Quit without Notice or Risk Being Fired?

jadelpn, LPN, EMT-B · Jan 24, 2014

Ok, so here's the first thing--If you are a union hospital, do not, under any circumstances go into this meeting without a union rep. If you are not a union hospital, here's the thing. Go into the meeting prepared. You can prove that you are charting in real time, per the fact that they can check this. Additionally, I am assuming that when you informed your charge nurse that your patients were transferring, you documented this. If you did not, then I would from now on. However, back to present. You have proof that the improvement plan that was started for you is being done correctly. Hopefully, you documented "Charge RN aware" when your patients were being transferred. If they throw anything else at you, I would not say anything right away. Take notes. Let them know that you need the opportunity to review said notes, and ask for a break if you need one. Easier said than done, but do NOT get defensive, do NOT make excuses, do NOT threaten to quit. Just hear them out, present your side when you have had the opportunity to review--and listen to your union rep. if you have one.

If you can not financially make it without working, then to quit would not be in your best interest. If they are going to fire you, then you could have the option of unemployment until you find another position. (not legal advice, just a thought, and all states differ in this regard). Another thought process is to see what internal positions are available, and transfer. State that in fact you are not a good fit for the unit. DO NOT trash the management, the staffing conditions...that would not be in your best interests moving forward. Do not confirm nor deny, state you can only go on from here, state the obvious improvement in your charting, ask what the options are for informing Charge when a transfer is taking place in that moment, when Charge is busy with other duties and not hearing what you are telling her. State patient safety--this patient could NOT wait to go to the ICU until Charge was available to give you her full attention.

Meanwhile, look at your options. I would not rule out small community hospital ER's (which along with your Med Surg experience could put you in a better place for ICU if that is your goal) to do some per diem. Look at various openings of other hospitals in the area.

Best of luck to you. Remember, your character as a nurse is important. Your practice as a nurse is important. Don't put any of that in jeopardy by being unprofessional and letting anyone get under your skin at this meeting.

HoneyBeGood · Jan 24, 2014

I did not chart that i had notified the charge nurse. During training it has been emphasized to document contact with the doctor but not to the charge. I documented contacting the doctor on all occasions. In these situations, one doctor called me directly and let me know what the plan was; I called the charge nurse, she was not answering her phone, so went to the nurses' station, saw she was on the phone, so I sat there and entered in the doctors orders, so that once she was off it, I would tell her. Same situation with another patient on the same day. When i needed to inform her of a transfer, she was on the phone. Nothing wrong with that…but they cannot expect me to sit around twiddling my thumbs waiting for her. I did not realize this was an issue. If it was why did she not talk to me directly the first time it happened? I would have been able to explain to her why I did not tell her immediately.

In another situation, I waited for the doc outside the patient's room to get an idea of what he wants to do with the patient. Patient had RR of 32 all through out the night shift, no one called the doctor. I wondered why not. That patient was the first one i went to see after giving report. His RR bumped up to 40. He was stating 96%. Really struggling the breath. Called respiratory and the doctor. Doctor just told me to tell respiratory to give him more breathing treatments and try to get him to cough up the phlegm. Not that long later the doctor was up on the floor in the patient's room assessing him. I waited outside the room, to get an idea of what the doctor was planning for this patient. He said likely all the heavy breathing was from the patient coughing and trying to get up the thick mucous, he wanted him to cough it all up, but to just keep monitoring the patient. He mentioned nothing in regards to transferring the patient. So I frequently checked on the patient while, caring for my other patients. While in another patient's room the doc put in transfer order. I was not informed. I went to past the nurse's station and the secretary informed me that my patient was being transferred. I had no idea, neither did the charge nurse. But we both found out then. I am not a mind reader. I did verbally inform her of what was going on, but she should have known my patient was unstable because he had been that way all night. When the charge nurses switch off they go over all the patient conditions. This guy was right next to the nurses' station. I was the one that followed up and informed the doctor.

So...

I work for a union. I will evoke my rights to have a rep.

How long can I wait to have this meeting with the nurse manager? I want to send and email today putting in my two weeks notice. I want to stall long enough to give my two weeks and then get out of there. She told me that this meeting is something that we need to set up soon. I have no idea if termination is on the table. But I have heard from other co-workers that calling a union rep puts you in a worse position with our nurse manager…"you don't want to **** her off." is what I have heard. Every thing is off the record.

Would this be a good tactic? I feel like I am playing Russian Roulette. If I go into this meeting unprepared for a termination and wait and see if they want to fire me, then I am screwed. But if i put in my two weeks and stall till the very end of the notice till doing the interview, then I have a great chance of leaving on good terms with this company and not being placed on the do not rehire list.

I don't want to leave without a new job set up but i don't want to be black balled either.

My mind is swirling with possible outcomes.

emma34 · Jan 24, 2014

If I were you I would just attend the meeting with your rep and listen to what they have to say. Don't make any rash decisions. They have already made their decision, perhaps it is just another written warning - you can't make any assumptions. Just hear it out. If you disagree with their assessment and their decision, grieve it with your union...

