Should I Stay, Or Should I Go?

[Starz_stuffs, BSN]

Hello, 

I apologize for the long post.

I am an RN with four years of experience in psych/behavioral health. I currently work acute care inpatient at a state hospital in Texas on a child/adolescent unit. While I enjoy working with the kids and have met many awesome coworkers, I am suffering from extreme burnout. I began looking for another job this Spring but instead, ended up going on unpaid medical leave for an unrelated health issue. I’m supposed to go back in August, but I really don’t want to.

I am thinking about looking for another job while out on medical leave and not returning to my current job.  I know this sounds like a crappy thing to do to my employer, and I do feel like I’m letting my coworkers down by not returning. However, despite dealing with the pandemic and all the horrible things that came with it; I.e. short staffing, sick patients, lack of PPE, confusing policies, etc; the unit I work on is unsafe.  

Proper procedures have been followed to report unsafe conditions and absolutely nothing is done about any of it.  These unsafe conditions include broken/non-functioning doors, broken/missing staff radios, dilapidated (broken metal, tile, wood) and unclean units; black mold in the break room, Safety glass from years of broken windows embedded in the sand in the play areas, broken restraint chairs, etc.

Multiple work orders, emails, conversations have been reported by multiple nurses, techs, RN supervisors; with little to no response except the usual gaslit, superficial responses. Kids are constantly finding objects to self-harm. There are many incidents of children requiring surgery to repair self-inflicted injuries. Any Tech or RN that is assigned to the child that hurts themselves is reported to DFPS for neglect.  With the perpetual staffing shortage, RN’s are consistently asked to work on the floor as a tech. RN’s feel obligated to “help out” but jeopardize their license.  

A couple of weeks before I went on leave my patient had an unauthorized departure and went to the top of a five-story parking garage next to the hospital (he didn’t jump, thank God). The tech that was caring for him did not have a radio to report the incident immediately. I had just given up my nurse radio to a tech on a 1:1 precaution, but luckily another nurse was able to alert me to what was happening. This is because the administration (nurse mgr, building mgr., and the safety director) refused to supply new radios to replace broken/missing ones. When nursing staff cried foul we were berated by the building mgr and safety mgr. The nursing mgr, even though was cc’d on all correspondence said absolutely nothing to advocate for nursing staff. This went on for months.

RN’s are consistently asked to falsify documentation. Instead of saying the patient caused a self-inflicted wound with broken safety glass found on the playscape, I was advised to write “clear aggregate stones” by my charge and supervisor because that is what “They” said to do.  Don’t worry, I did not comply.

The nursing staff was asked to document that a latency age child (under 12) was on his assigned unit in the EHR but actually he had been physically moved to a male adolescent unit (13-17.9) to make room for covid isolation patients. The adolescent male unit housed a sexually aggressive male and several very aggressive autistic males. The child was placed on 1:1 precaution for his safety, but again, if the child had been hurt the staff caring for him would be reported to DFPS.  Luckily, the child was unhurt, but this would have continued except for an anonymous call to DFPS demanded the child to return to his proper unit on the spot. This incident was reported over several weeks to nursing management. I finally cc’d the CNE to the correspondence as nothing was being done about it.  My coworkers thanked me for advocating for the child but management wrote me up for breaking the chain of command. 

Nursing leadership is miserable. My immediate supervisor is awesome but the nursing manager is terrible.  He was promoted to nurse mgr almost a year ago and has received multiple complaints. 5 nurses and numerous techs have quit and/or been reassigned since he arrived. Communication is so poor, and the work environment is very toxic. For instance, the nursing mgr. was advised he could not view video footage of the units without probable cause. This is because he was watching footage of staff from his office and work computer at home. Communication is nonexistent and a “do as I say not as I do” attitude is common. He also has multiple sexual harassment claims from his previous and current units. Please don’t think I’m trying to bash my manager, I’m just trying to create a picture of what I’ve been dealing with. 

I feel so done with this job. I feel sad because I came here directly from nursing school to work with this population. I’m passionate about providing nursing care to indigent Texans dealing with mental health issues. That’s why I became a nurse. But this job is breaking me. I think I should just move on.  I just want to provide safe care. What would you do?

[Yoonsung0506]

One thing I want to tell you is TAKE CARE OF YOUR SELF. Don't think about other people or you let them down or how they will think about you for not returning. You feel unsafe working there. YOU feel unsafe. you feel burned out, YOU are burned out PERIOD. 

take a break and then come back to nursing. that is OK.  

Take care. 

[Starz_stuffs, BSN]

Hi! Thanks so much for taking the time to read my post and responding.  When I initially  re-read my post, I realized immediately that 1. I was burned out. And 2. This is not the right job for me. ? Putting it all on paper was a great exercise for me and helped me to look at my work situation with a new perspective.