Should I stay or should I go?

[Been there,done that, ASN, RN]

I have been travel/agency nursing for the last 5 years of my 28 years in nursing.I am currently in a contract at a facility that I feel compromises the quality of care I can deliver, and the safety of my patients.Not to mention MY license,, of course.

It is a fast paced observation unit, only 11 beds, but it is not uncommon to discharge 3 and receive 3 patients in the same 12 hour shift . I share the RN responsibilities with one other nurse. Recently I received 2 direct admissions, and an ER admission within a 5 hour time frame.

My main concern is the lack of physician availability to report changes in patient conditions that require additional orders. They simply do not respond to pages, calls, etc. For example,I received a direct admit in a third degree heart block,, called 3 times for physician support, no answer, Come to find out,, it was a totally inappropiate admission to this unit.

Another patient was experiencing chest pain, unrelieved with the nitro and morphine orders I had. I obtained an Ekg, and was told there was not a doctor to interpret this EKG, and it was up to me to do so. When I approached the manager of the unit the next day, I was told I would need to fax the EKG to the cardiologist on call and ASK if I should do anything else!!!

Please give me your input, have 2 days to decide whether to continue.

[himilayaneyes]

You ask something that in reality is very simple. Here's a biblical principle...let the peace of God be your guide...sometimes we ask God and others what we should do...when in fact He's already telling us what to do...seems to me He's already telling you what to do. If you don't have peace about working at this facility, you should leave...especially if you feel it's compromising your license. You have 28 yrs as a nurse, but all it takes is one incident to lose your license. Protect your patients and your license. Don't think for one sec think that the hospital or your agency isn't going to throw you under the bus if something happens. Leave them and set up another gig. Good luck.

[aileenve, ASN, RN]

Your pts life and your license are in jeopardy!

[OCNRN63, RN]

Fax the EKG to the cardiologist and ask if you should do anything else?

I think you need to get out of Dodge.

[Been there,done that, ASN, RN]

Thank you so much for your reply, i did indeed leave God out of this question.After all, He was the one who guided me to the helping profession.

[Tweety, BSN, RN]

God won't do your charting and leg work.

If you document properly, such as document that you used the chain of command, document each and every call, and do an incident report each and every time, and do what you as an RN should do then your license isn't at risk if physicians aren't doing their job.

Always use your chain of command and document in the record, "No physican response, manager/house supervisor notified", etc. Courts usually look favorably on nurses and don't hang them out to dry when it's MD neglect.

For example document each call, then if you don't receive an appropriate response then let the manager know, and document that and do an incident report. It could be tedious but it could save your butt.

They might label you a trouble maker and ask you to leave, which will be a blessing.

[Been there,done that, ASN, RN]

thank you so much for your reply. After i wrote it down, it became clear. However, it really helps to hear from other professionals.

[Been there,done that, ASN, RN]

Thanks, did indeed try to document my attempts. however,I have 3 hours of training on that EMR, not sure where to d o that. Plus as usual, not enuff time to cover my butt when I am trying to take care of my patients.

[Medic/Nurse, BSN, RN]

i would not stay -

no how, not now.

i would go -

on a plane,

on a train -

in the rain -

just not down the drain.

take the bus - if you must,

but just go and don't be slow -

this gig is bad,

don't be mad - just glad that you can go, go, go.

if you are feeling this spent now - how will you feel in three months of this madness? 28 year nurse - you do, indeed, know the answer to this question - just know that others have made the same decision. it is fair to think that others may have toughed it out - but, why would you want to??? kudos to tweety - great advice - but from someone who has been in a bad situation where i spent lots of quality time with "risk management" from the "incidents" that required reporting with most every shift - it is just not worth it. i left a contract 11 days early - it cost a fortune and yet it was a great investment in my future and career

good luck.

practice safe!

:angel:

[Been there,done that, ASN, RN]

Thank you so much for the advice,, I truely appreciate Dr Seuss, not so much the docs THERE

[canesdukegirl, BSN, RN]

Do you have another assignment lined up? I was also a traveler, and I had the most wonderful recruiter-she always had my back and had another assignment lined up for me. Is your recruiter aware of what you are going through?

I would not hesitate to leave. You are in a bad situation, and it is COMPLETELY inappropriate for the MDs to not be available. FAX the EKG?!?! Are you kidding me? How bout "fax me a plane ticket outta here!"

[royhanosn]

enough with the religious stuff! go to your supervisor and tell them. If nothing changes, look for the another job. You sounds like a consciencous worker, but dont take it personally, its the workplace fault not yours.