Most of my coworkers are leaving...

[purplegal]

Currently, I'm working at a rehab/long term mix facility, primarily working with the rehab patients. If you're lucky, you have a second nurse with you, and you split up the work assignment so it's more manageable. If you're not and this happens a lot...you sometimes have 20, 40 or even 60 patients to look after. While working here, I have met some great nurses and coworkers. When I need help, I know I can go to most of them for their advice and recommendations. We're great about helping each other out, so that when one of us is behind, the other jumps in and helps keep the pace going.

The problem is, almost every single one of these people is leaving. I completely understand why--our workplace is very chaotic, we're often lacking in crucial medications, medication errors occur because changes in orders are difficult to find, management would rather criticize than be supportive, and we're so short-staffed that mandations occur almost every day. At the same time, it makes me nervous to continue working at this place.

While I have certainly had successful shifts without some of these coworkers, I really do count on these other people to help my shifts go more smoothly. They're great assets during emergencies, when there are many tasks to complete, or when a patient asks a question that I am not sure about the answer to.

At six months, I have been there longer than most of my coworkers. Yet, I can honestly say that there is much I still do not know, and am not ready to be a resource person for others, which is probably what will happen since many new people are going to have to replace these people's positions. I am not sure whether or not to continue employment at this facility; at the same time, if I left, I would be seeking my third nursing job in one year, which wouldn't necessarily be a good thing, either.

What are your thoughts? Would you stay or leave?

[chacha82, ADN, BSN]

Working 24 hrs is incredibly unsafe and I can't believe that hasn't been reported yet.

[Libby1987]

I don't think you're asking the right questions.

You need to establish a work record and demonstrate mastery of something before the optimal doors and/or jobs become open/accessible to you.

What *I* think you should be investigating is how can you cover yourself with adequate documentation, reporting and limit setting in a high risk environment while you build a much needed skill set. And then forget about having a personal life for a year or so until you can put together a more impressive resume as well as confidently represent your abilities in an interview.

[SmilingBluEyes]

I constantly see people on here advise others to up and quit. Think hard before such action and when you do please give a 4 week notice. This is the ANA guideline

My license is worth far more than a job. So yea, "up and quitting" is sometimes the only option. I did that once and I never looked back.

[Jedrnurse, BSN, RN]

I constantly see people on here advise others to up and quit. Think hard before such action and when you do please give a 4 week notice. This is the ANA guideline

I'd bet that the ANA guideline comes from paper pushing "nurses" who would keel over if they worked in an environment with that type of assignment the OP describes...

[purplegal]

I don't think you're asking the right questions.

You need to establish a work record and demonstrate mastery of something before the optimal doors and/or jobs become open/accessible to you.

What *I* think you should be investigating is how can you cover yourself with adequate documentation, reporting and limit setting in a high risk environment while you build a much needed skill set. And then forget about having a personal life for a year or so until you can put together a more impressive resume as well as confidently represent your abilities in an interview.

I completely understand that it will probably take me time to find the ideal job and that I do need to get experience somewhere. However, I feel that this experience should take place in an environment that is both safe for staff and patients. Sometimes, I question whether this facility can do that because we are seriously lacking in some very important resources. My documentation, one of my strengths, is very thorough and complete. However, there are some instances that I feel that even complete documentation would not cover me. If someone dies because the correct type of insulin could not be found, I am still held liable because I was that patient's nurse. I highly doubt that documenting, "Medication was not available," would be found legally acceptable.

[purplegal]

Also, I found out yesterday that not only are they not increasing the staff that they need to, they are actually DECREASING numbers. Now, during the evenings, one of our busiest units, which used to have 2 aides, will only have one. On my unit, one of our aides will be required to leave during one of our busiest parts of the night. This increases the workload for those of us behind, and mistakes are more likely to be made because we are feeling rushed. However, the admission numbers continue to increase as well as the acuity of the patients. This was put in place to decrease overtime hours for the aides, but this is not the right way to do so.

[NuGuyNurse2b]

oh no, you gots to get outta there.

[Buyer beware, BSN]

The 'losing my license' mantra is greatly exaggerated, especially in the realm of LTC/rehab/SNF. Generally, nurses do not lose their licensure over sloppy care or medical mistakes.

The vast majority of nurses lose their licensure over impaired practice, theft, drug diversion, intemperate use of controlled substances, and failure to complete mandated impaired nurse programs.

And statistically, nurses who work at acute care hospitals are far more likely to see their nursing license numbers referred to the state BON for complaints over sloppy care. LTC/SNF nurses are far less likely to have their license numbers referred to the BON for complaints and investigations.

True, more true and morest true.

But OP, I think I detect something you're saying in-between the lines

Although I have never worked in a LTC, I will say that one of the biggest laments I have had over the years is to see friends and colleagues move on.

People get married, they relocate, they have children, they do other things and in the saddest of cases they die.

Nothing stays the same except the rememberance of some of the most profound memories of shared loss of certain patients, incredible team work and commarderie and some of the most, bring tears to your eyes, bent over laughs.

Oh, yeah. Lots of those, too.

[SmilingBluEyes]

The kind of place the OP is describing, should lose its license to operate. NO "right" insulins, snacks for diabetics. People mandated to work 24 hours or more. This place should be reported to the state. And yea I would still quit. But I would be calling the state health department on my way out.

[incredibleme]

Wow! I am very curious as to where you work because it sounds a lot like my first nursing job. I stayed for 4 years and watched much of the same behavior you have described-nurses (good ones, too) coming and going. Mainly due to the work environment-too busy, mostly. Skilled patients require a head to toe assessment every shift and when they started having the aides run around to get vitals, I knew there was a problem. The nurses weren't able to get these assessments done and are still required to complete the charting. This happens a lot in many facilities.

But that is another topic. I eventually left too when I felt as though my license would be in jeopardy. Perhaps it may be time for you to move on.

[SmilingBluEyes]

The place I used to work had similar issues. Someone (not me) called the State and they were forbidden to take new admissions, literally "frozen" until all deficiencies were cleared up. Their reputation suffered along the way. I was glad by then to have been long gone. I just wanted off that sinking ship.