Insubordination

[Trickyp713]

I've been a nurse at muy current long term care facility for 4 years. I currently work weekends, and I've never seen our staffing so bad. It's to the point where we have our DON and administrator demanding we manage an entire unit alone, with 1 or 2 aids in addition to managing another unit we can't possibly be on. It's exhausting and impossible. Some staff have spoken of refusing to take another unit, but fear this could be insubordinate. Ive nearly killed myself working 32 hours in 2 days because to me the moral duty is patient's first. I personally habe been extending beyond this demand because i want my fellow employees happy and stress free. I strongly believe my administrator is pushing us to see what we will minimally run with, and just get by. but it's bad caste and it's unsafe. She waited to late to get agency. Is this insubordination to say ill cover my hall only?

[MunoRN, RN]

Unless you have legally defined ratio limits, then it is actually insubordination to refuse to do what your employer tells you to do, and you can be fired as a result.

That doesn't mean you're a bad nurse for being insubordinate, in many situations being insubordinate is the only reasonable action for a nurse.

[Trickyp713]

We do not have legal ratios

[jodispamodi]

We do not have legal ratios

You may not have mandated nurse/patient ratios but every state mandates minimum staffing requirements (meaning by law they cannot have less than a certain number of nurses/cna's) for snf's, sub acute rehabs, etc. its completely different than nurse/patient ratios. If they do not adhere to the minimum staffing requirement the state could shut them down.

[Trickyp713]

Thank you. I'll have to look into this

[Scorchednurse]

If you refuse because what is demanded of you is unsafe, unethical, or illegal does not mean you are being insubordinate, it means you are covering you're a**and your nursing license.

Doesn't mean you're covering your a**from being fired...but you're probably better off for not being there then. I worked in a "post acute" (where the acuity was ridiculous for the setting) and in one shift was given 67 patients with 3 sets of keys for 3 med carts, 16 pts in iv abx c piccs , 2 peripherals that needed to be started with iv hydration, 3 med passes to get through in that shift, 4 wound vacs, 7 actively dying hospice patients, 5 admissions, and 3 discharges...all to cover call offs. I spent 28 hours there those 2 days. At midnight I saw dozens of post its left from aides at the station with prn requests I never saw from the morning before. I called when I got home and said I couldn't come back. It was dangerous.

[amason2021, CNA]

ChryssyD said:

Tricky: You know, I'm kind of in a similar situation. Staffing is really bad, they can't get anyone in, and when they do the people don't stay once they see the problems in the facility. It's so frustrating. I love the people I work with, and I really love the patients; I feel they need and deserve the best care from people who understand and care about them. People like me. But I've been used and abused, written up for stupid things no other place would write a nurse up for, been flat out told that even if I'm sick and haven't slept all night I need to suck it up and get in to work, no matter how unsafe I think that is. The nurses are generally great, but administration sucks. I'm so tired, and I have worked every single holiday in the past 7 months, and I am scheduled to work Christmas eve, Christmas day, and New Year's day. I am so angry and so tired of the lack of consideration. But, I'm a nurse. What else did I expect?

Seriously, though, best of luck. I keep on where I am because of the patients. But there may come a point when you can't take it anymore, and that's when you should leave. I know I'm close to that place. If and when you get there, trust me, it's OK. You have to take care of you and your license. Hang in there, by all means, but when it's time to let go, just do it. Peace.

I left a facility after three weeks in August of last year for the first few issues you mentioned for a hospital setting and best decision ever! And one facility I worked at as a cook, they pulled the same holiday stunt as you mentioned(because two dishwashers were dating, how they allowed that is because the administrators son was the supervisor and the dishwashers and super were best friends, dish people had a kid together and wanted to celebrate with the kid, as if I don't have a step kid myself), this one I'm glad they fired me because they have a host of problems after that.