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.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
When I was young and inexperienced, I had a lot of older mentors who would have been available to help me navigate situations like this one. Luckily for me, I didn't get injured until I was much older and knew how to handle things. But times have changed, and it seems even the older nurses I've worked with are not as well versed in these issues. So who helps the younger nurses?
I still think there should be a class in nursing school about labour laws and how they affect nurses. They should learn the real pros and cons about labour unions (not the usual propaganda) and should be given some sort of an algorithm for navigating an injury. To hell with "leadership". How about just "nurse survival"?
I still think there should be a class in nursing school about labour laws and how they affect nurses. They should learn the real pros and cons about labour unions (not the usual propaganda) and should be given some sort of an algorithm for navigating an injury. To hell with "leadership". How about just "nurse survival"?
It should include topics like how to negotiate like a professional, how to interact with providers (doctors, PAs, NPs), and how your nursing license works - what can make you lose it and what can't.
Oh, and how to advocate for yourself, because nobody else is going to do it for you.
And how to survive the first year - specifically, how to handle constructive criticism without thinking that you are being attacked.
Specializes in ER, ICU/CCU, Open Heart OR Recovery, Etc.
When I was young and inexperienced, I had a lot of older mentors who would have been available to help me navigate situations like this one. Luckily for me, I didn't get injured until I was much older and knew how to handle things. But times have changed, and it seems even the older nurses I've worked with are not as well versed in these issues. So who helps the younger nurses?
I still think there should be a class in nursing school about labour laws and how they affect nurses. They should learn the real pros and cons about labour unions (not the usual propaganda) and should be given some sort of an algorithm for navigating an injury. To hell with "leadership". How about just "nurse survival"?
Labor/disability and licensure law, both in depth.
Most people that I have seen get injured at work, work with the injury to stay employed (meaning they don't take off a lot of days of work to heal) or get fired.
As a long time ICU nurse, I am flabbergasted that you think ICU is going to be easier physically! Yes, you will have a preceptor but do you expect to be simply observing him/her work while you sit the number of minutes you require based on your injury? What if your patient codes? Can you do CPR? You admit that you were manipulating the system and biding your time till you can get into the ICU job. You didn't show up to work one day because you made the choice that you didn't want to drive into work every day for 3 hours work. They were trying to help you by giving you an opportunity to do some work that your body could handle and you blew it off. Why should they continue to accommodate you when, by your own admission you expect to be able to go to another department and be able to sit for the number of minutes you require because you have a preceptor to help you? It is a fallacy that ICU is somehow less physical. All of your ventilated and sedated patients require cleaning and turning at least every two hours. You will continually need to be assessing and reassessing. You will be hanging a ton of IV stuff, giving blood and blood products, suctioning and yes, helping people to the BSC or bathroom, all of which require you to be up and moving. Your preceptor is going to be reporting to your manager how you are doing. What will he/she say? ICU requires a go-getter attitude and work output. If you don't take responsibility for the level of your work, you can literally kill someone. Please read back over the things you wrote. Replace you with a co-worker. What would you think of that nurse?
As a long time ICU nurse, I am flabbergasted that you think ICU is going to be easier physically! Yes, you will have a preceptor but do you expect to be simply observing him/her work while you sit the number of minutes you require based on your injury? What if your patient codes? Can you do CPR? You admit that you were manipulating the system and biding your time till you can get into the ICU job. You didn't show up to work one day because you made the choice that you didn't want to drive into work every day for 3 hours work. They were trying to help you by giving you an opportunity to do some work that your body could handle and you blew it off. Why should they continue to accommodate you when, by your own admission you expect to be able to go to another department and be able to sit for the number of minutes you require because you have a preceptor to help you? It is a fallacy that ICU is somehow less physical. All of your ventilated and sedated patients require cleaning and turning at least every two hours. You will continually need to be assessing and reassessing. You will be hanging a ton of IV stuff, giving blood and blood products, suctioning and yes, helping people to the BSC or bathroom, all of which require you to be up and moving. Your preceptor is going to be reporting to your manager how you are doing. What will he/she say? ICU requires a go-getter attitude and work output. If you don't take responsibility for the level of your work, you can literally kill someone. Please read back over the things you wrote. Replace you with a co-worker. What would you think of that nurse?
