Help, nurse in distress!

[Nurselife808]

I have been a nurse for 2 years now. I spent 1.5 years working at a rural med surg hospital. 3 months ago I transfered to the city hospital in the critical care PCU. The thought is to transition from PCU to CCU. I have many concerns about the unit, and have addressed them to my supervisor and nothing has changed or been said. I am very unhappy with where I am at, feel unsafe, and feel my patients are unsafe. To transfer within the system I am in, I need to get a written release from my supervisor, so I am allowed to apply for other jobs. What is a good way to bring this up to him? And what if he says NO? Could use some good words of advice on how to go about this.

[kbrn2002, ADN, RN]

I wonder, in the absence of an actual "safe harbor" law/policy/etc., what would happen if one still sent an email to TPTB (Unit director, Director of nursing, and on up) that they were accepting this assignment with great reservations over the safety and appropriateness of said assignment.

There is no safe harbor type laws where I live, at least that I am aware of. The local hospitals have policies in place that allow for staff to file an unsafe staffing complaint. I have never really heard of any system wide changes happening because of this though. I work in a SNF and no such thing exists, we are stuck with the resident assignment we get. We have on more than one occasion worked dangerously short staffed and somehow survived the shift.

[CrunchRN, ADN, RN]

Op -

I would just tell him that you feel the unit is not a good fit for you and thank you for the training blah, blah, blah (make nice), but that you would like to apply to other units and that you will work hard to make any future transation easier for all parties.....

[Have Nurse, ADN, RN]

So, let me get this straight. You've been there for 3 months and have informed your direct supervisor of all the things that are wrong with the unit. Did he ask you your opinion or did you just offer it up? If you offered it up I can see this going one of two ways. He'll sign your transfer paper just to get rid of you because I'm going out on a limb here to say I doubt he was very appreciative of your unsolicited advice. Or he will refuse and enjoy riding you hard until eventually getting you to quit or outright firing you. As the new kid on the block I'm fairly certain you have dug yourself quite a hole while simultaneously shooting yourself in both feet. You might want to start looking elsewhere for employment. I'm honestly not trying to be mean but I literally cringed when I read your post. There's a way to do things and going in with guns blazing just isn't it. Especially in the nursing world. And new to the unit. Frankly I think your best bet is to try to fly under the radar for awhile.

I respectfully disagree. First, let's put the sabre away. This is still a "fairly new" nurse who has been taught to assess situations and put safety first. She is asking for guidance, not to be cut off at the knees.

Any Manager worth their salt who works with her should know this and respond without being offended.

It may help however, if she could offer some possible solutions to assist in solving the problem. If not, she may not be an appropriate fit for that floor. If that is the case, then for her own piece of mind she may wish to leave that entity altogether.

If she has legitimate concerns and they are present respectfully and documented well, her Manager should be receptive to at least hearing her out. The fact that her predecessors before her also left should be a "red flag."

Sometimes all you can do is stand.

[Wuzzie]

I respectfully disagree. First, let's put the sabre away. This is still a "fairly new" nurse who has been taught to assess situations and put safety first. She is asking for guidance, not to be cut off at the knees.

Any Manager worth their salt who works with her should know this and respond without being offended.

It may help however, if she could offer some possible solutions to assist in solving the problem. If not, she may not be an appropriate fit for that floor. If that is the case, then for her own piece of mind she may wish to leave that entity altogether.

If she has legitimate concerns and they are present respectfully and documented well, her Manager should be receptive to at least hearing her out. The fact that her predecessors before her also left should be a "red flag."

Sometimes all you can do is stand.

First there was no sabre and I did not cut her off at the knees. I'll thank you to dispense with assuming what my intention was. What I DID do is speak from more than 30 years of experience in the nursing culture and personal experience being the squeaky wheel. It rarely ends well for the person pointing out the deficiencies no matter how good the intent behind it was. Also, she did not give all the details in the first post and had you bothered to read my additional post to her I let her know that my answer would have been different had I been given all the additional information. I also gave her some things to do and to look out for but in your haste to chastise me you failed to notice them. Given the fact that there has been a mass exodus and repeated efforts by previous staff to fix the issues it is clear the manager is not interested in hearing the complaints or the solutions from anybody which is why I warned her about what may happen. Should the manager listen? Of course! But in this case the manager is not or things would not be the way they are. She is tilting at windmills with this manager and will be the only one hurt in the end.

[Buckeye.nurse]

I just want to chime in on calling safe harbor. I agree with Wuzzie...see if there is an equivalent document in your state, although it may be called a different name. For example, California, Washington state, Michigan, Ohio (and I'm sure others) have a document nurses can fill out called "Assignment despite objection". We are encouraged to use this by our union if we feel our assignment endangers the patients under our care.