Need advice please!

Specialties LTAC

Published

I am typing this on my phone so forgive any mistakes.

I just took my first nursing job at a 90 bed LTC facility. Upon hire everything seemed great! I was told I would have three days of orientation, and could ask for more if need be. My first day of orientation I was shown how to use the med cart, pass meds ect. Learned that about 90% of the residents have behaviors, so it's more like working in a pych field (not really an issue). Second day, the other nurse didn't show up for her shift along with 3 cnas so we just had to bust tail to get meds passed with only us two and 1 CNA (who was a saint!!l Third day, was thrown out on my own with no help and when I stopped to ask questions was in turn asked why I stopped passing out meds...and that I only had X amount of time to do it and go back to work. I asked for more orientation days because I have not been shown how to do ANY OF the proper paperwork and was told that I couldn't have anymore because they were short staffed. I actually witnessed the director of the facility scream at nurses (to the point where they were in tears) and GRAB a resident and shake them and tell them to "shut that **** up" because they were hollering out in the hallway (this resident has a mental illness, and regardless no one should lay a hand on her for any reason like that). Should I run?? I've never quit a job in my life! How would I explain that on a resume? I come home and cry everyday for these people and want to make a difference in their lives, but I want to keep my license!! Please someone, anyone, give me some advice. I tried asking a senior nurse at this place for advice and all they said was "**laughing** welcome to nursing little girl!!"

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Also, there is no treatment nurse,unit nurse, secretary, and the DON is only there for a few hours a day. Everything is on you all the time. Which I could probably handle if I didn't have the entire patient load and more training. I'm not usually a whiner, but I'm at a total loss. I want to love nursing, it's what I've always wanted to do with my life. I loved clinicals, and I love people who need my care..I just don't know what to do.

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Get the hell out of dodge!

3 days as a new nurse in ANY position just isn't enough.

90 patients and 3 nurses (common), 90 patient and two nurses..uhhh nope! (I've worked LTC and its not uncommon to have 30-35 patients, but if anyone tried to hand off 45 patients to me, I'd literally laugh in their face and refuse the assignment) but 2 nurses and 45 patients each?? and 1 CNA to care for 90 patients??

The director of the facility physically grabbed a resident and screamed at them using foul language?? That right there is illegal! And I'd report it.

Count your losses and get out..now.

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That is most likely what I will be doing! Yes, she did! Everyone is scared of that woman. I'm applying for other jobs now, but won't it look bad that I just quit? I have only been there a week. I don't even know if I should be putting them on my resume or not. I plan on writing a letter to the company who owns the facility also.

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CT Pixie is right, "Get the hell out of dodge!"

I'd add, "And never look back with regret." There are some jobs that are not only a joy to leave, leaving them speaks well of your decency and professional skills. This is one of those. It's up to you whether you put it on your resume or not. For a mere week, you might consider it mere temp work and not worth mentioning.

Leaving that quickly can easily be explained in subsequent job interviews, that is if it even comes up. Stay and this obviously dysfunctional facility will have sufficient time to manufacture dirt on you, particularly if you show any inclination to be a whistleblower. They might even fire you, which puts on you the onus of explaining that to potential employers.

And I would strongly suggest that—as guilty as you might feel about it—don't give them two weeks notice. That'll also give them time to collect dirt. They created this mess. You have no responsibility to make this easy for them.

Instead, provide them with a letter detailing what you've described above and making your resignation effective now. They need to have in place ways of filling in staffing shortages for last minute sicknesses. This is much the same. Don't let them play a guilt game with you.

Are you in a nursing union or other professional body? If so, by all means contact them for advice. This situation is common, so go for all the expertise you can get, particularly expertise that knows your state laws. Employment laws are almost exclusively state-based.

You might also find it more reassuring to hire a lawyer, particularly one who knows employment law. A nursing union can give you advice there too. They may even have provisions that cover some of the costs for their members. If you're not a member, maybe they'll still refer you to a good lawyer.

If you aren't able to get union help, search online for lawyers with that speciality in your community and some experience with nursing situations. Reputable lawyers know that there's a sense where you need to try them out before you buy. Ask for some basic advice and, if one seems to know what they're doing, consider hiring him or her to help your with that resignation letter. That'll repay them for their time.

