Job abandonment

[Nurse_CrystalRN]

I work in a LTC facility, and the company is horrible. Like, beyond horrible. I've put up with a lot of crap from them and I've only worked there a couple of months. Today I walked onto the floor at the beginning of my shift and was immediately alerted to the fact that another nurse had called in sick and I was gonna be assigned her patients PLUS my own. That would have made 46 patients. I'm a new nurse, I'm not comfortable with that AT ALL. I haven't clocked in yet or done my narcotics count and received report from the off going nurse. I immediately go to the aDON's office to let her know that I wasn't comfortable taking the assignment and she simply said, "You have to. We don't have anyone else to cover right now and if you don't accept it you could lose your license for abandonment". Im a new nurse, but I'm not stupid. I know the abandonment law. I have to receive report and accept responsibility for the patients first for it to be considered abandonment. I said that to her and she said, "Well you're welcome to leave right now, but if you do it'll be job abandonment and you'll not be eligible for rehire". That's fine with me, this place is a crap hole anyway. So in the heat of the moment, I decided to walk out. There's no way I was accepting the assignment and I wasn't about to be bullied into it. Now that I'm about to begin the job hunt again, I'm worried about how this is gonna affect my career. I know it's gonna look bad that my first nursing job I only held for a few months and suddenly walked out on. What should I do? And is there a better way I could have handled the situation? At the time, I was just so offended and pissed off that I walked out without a second thought. I'm taking this as a learning experience now.

[sailornurse]

While it is still fresh in your head, I would document the details, names of staff who overheard, the day shift nurses on duty. It may come in handy. Not sure if you should contact BON or not in case they try to report you for god knows what, the abandonment that never was.

Good for you that as a new grad you understand what abandonment actually is. When I moved back home after 15 years experience and fresh out of the Navy Nurse corps, the local hospital, nurses did not understand what abandonment is. In fact, just off orientation, the day nurse gave me a slip of paper with room numbers, (not even patient's last names) and asked if I "accepted my assignment". To which I replied, can't say since I have not received any reports, don't even have names of patients, let alone a diagnosis! Yeah they actually believed that a list of room numbers was enough information to make a judgement call about the safety of an assignment, idiots!

Sounds like you also stand your ground and not be pushed into taking charge nurse position without experience and training, another issue that new grads do not always understand that you can say "No".

Good luck with new job. Most likely, local facilities are probably familiar with this poor excuse of LTC.

[gonzo1, ASN, RN]

You did the right thing. They can't touch you as you did not even clock in yet. This would come under employer/employee dispute, not under nursing care of BON. It's better to be unemployed than lose your license or have something happen to a patient.

[CMLPN08]

You did the right thing, everyone knows you have to clock in for it to be abandonment. Some places just don't care. Good luck with your Job Search!!

[HouTx, BSN, MSN, EdD]

Kudos to OP!!! It's very gratifying to see that our new nurses are well-informed about their Nurse Practice Act. The essence of professional behavior is making those very courageous decisions - the ones that arise from one's own sense of integrity.

I know that it may not be very comforting, but over my (many, many) years of nursing practice, I have never once regretted making the hard choice rather than just accepting and coping with a wrong situation. Sure, it is usually hard to deal with the immediate consequences, particularly if it means changing jobs - but it always worked out for the best.

I'm so proud of you.

[LPNtoRNin2016OH, LPN]

I would have done the same. I would rather find a new job than face a lawsuit because I had too many patients to every safely take care of. If you are returning to LTC, ask about the patient ratio, IMO anything over 1:25 is too much. Also, see if they let you talk to someone who works there, like a peer to peer interview. The one place that let me do that, the place I PRN at currently, is the best LTC I have ever been in. They weren't scared to let me talking to a current employee because they knew she would say good things.

[SWM2009]

Posts like these are why I sometimes I think I work in the Utopia of LTC. My DON/ADON routinely work the carts on any shift if they are unable to find coverage for call outs.

[Deredain]

I took a job last summer in an assisted living facility. It was for every other weekend as I have a full time job. I was told that the patient to nurse ratio was 20:1 and that I'd be able to take my time going through orientation as a new nurse.

After 6 weeks, I resigned. What I came to find was that there was only one nurse for 55 patients. These people needed much more than just a med-pass. My first day they basically handed me patients and there wasn't much of any orientation. By week 2, I have 30 patients to myself. The nurse training me was an LPN. I only found this out by looking in the assignment book to find LPN next to her name. Both the LPN and med aid were handing out narcotics and from what I understand of the law, under my license since I outranked them both. When I was assessed for med pass, I asked the training coordinator how she expected me to learn like this and she just stared at me. No answer.

It was not worth losing my license. You did the right thing by telling them and quitting.

[Sweet&PreciousRN2B]

It was good of you to leave, to me that sounds like unsafe staffing and there is no telling if you would have had a free-from-risk shift or the shift from hell. That ADON wanted to guilt you into taking the extra assignment. Remember, what we don't dispute is what we allow... Good luck on your Job Search! :)

[msancheeze, BSN]

You absolutely did the right thing. I found myself in a similar situation the first year of my professional nursing career and again, just last week. I found it emotionally jarring to have to walk off a job and stand my ground, but I left with my professional integrity (and my nursing license) intact.

[misstrinad]

You did the right thing. Honestly I would report the facility for threatening you, although that becomes a he said she said unless others have lodged the same complaint. Other facilities I'm sure will be aware of the shoddy reputation , just explain during your interview when it comes up. Any facility that doesn't understand why you didn't accept that unsafe assignment isn't a facility you want to work for anyways.

[kbrn2002, ADN, RN]

The stupid abandonment threat aside...There was nobody else? What about the DON? Last I checked that acronym stands for Director of Nursing which means the crazy boss is a nurse. Sheesh, I can't stand it when management acts like there is nobody else when THEY are the somebody else that could drag their behinds out from behind a desk and pass some meds.

[Satchmo]

I would say the large majority of LTC facilities are more like the OP and others suggested.

I don't know why they are this way. The entire system needs to be revamped.

Also, if you're going to be disturbed by having med aides and the like passing pills under your supervision and license - along with a patient load of 30 or more people - LTC nursing isnt for you. That is the reality every hour of every day.

Overworked, underpaid - but ain't we all!

Edit: I meant to reply to SWM2009, LPN but forgot to quote I guess.