Reporting your workplace

[nerdynurse7, ASN, CNA, LPN, RN]

Hello, I am a fulltime LPN on a subacute unit that can fill up to 30 beds. I first started working in July as a new nurse and I have been the charge nurse on the 3-11 shift. I am given 2-3 admissions most nights with 16-22 patients on a regular basis. I have patients in all sorts of conditions with IVs, GTubes, Trachs, diabetes monitoring, wound treatments, etc. I HAVE A LOT OF TASKS ON HAND. I never get out of work on time never mind taking a break. I leave at 2am and have to walk in the dark to the back parking lot where there is minimal lighting. I do not always finish charting on all my patients. Whenever management is around they have all these requirements "we need to add these protocol orders" "we need to add this in our notes" "we need to start doing this" "we" refers to me, by the way. Basically I have too much on my hands yet they are throwing more and picking on everything. Ontop of it there is only one CNA on the floor most of the time, with patients who are fall risks and more than one assist with transfers and bed mobility.

I want to report this and the abuse I am going through, unable to take a break or even use the bathroom. I do not know what, how, and where to go about this. Do not comment and say something inconsiderate. Any advice will help. Thank you.

[HouTx, BSN, MSN, EdD]

From the patient ratios you are dealing with, I am assuming you are you in LTC or LTAC. If so, how is your RN supervisor involved? Have you examined your state's scope of practice rules to determine whether you're in compliance? From the descriptions of patient interventions you provided, it would appear to necessitate the physical presence of an RN. From a practical standpoint, without another qualified licensed nurse available, even taking time to go to the bathroom could constitute 'patient abandonment' and that's a completely unacceptable situation.

If you are in LTC and feel that patient care is not adequate, there are many ways to address this. One way is by reporting it directly to CMS - or contacting your local Ombudsman. HERE is information about that process. In the meantime, make sure that your own practice is absolutely compliant.... do not chart anything that you have not done, even if 'management' tells you to. I would also advise you to begin looking for another job, because even though it is supposed to be illegal to retaliate against whistleblowers, you may find yourself out of a job.

Now - about the 'abuse'. This is not a word that should be used indiscriminately. Exactly what is being done to you? If you feel that you're being overworked, that's not abuse. If you are having to walk out into a dark parking area because you had to stay late, that's not abuse. Are you being yelled at? threatened? harassed? Are you not being paid for time worked? What have you done about it? Have you met with your supervisor to discuss your issues/complaints? If not, that is the first step. If your supervisor does not respond appropriately, go to HR.

[nerdynurse7, ASN, CNA, LPN, RN]

There are discrepancies in my paycheck, when I first started working there I did notice and would report it. But now I do not have time to write down all my time and match it up so I would not know if they are not paying me for time worked, but it is a large possibility. HR and supervisors do not tend to care when you report being overworked.

[caliotter3]

Are you doing all of the admissions by yourself? Seems to me the admissions assessment had to be done by an RN, but I may be wrong. I would put keeping track of your time as number one priority. At least if you make sure you are paid correctly, then you will have accomplished one item to your advantage. And start on Monday, to look for a new job. What you describe is too much for a new nurse to deal with successfully. Find another facility, where they have some CNAs to help, another nurse or two to split up the patient load, other positive attributes, and get out of this one as soon as you can, with your skin intact. Best wishes.

[canoehead, BSN, RN]

In the first year it is normal to feel overwhelmed. You might have too much work, it sounds like it, or you might not be delegating appropriately. Talk to your supervisor before you talk to anyone else. Talk to your coworkers, are there easier ways of doing things? If your coworkers don't feel the same way you do, I would be hesitant about reporting outside the workplace. You need a few years under your belt so they can't belittle your assessment, especially if no one else complains.

[tokmom, BSN, RN]

Do you see neglect that is reportable? The Department of Health is a great place to start as well. I'd at least see what your state WAC's have to say about your type of work place.

As for your paycheck, I'd go back to payroll and have them explain your paychecks to you so you have better understanding of what they should be looking like.

[BeenThere2012, ASN, RN]

There are discrepancies in my paycheck, when I first started working there I did notice and would report it. But now I do not have time to write down all my time and match it up so I would not know if they are not paying me for time worked, but it is a large possibility. HR and supervisors do not tend to care when you report being overworked.

You must find the time to keep track of your hours. No one will do this for you. If they are repeatedly not paying you for the hours worked, you will have a case on that as a start. It only takes a second to jot down the time you arrive and leave. Keep a notepad for this.

As far as being responsible as a charge nurse with one CNA, that sounds like​ they are not in compliance with safety standards, but you must contact the ombudsman and your state regulatory agencies to be sure.