I've already explained most of this in numerous prior posts but I'll bite and explain it again with more depth.
I don't think ICU is less work intensive. I know though, that it requires several weeks of training before I'm really thrown into the mix. For instance, I have to do ACLS before I can even participate in a code. There's additional medication classes I have to go to and tests I have to pass before I can give meds, and those would likely take up the first week by themselves. Toss ACLS in there on week two, PALS week four, and you get a picture where I'm off my feet a lot of the time. Not to mention that when I'm not off my feet, I have a preceptor there so I'm not being pushed to lift alone or do things my back can't handle like if I had 6 patients and any number of them were total cares and the rest were post-ops or significant injuries.
I have a go-getter attitude. It's why I'm (er, I was) trying to rest through the education, so I can go ahead and get that done and hit the floor running once I'm healed, which seemed like it should've been soon given the good progress I was making. It's why when a manager tells me I can work whenever I want and she doesn't care to know about it, I take that and run with it. It's why when she indicated that wasn't what she wanted, I immediately changed and did what it seemed like she wanted, and kept in constant communication with her about how best to do this job and what I was doing with it, and I thanked her for the opportunity all along.
There is a lot of assuming the worst going on here. I didn't think it was hard to understand how somebody could get confused when having to communicate about a difficult issue with four different managers, none of whom were great with communication themselves, but apparently everybody here is perfect and I'm allegedly just trying to cheat the system and screw my employer over while getting free money, despite the fact that I've explained several times how that doesn't add up. It's tiring.
amnesty, Is it possible that your employer doesn't see 'a go getter attitude' but an employee who comes across as self motivated and unable to see the bigger picture?
Oh, and how to advocate for yourself, because nobody else is going to do it for you.
That is literally what I feel like I'm doing, and that's what I'm being thrown under the bus here for. If anything, I should have been even more proactive in my advocacy and gone straight to the critical care nurse manager once I knew the injury was likely to affect my start date. I could've advocated for her letting me use the first few weeks to get all the additional education out of the way so I could hit the floor running. Knowing what I know now, it seems unlikely she would have accepted, and it may not have been enough time for me to heal either. But at least I'd have tried, and the communication would've been better.
I'm learning a lot more about workers comp and on-the-job injuries than I ever thought I would at just over a year into a profession .
dishes, it is possible. It's not something my former med-surg manager would ever have thought. But the fact is, I'm dealing with 4 managers who don't know me at all. One liked me enough to hire me, but possibly now views me as broken goods. One already disliked me for wanting to leave my already-short-staffed floor. One said one thing and did another. And the fourth, the risk manager, seems just as overwhelmed by having such complications to deal with as I am, but she's been nothing but kind and I feel like despite any deficiencies, she's tried her best the entire time. She's the one I'm concerned with in the present, and she hasn't expressed having any sort of issue with me. I'm pretty sure I'm okay on that front.
I'm not worried about being fired because of the nurse managers complaining about me. I'm worried about being fired because my hospital's administration has a long record of treating nurses poorly and saving money any way they can no matter whom it screws over. With that said, though I wish more of it was on the constructive side, I do appreciate the criticism I'm receiving here. I need to be as close to perfect as I can be in my dealings with this, and I need insight from other nurses to help me navigate it, because it's clear I don't know how best to do it on my own.
