It means that for nurses At Will is now a one way street. But by all means, keep voting for Republicans.
I'm at the end of my career, thank God, but if I wasn't a hospital would be the last place I'd work, especially now. BUT, as an aging Boomer, what does that mean for me if I need to be hospitalized? It's frightening to even think about.
Remember, you are being replaced with foreign nurses, most from the Philippines and India. Their nurses are better trained than ours so we need to just get over it.
I too, am just done.
I have worked with numerous nurses from the Philippines and every one was a very good nurse. However, I would bet that somewhere you might find a not so great nurse from the PI.
And by no means are they all "better trained than ours". Why would you state such a sweeping generalization?
If by "better trained" you mean they have certain basic skills mastered before they come to America, that might be true, since we no longer have diploma schools, where students received significant clinical time to master hands-on skills.
In our quest to make sure nurses are recognized as professionals, we have increased book learning but shortened clinical time, it seems to me.
Unless it's dealing with cutting edge issues like water bottles at the nurse's station, the Joint Commission doesn't get involved. Immediate health and safety issues would normally be reported to a state agency such as the DPH or whichever one has responsibility for licensure and enforcement in your state.
They will it can be a patient or family complaint or even an anonymous complaint and they will come I've seen it over the years and I know they did when I reported a situation as well and they were going to be following up to see if improvements were made. I'm retired, so I don't know what actually happened, but at least I tried.
amoLucia
7,736 Posts
I think the 'see no evil' monkey is practicing 'head burrowing in the sand' like the ostrich!