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 Surgical, Home Infusions, HVU, PCU, Neuro.

The Safe Harbor Rule (SHPR) is a nursing peer review process that any type of nurse (licensed vocational nurse or registered nurse) can initiate in good faith whenever asked to take part in assignments or conduct that might result in one or more violations of Texas Board of Nursing rules and statutes. The Safe Harbor Rule was put in place to prevent retaliation by employers and shield the nurse's licensure from action by the Texas BON when an RN or LVN reports practices or assignments that they believe may detrimentally affect the manner in which nursing duties are carried out. Envoking prevents action to be taken I the nurses license when the nurse deems an assignment unsafe that may result in harm. Even if the supervisor refuses to sign the safe harbor that does not make it invalid, but the request for power review must be made before the assignment is accepted.

I do not know if other states have something similar to this as I have only practiced in Texas.

It is not illegal for you to refuse an assignment but refusal of an assignment could result in termination. Most states are at will so you can terminate your employee/employer relationship at any time and vice versa. This does not however carry over to unemployment and may cause loss of benifits.

Specializes in Adult Primary Care.

I'm so sorry you are going through this. I also really dislike the "team player" approach in trying to make you feel guilty. I wish you the best in your next position.

Thank you for your support.

I unfortunately am going through a similar situation. You seem to have a heart of gold and really care for your patients. Find a facility that appreciates that. Unfortunately from the sounds of it, a lot of SNF are taking higher acuity patients and increasing the nurse to patient ratio. I wish you the best in your future. Wherever you go next will be lucky to have a nurse like you! :)

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