I see a few issues with your ICU plan. First of all, you would need to have an unrestricted return to work to be allowed to start work with a new department. You seem to think that you will be "off your feet" because of classes and unless your hospital does things very differently ACLS and PALS are two day classes. You say you won't be passing meds but didn't you already pass meds on your prior floor? As an experienced nurse you would be expected to pass medications and with the assistance of your preceptor give ICU meds also. Although you will have classes, much of your time with your preceptor will be "on the job" much like nursing school was. You learn stuff in class and you do it in clinicals. One of the things that concerns me about you is statements such as "everyone else is perfect" You posted and requested advice and then when experienced nurses reply and you don't like the reply you immediately embellish your story and accuse others of not understanding or not being sympathetic towards your plight. I'm not saying that you're being dishonest but you are making excuses. You are now in limbo between two departments and don't currently have a home. You were given the opportunity to do desk work and then took it upon yourself to not show up one day because you think no one would want to drive to work every day for 3 hours. You say you don't have to worry about codes because you don't have ACLS. You do have CPR don't you? You absolutely might be doing chest compressions, pushing a cart, or shoving a backboard below some 300lb guy. Right now you are caught between two departments, neither one of which wants to accommodate you. That's a huge red flag. You really only have a job on paper. It is perfectly within the bounds and legalities, in most cases (check your employee handbook) for your ICU manager to rescind your job offer and for your med-surg manager to not want to take you back. The ICU manager hired a nurse with no work restrictions. The things you have done and not done in the interim did not help you. You don't come across as if you are willing to do whatever it takes to get to your new job. Is your facility unionized? If so, speak with a union rep. Otherwise, speak to a workmen's comp lawyer and follow his/her advice. You may be in for a long haul in getting to the ICU and it is entirely possible you will not get there, in your current facility at least. Please pay attention to the advice you have been given. No one is out to get you. You asked for advice and have received a lot which should be helpful to you. Quit making excuses or blaming communication problems on your managers. Communication is a two way street. If I were you I would have asked for a sit-down with the ICU manager, been honest and laid it out on the table. It would have shown that you really want the job despite your injury. Instead, you now come across as someone who isn't a "go-getter" for want of another expression. Thinking that you will have 6 weeks of lighter duty because of orientation is just not realistic.
Try to have a sit-down or a one to one phone call with the ICU manager, express your concerns, re-iterate that you really want the job and ask what you need to do to ensure that the job will be available to you.
Regardless of whether or not your ICU orientation will be comprised of mostly "light duty" (and I suspect it's not going to be nearly as light as you are assuming), you have now hurt your back. My experience with back injuries is that you are never really the same afterwards-you will always be at risk for another injury.
ICU is very very physical. You are constantly having to lift people who are bed bound. Turning them and pulling them up in bed is a is a constant struggle. You have to travel with your patients when they go to CT or MRI or other places. Pushing them around in a bed or stretcher is hard on your body. You can be just as stressed out with your 2 assignments as you were with 6. Don't even get me started with the amount of time you will spend wiping poop off bottoms, cleaning up vomit, and dealing with other nasty secretions.
ICU is no piece of cake, and you are going to have to be VERY aware of body mechanics while working there. You can probably count on the fact that you will injure yourself again at some point in the future. I'd had back issues long before I became a nurse, but I believe my neck issues (have already had one surgery) are directly related to the physical work required in the ICU.
Thank you for saying this. I've lost count of the number of people who have said it's easier because you "only" have two patients. I've been blessed because I've never had an injury but I have left work many times aching from head to toe
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TriciaJ, RN
4,328 Posts
When I was young and inexperienced, I had a lot of older mentors who would have been available to help me navigate situations like this one. Luckily for me, I didn't get injured until I was much older and knew how to handle things. But times have changed, and it seems even the older nurses I've worked with are not as well versed in these issues. So who helps the younger nurses?
I still think there should be a class in nursing school about labour laws and how they affect nurses. They should learn the real pros and cons about labour unions (not the usual propaganda) and should be given some sort of an algorithm for navigating an injury. To hell with "leadership". How about just "nurse survival"?