Soooo, I quit

[TX911]

I've posted here quite a bit but have been here in awhile so I couldn't log back in for some reason. Anyway:

I've worked ICU for the last year. I was a paramedic for years, transitioned to RN and got a job out of nursing school in aforementioned local ICU. Throughout this year we have been understaffed, stretched to 3:1 ratios EVERY night, even when caring for CABGS, valves, heads, etc. Didn't matter what it was, you had three every night.

So the night before last, I had a 8 hour old CABG, a 21 year old dying from complications of cystic fibrosis with the family all in the room wanting information (looking to have some sort of control over a bad situation I imagine), and a schizophrenic pt admitted post status epilepticus that I cannot see from my pod with the 2 aforementioned pts in it. I told charge that I could not see the SE pt, had this heart, and that the family needed some attention with the CF patient. No dice. "Everyone has three again, I don't have anyone else to take the heart." I told them I'd get through tonight but I wasn't doing it again (we all say the same thing every night and yet we all come back.) I get through the night with minimal incident.

So the next night I come in, have the same 21 CF pt, a new GI bleed on bowel prep with a hgb- 6.9 getting blood, and a new admit HTN on cardene and getting peritoneal dialysis q 4 hours and is just generally very needy. I can't give this guy the attention he wants, my poor lady with GI bleed keeps messing the bed, and the CF family is still very frazzled. So I get in a groove finally and get some things lined out when I happen by more GI bleed's room and she raises her hand. She tells me she's messed the bed again. I say no problem, just now? Then she proceeds to tell me "No, about an hour ago. I didn't want to bother you, you just looked so busy." And right there ladies and gents, I was done. That was it for me. I told her that no matter what, if she has an accident to hit that call light and I will make sure someone comes immediately (we don't have PCAs regularly either, did I mention that???) . I then proceeded to tell charge that she needed to call someone in because I was done. She tells me that there is no one to come in, so I said fine, I'll finish tonight, give report to oncoming in the morning, but they can consider this my last shift. A year of this garbage is enough.

True to my word, I finished the night, gave report to oncoming, said goodbye to my pts, and approached the "director" and asked her if she wanted to do this here or if she wanted me to go downstairs and talk to the honcho. She gives me this disappointed look (like your mom does) and says, "no I'll take it." I hand her my badge and walk out. In my younger years I would've probably gave her about a 20 minute tirade in front of everyone about exactly what I thought of her and her units staffing practices (the 3:1 ratio is deliberate for "productivity" numbers, though they've been lying through the last year telling us it would get better.)

So, today I feel bad about not giving notice and I know that it was unprofessional. I know that and I'll wear it. But at the same time, in that same situation, finishing the shift and not tearing through the director was all the professionalism I had left in me. I feel cleansed, but at the same time disappointed in myself to a degree. Partially for not blowing my lid at her and partially for not giving notice. I've worked since I was 14 years old and this is the first job I've ever had that I couldn't go back to whenever I wanted. I still talk to my old oil field bosses and I'm headed back to my previous ambulance job full time. So I'm going to mentally chalk this one job up as the exception to my professional history and not the rule. I feel that it was my fault for not gritting my teeth and bearing the two week notice, but I have no plans of ever going back there again or ever working for a hospital that that company owns. I will miss my friends there dearly but I just couldn't stomach it any longer.

The problem is now that as far as nursing goes, that job in ICU was my only experience and now on applications I have to check not eligible for rehire (I'm sure.) So I guess my best bet is to just stay a medic and be honest when it comes to what happened.

Anyone ever have anything similar happen?

[eatmysoxRN, ASN, RN]

Wow. That terrible for you. It sounds like you are an excellent nurse who was put in a terrible situation. In my eyes, every single time you said that you wouldn't do it again, it was kind of like giving notice. I know the facility won't view it like that, but if you have no intention of working there again, you shouldn't worry too much.

Do you think your manager would honestly give you a bad reference? I don't know that you have to tell other employers that you didn't give notice, but even if you did, I'm thinking they would be understanding. I think you should apply for ICU at a different facility.

Best of luck. :-)

[mindlor]

I am sorry for the way things turned out for you. I share your frustrations and while I do not work in ICU I work on the floor of an LTACH and generally have 6 or 7 extremely ill patients.

I am able to prioritize by saving the GCS

Over this past weekend I had an A&Ox3 lady with end stage ALS. I have had her before and knew that she would be on her call light about every 10 minutes.

Anyway to make a long story short I guess I did good by her and at the end of my shift she gave me a huge smile and mouthed Thank you soooo much!!! ( she has a trach)...

I almost cried right there and I did cry on the way home. She is such an awesome lady with a wonderful family.

I guess my point is, in my brief experience I have lesrned to savor moments like these and to hold on to these memories when I have a horrible set and my shift is heading south......

Some days at the end of my shift I feel like quitting and other days I leave walking on a cloud.........

It is a HORRIBLE yet WONDERFUL place to work LOL

Anyway, I wish you well

[Nurse ABC]

Well I have to say good for you and at the same time bad for your career. However, having a year's worth of ICU experience is in your favor since it's so specialized. Plus you weren't fired, you just quit. I would apply for either travel nursing or another hospital system (what abt trying the ER?), flight nursing, or any other place that could use your experience. Then on my application I would use people you worked with and even your manager if she'd be willing for your references. I would be up front and say you didn't feel working conditions were safe and you brought this issue to the managers several times and since nothing was done and you knew you didn't want to work for them again you didn't bother with the standard 4 week notice since you already had another job lined up and didn't care if you were eligible for re-hire.I would hate to see you not do nursing since there was a reason you left being a paramedic to get your degree. Good luck!!

