Hanging myself out to dry

[diane227, LPN, RN]

I have worked at my current position for about 5 years (charge nurse, 3-11, 34 bed medical- ortho floor). I have been a nurse for 32 years with most of those years in management at the nurse manager or director level. I left upper management by choice and was happy with that decision.

About three years ago I began to ask hospital administration to order wall suction devices for all of our rooms. We did not have enough available in our facility to provide bedside suction for each patient on aspiration precautions. I felt very strongly that this was a major safety issue and I made multiple attempts to get this situation resolved because it was a housewide problem. As this is a small hospital and it was in the red, there was no money to buy any equipment with.

As it came to pass we had a major change in upper management and the hospital made a huge turn around and for the first time in years started making money. They were able to renovate the building and buy new beds and other new, badly needed equipment. But still, no suction devices. Again, I asked over and over what the status was of this suction situation. "They are coming" is what I was told over and over.

The CEO of our hospital is a very nice man and he and we got off to a good start with each other from the day he came to our hospital. He has a very open door policy and he is a hands on kind of guy. So, I sent a very nice email to him with a copy to my manager. I expressed my gratitude for the new beds etc and ended my email with a very short request to know what might be the status of the suction device order and when we could expect to get them. He sent my email to the person that was to have taken care of this asking why it had not been done. The next thing I knew, I was called into the director of nursing's office (she is new and I had never laid eyes on her. I am older than her and have been a nurse longer than she has). My manager was there and they began the documentation process to explain to me that I went around the chain of command and they were embarassed and I was not to do this again. Sign here. I was mortified. I could not believe it. After trying to do someting to maintain PATIENT SAFETY this is the thanks I get. I was so hurt, I could not stop myself...... I started crying. I am 55 years old and there I am with these two people who do not, with their combined years of nursing experience, have the years that I have, telling me that if I do this again, they are going to fire me.

The new director will now allow you to speak about a problem. She cuts you off. When you bring up an idea, she shoots you down. In meetings, no matter what anyone says, they are made to feel stupid. I have never had anyone made me feel this bad in a long time and am so angry about this that I just don't know what do to. What do you guys think?

When I was a manager I had one employee go over my head one time. But I did not write her up. I sat with her and asked her what was going on that she felt she could not come to me any more. What had become of our relationship that she felt she could no longer talk to me.

At this point I am afraid to report or say anything. Any advice or feedback would really be appreciated. Thanks everyone.

[hypocaffeinemia, BSN, RN]

Clearly you're in a toxic work environment and it'd probably be in the best interest for your mental health to cut your losses and seek employment elsewhere.

You could even seek some cathartic bridge-burning on the way out by letting said CEO know exactly why you're leaving.

If you choose to stay, know that there is very little you can do to change the culture as currently enacted by the CNO as long as she is employed there and even less you can do to bring about a swift end to her reign.

Best of luck.

[RelloydRN]

I have to say that you really should have followed the chain of command there. But I think to be written up for that is a little bit too much. She could have just warned you verbally about what you have done.

Let's put yourself in to your DON's shoes. I think it made her feel stupid not to notice that your hospital is in dire need of suction machines. Suction machines are more important than additional beds as these things address the basics of ABC's. If you have a 20 bed unit with only 1 suction machine and lets say 9 of them needs clearing up their airway, then you really have a big problem over there. She should be the one to notice that inadequacy first, which in this case you are the only one who have seen this as a problem.

My advice for you is to follow whatever protocol they have for these suggestions. Even if you have no intentions of making her look bad by going directly to the CEO, her ego would really be hurt not noticing such a very basic need in your unit.

[morte, LPN, LVN]

I have to say that you really should have followed the chain of command there. But I think to be written up for that is a little bit too much. She could have just warned you verbally about what you have done.

Let's put yourself in to your DON's shoes. I think it made her feel stupid not to notice that your hospital is in dire need of suction machines. Suction machines are more important than additional beds as these things address the basics of ABC's. If you have a 20 bed unit with only 1 suction machine and lets say 9 of them needs clearing up their airway, then you really have a big problem over there. She should be the one to notice that inadequacy first, which in this case you are the only one who have seen this as a problem.

My advice for you is to follow whatever protocol they have for these suggestions. Even if you have no intentions of making her look bad by going directly to the CEO, her ego would really be hurt not noticing such a very basic need in your unit.

this was an ongoing issue, nursing management had been previously made aware, i would think.....OP if this is that small a hospital, i would think you could make the CEO aware of your present situation in a discrete, private manner...

[mamamerlee, LPN]

They have no plans to spend the money for this equipment, no matter who you notify. You are now an official thorn in their collective side. Do you have someone in HR that you can speak to? This was not an appropriate thing to write you up for.

Lay low, maybe start looking for another job.

A letter to JCAHO may be in order.

Best wishes!

[JordiesMomRN]

I'm sorry this has happened to you, but in my humble opinion, you did not follow the correct chain of command. I think you have to remember that you are a charge nurse now and no longer in "management". I think your manager had every right to speak to you about it with a warning, but I don't know if you should have been written up. You mentioned that your managers are younger than you and that you had never even met them. Unfortunately, things have changed in the hospital environment, some management just want things to look good and don't care how we feel about it! I was a manager in my hospital for many years before I went to nursing school and became a staff RN. It was a big adjustment for me too, but I clearly understood where my place was. Lay low, they have spelled it out for you and perhaps start looking for a different position if fear your relationship with your managers is too damaged. I feel your frustration and pain.Best of luck to you.

[caliotter3]

If you choose to stay at this job, you now know that you need to keep your mouth shut. You also know that the equipment won't be coming anytime soon.

[rn4ever?]

Maybe you mean well but you didn't follow the chain of command. You are a charge nurse now and you should do what is in the job description of a charge nurse. It doesn't matter too if you have more experience than your manager or if you are more qualified than her. The thing is she is your boss now. I know what happened was upsetting and I hope you'll feel better soon. But just think of the time when you were a nurse manager.....if someone complained about something and went to the CEO straight up, how would you feel? Moving forward, just do what is expected of you in your job and let the higher ups deal with the other stuff. But if your relationship with the higher ups get really sour, maybe it's time to start looking for a new job.

[stephanienicole87]

I found myself in the same situation, only I am a new nurse. I didn't go to the unit manager simply because I forgot we had one on the unit, our other units do not have managers and I float. I didn't get wrote up but a nasty message on my phone on my off hours.

I understand we should follow chain of command but really it isn't a huge deal, it isn't like you were a repeat offender. Also, you did make management aware but they had changed so shouldn't that count? I say you either have two choices: Let it go or pursue a nursing job elsewhere.

I did turn in my two weeks but reconsidered when they asked me to stay d/t the economy and fact I almost had a year in.

Good luck with however you handle it.

[steelcityrn, RN]

Oh well, guess in hind sight you could have just sent him the email thanking him for the beds, and her asking about the suction machine. One thing for sure, it will blow over and they will be breathing down someone elses neck soon.

[PostOpPrincess, BSN, RN]

EVERY endeavor you have made should always be in writing.

Then you can show EVERYONE you've been working the chain of command for YEARS.

You set yourself up.

Next time, you know better. And document everything...they cannot go against you with documented proof AND they HAVE to address it once it is on paper....

[caliotter3]

EVERY endeavor you have made should always be in writing.

Then you can show EVERYONE you've been working the chain of command for YEARS.

You set yourself up.

Next time, you know better. And document everything...they cannot go against you with documented proof AND they HAVE to address it once it is on paper....

Good advice here. There is less tendency to sweep aside anything that is documented in black and white.