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?

[TX911]

I'm a dude. But thanks for the vote of confidence. Wish you luck in your new endeavor!

[eatmysoxRN, ASN, RN]

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.

I think you have to do what is best for you. If you felt uncomfortable (who could help but feel uncomfortable in the situation you described?), then you did the best thing. Being able to handle 3 ICU patients seems like it would give you excellent experience.

I think nursing has become more about money than safety, which is unfortunate. I base this on things I've read on this site. Nurses are expected to do more than truly possible. Take excellent care of and cater to the needs of every patient, whether it be a medical need or a whim they have. I blame Press Ganey. Anyhow, I still think you should pursue another position in a different ICU or the ER.

[CrunchRN, ADN, RN]

It is ok. You will still have great references and your reason for leaving is very understandable. No worries. As long as you don't have a pattern I think in your case honesty and stellar refs will be all you need to overcome this.

[Laura Z. Pam]

TX911, I don't think you made a mistake at all. You need to saved your license while putting your employer on notice that their staffing practices were unacceptable. Nursing is NOT like accounting or delivering mail or changing oil for a living, we have a moral responsibility to refuse inappropriate assignments. You refused to let your hands be used to harm people, and that is a good thing. Also, by law, no one can ask anything of your employer but the dates that you worked (not that every place follows the law). Any nurse who does not tolerate poor working conditions strikes a blow for all other nurses and for all patients every where. Good Job!!!

[TX911]

The directors of Press Ganey should be all be arrested and charged with extortion, fraud, and racketeering. How Press Ganey or JAACHO for that matter, are allowed to operate is true, modern day exercise in governmentally protected organized crime.

And thank you, I'm still weighing my options. But hey, at least we have options right?

[Vinniesguy]

Employers and unit managers will continue with unsafe practices like this until people start standing against it.

Walking out with no notice might be the wake-up call they need. And in my experience - in situations like this - it just takes one person to pull something like this and then the rest follow!

[Esme12, ASN, BSN, RN]

Press Ganey does surveys.....essentially so does The Joint Commission (formerly known as JACHO). The hospital administration is the one manipulating the data for their benefit and blaming Press Ganey/The JC to look like the innocent bystander......with the 'They made me do it" mentality. It is the corporate greed that is so rampant right now that the hospital administrators are lining the corporate pockets and using the excuse that "There is a critical nursing shortage"............

It's all to keep staffing costs down, keeping profits up, and abusing the nursing staff they have by saying there is no one to hire due to the "shortage" when the know full well they can fill those spots with competent nurses and train new graduates to fill the gap and that with good working conditions nurses will stay because the inherently hate change......then they place their propaganda out to a desperate public wanting to work so the market remains flooded with a plethora nurses driving salaries/benefits down.

Like it did for Wall street, the banks, the housing market, and the auto industry big wigs...this will explode in their face. Unfortunately patients will suffer.

A recent statistic was released that 45,000 people every year die in intensive care units due to mistakes.....as many deaths that are caused by breast cancer.......a severe increase. We all know nursing will be blamed but with staffing ratios and acuity like the OP experienced it's no wonder why it's so high.

:hug: I'm sorry you are going through this....my vote is it's always safe to say "It wasn't a good fit." and You can call your director and have a real talk about why you left and that you couldn't take it any more....it was not safe. At least have a face to face to say your piece.....if for nothing else, for the patients who will no longer have you to care for them.

Good Luck!!!

[nuangel1, BSN, RN]

you sound like a very caring and experienced person.you felt it was unsafe and it most definetly was .i worked ICU for 11 years .a fresh cabg is a 1 to 1 in my experience.you have good references say it was not a good fit and move on.good luck with your future endeavors you have lots to offer.don't look back.

[Anna Flaxis, BSN, RN]

I applaud you for standing up for yourself and for patient safety. Standing ovation over here!

[noyesno, MSN, APRN, NP]

I advocate for a two weeks notice in all situations except situations involving unsafe working conditions. Continuing to throw yourself to the wolves for two weeks, is dangerous for both your nursing license and mental/physical health.

While I do agree, it'll leave the workplace shorter on staff than it was to begin with, your employer no longer deserves the courtesy of a two weeks notice when they subject their employees to unsafe working conditions.

Also, you've put up with this crappy conditions for a year so some will say, "what's another two weeks?" Well, you've reach your tipping point, the situation with those three patients have helped you "see the light." Continuing for two weeks, now that you fully understand how unsafe your workplace is, would not be the decision of a sane individual.

Thank you for standing up against unsafe working conditions.

[xoemmylouox, ASN, RN]

I have quit like that once. There are times when you simply cannot go in for another shift. You can say I should have.. But NO the employer should have done what was right for the patient. They failed not you. I was at an LTAC and the ratios were like 1:8-10. Oh yeah and there was maybe 1 RN and 4 LPN's to cover all patients. We were NEVER allowed to call 911 we had to run the codes ourselves which would have been fine if more than one staff member was ACLS certified. After one super riduculous night shift I left a note for my unit manager saying I was through (she was never there in the am at a decent time as she didn't want to hear our complaints). She called me back and asked "so you said you have resigned effective immediately... Does that mean effective immediately?" Uhhhh .. Nope I'm gonna stay OF COURSE it means effective immediately.. I have heard it has actually gotten worse.. They did away with PCA's so the nurses do everything. You couldn't pay me enough to go back.

[Faeriewand, ASN, RN]

You did the right thing! No regrets! Staying any longer would have been wrong.