How to leave toxic work environment when you're the only RN?

[pumpkinqueen]

tldr; Toxic manager (LPN) using me (RN) for my license in LTC setting, threatens to report me to the board if I leave. 

I've been working in the LTC setting for the past 9 months. This was anticipated to be a short term solution, as the last hospital I worked at closed unexpectedly. I'm also PRN at a hospital in my previous specialty, which I would want to work at full time if the position was available. 

I'm the only RN at the small LTC facility, and the manager is a long time LPN. There were 2 other RNs at one point, but they quit. They've been looking for another RN for the past 5 months without any success. I used to really enjoy working there, but over the past few weeks, I've begun to see how toxic management is. The manager has always been very controlling, and has squashed any attempts I've made at independence, while also pressuring me to do everything independently. If I were to insist on doing something differently than how she'd do it, she'll say in a huff, "Oh, well, it's your license." Making me feel not only unsupported but incompetent, and also that she's using me and my RN license to implement changes that she wouldn't be able to do with only her LPN license.

I asked her what she would've done if I hadn't applied when I did, and she said that they had another applicant that was previously an LTC DON for over a decade, but she decided on me instead because I was, "more trainable." Which I now interpret as, "more easy to manipulate into doing what I want you to do."

She made the comment the other day about how herself and the assistant manager (non nurse) had to take on RN duties when they've been without an RN in the past. I asked how they were able to do this as it was obviously outside of their scope, and she replied that in our setting if no RN is available and a job opening is posted, that management can take on RN duties. 

When digging further on why they were without an RN, apparently it was due to not only one, but several RNs quitting and leaving them without an RN over the years. The manager asked me if I knew what they did to the RNs that quit like that. "Reported them to the board?" I questioned, and she nodded, looking at me severely, making me feel that she intended to do the same to me if I were to quit.

The work they want me to do would involve 80+ hours per week to accomplish, and they have me capped at 50 hours. I'm told on a daily basis how I'm not meeting expectations. When I reply that no one could feasibly do the work expected in the hours allotted and say we need another nurse, all the manager says is, "Well, we're trying." She tells me of all the places the job opening is posted, and I've yet to see it anywhere (believe me, I've looked). They also want me to take on being on call 24/7 without adjusting my pay to reflect that increase in hours. I'm already on call 24/7, but the manager takes the initial calls and dispatches them to me if necessary. They want to salary me, but I know it's just an attempt at increasing my hours and responsibilities without having to pay me overtime for actual hours worked.

I honestly don't know what to do. It's gotten to the point that I actively dread going to work due to the anxiety being there causes. I've even thought about quitting and using COBRA to keep my health insurance and just pick up at my PRN job to supplement until there's a scheduled position available. I could get full time hours picking up at my PRN job, and if a position became available, I'd have seniority in applying for it. 

Would the manager have grounds to report me to the board if I quit, since I'm the only RN? Would I have to stay on at least part time until another RN is hired? 

[JKL33]

4 hours ago, pumpkinqueen said:

When digging further on why they were without an RN, apparently it was due to not only one, but several RNs quitting and leaving them without an RN over the years. The manager asked me if I knew what they did to the RNs that quit like that. "Reported them to the board?" I questioned

??‍♀️ For what? Why would you ever even suggest that?  Sorry...I don't mean to insult you but sometimes I'm astonished at the way people invite others to manipulate them.

You have had enough--no, way too many--conversations with this woman.

If you wish to resign, do so. Give proper notice. Whether or not you are the only RN is utterly irrelevant. This person is a liar and manipulator.

Do not engage in any more conversations with her. Just send her an email that says, "Dear [So-and-so], this email is to let you know of my decision to resign my position as [your designated role] at [facility]. The last day I am available to work is [date two weeks from day of email]. Thank you for the opportunity to care for the residents at [facility]. Sincerely, [your name]"

If she says she will need to report you to the BON just say, "There are no grounds for that. And they don't take kindly to malicious reports."

THE END.

[TriciaJ, RN]

You're accepting indentured servitude out of fear of being reported to the Board?

I was reported to the Board.  It was malicious and retaliatory and they had it pegged before I even got there. We went through the paces then we all had a good laugh and I went home.

