So fed up:( Could use some help:(

[Nikelbee]

Hi All:)

I'm actually not a new poster, I've posted before but not for a while and cannot remember my old log in name so here I am again:)

Anyway, I just really need some words of encouragement, wisdom, advice, anything right now, before I crawl into a corner and literally cry my eyes out.

I've been a nurse for a about three years now. I just started working in a hospital on an oncology/ med-surg floor in June. The hospital is a catholic hospital, and pretty run down to say the least. Most of our patients don't have insurance and are on some type of medical assistance. I'll make a really long story as short as possible here...

About a month after I started the job, it was announced that our "plan of care" was changing to "Primary Nursing". The idea behind primary nursing is that they will give us four per nurse, but take away our nurses aides. The nurses are responsible for EVERYTHING. Vital signs, baths, incontinent changes, accu-checks, medication administration, dressing changes, feeding...etc. What they told us is that the doctors were complaining that patients were getting bed sores, and they think it was because the nurses weren't bathing the patients themselves so obviously werent doing good enough assessments. They then assigned people in the hospital for us to page that would do our labwork and ekgs. Any and everything else the nurses are responsible for. This scared me when I first heard it. I thought, what if one of my patients goes bad? Its hard enough these days as a nurse WITH an aide to get what you need to get done, but now..take my help away?? The best part of it is...they kept our aides on the floor...the aides that dont have to do anything. They are there "if we need some extra help, but are not required at all to do what they were doing before." Needless to say...solitaire has become a popular game:madface: .

It has come to the point to where the aides..and not all of them, we have a few great ones on there, but yes sadly, most of them...love their new position, and I can't blame them. I'd love my job too if I was them.

Now heres the doozy...all the nurses usually have 6 patients. Or for example..last weekend I had SEVEN patients. The aide on the floor refused to do accu checks or vital signs for me stating "I dont have to do them." I called the supervisor and was told later "I can't make her do something shes refusing":angryfire One of my patients passed that day, another was put in restraints...it was just a horrible horrible weekend. My manager addressed the issue that week with the aide telling her that if I have that many patients she must help. But that was only one incident. Never have I had four patients since this plan of care started. Its usually 5-6, most of the time 6. I cannot keep up with my work, my medications are late, the pateints arent getting the care they deserve, the rooms are a mess (housekeeping is a whole other story), trash gets emptied three times a week maybe in patients rooms...I just cant do it, and its not my fault. None of the nurses can do it. Were all so frustrated. And the head of the nursing dept. who thought up this lovely idea stated that if we dont like it, we can walk...how nice

I work a 12 hour shift, at 3 pm alot of the staff leaves. We had a census of 20 patients today. At 3 pm, all that was left was another nurse and I...and one aide. They were about to give both of us 10 patients each. I lost it right then. I said "I am not taking 10 patients, I refuse to take 10 patients, I dont even think that's legal! If I'm givin 10 patients I am walking out of this hospital right now. That is a risk to my license and a risk to these patients." I was FURIOUS. My charge nurse who was also to leave at three was right there with me being as upset as I was. She was making calls everywhere to everyone trying to get answers...noone knew anything or what was going on. She even called the head of the nursing dept who thought up the lovely "primary care" idea....paged her three times. Surprise surprise, no call back. I then told the charge nurse that I wanted to know where the head of nursings office was because I was truly going to go there that second myself and demand support. I was then in the med room with my charge nurse and we were both talking about how upset we were about the situation. She then said to me. "I told the manager of the floor that you are going to leave..she said if you do shes going to report you to the state and get you for abandonment of patients"

Right then it hit me. Shes right, I am abandoning my patients..this isnt their fault. But its a catch 22 here. She was right, but on the other hand I was SO ANGRY that I was threatened..and not offered any type of support. TEN patients?? O and did I mention the other nurse on the floor with me just passed her boards last week and it was her FIRST day on the floor? How is that safe? How can you tell me that youre going to give me ten patients with one aide for the whole floor and think thats okay? They know its unsafe, they know its unfair, they know its dangerous. But after what my charge nurse just told me my manager said ...they know they can do it to me...I cant abandon my patients.

