I hurt my back at work and I think my employer is going to fire me. Need career advice.

[Amnesty]

This is long! I tried to be as concise as possible but there's a lot that's happened.

I hurt my back 5 weeks ago while working with a patient. I immediately reported it for workers comp purposes. I worked out the rest of my week and then when it didn't feel better after a few days off, I sought treatment via the workers comp panel. I was diagnosed with a lumbar ligament strain and given 10 days of work restrictions stating I couldn't walk any more than 15 minutes every hour. This meant I couldn't work at the bedside. My manager said she couldn't accommodate me, the risk manager said nobody else in the hospital could either, so I sat at home for the 10 days.

Returned to the doctor, basically felt the same. So I got another 14 days with those same restrictions. With WC, unless you miss 21 days, the first 7 days are not paid through WC. You have to use your PTO for it. It looked like I was going to be out more than 21 days, but then my employer called me a couple days after I notified them about the 14 day add-on and said they found accommodation. I was to report to ER to do phone surveys.

The ER manager assured me this was nearly a full-time job and that she had told the risk manager it was always here because the surveys piled up so easily. My first thought (which I kept to myself) was, "Oh, so this has been here all along and they just didn't care until it was their dime I was sitting at home on, not my own." I reported in a few days later, got training, and started. It was not a full time job. It took me 3-4 hours a day. The manager said she didn't care when I did it or how I set my hours, but when I skipped a day, she emailed me to ask if I was coming in or if she should have someone else do it. That was weird to me, because she knew it didn't take me long, and why not have a day off after I'd worked 3 days prior, and then just work 6-7 hours the next day? I explained my plan and asked for advice on advantageously grouping the days. She ignored that. I figured she wanted me to come in every day, so I came in every day. After doing it for about a week and a half, it was time for my follow-up appointment at the doctor (this was on Monday of this week).

Now before all of this, I was supposed to be transferring from my med surg floor to a critical care floor. My medsurg manager had told me near the beginning she'd speak with my critical care manager and let her know what was going on. I'd heard nothing back, so I assumed we were still on track. My transfer date was only a week away, so when I went to the doctor, I told them I felt a little better (I did) and begged them to lift the walking restrictions so I could go to my new floor. I assured them there would be plenty of new orientee education I'd have to do so I could take it a little easy at first. The doc relented but warned me to rest plenty and stop if it was straining me.

I happily gave the new manager a call and let her know I could walk 45 of every 60 minutes now. She had never heard a word about my back injury. She said I'd have to talk to the risk manager about it. I said I had been in contact with her for weeks and she'd already directed me to my nurse managers. She said she'd call me back. She didn't, not on Monday or Tuesday (and she said she would by Tuesday). Wednesday I got an e-mail from another person in that department saying I needed to call the risk manager.

Side insert: I had called my med surg manager Monday to let her know about the new lighter restrictions, and she'd tried to put me back on the floor. I said that wasn't possible since I couldn't sit 15 minutes of any of the hours between 7p-12a (the shift is just too busy) and couldn't ask another nurse to do all of my heavy work for me, and compromised saying I'd come in to help during the busy hours but not take patients. She agreed to this.

So I called the risk manager Wednesday after getting the email from the critical care department, and she informed me that my new department couldn't use me and my current one wouldn't be keeping me either. After this week, I'd be department-less. She also said that since I was working on my med-surg floor, I didn't need to do the ER surveys. I tried to explain that I'd like to do both because it gave me nearly full-time hours if I did, but she said ER didn't need me. (What? How did they go from a huge backup to not needing me in 9 days? And why didn't the ER manager tell me?)

What's worse is that after two nights of doing the resourcing, I noticed my back hurting worse. I've had to back out of that. So now I'm doing nothing again. I've got 4 different managers who can't tell me a damn thing. I've got a back that feels about as bad as it did in the beginning after doing just 5 hours on two different nights of walking around more often. I have no idea if it's going to get better. The risk manager is supposed to call me tomorrow and tell me what I'm doing next week, but she's said she was going to do that before and ended up telling me to stay home. I'm very scared that she's going to tell me I'm fired.