HoneyBeGood · Jan 24, 2014

Thanks for the advice. I will go with a rep and hear what they have to say. I get paranoid and tend to think in worst case scenarios. I know i did not do anything wrong but this is just ticks me off that I am being put through this.

Sam J. · Jan 24, 2014

I'll add other scenarios- what to do when you are given the option to resign, or be terminated? The age-old dilemna, that is sadly common in nursing. It can happen to anyone. Is it better to quit without notice, or be fired? Does it 'really' matter if you give notice, or quit without notice? Does giving notice give your employer a reason to simply fire you? If yes- will you be documented as having quit, or as having been fired? Whether you quit, even after doing a good job, or are fired (with or without a cause), will they give you a good reference or a bad reference? Either or any way- it's my experience that there is no better option when you find yourself in these situations. Also, to muddy the waters further, you say you get along with staff- but how do you really know what other staff might think about you or say about you? Hmm.

HoneyBeGood · Jan 24, 2014

I would like to transfer to another unit with another manager. I have only negative things about my manager but a lot of positives about other nurse managers on other units. I think I will fair well with a clean slate with another manager.

jadelpn, LPN, EMT-B · Jan 24, 2014

Have a conversation with your union rep. That is why you pay union dues. They represent you and your best interests. The "don't **** off the boss" tactic is quite something--perhaps because these allegations may not hold much merit.

Always document when you tell your Charge something, that by policy, you are supposed to. CYA in these instances. And why were you putting orders in for transfer? Isn't the MD supposed to do that? In any event, this is just a crazy scenario--and hardly worth disciplining you over--unless you are not to be putting those orders in--could be any number of things.

The other part of this seems like bunk--if you both heard at the same time the MD was transferring---from the secretary, then perhaps the secretary should be transferring the call to the charge nurse instead of taking a message and verbally telliing ya'll at the nurse's station.

Most union contracts have rights to a union rep present. If they are putting termination on the table, then it is your best bet to negotiate.

Again, none of this is meant for legal advice, per TOS, and I certainly can't direct you what to do, nor am I trying to--just some suggestions from an impartial party.

HoneyBeGood · Jan 25, 2014

The doctor called from another unit and told me to put in the orders. Patient CT showed perforation, though patient had been stable all day, except for ℅ of pain unrelieved by pain meds. I took the orders and read it back to him. There were some I was unfamiliar with. After getting off the phone with the doc, i called the charge. She did not answer. Then I went to the nurses' station where she was talking on the phone. Logged onto the computer and started putting in the orders. Another nurse was helping me put in the orders, I let the aid know that my patient was going down to the ICU. While I was putting in the orders, the charge got off the phone and I informed her what was going on. Patient had complained of a lot of pain unrelieved by med intervention.

Ruby Vee, BSN · Jan 25, 2014

I have been called in to a meeting with my nurse manager. She said there maybe disciplinary action taken, in regards to informing my charge nurse that a two of my patients were being transferred to a more acute unit. I did not put my patients in danger. She was on the phone. While I was putting in doctors orders and actively getting my patient transferred to the ICU. They were off the floor in a timely manner. From what I gather, the charge nurse on these 2 occasions was not timely informed about my patients' transfer.
I know it is BS.
I have had a feeling they are looking for an excuse to get rid of me. I have 1 written warning already, for not working fast enough on the floor and documenting in real time. This is when I was a new nurse on the floor. I would document outside the patient's room or when I had time. No one on my floor documents in real time. But I just had to say I would make it a priority and I would work on it. I think I am one of the only nurses NOW on my floor that charts real time. Who has the time? (I work on a busy med surg unit, day shift, 4-5 patients). I am efficient, get along with all staff and have had no complaints from patients or their families.
I can't believe I am being called into this meeting this. The day this happened the nurse manager was prowling around our floor. Everyone seems to be scared of her, but I could careless, because I knew I was not going to stay that much longer, so I grit my teeth and bear it.
Since I have already had a written warning…I am worried this could be used as an excuse to fire me.
If I know I won't be fired, I will just hand in my 2 weeks notice and quit. I am tired of med surg; patients and management. I am tired of having to look over my shoulder at work because the Big Bad nurse manager and her Charge Nurse minions are yapping at everyone's heels. I love my co-workers but I hate going into work.
I like patients who I don't have to talk much to. OR, ER, or ICU is my calling. I am not a med surge nurse, but I am happy to know that i can do it, though.
But if I am at risk for being fired because of this, I rather just quit. I rather quit without notice. I know it looks bad but is it not worse to be fired?
Is it okay to quit before even going to the meeting? Honestly i don't want to hear their BS. I know I am a great nurse. I know I did not put my patients at risk and did what I was supposed to do. I am livid that I am even being called in for this. Form of humiliation. But on a technicality they want to write me up or possibly fire me?
If you give management criticisms you get in trouble? Poor staffing conditions which make it unsafe for patients and staff. They have safety policies which they know nurses can't meet due to poor staffing but you are expected to follow it. Even though the unspoken words are 'just get the job done, we don't care how you do it, but just do it.'
I am applying for jobs, but I don't want to wait till I get a new one…it could take months before I get a new job. What should I do?