What do I do? I ask because...this WILL happen again, I can guarantee it. How wrong was I? Theres got to be some type of nursing law in PA about a nurse patient ratio. If there is, can anyone tell me exactly where to find it because I'd like to keep a copy handy;) And...if there is a law, and they gave me over the ratio that is legal, and I did walk out because of it..could my license be taken away?

I came home in tears..I am beyond disgusted with what has been going on there the past month and I dont know how much longer I can take it. But I'm not one to just quit...I want to fight...how can they do this to us..how can they do this to the patients..how is that okay? Or ...is it? And if it is..I see why theres such a nursing shortage.

Can anyone please help me with my situation. I'm just so sick of coming home in tears, its truly starting to effect me outside of work. How do I fight this..or can this even be fought?

Thank you so much for listening everyone:( *hugs* I look forward to hearing from you.

[vamedic4, EMT-P]

Nickelbee,

I'm sorry you had to go thru all that!! Your manager needs to get her lazy behind in there and do some work, sounds like. And perhaps it's time to find another job. Nowhere on the planet is a 10:1 ratio safe nursing care.

Don't abandon them on your shift...just call in and quit...after it.

You are a nurse, and you can get employment anywhere - you don't have to put up with that low of a standard of care.

Good luck!!!!

vamedic4

[JentheRN05, RN]

Well - I actually looked it up at one time in my state (Indiana) - it was NOT abandonment if the shift prior to you was still there and also you had not received report on the patients. If you leave BEFORE given report then you are not abandoning your patients. You do not HAVE any patients to abandon if you haven't been given report on them. Good luck - and get out of there while you still have your license

[Pompom]

Wow, that is awful! It is no wonder why so many floor nurses transfer to the units. I would not stay in that unit, start looking for another job pronto. You could also go agency for a while. Good luck to you.

[LDJRN]

she said if you do shes going to report you to the state and get you for abandonment of patients

i know that in my state, all you have to do is give report and count with another nurse (floor nurse, supervisor, etc.) and they can't report you for abandonment.

i'm not even sure, but don't all states have "safe harbor"?

[medsurgnurse, RN]

turn in your resignation effective immediately. forget about that day. just don't go back. It' s not the fact that you have x number of patients its the fact that they retained and are paying the CNAs to do nothing. Insane.

[psalm, RN]

...an anonymous call to jacho? (spelling). Would that help?

[Nikelbee]

Thanks everyone! I think I just needed an outside opinion and they were good to hear. Does anyone know in particular where I can find if there is a state law on nurse/patient ratio? I checked on the state board of nursings website but its like finding a needle in a haystack haha!

[NRSKarenRN, BSN, RN]

No law on patient nurse ratio at this time.

[Sue Damonas, BSN]

Get out of there!! That's so unsafe!! I got out of a similar situation and it was such a relief. Keep us updated on how you're doing.

[Nikelbee]

*hugs* I'm on it! I emailed my resume to chop today and also called an agency. I'm sick to my stomach even thinking of walking in there tomorrow ughh:( I'll keep you guys updated on everything!

I spoke to one of the nurses on my floor today and it kind of made me feel better. It seems the nurses there havent been treated well for a long time and I'm the first one to really be the "outspoken" one. Believe me this isnt the first time I've challenged management and complained about the working environment there. She had said to me today "I give you alot of credit, so many of us are so unhappy, and youre the only one that has the guts enough to come out and say it to them."

Thank you all for your help. Updates coming soon to a theatre near you! LOL:pumpiron:

[STICU]

I think unionized hospitals have set patient to nurse ratios, also I think California has a state law instituting ratios.

Best wishes in your search for a new job. I do agree that transferring is better than staying, for both yourself and your patients (providing suboptimal care isn't much better than giving no care at all).