The weirdest part is every other person I've known who got on-the-job back injuries (they're not exactly uncommon on an understaffed med surg floor) got put in an office doing chart audits. I don't know why this wasn't offered to me. But at this point, I've been jerked around so much that I have to doubt my employer will even offer to train me for another position like case management or clinical informatics.

I've looked around for other jobs, but I just graduated last June, so I only have a year and some change under my belt. It's not enough for any of the away-from-the-bedside jobs I've seen posted in other places. It's not even enough to transfer to the non-bedside positions in my own hospital.

Is there anything I can do? Even if they do fire me, I don't think they're stepping outside their legal bounds, so it's not like I have any kind of legal recourse. I feel like I literally busted my hump working 3 years for this place (I worked through nursing school on the floor I was leaving) and I've been tossed by the wayside as just another busted nurse nobody has any place for. It hurts to know I got hurt taking care of other people and now my employer won't even take care of me.

[Kooky Korky, BSN, RN]

Sorry for your situation, Amnesty. Of course, I do not really know what's going through anyone's head, but it would not be uncommon, I think, for them to let you go.

I am not surprised that being on your feet more caused you more back pain. These sprains and strains take a very long time to resolve when we try to push it. You might need a brace, Physical Therapy, just plain more rest, pain meds and muscle relaxers, better shoes, orthotics. Just how long does your doc think you should be taking it somewhat easy?

I think there are too many people involved, too many managers, none of whom really wants an injured worker. If you were the manager, you would certainly not want an impaired worker either. NOt that that makes your situation any easier, unless to make you realize it's not your personality or something in your past, it's just that they need someone to do the work dependably.

You really need straight information from each one separately. I'm afraid that if you push too hard, though, they will each give you an answer you don't want to hear. Part of me says to ask each one, point blank, like the ER manager, what the story is. Nicely, of course. Or ask about being assigned to chart audits for awhile.

Talk with 3 Employment Law attorneys and see what each advises.

Do you have short term disability insurance? How about long term?

Keep your chin up and you will find the silver lining. Maybe not immediately but eventually you will see how God worked things out for good.

If you wind up job-hunting, don't bring up this episode if you can possibly avoid it.

Hospitals might hire you for some positions you mentioned since you already work there, even with less experience than they say they want. All if not lost.

[Libby1987]

I think they caught you trying to manipulate a sensitive issue.

You should have just taken the consecutive short phone shifts without trying to make it work it better for you.

You shouldn't have had this fleeting improvement in order to not miss your ICU transfer, but then have your pain worsen once it appeared the ICU gig wasn't going to happen.

And you really shouldn't have shown your attempt to roll this into a coveted case mgmt or informatics position.

Not for a non career ending strain only one year in.

Someome more informed will have to respond to the legal aspects.

[AllOfMyWat]

Your employer is not your mother. You were able to work a few days at a normal pace. If I am truly hurt, I want treatment at a hospital right then. I'd call shenanigans, too.

[Extra Pickles]

if someone were telling me your story as a third-party situation I'd feel pretty sure you were trying to pull something. You were injured and your injury was minor, and when your employer accommodated you by giving you an easy phone job you chose to do it for three days and then not show up on the fourth day. You didn't clear it with the manager you just didn't show up. Shouldn't surprise you that now you are on their Loafer Radar! Doesn't matter if she said she didn't care how you scheduled your hours she obviously meant that she didn't care if you came in at 6am or 9am, not that you could just randomly skip days of work!

Then when you think you are going to lose a position you wanted you miraculously got better and are suddenly able to do that job, or nearly so. You weren't willing to finagle your doctor into signing off on the med surg job, only the ICU job. That tells me that your injury wasn't such a big deal, you were just biding time until you got the new gig. Yet another Red Alert for your employer. Why would they offer to train you for a plum job doing chart reviews when you don't look much like a dedicated employee in the first place? A dedicated employee shows up for work and doesn't manipulate the system when it's convenient. Your ICU manager and med surg managers both recognized they were being manipulated and reacted accordingly.

Looks to me like your recourse is to heal this minor injury and get another job that you are qualified for and capable of doing and then do it.

[SmilingBluEyes]

I am having a tough time with your story, too, for the reasons already mentioned. I would add, I am truly sorry you were injured; no one wishes that on themselves or anyone else and it sucks.

