Live's and licenses at risk

Specialties Geriatric

Published

In May of this year I was hired as a brand new nurse at a ltc facility to work the night shift. The facility has 2 wings and each wing has 2 halls. Being a rather large facility of 140 beds and a new nurse I was concerned with staffing but was assured that for my particular shift there would be 1 nurse and at least 2 cnas to each hall for a total no less than 4 nurses and 8 cnas.

This was the case up until a few weeks ago when a new company took over and took away people's vacation time, increased the cost of our insurance and decreased our wages. It wasn't long before staff started dropping like flies due to all the resignations.

Last week I came into work only to find out I was the only nurse on my wing, and to top it off I was down to one cna. The other wing only had it slightly better at 2 nurses with one CNA.

This was not only unacceptable but extremely dangerous. I immediately called my ADON to figure out what to do since I and 1CNA couldn't possibly care for 67 high acuity patients only to find out she and the rest of upper management were well aware of the situation. She said that everyone was working hard and making sacrifices and that I too needed to be a team player. Incredulous, I explained my issue wasn't with working hard but with the safety and well being of the residents. She then tried bullying me with threats of abandonment until I told her I hadn't accepted responsibility of the additional hall nor had I been given report on it, and that I would not be doing so. She then said she understood my concerns and would get back soon with a solution. Within minutes my DON called me and was very understanding, saying she understood my position, that she would feel and do the same. She said that she knew how much I cared about the residents and hoped that despite refusing the extra hall I did my best to care for them in anyway I could because that's as much as she or the BON expected. That was 2 shifts ago, 2-12 hour shifts with no breaks or down time at all. Ive cared for my hall as I always do, albeit in an speedy and abbreviated manner(which still makes me nervous) and I've done everything I could for the other; including but not limited to passing the 11p to 5a meds, caring for an extremely brittle diabetic, 3 tube feeds, 2 trachs, prioritizing the most important treatments and dressing changes, and 1 brutal code.

Yesterday I was nearly to work when I recieved a phone call from one of the day shift supervisors who informed me I was suspended pending further investigation for abandonment and dereliction of duty because I hadn't been passing the extra halls 6am med pass. I tried explaining that it wasn't my hall, that I never accepted responsibility, took report or did the narc count for that hall, and to talk to the DON because she knew what was going on. She told me that the DON gave her the order to suspend me.

I'm shocked, hurt, and scared. I'm in desperate need of any and all advice I can get about what my I should do next.

Specializes in Transitional Nursing.

Who was in charge of the second half of your hall? Someone had to be in possession of the keys and thus the residents. To the best of my knowledge you can't be charged with abandonment if you didn't accept an assignment. That being said, if the hall was abandoned by a prior nurse and you didn't take action to alert management that there was a hall with no nurse that could be another story.

This was overnight shift, I assume. 60ish patient isn't all that uncommon if they are stable and mostly sleep through the night, but you said you had a code, so I am assuming many were not stable.

I would seek out an attorney and contact your malpractice provider if you have one.

The system is very, very broken and a lot needs to change. Unfortunately, sometimes the squeaky wheel gets replaced, at least in my experience. I'm still trying to find a way to speak up about these kinds of things without alerting my employer, as I fear they would frown upon one of their nurses essentially saying their staffing etc. is unsafe.

I think if it were me and I didn't accept an assignment I would make sure that someone else either took it over or kept it from a prior shift. I'm curious to know how this played out.

Like I said, the system is broken. I really wish there was something we could all collectively do to try to make things better.

I can't thank you enough for taking the time to reply and offer your advice. The first night this happened I called the on call rn, no answer, then my ADON, who then had the DON call me. During this time the mandated nurse of that hall left and placed the hall keys in a desk drawer in mds room, unbeknownst to me. After several attempts to reach him my Don called to tell me where they were.

The following night one of the night nurses on the opposite wing took report and did the narc count with the mandated nurse when I once again refused, then left the keys on my cart. I once again called to report this, and was once again told to do my best, I also sent her a text with the same info just to cover myself.

I just can't understand how they feel this was my responsibility. Once again THANK YOU! I feel so much better and will be taking your advice and contacting an attorney Tuesday when they are back in office after the holiday

Specializes in Gerontology, Med surg, Home Health.

I'm pretty sure putting the keys on your cart does not constitute your accepting the responsibility?

Yeah contact an attorney that is well versed in dealing with your state's BON for sure. Also, put in your notice and when looking for a job remember that if your employer asks you to do unreasonable tasks and you comply then you are putting your hard earned license at risk. These places live in the fact that nurses are always willing to "go the extra mile" and pitch in. Being understaffed improves their bottom line and puts your license at risk. Guess which one of those facts they care about?

Specializes in Surgical, Home Infusions, HVU, PCU, Neuro.

I'm so sorry you are going through this, I would be livid. Does your state have a safe harbor? If it does them I would have evoked this . Save the texts and hopefully there was a response to yours acknowledging the problem. Future reference, if it were me, besides envoking safe harbor I would have sent an email and CC the DON and precious nurse. This has a delivery timestamps that gives evidence for delivery, the text doesnt unless response was received. Do you have a gmail acc? I would make this acc if not, there is a way to embed a tracking blip in the gmail's that show delivery time, when and how many times said email was opened, the vicinity said device was when opened and sometimes what device opened the email(iPhone, windows desktop ect ) this may sound extreme but you are working for your license, not theirs, and no one will protect it but you. Best of luck

I'm shocked, hurt, and scared. I'm in desperate need of any and all advice I can get about what my I should do next.

