IRN2011

update to the thread: I talked to my director yesterday and reiterated again to her that I did not request to not float to covid unit, it was my charge nurse and her deciding that for me.. and that I have no issues floating to covid. I have a history of cancer which has been treated and thus not a disability so I will not be filling out the ADA form that corporate wants me to nor giving them access to my medical records. She was fine with that. This morning I received an email from corporate (which conveniently is in a different state) with a legal letter stating I have 5 days to have my doctor fill out the ADA medical questionnaire or they will consider the lack of response job abandonment and terminate my employment. I am now seeking out legal council.

Completely agree.. and to be honest I don't mind if those seeking to be exempt from taking care of covid patients all together be screened for a valid reason as to why.. since if we are wearing proper PPE we should be well protected. The issue I have is not the fact that I'm taking care of covid patients.. I've been doing that with no complaints for the past year. My issue is that my director and higher ups are telling me they are trying to protect vulnerable populations and have decided for me that they will not send me to covid units anymore to protect me even if its not a choice I made for myself.. and than are requiring me to give them access to my medical records to justify their decision... all because I have had the mishap of being diagnosed and treated for cancer 10+ years ago when I was in my 20's... If they need my pathology proving my cancer, I have no issues giving that to them.. but what I object to is the filing out of a disability form stating that I need modifications to do the core functions of my job and access to all my medical records while I'm employed by this corporation because I was treated for cancer more than 5 years prior to working for them and it has not once stopped me from performing any functions of my job.

Hey everyone, So I've been floating between my main unit in CCU/CVICU and our covid ICU with no issues since the pandemic hit last Feb. Last month my heartrate started going erratic and turns out I was in thyroid storm (history of thyroid CA s/p thyroidectomy on Synthroid now). I remember showing up to work one day and the moment I got to the nurses station I started feeling palpitations and had to sit down.. I hooked myself up to the zoll with my charge nurse to find me taching in the 180's - I ended up going to the ED and getting IV labetalol. My endocrinologist does not want to lower my Synthroid dosage even though my last TSH is 0.06 due to high chance of cancer reoccurrence - so now I'm seeing a cardiologist and ended up being started on labetalol which has controlled my heart rate. Around the same time, my charge nurse started refusing to float me to our covid unit, stating that due to my health she didn't want me to be exposed to it (our covid unit is still a lockdown unit where you get a single 30 minute break and wear the same PPE/gloves locked in the unit for the whole 12 hours straight... most people like myself bring our own N95's and envo masks as the hospital still only provides a single N95 per 2 weeks and 60+hours on a single n95 just doesn't cut it for me). When my charge stopped floating me to covid, she came up to me and asked me to get a doctors note from my PCP to justify her decision to not float me to covid anymore. I talked to my director about this and she is also in agreement that due to my health I shouldn't be floated to covid - so I went to my PCP and got a Dr's note. Fast forward a few weeks and now corporate is calling me and stating that due to how many people have Dr. notes excusing them from working on the covid unit, they have a form that needs to be filled out by the physician. The form is an ADA disability paperwork that is written in a way that makes it sound like I am incompetent. There's 17 questions, extremely repetitive, and all involve the doctor explaining why I need 'modifications to my daily routine at the hospital to allow me to perform my core functions as a nurse'. They also require a waiver to be signed that allows corporate full access to my medical records and to discuss my treatment with my doctors. I called corporate to clarify the paperwork as I do not have a disability and I am not immunosuppressed; I have a history of thyroid cancer that has been treated and no longer an issue minus a little flareup that has now been taken care of. Its not my decision to not float to covid-ICU and I have no issues floating to work there. Corporates response to my inquiry was "yes, you do have a disability as you can potentially get sick if you get covid due to your history with cancer, so have your doctor fill out the ADA paperwork as if you have a disability, and your disability is your cancer history". I feel like this paperwork will bite me in the butt in the future and am against signing a form that states I have a disability that inhibits me from performing my functions as a nurse and giving my medical records and access to future records to my employers when I am fully capable of performing the functions of my job and only 32yrs old. The form is due back to them today, still trying to figure out what or even if I should write to corporate. I feel like this is a complete violation of my personal privacy.

