Mandated!

Nurses General Nursing

Published

I started a new job as an ICU RN in January, and I'm still on my 6 month probation. I work for a large University State hospital and mostly it's a good place to work, but now I'm starting to think otherwise. Last week I worked 6 12hr night shifts in a row by choice as I pushed all my shifts together so I could arrange a few days off to go home to England and see my family. On the morning of the last shift, 2 hours before I finished, they told me I was mandated to return at 3pm, although I only finished work at 7.30am. I told them that I was due to leave for the airport and had a flight, hotel and car rental booked and spent $2000 on my trip, and everybody knew I was going on vacation. They told me that they didn't care and that I had to return to work from 3-7pm or I would be in trouble. I refused as I thought this was unfair. I know we may get mandated on occasion but I thought there should be some leeway if you have mitigating or unavoidable circumstances. Anyway, I went on my trip as I hadn't seen my parents in 6 months and I wasn't going to miss it.

When I returned nobody said anything to me, but on the the very first shift I got mandated again, this time to work from 7am to 11am after a night shift, so I effectively worked from 7pm until 11am...a 16 hour shift! I had no breaks at all in 16 hours, and I kept on getting more and more patients. During that shift I had about 5 ICU patients, and even though I managed to transfer all but one of them they still didn't let me go home. The last patient was not intubated and was waiting for a transfer, and for some reason they'd drafted in a floor nurse and a 1:1 that the patient absolutely did not need, and yet they still demanded that I stay and take responsibility for this patient, even though the floor nurse was more than capable of caring for her. It didn't seem to make sense to me. I can not understand why a low level non-ICU patient needed an ICU nurse, a floor nurse and a 1:1 all to herself when we were so short staffed. Madness! At 10.10am they even had the cheek to give me another patient, after working nearly 16 hours with no break. The worst thing was, I was required to return that night at 7pm for another shift, and by the time I got home that day, I'd only had 3 hours sleep. I felt terrible and now I've very annoyed at the whole situation. It seems very unfair.

It appears that they use mandation as an answer to every day staffing problems instead of solving the problem in other ways. They never cancel scheduled open heart patients if they don't have the staff...they just mandate people to come in instead. In England this would never happen. In my old unit in London if we didn't have the staff we would not accept the patient, and if there was no bed then scheduled (non-emergent) surgery would be cancelled. Also, this unit appears to accept any old thing into ICU. In England patients had to fulfill criteria in order to be accepted into ICU. Here we take anything. The other night I had a post surgical hip arthroplasty. When asked why he was coming to ICU I was told because "he was bilateral"! I mean what's up with that? He wasn't even intubated or even very sick. He went out the next morning. I work with a travel nurse who wants to become part of the staff, and yet they tell her there are no vacancies, despite us getting mandated all the time. I don't think I can live like this as I play in a band that travel all over the US, and if I have a plane ticket to a show I won't be able to stay at short notice. I believe a day off is a day off unless it's an emergency. I need to be able to have a life and plan things and not live by the phone waiting for the call from work. I am seriously considering leaving and becoming an agency nurse.

Specializes in Critical Care and ED.

They did tell me that I might be mandated when I applied for the job, but being from England I didn't really know what that meant. I've never heard of of it before, and I thought it would only be initiated if it was an emergency. I had no idea they routinely used mandation as a way of solving their staffing problems. It never occured to me that they would make you do that after a 12 hour shift. I thought they would only expect you to come in on a day off. How naive I was! In the 4 months I've been here I've never seen an agency nurse here...everybody is mandated instead. In fact one of the day staff, who starts at 7am, has been mandated to come in at 3am this morning...and then go on to do her 12 hour shift ntil 7pm tonight. :angryfire Interestingly enough, despite this being a state hospital and there being a protocol for absolutely everything, there is apparently no protocol for mandation. How convenient! :rolleyes:

Nursing employers today are just rediculous.

I will never be a regular, full-time employee again.

Nursing employers today are just rediculous.

I will never be a regular, full-time employee again.

Fortunately my employer is not ridiculous but I'm with you on the never work full time again. I started working part-time when I had my son and I will not ever work a full time job again.

steph

Specializes in RN, BSN, CHDN.
Welcome to America, madwife. It's hard for a UK nurse to comprehend as this sort of thing would never happen in England. We don't have unions here. I really miss the NHS now! The nursing over here is completely different, and changes from hospital to hospital and state to state. It's not a national standard like back home. I yearn for my old unit in London where we only ever had one patient at a time. This is really, really hard, and the worst is you have to be absolutely perfect or you get in trouble for the silliest thing, like forgetting to write in a daily weight. No matter you haven't had any sleep in 48 hours....god help you if you forget that daily weight! In England if you had a really busy shift you could pass on stuff to the next nurse...not here. You stay until it's done, even if you've had 5 patients and worked a 16 hour shift. I sound bitter coz I feel bitter. :madface:

I read threads like yours and it makes me really frightened to come work in US, I cant beleive how you have been forced to work such horrendous hours. Can you refuse or have you no choice. Did you go it alone to the US or did you go via an agency?