Glad you posted to AN, it's a good first step in dealing with the emotions that have come up as a result of the way you've been treated, and it's important to be able to set the emotions aside in order to effectively make decisions here. I'm sorry that as a new nurse you've been slapped with the reality of nursing today, which is that money talks and mostly management couldn't care less about their staff or their patients.

Think about this for a minute from their point of view. As desperate as they are for staff, and knowing you did all you could humanly do to care for too many people, why would they suspend you? My bet is that you have identified yourself as a liability to them. You've showed you won't take legal responsibility for an impossible assignment and know that the conditions are unsafe. The only thing worse for them than no warm body has become a smart and ethical warm body.

I highly recommend you resign, effective immediately. Or give two weeks as you are suspended anyway - but don't actually work another shift. What they've shown you is they are willing to hang their problem on you, and if you work again and something happens the view from under the bus won't be pretty. You need to leave this nightmare anyway and this way you can truthfully say you were never asked to leave a position. If pressed, you can say you were suspended for declining a staff nurse assignment of 70 mixed custodial and acute care patients. Any health care org will get it.

While you are likely not at risk from the BON as you never accepted report and therefore never had a duty to care to be then derelict of, your having given some meds gives them something to try to hang you with. But it was the nurse who left having not handed off the care of her patients to someone else whose license is really at some risk from the BON, not yours. Your employer in an employment at will state has a right to suspend or fire you for anything, even something grossly unfair, unless you are part of a protected class and can show discrimination. The question of your exposure to the BON is something totally separate.

I'm not sure you need a lawyer. You need to print out and secure all documentation about this in a very safe place in case they do try to hang you with the BON, and I would immediately retain a lawyer if I heard from the BON, but unfortunately no lawyer will be able to make them treat you fairly. I know their accusations hurt like hell, and I know having the DON sound so understanding only to suspend you is a mind blower extraordinaire, but this organization has shown its colors. When you look back on this you may actually be grateful you were given the opportunity to get out of a hellish situation with no consequences to yourself.

I just have to say what an amazing and supportive group this is. I can not thank you all enough. I had a meeting with the administrator, DON and ADON today about the the incident. During questioning I was told that it was illegal for me to refuse assignment of the additional hall because of my concerns for the patients well being. I'm absolutely sick, literally sick about the entire thing. The worst thing was hearing how much my patients miss me. I have worked hard to develop a relationship and getting to know each and every resident on my regular hall so that I can not only care and advocate for their physical health but also for their mental and emotional health.

After much thought and consideration I've decided to resign and it truly breaks my heart. I never imagined there would be something I'd go through in my professional life as difficult as the grueling ups and downs of a nursing student but this emotional roller coaster is by far so much worse. The only thing getting me through is the love and support you all have shown me and hope that I too can someday help someone on here through a difficult time in their career.

Great advice, thank you.

Specializes in Gerontology, Med surg, Home Health.

I've never heard of safe harbor. I have heard of nurses standing up for their rights and the rights of their patients. You didn't accept the count or the keys, so I don't believe there is any issue of abandonment. I've been in the business since dinosaurs roamed the earth...been a DNS for 13 years....never heard it was 'illegal' to refuse an assignment. I concur with my colleagues here who tell you to keep a record of everything that was said and get out of there.

In May of this year I was hired as a brand new nurse at a ltc facility to work the night shift. The facility has 2 wings and each wing has 2 halls. Being a rather large facility of 140 beds and a new nurse I was concerned with staffing but was assured that for my particular shift there would be 1 nurse and at least 2 cnas to each hall for a total no less than 4 nurses and 8 cnas.

This was the case up until a few weeks ago when a new company took over and took away people's vacation time, increased the cost of our insurance and decreased our wages. It wasn't long before staff started dropping like flies due to all the resignations.

Last week I came into work only to find out I was the only nurse on my wing, and to top it off I was down to one cna. The other wing only had it slightly better at 2 nurses with one CNA.

This was not only unacceptable but extremely dangerous. I immediately called my ADON to figure out what to do since I and 1CNA couldn't possibly care for 67 high acuity patients only to find out she and the rest of upper management were well aware of the situation. She said that everyone was working hard and making sacrifices and that I too needed to be a team player. Incredulous, I explained my issue wasn't with working hard but with the safety and well being of the residents. She then tried bullying me with threats of abandonment until I told her I hadn't accepted responsibility of the additional hall nor had I been given report on it, and that I would not be doing so. She then said she understood my concerns and would get back soon with a solution. Within minutes my DON called me and was very understanding, saying she understood my position, that she would feel and do the same. She said that she knew how much I cared about the residents and hoped that despite refusing the extra hall I did my best to care for them in anyway I could because that's as much as she or the BON expected. That was 2 shifts ago, 2-12 hour shifts with no breaks or down time at all. Ive cared for my hall as I always do, albeit in an speedy and abbreviated manner(which still makes me nervous) and I've done everything I could for the other; including but not limited to passing the 11p to 5a meds, caring for an extremely brittle diabetic, 3 tube feeds, 2 trachs, prioritizing the most important treatments and dressing changes, and 1 brutal code.

Yesterday I was nearly to work when I recieved a phone call from one of the day shift supervisors who informed me I was suspended pending further investigation for abandonment and dereliction of duty because I hadn't been passing the extra halls 6am med pass. I tried explaining that it wasn't my hall, that I never accepted responsibility, took report or did the narc count for that hall, and to talk to the DON because she knew what was going on. She told me that the DON gave her the order to suspend me.

I'm shocked, hurt, and scared. I'm in desperate need of any and all advice I can get about what my I should do next.

Thank you for sharing your experience. I'm sorry have nothing to offer but a virtual hug.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

So sorry about this, jendes. To have them invoking the "team player" in the face of all that is just perverse. All the best to you.

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