agency hands down is making more at my hospital. they just started hiring Crisis RN's down here in florida and posted 120/hr for ICU and 100/hr for medsurg... meanwhile us staff nurses are averaging around 28-33/hr with no incentives for picking up extra shift, no hazard pay, and no bonus when we are floated to covid units... our Covid-ICU's don't have dedicated staff.. so you pretty much show up and check staffing assignment to see if you're floated there or not.. every shift is a mystery at this point, there's no continuity of care anymore

Currently at my hospital we have a typical 1:2 with the occasional 1:3 ratios for ICU's. If a patient is a fresh hypothermia, is rotoproned, CRRT, or IABP/impella than they are 1:1 unless we are severely short, but they would go out of their way to tripple all the other assignments first before giving a second patient to that assignment. Covid-19 units on the other hand are kind of the wild west (at least at my hospital). In florida, things are starting to up-tick a bit again... they converted three units to covid-19 stepdown/ICU's.. they are the only units that mix stepdown and ICU acuity.. mostly because what we find is when a covid patient is crashing, we don't have time to move them to a new unit. Stepdown nurses still treat the stepdown patients and the ICU nurses treat the ICU patients, the only difficult part is that unlike traditional ICU rooms in where there's only 1 patient in each room, they are doubled.. you can have two step-down patients in the same room.. one ICU and one step-down, or even two ICU patients in the same room (I feel for the patients.. I'd hate to be the step-down patient on high-flow or bi-pap and sitting next to a fully intubated and proned patient in the same room). in COVID-land, our nurses used to be 1:2 max for ICU and 1:4 for stepdown... however as we continue to get more patients and open up more rooms... we are now 1:3 for ICU and 1:6 for stepdown covid.

sadly this is par for the course. I've been exposed multiple times responding to rapid responses on covid-negative units for patients in respiratory distress and emergent intubated with no n95's available for staff only to find out that they were not covid-swabbed on admission. When I became sick, the hospital refused to acknowledge that it could have been due to exposure at work and I had to seek my own testing. I self-quarantined for the protection of my patients and was told that I could not use my PTO for my time off until my test results that I had to go out of my way and get tested at a drive through test center as the hospital refused to test me came back. They said that they would not honor my PTO and consider my call-outs as a 'leave of absence' if my test results came back negative as too many people were calling out for being 'exposed' and coming back negative. Sadly, Here in Florida this is completely legal as we are a "right to work" state, and the state determines the individual corporation can determine how and when an employee uses their PTO and has the right to deny PTO hours if they deem it is an improper use of it.

