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Help! stay or go?

Emergency   (2,183 Views | 13 Replies)
by takeiteasynyc takeiteasynyc (New) New

547 Profile Views; 9 Posts

Im still on orientation and am going to be evaluated soon at my new ED position. (i have yr+ of prior experience in an different ED) There's a chance I might be let go due to minor non-life threatening mistakes i've made and lack of morale. There are parts of the ED i love and am completely amazed by---continuous learning, being around strong and capable co-wrkers, always having the MD present and there are parts I hate. The hustling, the continuous under staffing issue. The shift I'm slotted to go into, nights has a 1:10 ratio, and becomes 1:20 when you cover breaks on top of being called to the trauma room when a notification arrives. This leaves the rest of my pts uncared for for however long I am in the trauma. If my team is strong and not busy taking care of their load they can watch my board. If not, I have to clean up when I'm done. The trauma room in my last ER job wasn't staffed in such a way. we had designated trauma nurses and MDs there the whole shift. Some of the nurses here just make it work..I have no clue how..it's not safe in my eyes. it's not ideal but people do it...I'm amazed and feel a little bad about myself

In anycase, I'm not sure what to do or say when my evaluation comes up. I want to hold onto my benefits (100% tuition, medical, pension, union), increase in salary and try to transfer into another dept ASAP but I'll have to stay in this ED for a bit and push through till I'm unionized or after a yr. Or the alternative, let it go, do agency work and start my search all over. Defer graduate school another semester which I did since starting the job :/ ..I'm drained, there are knots in my back and am very ambivalent about the ED esp. nyc EDs..

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emtb2rn has 21 years experience as a BSN, RN, EMT-B and specializes in Emergency.

2,689 Posts; 29,476 Profile Views

1:10 as a regular ratio is unsafe and unworkable in my opinion. Don't know what your options are but I would suggest getting out as the benefits don't seem to outweigh the risk of losing your license.

Did you ask about ratios before accepting the job? If so, did they tell you 1:10 or something else?

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9 Posts; 547 Profile Views

those ratios are normal in nyc...my last place was like that but we didn't do break coverage that way, where you take on your partner's load. they did tell me 10-13 but not about break coverage

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emtb2rn has 21 years experience as a BSN, RN, EMT-B and specializes in Emergency.

2,689 Posts; 29,476 Profile Views

And that 1:10-13 is for esi 1, 2 & 3 patients? If so, wow. Hope you're making at least $60/hr.

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Farawyn has 25 years experience and specializes in A little bit of everything..

2 Followers; 12,645 Posts; 98,423 Profile Views

What is the "lack of morale"? Do you think that, or did someone tell you that?

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9 Posts; 547 Profile Views

yup its for esi 1,2,3 and a big NO to 60/hr

its both with lack of morale-- i'm told i lack enthusiasm and don't want to seem like I want to rush into traumas. That was initially now. now im just tired of proving myself for something I don't really want- this particular ED but I'm not sure how to salvage my resume. how do i explain leaving after less than 1/2 yr. i'm told not to bad mouth your old work place but how else can I explain it...

I'm also wondering is it better to resign at this point or wait for the axe to fall

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9 Posts; 547 Profile Views

my hospital excluded me for ebola training also.

I'm not likely to triage but really???

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icuRNmaggie has 24 years experience as a BSN, RN and specializes in MICU, SICU, CICU.

1,970 Posts; 25,406 Profile Views

Go find a per diem position now in another ER with decent staffing. A smaller facility might be a better fit.

Resign in good standing.

You will have something to fall back on and that could lead to a FT position.

They are not going to ask why you left except when you complete the application. Stop worrying about that.

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9 Posts; 547 Profile Views

how do i resign on good standing while on orientation. Usually I give a month of notice, sometimes more if they seem seriously understaffed but I'm not sure how to do that on orientation....

and should i come in person with a letter, do I explain it as a family emergency-my resignation or no excuses

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icuRNmaggie has 24 years experience as a BSN, RN and specializes in MICU, SICU, CICU.

1,970 Posts; 25,406 Profile Views

Are you ready to function independently in this ER if they let you off orientation? 10 pts is absurd and dangerous. The lack of enthusiasm could be sheer exhaustion.

If you could stick it out for a year you could transfer to another unit. A lot of ER nurses transfer to PACU and love it.

Go to your evaluation, maybe it isn't as bad as you think.

If you resign in writing just keep it brief and thank them for the opportunity. Do line up another job just in case.

Leave gracefully. Do not criticize their ratios or anything like that, they already know.

Edited by icuRNmaggie

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Altra is a BSN, RN and specializes in Emergency & Trauma/Adult ICU.

6,255 Posts; 40,953 Profile Views

As noted by several here, 10 ER patients of mixed acuity is dangerous ... but it is known to be the norm in NYC EDs. What is not the norm is the way that OP describes trauma staffing. That is absurd.

In my experience, if there is a decision to terminate a nurse, the termination occurs -- they don't wait for such and such review period to conclude. If you need the benefits, I would try as hard as you can to hang on to this job and perform to the absolute best of your abilities while you actively search for another job.

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CoolDork has 5 years experience and specializes in ED, SICU.

7 Posts; 547 Profile Views

That ratio does seem absurd; however, what are your resources? Does NY use med techs, medics and CNA 2's. If so, it can be stressful but manageable with how many resources you have at your finger tips. Currently at my facility, I have 4 pt's with CNA IIs as my only resource. Not to mention there are only 3 of them to staff a 57 bed ED.

I don't know how I would manage in your shoes right now but God bless your situation.

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