now I am in trouble

[lizbots]

I work in a assited living unit. I have 65 patients on three floors and I have three aides on the 3rd shift. I received a call from nursing unit that I have to send an aide to help them. I declined, everyone was busy. They wanted an aide to satisfy their staff to patient ratio because they were understaffed. My supervisor called from home and send to send an aide, I declined. We were too busy, I wasn't done passing meds, pts wanted showers and treatments. I feel that I was making a medical decision regarding the safety of my patients and they were making a business decision so that their paperwork/ratios are complete. What should I have done?

[Blackcat99]

I think when your nursing supervisor called you from her home that you should have sent someone immediately to that unit. We may or may not agree with our nursing supervisors orders. However, they are the ones "in charge" and you can now be written up for "insubordination" or even worse.

[elljayo]

how did this turn out?

[DavidFR, BSN, MSN, RN]

If you felt your unit would have been left dangerously understaffed, you did right to refuse. I cannot disagree more with the poster above who feels you should blindly obey a supervisor. In general yes, you follow their requests, but when you feel patients and staff are being endangered, you have to speak up. When I worked in the UK there was a concept of the unit manager having ultimate 24 hour responsibility for a unit: (s)he could have put out the SOS for emergency bank or agency staff, and if there was really nobody available, come in him/herself - that 24 hour responsibility should be reflected in the pay scale. My experience is that agency staff will come out at a moment's notice if the price is right - managers have to be prepared to make it worthwhile. Why was their such a dire need for your aide elsewhere? Had your manager stuffed up on the rota? You as a nurse on the unit should not be expected to compromise the saftey of your patients and colleagues. At the end of your shift I would have backed up your action with a written statement justifying why you felt you couldn't release an aide, had it witnessed by one of the staff you were on with, kept a copy for yourself and sent a copy to both your supervisor and to his/her boss. My message to everyone is get unionised - their back up is always helpful in scenarios like this. I hope this turns out well for you. If my relative was in your care, I'd be glad you defended correct staffing levels, though as I understand it you were one nurse and three aides for 65 patients on three floors - that's pretty crappy staffing levels to start with.

[Blackcat99]

I have seen nurses get fired for not doing what the supervisor wants them to do period. However, if you live in an area where there are plenty of nursing jobs available then I guess you can do whatever you want. Good luck.

[DavidFR, BSN, MSN, RN]

I have seen nurses get fired for not doing what the supervisor wants them to do period. .

Similarly nurses have lost their jobs and/or their licenses for blindly following the orders of a supervisor or a doctor when that decision was wrong and endangered somebody. Obviously you don't systematically refuse every demand made of you, but when you think something is not right it's your professional duty to question it. Being unionised is an enormous help if you find yourself fired unfairly.

[Blackcat99]

Yes, it seems that only union jobs are safe. I am in Florida with no unions anywhere and no decent hourly wages either.

[nurse.sandi]

Three floors..three aides. Hm. I would of argued that point with my supervisor. Seems like a huge safety issue with those numbers. But maybe there is different rules for your unit versus the other unit. Good luck.

[nurse.sandi]

Yes, it seems that only union jobs are safe. I am in Florida with no unions anywhere and no decent hourly wages either.

Bring up the topic of unions with your coworkers and see what they think. or watch em get up and walk off..