[TX911]

Well I have to say good for you and at the same time bad for your career. However, having a year's worth of ICU experience is in your favor since it's so specialized. Plus you weren't fired, you just quit. I would apply for either travel nursing or another hospital system (what abt trying the ER?), flight nursing, or any other place that could use your experience. Then on my application I would use people you worked with and even your manager if she'd be willing for your references. I would be up front and say you didn't feel working conditions were safe and you brought this issue to the managers several times and since nothing was done and you knew you didn't want to work for them again you didn't bother with the standard 4 week notice since you already had another job lined up and didn't care if you were eligible for re-hire.I would hate to see you not do nursing since there was a reason you left being a paramedic to get your degree. Good luck!!

My team leaders (charges) and co-workers have all called and such and said to put them down as references. One of my old nursing instructors also found out about it and called to ask if she could do anything and to use her as a reference.

I already had a degree as a medic and I guess that's why this feels so frustrating. It wasn't a move up to nursing, it was definitely a lateral move. I did it for the experience and because I wanted to not only have more options but to also get a feel for higher level treatment so that i could do my job better. And i land an ICU gig and am gone after a year. It just looks bad. But again, I'm not practicing in that environment. I sit for my CCRN next week and then maybe I'll start looking into nursing again. Until then, I'm going home to the ambulance. It may be a dumpy shack with no indoor plumbing and tin foil on the windows, but home is home.

[TX911]

Wow. That terrible for you. It sounds like you are an excellent nurse who was put in a terrible situation. In my eyes, every single time you said that you wouldn't do it again, it was kind of like giving notice. I know the facility won't view it like that, but if you have no intention of working there again, you shouldn't worry too much.

Do you think your manager would honestly give you a bad reference? I don't know that you have to tell other employers that you didn't give notice, but even if you did, I'm thinking they would be understanding. I think you should apply for ICU at a different facility.

Best of luck. :-)

Everyone up there that I worked with save for a couple, are all excellent nurses. I wouldn't classify myself as one, but I felt like after a year I was on the road to competence. That also stings a little. Many people have stuck it out and stayed, so does that mean I'm just not a nurse? Is this what nursing is? All questions i thought i would have answered for myself by now.

[classicdame, MSN, EdD]

Don't give up nursing yet. Being chronically understaffed is justification for leaving and you can claim that you always felt your patients were not getting safe care. Being a patient advocate is not a bad thing. I just feel bad for the remaining nurses there. Until more nurses are added the situation will not improve. So sad

[Been there,done that, ASN, RN]

My first thought is KUDOS TO YOU!!! ( now there's a pair)

But ... what you did wrong was letting it build up to the point that you just had to quit ... .on that very same day.

Dang, hindsight is always 20-20. You put up with the bs for a year , until you blew.

Hopefully , there is some documentation that you repeatedly expressed your concerns for patient safety... related to that RIDICULOUS ratio. That will help your cause.

You are NOT ineligible for rehire!!!. For one thing, just ask them.. I will bet the rent they would take you back. Many facilities only ask for your dates of employment when checking references.

You have one heck of a talent there, if you could pull off the shifts you described. Don't give up nursing. When you are asked about this position, stand firm with " it was against my ethics to work in an situation that was unsafe for my patients."

Good luck.

[Good Morning, Gil]

Good for you for leaving an unsafe situation. 3:1 is not a safe assignment in an ICU. Well, maybe intermediate ICU, but what you described was not intermediate. A fresh post-op CABG is typically 1:1 in our CVICU. I work in a general MSICU and always have 2 patients, and with no CNA's, that's enough. It literally wouldn't have even been possible for me to take care of my unstable patient, and my stable, critical patient last night, was running all night long.

You did the right thing, though, like you said, it would have been better to give your notice, but what's done is done, and it looks like you have some good references, and you have a job to fall back on in the meantime until you find something else.

Just be sure you know the ratios up front this time, and if I were you, I would be honest, and say that you felt the 3:1 ratio was unsafe in this job, which it was.

Best of luck to you! We nurses shouldn't even have to deal with poor ratios like what you mentioned, but it is what it is, and has been an issue for a long time, not changing anytime soon.

[TX911]

Thanks for the encouragement guys. i know that bottom line I didn't do the ideal thing, but as Gil says, what's done is done!

[bostonbakednurse]

Being a frequent job seeker, I can assure you that how you left that job is of no importance, as long as you don't tell your next employer why you left. When you give names and numbers of references, use coworkers that you know will give you a good reference. Hospitals rarely take the time to call Human Resources for the dates. It's too time consuming. But they will call the references that that you tell them to call. (sometimes not)

So you had it and left. I've done that myself before and at the time, did not regret it. I know now that there are steps that I can take and resources to get me through, even if it's a vacation!

Don't beat yourself up. You must care greatly about the patients and I bet your a thorough, hardworking nurse.

[simonemyheart]

Hello.......I feel you're pain!!!!

I work on in PCU and we can have up to 7 pts, but average 6:1. It is unsafe and fair to us or our pt's. I just got a new job and I look forward to turning in my 2 wk notice.

You are a brave woman!!!!