As I understand it, you transferred two patients out of the unit without informing your charge nurse? "She was on the phone" isn't really a good excuse for not informing her. That's the sort of thing a charge nurse needs to know. If you're being called into a meeting for this, it is not BS. You screwed up. Admit it, apologize and move on.

Frankly, it sounds as though your attitude toward your job and your manager is very negative. Quitting without notice and being fired both look bad. My advice would be go to the meeting, admit that you screwed up and apologize. Then suck it up and stay until you find a new job. It's going to be a lot more difficult to find a job if you're not working, especially if you're not eligible for rehire at your current job. (Which you will be, if you quit without notice or get fired.)

If you don't want to talk to patients, I'd advise against ICU. You spend your day at the patient's bedside, in their room rather than running up and down the halls between patients. You'll spend the day talking to the patient and their visitors.

Med Surg may not be your calling, but it IS good experience. Reading your post, though, it doesn't sound as though you've been very successful at it. So perhaps you are not the excellent nurse you think you are and really do need to listen to and internalize your manager's criticisms.

HoneyBeGood · Jan 26, 2014

Ruby Vee I don't think you read my post. Please go back and re-read them. SMH. All those patients: the charge nurse helped me move them. She knew they were leaving before they left the floor.

I am thinking the issue is informing the charge nurse about a change in status of my patients.

I am thinking...she should have known they were going down the drain before the doc even put in transfer orders.

Problem is...when all this was happening SHE WAS NOT AVAILABLE, for me to tell her what was going on. I am not going to sit around and twiddle my thumbs waiting for the charge to answer my call before i start caring for my patients.

And 2/3 of the patients were expected to discharge. They had been stable. Scenarios:

PT 1

In for PNA. Through out the night shift...his RR was 32. Night nurse did not call the doc. He was the first patient I went to see. His RR was up to 40. I called respiratoy and the DOC. The day charge should have known the patient was in this condition. The night shift nurse and charge should have. i am not sure if they were...but I was wondering why she did not call the doctor. She checked on him 3 times that night and his RR stayed 32. Really working to breath. I called the doctor to do something about it. When he finally decided to do something about the patent, I was in another room with another patient that needed my attention.

PT 2: Was expected to go home. His vitals had been stable the day before as well as through the night. i went in to assess him. His HR went from 80 to 150 at rest. Irregular rhythm. No chest pain or pressure. I immediately called the Doc. I went to nurses station to tell the charge, she was not there. I put in the stat EKG orders the doc told me to put in. Doctor comes immediately to assess patient. He says the patient is fine now. EKG is done and shows new onset of AFIB. Doc is surprised. Goes back to talk with patient. In the mean time i am keeping a close eye on the PNA dude who is working hard on breathing. Doc decides to transfer patient with Afib. When this happens the charge nurse finds out. She is looking at me like when did all this happen. I am like JUST NOW. I explained to her his HR shooting up and the EKG results.

She helped me move the patients off the floor.

Next day

PT 3: this patient is expected to go an ECF. He has a peg tub that had a lot of drainage. I called the wound care nurse to assess and change the dressing. The doc and charge were informed of this during morning rounds. Later I go in with the wound care nurse and she thinks it would be best to get an ultra sound of the pt's and because of all the drainage. It showed nothing. later in the day the patient complained of pain in the abd. This is not new, he had been ℅ for days and had been given hydros for it with relief. I give it to him. Re-assess his pain and he says the pain is worse 30min later. I call the doc. Doc orders CT of ABD and a dose of Ativan to calm patient. Patient is resting comfortably in room sleeping with VSS, after having the CT. After CT results come out doc calls me and says there is a perforation and he is going to transfer patient. Patient was stable up until the point the doc transferred him to ICU. He gives me orders to put in stat. After getting off the phone with him. I called the charge. She did not answer so I went to nursing station to put in the orders and wait to tell her what was happening. She was surprised he needed to be transferred as well as I did. He had been stable and his labs were in good range. This all happened in a span of 10min.

Sam J. · Jan 26, 2014

HoneyBeGood: You sound like you REALLY know your stuff, and I consider myself unusually intuitive. It sounds also like you have been thrown under the bus. Welcome to the world of nursing- the profession that is well known to 'eat its own offspring'. I've been in your shoes, so I empathize with your situation. Too bad there's rarely a way to bow out gracefully, without future repurcussions, whether you want to quit or not. Nursing does NOT allow for errors, slights, or mistakes, either real, or perceived (as in imagined). Good luck.