But you need to talk to attornies specializing in disability law, not us. First, they and only they, can help you flesh out what to do next. And like the others, based on your very long story, I think you are trying to manipulate a bad situation to an unfair advantage for you. Not cool.

[cleback]

I think you got some good responses that show how your employer is viewing this. I don't see you as being so manipulative.. I think you were a bit confused on expectations and commited a few missteps. I would tread very lightly. Take whatever they want to give you on their terms. Don't try to negotiate better hours or different duties... even if your ideas make better sense... they have the upper hand now. If you are let go, take it as a learning experience.

I do not know legal ramifications, but I would avoid that route if you want to salvage your job.

[Amnesty]

Okay, I'll elaborate:

When I started the phone surveys, I was trained on a Friday, and knocked out a bunch that day, then came back and did it Saturday and Sunday as well. On those days I figured out it wasn't going to be a full-time thing. I don't think the NM knew I came in on the weekend, but when she looked at the queue Monday when I wasn't there, she should have been able to see that I'd done all the weekend calls already. She continued to act really strange throughout my time with her. There was never a place for me to sit and do these surveys because, obviously, it's a full and busy ER. That I get. What I don't get is not finding me an appropriate place to do them (some privacy required since I'm talking on the phone about patient information). In the end I had to go find a spot by myself. Then there were lunch add-backs. Our employer auto-deducts 30 minutes for lunch. Lots of days, I wasn't there long enough to take one. I emailed her before going home if that was the case. I logged into our paycheck app the day before hours were to be submitted to payroll and noticed she'd only given back 2 lunches, and one on the wrong date. I sent her an email letting her know again which dates I needed the lunch time back for, and that she'd accidentally given me an extra lunch date back on a shift where I definitely had taken a lunch. No reply, no changes made.

Now which of you wants to get work-ready and drive to work every single day of the week for just 3 hours of work? Probably not a single one. And the ER manager in the beginning had blatantly stated it was perfectly fine not to do that. What I'm figuring now is she didn't expect me to work on the weekends and that's what threw us off. As for asking about grouping days, the big issue was that once I called someone, if they didn't answer, I had to try to re-reach them before they fell out of the system (takes 5 days). So I couldn't work every 3 days because then the person I called on Monday might've already been in the system since Saturday, and by Thursday, would be gone from the system when I came back in. I proposed working every other day. Honestly, I think she just had no idea how quickly someone could get through with those calls. The girl I trained with was in the admissions department that works alongside ER and comes to get new admits set up on the floors during the day (but only M-F). She said she does about 30 people an hour, which was about my speed too. But they have a new orientee in that department, and on the day I found out I wasn't allowed to be doing it any more, the admissions unit nurses were the ones doing it.

With all that said, I understand not wanting to pay me to do it if somebody else could pretty easily just add it into their job (the admissions unit has a lot of down time between patients). But I don't get the lack of communication and blatant ignoring of my e-mails.

As for manipulating the critical care situation, I absolutely did. I know for a fact there's a lot of sit-down education (PALS and ACLS just for starters, then additional med exams and equipment education) that the new critical care nurses have to do. And the difference between it and the med surg floor I'm already on is that I would have had at least 6 weeks where I was not doing direct patient care on my own. Point blank, I already did not care for my med surg manager much. She's new and trying to run a very heavy floor with no floor experience whatsoever. She's made a lot of mistakes. Taking somebody who can't walk more than 45 of 60 minutes, can't lift more than 30 lbs, and giving them a full patient load on an understaffed floor at night when we sometimes don't even have a CNA and then saying, "You just have to ask for help. It's like if you were pregnant" is a mistake. I've seen other nurses try to do what she was suggesting. They've reinjured themselves. I wasn't going to let that be me. I countered with something that was completely within my limits, and I was happy to do it. Being back on the floor with my coworkers (whom I love) was awesome. Actually doing patient care was awesome.

