am i reasonably resigning?

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Hi there :)

I graduated from nursing school in May and have been working as a med-surg nurse since September. I just hit my six month mark and am brinking on seven. I love being a nurse. I love my coworkers and my patients. However, I can't shake the sense that my job is unsafe and I need to get out of there.

Our staffing is horrendous (which I know is like most places), but when I say horrendous, I mean that two days ago I had eleven patients on PM shift. I was "protected" for the first six months of this job cuz the newbies are only allowed six patients at a time. Now that I suddenly broke my six month mark, though, suddenly I found myself being one of two nurses for twenty-two patients. I couldn't keep track of anybody and I did not feel safe on the unit. The average runs at about eight or nine patients, but I have seen nurses at ten or eleven patients often enough in the past who were still expected to take admissions.

A week or two ago, I had an admission who died (but not on my shift thankfully) and it was a patient with whom I had a good rapport. Finding out that patient didn't make it felt awful because he died of some minute thing. All I could think about when I had eleven patients is how I was praying no one else coded because I would never have known. It just feels like I'm gambling with people's lives and it's not worth it. I didn't have time to catch the little things and, as we all know, the little things can be so important. My coworkers tell me that "you have to make room for human error," which I get, but I want out.

I'd been planning on handing in my two weeks notice tomorrow, but now I'm second-guessing myself. I don't have another job lined up and I pay approximately $1000 a month for my nursing loans. However, that uncertainty seems minute when compared to playing with the safety of someone's parent, grandparent, sibling, or child. Am I crazy for quitting without another job lined up?

Please let me know what you think :)

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

NEVER quit a job without having another. Plan on leaving, get a position. Then quit. It is always easier to get a job when you have one.

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Specializes in Clinical Research, Outpt Women's Health.

Yes, you are crazy. Those patient loads are crazy too. However, I would not resign until I had another job. Unless you can afford to be jobless for a year, possibly.

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Definitely not safe and should be reported

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I wouldn't resign without having another job, especially when you have bills to pay. When I was at the 6 month mark at my job as a new grad, I felt similarly. It's been a year now and I still believe the ratios we have aren't ideal, but I have learned to deal with it and I have my routines. I'm much more comfortable in the position. Stick it out, it will get better and you will leave this job with awesome time management skills. Apply for jobs and resign when you secure another position.

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Specializes in Critical Care, Education.

Totally agree with PPs. Stick it out until you line up another job. In the meantime, I encourage you to take the time to report any "near misses" or incidents that may occur on your shift. In most organizations, this documentation is processed by Risk Management - NOT the nursing chain of command (for obvious reasons). RM needs to be made aware of what is going on - they usually have a direct line to the CEO & CMO - very influential.

If your state BON has any type of 'safe harbor' process, be sure you are using it. This is a process whereby a nurse can file a 'protest' at the beginning of a shift if he/she feels that the workload or assignment is potentially unsafe. Then, if anything happens due to those issues, his/her license is protected. Does NOT protect you from individual competence issues, just things that would arise from excessive or inappropriate staffing.

If all else fails (I am assuming you have already expressed your concerns to your supervisor), use your organization's "Compliance/Ethics" reporting system. This is another type of resource that bypasses the normal chain of command & all reports are reviewed by the Compliance Officer - who reports directly to the CEO & Board. This mechanism is mandated by Federal Law and intended to help root out fraud and abuse... but can be used for any type of "wrong" situation. It is a 1-800 number & you can probably make an anonymous complaint - but in this case, you would probably need to identify yourself so that the investigator can contact you for additional information.

Make sure you follow all organizational P&P in order to avoid spurious retaliation. Have courage.

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Specializes in LTC Rehab Med/Surg.

I echo all the posters above about the "don't quit til you have another job" advice. I am wondering, how in the six months you were orienting, you didn't recognize the 11/1 ratio that was looming wasn't safe?

As for reporting the facility, be aware that there will be retaliation.

Anonymous exists only in theory. The hospital will know it was you. They always do. Reporting unsafe conditions is a noble and admirable thing. But there are consequences.

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I wouldn't quit yet. I know it is scary and you most likely feel sick before every shift. Use your days off to hunt for a new job. Find a new one, but make sure you aren't jumping from one h#ll to another. Good luck and try to keep your sanity in the meantime.

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Specializes in Care Coordination, MDS, med-surg, Peds.

When I was working in a hospital as LPN and then as RN staff nurse on a medical floor, the normal and usual for a 29 bed floor was 2 team leaders,(RN,LPN or RN and RN) and 2-3 aides, rarely a med nurse. I did this for 10 years. that, BTW is a ratio of 15 or 14:1 lic. nurse.

I was never in fear of my license as so many are. I had terrific aides as co-workers and could and did trust them and when they asked to look at someone... well,,, I RAN to look at them!!!!!!

Yes it was a full medical floor with TPN, Blood, IV's, etc., one on ones, the whole shebang!!!

If I was physically able, I would still be doing it! with the same ratios!!!

This is just my experience... not knocking others.....

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

When I worked Med/Surg back in the day, we had 15 patients on the PM shift with an aide or an LPN. Yes, it's busy, but with team work we survived.

If you're truly concerned about the staffing, use the "safe Harbor" or "assignment under protest" processes available to you. And unless you're prepared to go without a paycheck for a really long time, make sure you have another job before quitting this one.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I don't have another job lined up and I pay approximately $1000 a month for my nursing loans.
Your staggering $1,000 monthly student loan payment is (unfortunately) the ball and chain that will keep you weighed down for years to come.

I agree with previous posters who have suggested to keep working at your current workplace until you have another firm job offer in hand. Your life will be made a living hell if you default on these loans. Good luck to you!

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Specializes in Critical Care.

Wow! How much do you owe in student loans? $100,000? Because of your student loans I have to agree not to quit your present job till you have another secured. If you put your loans in deferment or forbearance, the loan interest will accrue and capitalize and you will end up owing even more!

I would be looking for another job ASAP. Hopefully you can find another job with better ratios. Good Luck!

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