Approaching tough subjects with the boss

Specialties Hospice

Published

I really could use some input because I am struggling and lacking the support needed at work. I am a PRN employee and after orientation I was temporarily asked to carry a case load for a few weeks... 7 months later, I still have a case load. I work 3 or 4 days a week and have equal to or MORE pts assigned to me then the full time nurses. This week I was assigned 5 new admissions in one day. Obviously, I receive no benefits, vacation, sick time etc... I have tried to discuss this with my supervisor multiple times with no success. In addition to having a case load I am responsible for, I am still doing PRN duties as needed and some weeks they have an LPN see my patients so that I can complete 14 day comprehensive visits for the other nurses. I have repeatedly asked for my role to be clarified since I case manage and PRN and I am told I am a PRN and this is what needs to be done for now, and then hear the team player speech. I always am the team player, one of two nurses who are.... We also are short a nurse right now so technically my boss has patients assigned to her, however she has never seen them and I am often stuck seeing them. When I was discussing my concerns my boss asked me "do you think it's fair I have a case load?" And I really wanted to say that it doesn't really effect my boss since It is myself and occasionally a few other nurses seeing those patients. I have very professionally and respectfully tried to discuss my concerns and the answers I get are to suck it up and get over it because I have no choice.

I love the patients, I just don't want to be taken advantage of anymore. If I am a PRN I should do PRN duties and if I am going to do more work than the full time nurses and have a bigger case load, I should be offered a full time position.

I am at a loss for words and truly defeated. Every nurse at our organization is looking for work else where and 4 have quit because of how unhappy they are

I would really appreciate some direction on how to approach this subject.

caliotter3

38,333 Posts

From your post it is obvious that nothing is going to change. Utilize your energy to find a new job and then give notice and leave, or else you will be dealing with this same situation for as long as you allow them to take advantage of you.

ShesanRN

48 Posts

I think your boss' responses to you so far have told you where she stands on the issue. I agree with the above poster, and the fact everyone else is looking for an out is a big red flag. The month I left my last nursing job, they lost 1/4 of their nursing staff; it was a mass exodus.

pfeliks

50 Posts

5 admissions in one day!!!!!! Impossible.

morte, LPN, LVN

7,015 Posts

you know the saying, "we teach persons how to treat us"......

If I were you I would put in my notice as soon as possible. Apply to other jobs first though. I was in you position before. It's not worth the anxiety. I have a family that want to enjoy. So I quit. Still don't regret it.

Specializes in Hospice and Palliative Nurse.

What a shame, it is the patients that suffer, right? I would definately leave, but pen a letter to your supervisors report or the Regional person. Be polite, but just state the facts. The top needs to know what is happening.

Peace

That is too bad :( I agree with the others that this employer is inadequate and unsupportive -- for whatever reasons -- and you've been going over and above with little respect since!

Even playing hard ball with your employer, like mentioning you have your letter of resignation in hand if you cannot be FAIRLY accommodated, might just blow up in your face or go nowhere fast, and who needs to go through that? Which mountain are you gonna die on? This one or . . . ?

It is too bad for the patients, but not because of anything you've done. You 'did your bit for Ireland' :) and basically DONATED your services with inadequate recompense for seven months. No big deal, consider it a kind of volunteerism :D . And a sign of the times in homecare becoming such an industry and money spinner. Your conscience ought to be clear.

Thank you for the input, it's really nice to get a perspective on things. I'm the youngest employee, so I think a lot of times people think that they can talk and treat me like they are my mother and I do not appreciate it.

I agree it is the patients that are suffering in our organization as a whole. Multiple nurses are out on FMLA and a few have quit leaving an entire case load with no primary nurse!

One of the things I make sure to do is take my time at my visits, answer their questions, and show interests in these patients as people.

I feel proud of the work that I do and that I'm giving my all, but I'm not proud of our organization. It disgusts me at times.

I just don't want it to appear to future employers that I'm someone who quits when things are tough, because nursing is always tough in one way or another.

Specializes in School Nursing.

Here is why they aren't offering you a full time position? Because they can get a full time case manager and a PRN peon for less money and no benefits! Right now, they've got it made!

If I were you, I'd ask tell them to pick, either you're doing PRN visits (no caseload) or you're a full time case manger, NOT BOTH.

Libby1987

3,726 Posts

you know the saying, "we teach persons how to treat us"......

There it is right there. Understandable because you are younger and new but you've got to turn this train around. And as long as you aren't putting your license on the line or doing anything improper, you might as well practice with this employer so you will be better prepared for future jobs with limits and boundaries (hate that word but not imaginative enough to come up with an alternative).

How do you say no to something you did not originally agree to?

You could start off by saying you will be sticking with your original perdiem schedule beginning week of 2/1/15 or whatever you think is fair. (You did let them steamroll you into a case load, you need to own that IMO and give them a reasonable amount of time to reassign patients, for the patients' sakes and your professional integrity)

Then everytime you're asked/assigned outside of your limits, you have to look at it like some kid is trying to get you to try some toxic substance. Are you going to be mealy mouthed or are you going to say absolutely not? (Calm and professionally of course but I think you initially need to equate it with something outrageous until you're comfortable with saying no.)

Give it a few weeks, get comfortable with sticking to your guns without emotion, feel proud of yourself, then go find a job with a sound company.

TammyG

434 Posts

I don't want to sound non-supportive, but I don't understand exactly why you are upset. You signed up for a PRN role, presumably because it offered you the opportunity to turn work down when you didn't want it, and to work hours that were convenient for you rather than being required to be working specific hours every week. It sounds like you are being asked to work more than you had planned, but you have the right to say "NO" -- that is why you are PRN. Is there a reason you have agreed to basically carry a full case load without full-time benefits?

I would tell your bosses that you want the position to turn into a regular position with scheduled hours and full benefits and give them exactly how many hours you agree to work, if in fact that is what you want to have happen. If they don't agree, then start looking for another job. But it seems you got exactly what you asked for.

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