Perhaps the letter could even go to the nursing home under the lawyer's letterhead. That signals that you already have counsel and are prepared to fight. In many cases, that will prevent that LTC from taking either legal action or, more likely, doing something linked to your certification. The more dubious the behavior these people might contemplate, the more intimidating they will find the presence of a lawyer. That's particularly true of bullies like these.

I know a bit about law, have done graduate work in medical ethics, which was, I tell friends, "meant studying law in a medical school." Unfortunately, I know nothing about employment law. Lawyers do not come cheap, but a good lawyer is worth his or her weight in gold. They know the laws. They know how to manage situations to their client's advantage. They know how to create a paper trail that will look good in court. And they know how to keep their cool when a former employer gets threatening. Have one, and you can step aside and let your lawyer fight for you. That can be very valuable. The fact that you hired one will also reinforce your claim to future employers that you had good reason to quit that job.

Now for some reassurance. That nursing union will know how these situations usually work out. In all probability, the LTC facility doesn't want any publicity about this and will do nothing. A lawyer is likely to merely be good insurance, worth hiring simply for your own piece of mind if you're inclined to worry.

The union and a lawyer can also give you advice about reporting that grabbing and screaming incident.

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Specializes in kids.

I actually witnessed the director of the facility scream at nurses (to the point where they were in tears) and GRAB a resident and shake them and tell them to "shut that **** up" because they were hollering out in the hallway (this resident has a mental illness, and regardless no one should lay a hand on her for any reason like that).

1-800-Ombudsman!!!!!

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Thank you so much for your response! Unfortunately I don't have the funds to hire a lawyer at all :( My husband and I live paycheck to paycheck (which is another reason I was praying this job would work out!).

I have an interview Monday at another facility, and did not go into detail about my current job (as I know it is bad taste to downright "bash" another company) , but I did give them a little information as to why I wanted to quit immediately. The DON there told me to "RUN!" also! I am an at will employee there, and it is a union, but I was told that it wasn't a union for the nurses? I don't really understand that though.

My next question.. how do I write out my resignation letter? I've never had to do one before. I know how to give one with the proper two weeks notice, but I plan on quitting tomorrow. Should I quit before my shift or after? I'm so very confused, and I truly hate to burn bridges. This is a pretty big company who owns a good bit of LTC facilities and I know once I quit I will not be eligible for re-hire at any of them.

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I'll take up what you said item by item.

Unfortunately I don't have the funds to hire a lawyer at all

Don't worry. You'll probably never need one. Go quickly and quietly, and they'll almost certainly leave you alone. The last thing they want is for this to blow up in the media. That'd get the attention of regulators and families of patients. And at this point, you've worked there so little, they have little to fear. If you were leaving knowing all you've seen for a year, they'd worry. As is, even if you went to the state authorities, you'd have little to say.

but I did give them a little information as to why I wanted to quit immediately.

You did well. Those at this new job now know enough to understand your leaving. That's what matters. It may even make the DON at this other job a bit more sympathetic and more likely to hire you. By being repulsed by what was happening you demonstrated that you're a caring, professional nurse. It'd be a bad mark on your record if you'd stayed and fit in to those horrors.

but I was told that it wasn't a union for the nurses? I don't really understand that though.

Unions tend to be either craft or trade.

* Craft unions are for those who do similar work (craft). Teamsters drive trucks. Nursing unions are for those in nursing. They are more focused more on what they do. A state nurse union, for instance, will lobby about mandatory overtime hours for nurses.

* Trade unions are drawn from those who work in the same industry (trade) such as the United Auto Workers. A janitor in a GM factory, for instance, might be in the UAW. Since their members do so many things, money issues tend to dominate.

My hunch is that the union is the SEIU, or Service Employees International Union. I've know some people in it and felt sorry for them. They tend to be people in poorly paying service jobs, including LTC facilities, who're often ill-treated. Service is such a broad area, it's more like a trade union. Here is their website.

SEIU - Service Employees International Union

Notice that they include healthcare and under that working at a LTC. Unfortunately, I don't think they realize the nasty realities. If fast-food workers get $15/hour, the chains will automate and get rid of many jobs. Their anger needs to be tempered with realism.

My next question.. how do I write out my resignation letter?

