I'm hoping to get some opinions. Recently management has come to me asking why I did not take a break a couple of times in one week. The simple answer is, I don't feel it's safe for me, the only nurse on the floor, to leave the floor in the charge of a single LNA. An LNA that has only been an LNA since Oct.
I work on a rehab unit. Sometimes I have 20 patients, other times census is low and we get down to 9 or 10. Normally there are 2 LNAs but when census is low, they cut one and I'm down to one aid. Last week there were only 9 patients and we had 1 LNA and myself. 4 out of those 9 are on bed/chair alarms and are in rehab for fx sustained from falling. These people are very confused and impulsive, especially in the evening (I work 3-11). I am expected to leave the floor with these impulsive patients on alarms in the care of an LNA. What if while one alarm is going off and she is in with one patient, another alarm goes off. If she is tied up with one, the other could end up on the floor. I expressed this to the DON and she really didn't acknowledge my concern, only telling me, "you need to leave the floor for a break." If they really want me off the floor, they need to send some coverage to my floor so I can leave. It's my license, not there's. I've worked other places and the nurse NEVER left the floor without another covering the patients.
I believe the policy of the facility is irrelevant. The policy of the facility may not be the policy of the BON. The facility isn't the end all be all of my licensure, the BON is. The policy just puts policies and procedures in the to cover their bums, we are the ones as licensed personnel that are in charge of knowing what is right and wrong based on our practice acts. The facilities are just businesses that are out to make money, not protect us or our licenses.
The reason why I mentioned your facility's policy is because you already mentioned that your employer conveniently does not see the danger of the only license nurse leaving the unit. I would bet a paycheck that it does not support this practice. At this point, it seems to me that your policy is the only resource available to you (at least, to make you case with your boss). Obviously, others had been taking their break, not being bothered by this situation (you are working against an established culture). Ask other nurses how they feel about it, there is more power in numbers. It seems to me you have two options: get a job somewhere else...or stay, and work toward changing the established system.
Call the state and tell them they are putting you in a situation to violate two rules. One your break, or two patient safety. They must provide someone to cover your break.
The reason why I mentioned your facility's policy is because you already mentioned that your employer conveniently does not see the danger of the only license nurse leaving the unit. I would bet a paycheck that it does not support this practice. At this point, it seems to me that your policy is the only resource available to you (at least, to make you case with your boss). Obviously, others had been taking their break, not being bothered by this situation (you are working against an established culture). Ask other nurses how they feel about it, there is more power in numbers. It seems to me you have two options: get a job somewhere else...or stay, and work toward changing the established system.
Best of Luck.
There are only 3 nurses that work on my unit. The 7-3 nurse, the 3-11 (me) and the 11-7. Yes, the other two do get a break but here is why.. The 7-3 nurse has the unit manager (an RN) the DON (an RN) and the wound care nurse (an RN) All on the floor (their offices are along the hallway and all within earshot). She has coverage. However, these people leave at 4pm and are not there for me when it's time for my break. The 11-7 nurse gets his break because all of his patients are sleeping and he feels comfortable leaving the floor in the care of an LNA (not my circumstances at all) so therefore the fact that the other two shifts do not have a problem getting a break is completely irrelevant.
Last night was another night with no break. I had a patient on IV vanco, another with a glucose of 409, an ETOH detox, and a new admission @ 5pm that wasn't even put into the computer system so I had to do the entire admit from scratch. Not to mention my other 7 patients with various needs.
Nccity2002, MSN, RN
208 Posts
The reason why I mentioned your facility's policy is because you already mentioned that your employer conveniently does not see the danger of the only license nurse leaving the unit. I would bet a paycheck that it does not support this practice. At this point, it seems to me that your policy is the only resource available to you (at least, to make you case with your boss). Obviously, others had been taking their break, not being bothered by this situation (you are working against an established culture). Ask other nurses how they feel about it, there is more power in numbers. It seems to me you have two options: get a job somewhere else...or stay, and work toward changing the established system.
Best of Luck.