I recently walked away from a position I had started the end of March, here is what led to my decision-
I came on shift and was assigned 3 patients initially, two were fresh admits after 4pm so many things were not done, right after report I get an admission a r/o, by the time I got that admission completed it was almost 10pm, still hadn't seen my other 3 patients, one was also another r/o. I get meds passed and at 11pm I pick up two more patients, also 1 that was a fresh admit that evening so it was not completed. right after report on those, I get another admission, a head trauma with hourly neuro checks...so I had 7 patients, 5 fresh admits, so 4 r/o's, 1 head trauma, 1 confused that was also 1 of the r/o's, and 2 questionable c-diff. in the first 8 hours of my shift I saw my patients once.
That is not safe at all, considering they were r/o's and a head trauma, oh yeah and one was a confused lady that kept hollering and trying to get out of bed. I went to the nurse manager at the end of the shift and expressed my frustration and concerns about all of this. During the shift I even spoke with the nurse supervisor regarding all of this, while SHE was sitting in the break room eating, which none of us had time to do, and all she did was shake her head and say there was nothing she could do and just do what I could to get through the shift.
Add that to the charting system that they upgraded to causing charting errors,potential of missed orders, another nurse had found during her chart check that night, that a patient was supposed to be getting fluids for the last 2 days and the order was missed because docs were writing orders on paper because of the system being difficult to navigate and time consuming. the medselect not working right and causing delays and potential med errors. The patients that are there for r/o's are not having troponin levels drawn when they should because they have trouble located when labs were drawn because they are put on the wrong visit...This all happened while I was on orientation and because no aide was scheduled that night, my preceptor was put into the aide role and I was flying solo.
Over that weekend I thought about all of that, including the fact that trying to sleep during the day was not working out at all because of my two younger boys. I was getting less than 4 hours of sleep a day. When I originally applied I applied for a weekend option day line, when the nurse manager called me to interview she told me that line was filled but this one was open, so I thought I could make it work.
Then the cost of driving back and forth with it being an hour drive, the cost of insurance being 294.00 a paycheck, I was bringing home about $500 a week. Between the cost of gas and childcare, I was working for very little. I had to weigh all of this into the fact of the issues with patient safety. I worked so hard to overcome so much in my past and get my degree and I don't want to lose my license. I explained all of that to the nurse manager and again to director of the floor. They both told me they understood but I guess not because, they of course didn't give me a good review.
I would hope that as a nurse reading these things you can understand why I had to make the tough decision to walk away. I love being a nurse and helping people and feeling like I couldn't provide the care they needed in a safe way, is something I couldn't continue to do. A fellow nurse told me that it was not uncommon for them to have up to 9 patients on the overnight shift, she told me there were many days where she would cry the whole drive home. I have never worked under my abilities and believe I am a great nurse.
So do you think I did the right thing? I sent an email to the director about all of this and she called me and left a message saying that she took my email to mean that I was done as of that day but she wanted to discuss the issues I had. I called right back and she didn't answer, I left a voice mail saying that I was sorry I missed her call and that if she could call me back I would speak with her about those things. She never called back and when I went in to clean out my locker she wasn't there.