I read threads like yours and it makes me really frightened to come work in US, I cant beleive how you have been forced to work such horrendous hours. Can you refuse or have you no choice. Did you go it alone to the US or did you go via an agency?

You know what . . . I think that while this does happen it is not happening very much. Most nursing jobs that I know about here in Northern California do not mandate.

So don't be afraid. Just do some homework before you sign up.

Best wishes -

steph

Specializes in RN, BSN, CHDN.
You know what . . . I think that while this does happen it is not happening very much. Most nursing jobs that I know about here in Northern California do not mandate.

So don't be afraid. Just do some homework before you sign up.

Best wishes -

steph

T :flowersfo hanks Steph

Specializes in Critical Care and ED.
I read threads like yours and it makes me really frightened to come work in US, I cant beleive how you have been forced to work such horrendous hours. Can you refuse or have you no choice. Did you go it alone to the US or did you go via an agency?

Originally I came over with an agency, who I ended up laving early and broke the contract because I was so disatisfied with the situation they put me in (no docs, no support, poor pay, no differential etc). I thought (obviously foolishly) that getting a job in a state run University hospital would be different. It may be better quality care, but with that comes much more stress and demands. I can't refuse to do mandatory overtime or I could lose my job, but at this point I think I'm going to leave anyway. Tonights shift has been horrendous. I was given two post op intubated patients...one of which had neuro surgery, the other had major abdo surgery. I hardly knew which way to turn or where to start first. It's just not safe.

Specializes in ER.

I will not be mandated, that's just the way I do things. If they call me at home I'm not available, and if they mandate me I've been drinking and can't comply. If no one relieves me and they knew about the hole I'll stay, but will expect to be able to come in late the next day- or will call in sick. I've done the research and the board will not discipline you so long as you don't leave a patient without giving report.

I pick up 12-20 hours weekly in addition to full time hours. They can fire me if they want to but I'll be leaving quite a hole.

Specializes in Psych, Med/Surg, Home Health, Oncology.

Rocknurse

I'm so sorry for your shabby treatment!! This is terrible. It puts your license in jeopardy. I think I would leave & find something else.

The place I work is pretty awful at times---but nothing like this. Plus--we are not required to do overtime unless we want it.

Now you see why nurses are leaving in droves!!

Mary Ann

You need to get out of there. You are risking the license you worked so hard to obtain and your patients are not receiving optimal care. Say no to overtime. I don't belive in over time, its not worth it.

Specializes in Critical Care and ED.

Thanks for all your replies. I really am now seriously considering leaving and joining an agency. It's not just the mandation issue, but the last few shifts have been so horrendous that I don't think I can cope anymore. It's not like I'm a new nurse or lack ICU experience. I'm a seasoned veteran, but never in my life have I been this overworked. They constantly switch assignments, sometimes 2 or 3 times during a shift, there is no consistency of care, and on occasion I've had as many as 5 ICU patients during one shift. Annoyingly, often these are not even true ICU patients and all you do is move beds all night, while the true intubated ICU patients get neglected because of all the bureaucratic BS.

Last night my friend had 3 intubated (very sick) patients, and I had 2 freshly post-op patients...one neuro (sub-dural evacuation) on pressors and 4-point restraints and one major abdo surgery who had a J-tube, G-tube, chest tubes, OG tube and JP drain, intubated and on pressors. Both of them started dropping their BP at the same time. What fun! One of my patients definitely suffered as I was not physically able to be there for him. The paperwork for new admits is unbelievable...most of it duplicated nonsense, and of course you are always expected to be perfect. I got the eye-rolling thing this morning because I put the wrong Fi02 down on an ABG form...so sue me! I had too much other stuff to worry about it! I haven't had a break on any shift since I started in January and yet amazingly they never pay me for that magic half an hour every day that is supposed to be an unpaid break! Watching the poor day staff come in at 3am this morning for mandation was heart breaking. I've had enough.

Specializes in NICU.

Same as Steph, I've never heard of mandating overtime. They do call us, we can and do refuse. We are well paid for extra shifts, base pay plus $20 per hour plus diffs. That's for anything over four hours. Usually, in my dept, people are good at helping out although sometimes staffing is horrible. Part-timers can work extra, anything over two shifts a week.

Of course when things go bad during a shift, we have to live with it.

+ Add a Comment