Hello everyone, Sorry if this message is in the wrong place on this subforum, or if it is a little long. I haven't really posted here or been active on the forums in a while. I've been in the middle of what feels like a mid-life crisis and I'm truthfully just looking for opinions. Even before becoming an RN I've had many thoughts of furthering my education beyond my ASN (I guess this is what happens when you define yourself as a 'forever student', holding 3 bachelors degrees, the first being in education). As I progressed in my career and changed specialties multiple times, so has my thoughts on what I would like to do as I get older. Before I even graduated nursing school with my ASN, I was dead set on becoming a CRNA as I believed it was the most familiar advanced practice nurse to my background of being a paramedic. I landed a position as a med-surg nurse on a 33 bed orthopedic unit in a very busy level 1 trauma center. The unit had a very high turn-around and burnout for new-grads. Within the year, I gained new responsibilities as a relief charge nurse. A year later, I officially took the ANM position when my predecessor retired. During my two year stint as a charge nurse, I made sure to stay active in all patient's care. Even though I myself identified as a new nurse, I took up the reins as a role model for our newer nurses and always tried to be a resource for them - or find the resources they needed if I wasn't able to provide myself. At this time I enrolled in and completed my BSN program. After two years of being a charge nurse I started to feel myself enter a rutt. I knew it was time for me to leave the unit to advance my training. I applied and quickly transferred down to CCU where I am currently an ICU nurse. (I'm currently studying for my CCRN certification). Next month, I'm told I will start cross training to CVICU. Working along side my critical care NP's, I've come to realize that I can't see myself doing any other advanced practice job other than critical care. I look forward to the long road of becoming a NP and than acute care NP someday. I say all this because I have an extreme passion for helping others, often to the point that I put others ahead of myself. It's one of the reasons why the calling of a nurse became so strong with me. I'm going to backtrack now for just a moment. When I was just starting out as a nurse, I met the love of my life whom was at the time working on my unit as a nurse-extern. I kept my feelings secret until the last day she was going to be working on my unit. (she was transferring to TICU as an extern for her last semester). Fast forward 4 years and we are now engaged and set to marry this upcoming 10/10/2020. She still works in TICU, now as a RN. She loves what she does and wants to continue her education as well and obtain her BSN. Our dilemma is that neither one of us want to sacrifice the other person's education and advancement of their respective careers. She wants to obtain her BSN for extra job security - but she has no admiration of continuing in an advanced practice role. She found her dream job, and she wants to stay a floor nurse in trauma ICU. Myself on the other hand, I see myself in a position that I can stay and continue to be cross trained in all the CCU/CVICU specialties.. but I really would like to further continue my education towards NP. We are currently at the point of our lives after just buying a house together and imminently being in wedlock (and our dream of hopefully having at least 1 kid on the way soon...) that we can only afford one of us at a time to go to school. We are in a crossroad with no road-sign. I told her the other day that I would put my NP dreams on hold this way she can go back to school and get her BSN, if anything for job security (our current employer is not a magnet hospital so they don't require a BSN currently). She wants to go back to school but has mentioned that she is willing to put her schooling on hold for me to follow my dreams. Both of us sacrifice so much for each other, and I appreciate her and she is the world to me. I just don't want my future dreams to sacrifice hers.

So an update to this story. luckily I've been asymptomatic for 13 days now since the exposure - still going to work. I've talked with employee health which is having me log down my temperature twice a day. As long as I don't develop a fever over 100.4 they will not test me (luckily I'm at the end of the incubation period.. we didn't find out he was positive until a week after my exposure). I've contacted my primary MD... his response was "this is absurd, I'm sending all my patients with exposure/symptoms to the ED since I don't have testing capacity myself, and they are turning them away as well".

Two nurses at my hospital have been placed on suspension for saying they are refusing the assignment before shift change until masks are delivered to the unit to ensure they have a mask for their shift

I was taking care of a patient who I admitted as a R/O caronavirus. The patient was admitted In respiratory distress and started on bipap. The patient became acutely confused and started tearing off his bipap. At the time, we were out of masks as they are being locked up in our directors office and the charge nurse was on her way to obtain another box or n95s. I watched as my patients sat dropped from 98 to 80.. to 73.. knowing the patient was RO I entered the room to place bipap back on the patient. (I instantly reported the exposure to my charge nurse who pretty much shrugged it off saying ‘hey probably doesn’t have it anyways’’. He then started to decompensate cardiovascular wise for me... blood pressure kept dropping and heart rate spiked into the 140s sinus. He ended up getting a liter or albumin plus another two liters of NS and started on Levo. I was able to stabilize him throughout the night until morning, gave report and went home.. .. when I came back that next night I found out he passed away on day shift. Fast forward a few day’s and I find out his test came back positive for coronavirus. I talked to my clinical manager about what I’m supposed to do since I had an exposure with a known positive and their response was along the lines of.. no you can’t be tested and yes you still need to come to work until you show symptoms. This is madness... I feel like if I come to work I’ll be exposing the whole ICU to this virus but I fear the repercussions If I Call out.

