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.
First, I applaud you for doing what many of us fantasize about doing every shift.
At my job we are chronically short staffed, we are supposed to have assignments based on acuity with the max being ten, but every shift, we come in, with acuity of 15+ and barely any CNAs. Running multiple patients on vents and multiple drips all on strict isolation etc etc...every horror story you can think of,, my unit has.
Every shift, I come in, I see my assignment, and swear am NEVER coming back,,yet I keep going back like a fool, mostly because I know if I leave, my coworkers will be in even worse situations.
I wish I could just follow through with my gut feeling about this place, but I guess I lack the follow through.
The problem with these places is they keep saying it will get better, they are hiring more staff, they are looking for agency coverage etc etc. Like you, I have been on this job right at 1 year, and if anything, it has gotten worse every day.
1. Patient advocacy is a class in a school that has little place in real practice. It has to be balanced between your career and the ego freak you have to address the patient's issue to.
2. Experience means nothing.
3. _______ nurses always get hired, _______ nurses never get fire. Explanation: I live in an area that is dominated by one particular church. They protect and guard each other like it was their money. I have seen more discrimination regarding other medical staff in favor of this particular group of people on a scale that makes the 60s pale. "Do you know so and so in Ward ___ "? "No, i'm in Ward ____, do you know so and so"? "Oh yes, he's great, we have to watch out for him." and on and on and on.
Sorry for the long story, I pray for our patients, with the future of health care (yes, doctors and nurses will be federalized and unions wiped out). If you're not healthy, get that way, your greatest danger isn't bad traffic, it may be a hospitalization.
Ghostwindrider
in response to what you learned. . .
1. Advocacy is real, We are the eyes and ears of the Doc. If something is wrong, fix it and move to the next. Critical thinking is the real advocacy. If one thing doesn't work, think of something that will. There are always ego freaks; brains and options (knowing yours and how to use them to your advantage) will go farther than giving up.
2. Experience means everything in the circle of influence where you received that training. Civil experience equates to "civilian" jobs, Military experience means next to nothing in civilian careers. If you want Military experience to mean anything, get the degree equal to the experience (8+ year or DNP) and work with an MD doing what you have experience with.
3. Slander is slander no matter what "church" you belong to. With nothing else to go on but this post, there should be a legal defense that would allow you to combat that particular problem, as long as there is documented evidence that it was that supervisor that made the difference in hiring.
In my experience, there are clicks with those on the inside and those on the outside. Again, in my experience, those on the outside are there by their choices and actions more often than not. It is too late in your case, but I left a toxic situation before getting fired (fried) because I wouldn't bow the powers that be (not necessarily upper middle management). Nursing is big enough to for those with experience to get a job and work until their dream job comes along (as long as you keep searching)
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Post Hijack over. . .
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As to the OP, I say Good on Ya' for getting out of the situation with your nursing license intact. You know that the staffingdefense would only go so far when the first of many lawsuits is won because the RN didn't advocate for his/her patients and now doesn't have a job but still has school debt for a career they can't use.
I've spoke with two travel companies and have interviews with the nurse managers at a couple of hospitals for two different gigs! I told both companies that I unfortunately did not give two weeks notice and why. Both companies said basically the same thing; that there is no expectation of notice when leaving an unsafe environment and not to worry about it. I still feel like a bit of a dope but i do feel a bit better. i feel like I was almost partially brainwashed into thinking that the environment we were in was acceptable.
Today another CABG nurse left to go somewhere else as well. So maybe that unit will change the way they do things. But who knows. Again, thank you all for the feedback and support. And Ghostwindrider, thanks for your service and try to stay up.
I think you did the right thing. In CT, each nurse gets 2 patients in the ICU and under no circumstances do they get more. It's unsafe for patients and it's your license that you are defending. If possible, since you did handle the situation with your supervisor professionally, maybe you could arrange to have a conversation to get on better terms so that you are able to move on without being afraid of this incident ruining hopes of future employment in nursing.
Ok...So I'm not an RN yet! I'm an LVN and currently in school to get my RN! I am reading and listening to of what is being said! You'll are making me think "Do I really want to go work in a hospital?" I work in 2 different skilled nursing homes on the skilled units one with 26:1 (8 hour shifts with a med aide) ratio and the other with a 14-20:ratio (12 hour shifts with no med aide)! I thought I had it bad...reading what type of patients you have, that is a bit much! Its not the patient care that you'll have me worried about, its the poor practice of the hire ups that concerns me. I have never been the one to go with the crowd or the flow so that would not work for me...I prefer to do what is right by my patients. Is this what I have to look forward to?
I have walked out on a job before and just didn't put it on my application or resume when I applied to other jobs, since I was not there that long. As for Gostwindrider; if you know that you left because it put your patients and license at risk and that supervisor is making it hard for you to get another nursing job, then you are within your rights to sue for defamation of character. They are not allowed to give any info besides verification of employment and if you are eligible for rehire.
