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?

[paradiseboundRN]

I walked out on a job last week. Granted, patient safety was not at risk, but my mental health was. I was a clinical manager at a nationwide home health co. My boss, who has a narcissistic personality disorder refused my 2 week notice saying, "you're on probation, so you don't have to leave notice", so I went to HR and then left. HR gave me a tissue and a hug. She said it happens all the time and that she will give me a good recommendation. She stated, "all the recommendations come through me". So I'm not worried about it. Good for you. If more employees did that, maybe they wouldn't abuse the nurses. But nurses bring a lot of problems on ourselves by being such good little soldiers. You"ll be fine! Try another type of nursing.

[morte, LPN, LVN]

to do any real good, this needs to hit the papers/blogs etc. The families of those three paitients need to know the danger their loved ones where in and why, not the hospital's spin.

[TX911]

to do any real good, this needs to hit the papers/blogs etc. The families of those three paitients need to know the danger their loved ones where in and why, not the hospital's spin.

Not sure how that would work or how wise it would be long term. I do agree with you in principle though.

[SHGR, MSN, RN, CNS]

You sound like someone I would love to work with- compassionate, hard-working, ethical, principled. Too bad for that unit that they lost you via terrible working conditions. Valuing "productivity" and numbers over patient safety, good nursing, and their staff's mental health is just so sad and so wrong. So many new grads want desperately to work in the ICU. They could have the staff they need, if they wanted to.

I wish you the best in your life and career. May your former employer see the light.

[Kooky Korky, BSN, RN]

I don't think documentation would help his cause. Admin doesn't want to hire more staff, the nurses gave in and took three pts when they should have had only 1 or 2, so Admin figures 3 is the new normal, the new expected work load.

I agree that all is not lost and he might even be rehireable. They might even accept notice at this point if he talks to the right person. I've seen people give notice, only to be convinced to stay on the job. Their notice was returned to them, they were still hired. OP should ask. Nothing ventured, nothing gained.

[Kooky Korky, BSN, RN]

do NOT do that.

[Guest343211]

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.

I agree with the above.

I can remember when it was mandatory in many states that fresh Open Heart Patients must be 1:1 for 12-24 hours-depending where--post-op.

This is the wave of crap I am talking about in other threads re: hiring freezes and mandating BSN or hiring new RN BSN b/c of the degree without STRONG clinical experience. See b/c right there, you are telling me that the RN to pts ICU ratios are ROUTINELY AS YOU HAVE STATED. Hmmm? What does that tell you people? They need experienced RNs, but they aren't hiring them--b/c of the politics of mandating BSN COUPLED with the current hiring reductions over the last several years. They have pulled back the reigns BIG time on hiring. No one is going to tell me, in most cases, New GNs w/ BSNs are going to curve up to strongly experienced RNs, even if they have been out of practice for a while. There are things you don't forget--the insight into clinical nursing judgment and so forth that you will not lose if you are a reasonably intelligent, and strongly experienced RN. You may need a a couple of weeks to feel good--but that is NOTHING like the curve of learning for an GN for God's sake.

Sigh!

I definitely agree with the above comment from been there about letting it build up, and then BOOM!

You are going to have to do some career repair here. Go and speak with the CNO if you have to do so, but try not to let this leave a bad mark on your resume.

OP I so totally hear what you are saying. And like the others, on one hand I want to cheer, while on the other hand, I have career fear for you.

Do whatever you can to make this as right as possible. Unfortunately, you need their reference.

[TX911]

Again, I have no intention of ever going back there. I would have no problems admitting that I should have given notice but on that some token I would expect an apology to me, the staff, and to the patients from the current administrative staff to even give a slight consideration of going back. And I think we all know that's a pipe dream. I'm happy being a medic. I

[BigheartRN]

Hi! I am a former critical care RN and just from reading your story the situation your describing sounds highly ridiculous and soo unsafe. I know that we don't have "mandated" nurse to pt. ratio but usually in the critical care area are max is 1:2, having a ratio of 1:3 is usually IMC criteria at least where I work. If any issues arise from you resigning to your job without notice you should contact your BON. Your license and the patients safety was at risk..you did the right thing and you hung in that nightmarish situation for 1 whole year so major kudos to you. Also usually fresh hearts ( less than 12 hours post op) are monitored 1:1 in the CVRR so it's so crazy you would have a 3:1 assignment with a fresh heart period. Best of luck to you! :)

[IdianaCNA1993]

well Im just a pee on CNA but I was thinking about quitting my last job the way you did (I got fired at 8 months for somthing I know I didnt do) but then I thought about going PRN and then getting another job so that I could make my own hours at my PRN job when I wanted and still have the security of the full time job. AND no Im not trying to add insult to injury. Im telling you this because I think tat at the next job if you have the oppurtunity to go PRN before quitting because you never know that place might get better and you can then go back full time! if that makes sense. I wish you luck in what you decide to do I think a paramedic with a nursing degree is a good thing :)

[MommyandRN]

I totally can understand. You stood up for what you believe in, and what they were doing is just not right. Or safe. Good for you. I do understand how you feel bad though. I have left jobs and then thought afterwards that maybe I should have stuck it out. But live with no regrets. It's over and done now. I don't think you need to leave it off your resume or say that you couldn't be rehired. Leave it there as a past position. When asked about it you can honestly say that it was unsafe. Just be honest about the situation rather than hide it. I think an employer would understand. Especially if you went right back to your paramedic job. It's not like you are unemployed. Good luck to you in your future.

[08RNGrad]

Agree with been there done that. It sounds like an awful and unsafe situation and so unfair to the patients. It is unfortunate things got to that point, but under those conditions, I would have done the same thing. Even if you have no intent of ever going back, you can never really know what the future holds, so you should follow-up with HR just to see where things stand. You owe it to yourself to get your side of things on the official record. You still have options....if you had continued with those ratio's and then lost your license, you'd be in an entirely different situation. Good for you for taking charge of a dangerous situation. Becoming an RN is no walk in the park. You sound like you were a great one...think long and hard before you give it up for good.