JKL told you how to resign.  Don't tolerate that crap for one more day than you need to.

THEY don't have an RN?  Guess they better start beating the bushes.  They have two weeks from the time you put in your notice.

[Hoosier_RN, MSN]

4 hours ago, JKL33 said:

??‍♀️ If she says she will need to report you to the BON just say, 

Just say okay and smile, walk  (actually run) away

[NurseBlaq]

Not to sound elitist here, but why are you as the RN taking orders from an LPN? I bet one of the reasons they can't keep an RN is because of that and her lying/deceitful self. I would email notice and be sick the rest of it. She's basically already let you know they're going to file a false report to the board anyway. Better yet, I would just give notice effective immediately via email and be sure to document (literally quote) her threats in the resignation. And how the hell is the assistant manager not a nurse at all yet doing nursing tasks? The whole setup is a licensure trap. I would never go back. As someone else said, THEY need you, not the other way around. If they report you to the board, sue them for libel/slander. I would resign effective immediately and report them to the board AND the state right after sending the email. That place is horrible!

[Hoosier_RN, MSN]

2 hours ago, NurseBlaq said:

I would resign effective immediately and report them to the board AND the state right after sending the email. That place is horrible!

I agree with turning them in. I don't care about excuses, an LPN cannot perform as a RN regardless of reason. In some cases, a RN can sign off their work, but other things, no

[By-a-thred, RN, ADN]

5 hours ago, NurseBlaq said:

 Better yet, I would just give notice effective immediately via email and be sure to document (literally quote) her threats in the resignation. And how the hell is the assistant manager not a nurse at all yet doing nursing tasks? The whole setup is a licensure trap. I would never go back. As someone else said, THEY need you, not the other way around. If they report you to the board, sue them for libel/slander. I would resign effective immediately and report them to the board AND the state right after sending the email. That place is horrible!

Your only job security is in your ability to take care of your LICENSE. This place is toxic in so many ways. Please feel free to report THEM to the BON and any other state agencies that oversee LTC. Your patients deserve so much better than this bunch of idiots. 

 

[JKL33]

5 hours ago, NurseBlaq said:

I would resign effective immediately and report them to the board AND the state right after sending the email. That place is horrible!

I do pretty much agree with this, too. It's probably safest. I wrote what I wrote based on my strong suspicion that this LPN doesn't know jack and is simply taking advantage of a willing participant. You are right, but I still like to think this woman could be handled easily. ?

[NurseBlaq]

4 hours ago, JKL33 said:

I do pretty much agree with this, too. It's probably safest. I wrote what I wrote based on my strong suspicion that this LPN doesn't know jack and is simply taking advantage of a willing participant. You are right, but I still like to think this woman could be handled easily. ?

Let the board do it. People like that have been lying and doing sinister stuff for years and feel invincible. Getting in the mud with somebody like her will only hurt OP. I'd just report and keep it moving. Let the alphabet agencies do their job. The fact so many RNs have left in such a short time is enough to let them know there are underlying problems.

[amoLucia]

Let them hire a temp agency RN for renewable contract lengths.

I worked one place where they had to hire a 3-11 RN Supervisor. It worked well. The gal was a 'good one'. She stayed a while until they were able to recruit an in-house one.

BTW - who is the RN when you're not working a day? R/T to being sick or holiday or other day-off, the facility continues to operate somehow. So they WILL manage without you - they are doing it when you're not there.

[vintagegal, BSN, DNP, RN, NP]

Put your notice in, keep a low profile. If someone threatens to turn you into the board, kindly remind them you’re not a slave and they are more than welcome to call whoever they want, including Mickey Mouse. Whatever what a waste of time. You’re more valuable than what you give yourself credit for.

[CardiTeleRN, BSN]

I've witnessed this when I worked as a CNA in a LTC. The management were functioning as RNs and DONs and they weren't licensed as RNs, LPNs, or CNAs. Needless to say, the place was ran poorly. The residents were always breaking bones from falls, always sickly, went wandering outside the facility, etc. The aides would be arguing with one another, the residents. I quit without notice.