I thought I had it bad...reading what type of patients you have, that is a bit much! Its not the patient care that you'll have me worried about, its the poor practice of the hire ups that concerns me. I have never been the one to go with the crowd or the flow so that would not work for me...I prefer to do what is right by my patients. Is this what I have to look forward to?
The truth is that it depends on what sort of company you go to work for. The hospital i was at was bought by a fairly large company that has a track record of........poor employee treatment. Earlier this year the company lost 1/5th or 20% of its value because they got their butts sued off for wrongful termination of a compliance officer who blew the whistle on Medicare fraud. Not only that, but the company's lead counsel quit on them during the case because there was no winning it and he didn't want his name attached to it. So the company's share price took a pretty significant tumble and they probably won't recover because they're good for a bout 2-3 significant lawsuits a year. Basically they're a large cap company with VERY excessive volatility which tells you that their business practices are questionable. They run strictly as a business first and healthcare is of secondary or even tertiary concern. make no mistake, I WANT my hospital to make money, but in healthcare you can't run a business as you would if you were, say, an ad agency or making widgets, etc. Each department at that hospital is audited monthly for "production" numbers. So it behooves managers to do as much as possible with as little as possible. The trick is to start slow giving people 3 and keep telling them it will get better and its all temporary. Slowly you keep grinding it out until one day people are just used to taking 3 and now it seems like a commonplace practice.
So, it would most definitely be to your benefit to ask around about the place you wish to work before committing and winding up in a situation like I did. And no, not all hospitals are like this one. There are a lot of truly wonderful places to work. Unfortunately I live in the armpit of the US at the moment and our options are quite limited.
Each of us has a threshold for what is tolerable and what is not. Sometimes we step over that threshold for financial and emotional obligations. It's never the right thing to do.
My hat's off to you TX911. I wouldn't worry too much about the two week notice thing. As other posters have said, and you've already found out, you're still very employable. As far as feeling less over giving up on your job, don't. Retreat is always a viable option in my universe.
Specializes in vascular, med surg, home health , rehab,.
You have no reason at all to feel bad about what you did, the managers and CEO at that facilty should, but of course they don't; the conditions you described are totally unacceptable and staying there, hoping its gets better would have been soul destroying. Whats appaling to me is how many hospitals are run like this and how many patients have and will continue to pay through the nose for crappy, substandard care? Good luck in your future, you walked the walk when it came to integrity, if more nurses did it might not this way.
Just because you quit doesn't mean you aren't elgible for rehire. I think you could list that on a resume as job experience and still get another RN job. Tons of people have been fired and continue to find other work. You QUIT, you weren't fired, so you may have burned that bridge at that hospital. Just have good references, which it sounds like you will have because of your good relationships.
I made a comment to the flake charge that we should have another nurse and aid/monitor tech as we now have a guy on telemetry. She chose to call the supervisor (yep, the same flake that was promoted to supervisor and became the torch bearer for poor staffing and egotistical management practices) and say I was complaining about staffing issues. All of which were lies. I was fired that night.
I ask the state's human rights commission to investigate practices of targetting and retribution and provide witness names and phone numbers. 1 1/2 years later I get a nice letter saying all of my claims were substantiated and found true.
Since leaving that hospital 2 years ago, I have been road blocked by this "supervisor" at every turn obtaining nursing work. Several VA positions were withdrawn after a phone discussion with this supervisor. All my references, including 7 doctors (ortho, IM, OB-GYN, family practice and cardiology), several charge nurses and independant nurses as well as patients. All meant nothing as soon as that "supervisor" got on the phone.
Ghostwindrider, it sounds to me like you have excellent grounds for a defamation lawsuit. Your former employer has no right to destroy your career, especially given that you were vindicated by a state agency.
If you're not using your former supervisor as a reference, why are they contacting her?
Dude, sue her *** off. Litigation doesn't solve all problems, but it goes a long way to solving some of them.
They are not allowed to give any info besides verification of employment and if you are eligible for rehire.
Alibaba
215 Posts
TX911,
First, I applaud you for doing what many of us fantasize about doing every shift.
At my job we are chronically short staffed, we are supposed to have assignments based on acuity with the max being ten, but every shift, we come in, with acuity of 15+ and barely any CNAs. Running multiple patients on vents and multiple drips all on strict isolation etc etc...every horror story you can think of,, my unit has.
Every shift, I come in, I see my assignment, and swear am NEVER coming back,,yet I keep going back like a fool, mostly because I know if I leave, my coworkers will be in even worse situations.
I wish I could just follow through with my gut feeling about this place, but I guess I lack the follow through.
The problem with these places is they keep saying it will get better, they are hiring more staff, they are looking for agency coverage etc etc. Like you, I have been on this job right at 1 year, and if anything, it has gotten worse every day.