I wrote a resignation is a situation not that removed from yours. My primary reason for leaving was to go back to school and do graduate work in medical ethics in the University of Washington's medical school. That's what I meant by 'studying law in the medical school.' My main professor was a lawyer.

But there was another factor in my departure that meant I resigned rather that give someone who hated working weekends a weekday only job by offering to shift to part-time on weekends. As a student, weekends would have been ideal and my pay there was been far better than any part-time work I could pick up as a student. I loved caring for teens as much as earlier I loved caring for kids on the Hem-Onc unit.

But tensions between nurses and the nursing administration had been growing worse for months and I didn't want to endure that any more. I got out just in time. In the two months after I left, some 20% of the floor nurses quit and hiring replacements became difficult. Nurses I met in my classes at the UW would say, "Oh, I would never work there," when I brought up where I had been. The core problem was an abundance of criticism from above but little or no praise or encouragement.

Did I bring up that growing tension in my resignation letter? No. I wasn't sure how to handle that, and I wanted to depart as amiably as possible. I did decide to do the nurses I was working with a favor. Day shift on the teen unit was hideously overworked. All but one nurse was in her twenties because, quite frankly, no one older could keep up the grueling pace. In my resignation paper I suggest to the DON that every bit of work that could be shifted to evening shift, which was similarly staffed but had far less to do, be shifted there. I figured it was a practical enough step, it held some chance of having an impact.

But in your case, I'd suggest that you keep your letter short and simple. You might say nothing more than "It seems quite clear that I am not suited for this type of work, so I am resigning effective XX today." Saying more will merely complicate matters and exhaust you still more. Besides, they know quite well why you are leaving. You need not tell them.

It's your call whether the effective time is the start or end of shift. If you suspect they'll treat you nasty, make it the start of shift. If you think the shock of quitting will give you an eight-hour reprieve, then make it the end of shift as a favor to your fellow workers. And if you decide to make it the end of shift, don't be surprise if they make it "now" instead. They'll see you as a bad seed, corrupting their other workers.

Whatever you do, drop no hints to anyone there that you have another job possibility, much less the actual locale. Revenge is unlikely, but give them no opportunity.

This is a pretty big company who owns a good bit of LTC facilities and I know once I quit I will not be eligible for re-hire at any of them.

I suspect this isn't their only LTC facility with problems, so your not being rehired at some future date is probably no loss. If you feel you should do something about these problems, write a letter explaining the deficiencies you saw to the firm's CEO, asking that your letter be placed in your permanent file. Be sure and keep copies of both letters. Then let it go at that. You've done what you could. Maybe your leaving will prompt someone who has worked there longer to file a complaint about the care there.

Treat this as a learning experience, put it behind you, and move on.

--Michael W. Perry

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Thank you ever so much for giving me such wonderful advice/information!! I truly appreciate it!! I will take all you have said to heart. I will update how tomorrow goes.

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Well, I went in this morning and the DON and administrator weren't there. I tried to call them and got no answer. They actually had me off the schedule for today (apparently they changed it yesterday or the day before while I was off and didn't bother letting me know). I waited around for almost two hours and tried to call numerous times. I finally just took my letter into the DONs office and laid it on her desk and slipped a separate letter (but worded the same, just addressed differently) under the administrator's door. Probably the most unprofessional thing I've ever done in my life, but I can honestly say I felt like an anvil had been lifted off my shoulders when I walked out. I didn't speak to anyone else there about what was going on, I kept it private. I know they have seen my letters by now, but I haven't received I phone call and I doubt I will. I've still tried to call a few more times and left 3 messages total today, but I doubt anything will come of it.

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Specializes in critical care.

T - what it boils down to is this:

Your job? Or your license?

You were put in a horrible and unsafe position. If something went wrong as a result of inadequate training and short staffing, you'd be thrown under the bus and potentially have a mark against your license. Or, what's worse, you could lost your license for providing unsafe care, when ultimately you didn't know better and weren't given adequate tools to do better.

So I ask again: your job? Or your license?

You made the right call. I hope you get that new job and they give you a nice, long orientation.

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Definitely my job instead of my license!! I worked to hard to get my license to have it taken! Thank you for your kind words. I hope I get the new job also. They have a one month orientation :) I just want to start fresh and put this all behind me.

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