Hello all, Recently my hospital went through a director carousel of some sorts. A few of the directors left(forced out) after we brought in a new CNO, being replaced from current directors on other units. My director was one of those that was moved to replace another unit, in return we have a first-time director who was previously a nurse manager of our oncology unit (my unit is tele-orthopedic, surgical). My director recently sent out an email that has many on my unit, myself included infuriated. The email states that administration will not tolerate clocking out late for any circumstances - in an effort to 'fix' the budget issues and 'excessive' overtime. The email also had a form they wanted us to sign to confirm that we will not clock out late unless there is a rapid response during shift change. Documentation is not considered a valid excuse to stay late - and verbally the director in our follow-up meeting to this email is expecting us to go downstairs to clock out, than return to the floor to continue to chart - on our own time! She even has gone as far to say for repeat offenders she will consider modifying the time-clock (Isn't that against labor laws?) my unit is already under-staffed with very poor morale. Majority of our night nurses haven't even taken a break for the last 6+ months as there's not enough time dealing with 8 patients all Q1-2 rounding. We have had it.. but we don't really know where we should go to attempt to improve floor conditions/morale. Sorry for the rant, but I needed to get this off my chest and into the air. Unfortunately, I would consider moving however I'm still 8 months short for my contract for the unit.. and 1.8years left on my hospital contract.. and it's 18k to break the contract.

my contract is a 3 year contract with an 8K signing bonus. They put all new-hires in a 'class' which lasted for 3 weeks that was pretty much an orientation to the hospital with rotating speakers from different departments and drug manufacturers coming in and telling us about their latest research about the medications their company manufacturers and why we should be using their brand of medications over others. The Hospital valued this 3-week education as worth $10k... plus the 8k signing bonus(we get it in installments.. 3 the first year, 3 the second year, and 2 at the end of the third year, which must be repaid if I terminate my contract within 3 years at a prorated rate... So at any time I decide to terminate my contract, I will owe the hospital over $10,000. The contract is assigned to my unit itself, so I'm unable to transfer to another unit until the contract is up. From what I understand after talking to other nurses who have been here longer than 3 years.. When I was in the interview process, I asked about why the educational fees were so high, their response was along the lines of : the hospital uses the contract as a way to maintain retention for newer nurses as majority of new-nurses in the past before they started this class transferred or quit within the first few years... and since we are the only level I trauma center within 50+ miles, they needed retention.

Unfortunately Florida does not have any laws for PTO nor for mandatory OT, from what I've researched administration can make their own policy and change it at anytime without notice.

Hey all, I've been in the medical field for the past 6 years as various professions (paramedic, nurse extern, nurse) but have only recently started working as an RN about a year ago. Per my contract we gain 4.4 hours of PTO bi-weekly and work 3 shifts a week. It has always been our policy that if we call out sick on the weekend we need to make up the weekend shift within a month if PTO was not used. Recently our unit and our sister unit who share the same director has gone through major staff changes with many nurses either retiring, quitting, or being fired (about 2/3 of all the nurses I started with not even a year ago are gone). Now we are severely understaffed and morale on the floor is waning... We host 33 beds and have a total of 6 full time RN's and 1 Care partner maxing at 8 patients each at night. The reason why I'm writing this is because I'm curious as to how other's have to deal with sick time and PTO. Recently my director decided to change the PTO rules on a whim due to our lack of proper staffing (Although she doesnt seem to think we are understaffed at all) and sent out an email to the whole unit listing every nurse who called out sick, when they called out sick, and the reasoning they gave the ANM when they called and proceeded to state that ALL called-out shifts must be made up within a week regardless of reason for calling out, and even if you took PTO. Many of us called HR to figure out the validity of this new 'rule' as it seems to be only on our unit, and HR stated that its a per-director discretion for how to use PTO in the hospital. What I don't understand is how you can be forced to 'make-up' a shift that you claimed PTO for within the next week... that would mean you would have PTO and OT on the same paycheck, which I didn't think was possible. My unit has such low morale that it's unfortunately a normal occurrence to hear discussion of disgruntled nurses putting in applications, or the countdown to when they retire/contract is up. We've had two nurses submit their 14-day notice and told to not bother showing back to work in the last month, and another breach their ethics agreement and walk off the unit mid-shift, abandoning their assignment due to low morale and unfair staffing ratios/acuity. The floor really has become toxic, but all administration seem to be blind to it. Unfortunately I still have 1.5 more years left on my 3 year new-grad contract, and would owe the hospital $10k if I was to break my contract and search out a different unit... I can't even transfer within hospital to a new unit until my contract is up.