I explained to my doctor at my Monday visit what I'm explaining to you here: There is a lot of difference between being on your own on a busy med-surg floor taking 6 patients and being expected to do it all, vs. being a new orientee in another department and always having your preceptor there for you. The doctor's NP is a nurse I knew from being pulled to her med-surg floor sometimes, and she completely agreed. She also thought that if I could take it a little easier as an orientee on my new floor, the six weeks of my orientation might be enough for it to heal completely. Since the walking aggravated it, I think it's safe to say I was too optimistic.

Also, I haven't mentioned anything to them about chart audits or any other job. I just know they usually give people on light duty chart audits to do. And they want at least a few years of experience for case management or clinical informatics, which I don't have, so I'm not mentioning that unless it's kind of a last-ditch effort.

No call yet -- Still waiting >_

[Amnesty]

I should also add that my asking about lifting some of the restrictions was not something I did randomly. When this first started, it hurt at a level 5-6 pretty much all the time. It would wake me up after about six hours of sleep because I'd get so stiff and sore. I was able to work through it, though, so I did. Calling out on a weekend would've meant further shafting my coworkers (plus a weekend meant fewer really "heavy" patients, who we usually discharge during the week). When 4 days off with rest, ice, and ibuprofen did nothing, I caved and went to the doctor. With the prescribed PT exercises I got, ice treatment constantly, and naproxen, the pain had come down from a 6 to about a 3-4, and it no longer hurt all the time. It was low enough that I could adapt to it and sometimes not notice it, which the doctor had explained was key.

[NurseGirl525, ASN, RN]

Your communication with each one of your managers was awful throughout this entire thing. That is exactly why it seems you are manipulating everything.

Why did you depend on your medsurg boss to communicate with your CC manager? Why did you not communicate with the ER manager that you came in on the weekend? You say she was supposed to look it up, see you were there, and just assume that you had finished them and decided on your own not to come in?

If you get fired, it won't be for your injury, it's for your lack of communication and shadiness you have displayed. You worked out the week and then decided you couldn't work anymore. And yes, your PTO time gets used up first. Those are the rules.

They have to handle the workmanship comp according to the law. This is not about having to do things on their "dime" as you put it. The workmans comp pays for this.

You are trying to manipulate the system. Yes, ligaments take a long time to heal. Usually 4-6 weeks. You should though have been in constant communication with your employer, which you were not, and skipping days of a job you were given. And yes, I would drive up for the job everyday.

you need to fix this. ASAP. If you are caught manipulating the system, the workmans comp may not pay you at all.

[Amnesty]

Why did you depend on your medsurg boss to communicate with your CC manager? Why did you not communicate with the ER manager that you came in on the weekend?

I didn't ask her to talk to my new manager. She just said she had, and I trusted that. It was my mistake for thinking she'd handled it.

The ER manager should have known I was there that weekend because she had at least two emails saying I'd worked Saturday and Sunday and hadn't needed to take a lunch those days due to the hours being short enough, and the queue only had the Monday calls. If I had been told that I needed to keep the ER manager closely updated on what I was doing, I would have sent an additional email explaining it. What I was told was that I could work whenever I wanted as long as the calls got done between 8 am and 8 pm. She even mentioned making it a M-F type of thing. When it seemed like she wanted them done every single day, I came in every single day.

I feel like I've done everything I've been asked to do and tried to communicate within the bounds I was given and got nothing back. There's plenty of documentation of this via the emails and texts to and from my med-surg manager. I don't think they have a leg to stand on if they want to try to deny me benefits for manipulating worker's comp, which there's no indication that they do. I'm not trying to manipulate the system to get money for nothing. I'm hurt. My back constantly aches. I'm trying to actually work and make a living while it's healing. It's driving me nuts being away from my patients and sitting down when normally I'm doing 36-48 hours a week of very active patient care. Is this really so foreign to you all that you'd accuse me of trying to manipulate my hospital for worker's comp money?

Anyway, I got a call today and I'll be doing some office work for another department next week. It's amazing how relieving it is to know I'm okay for another week.

[applesxoranges, BSN, RN]

Well, for PALS and ACLS they usually have to have certified instructors meaning they would have to pay for a class and then have you do an instruction. I used to help out with BLS check offs in ACLS because I was a BLS instructor but technically that may not have been allowed (we did both together). However, I never did any of the other ACLS skill stations.