Took A Stand At Work.....


Thanks to the wise advice of the people at, I took a stand at work and started refusing to take assignments that were more than double the ENA recommendations for staffing because it wasn't safe for my patients for me to have 5 shock room patients or 9 exam patients.

I have been very vocal at work about how unsafe it is to have all 28 beds full with only 5 nurses in the department. I have also been quoting the quarterly publication that the board puts out regarding how a nurse should handle an unsafe assignment. The icing on the cake was having to put a trans-venous pacer in a woman with a heart rate of 20 and not enough nurses to cover the little things such as recording (we paper chart) and someone to be the "go-fer" for the sterile nurse setting up for the pacer.

Yes, I was smart enough to start looking for another job BEFORE I did this and have accepted a position in a different hospital. It is a good thing too because this went over like a lead balloon. I was told last week by the assistant manager that I was not allowed to say at work that I was going to call the board and find out if the article from 2005 was still in effect, or if I needed to do something different to protect my license. I was also told that my negativity was undermining "all of the positive changes" that they had implemented.

Now, at the time of this conversation, the changes that had taken place were that all of the agency nurses (30-40% of our "staff") were cut from the schedule, additionally, the number of nurses allowed for every 4 hour time block was decreased by 1, in-house registry (IHR) staff were allowed to bump a regular staff off the schedule because IHR never gets put on call, the exam beds were going to be staffed at a 1 nurse to 7 room ratio, and there was the addition of 12+ tasks to the list of things that we already don't have enough time to do.

My immediate supervisor has been very supportive of me and my stand. She confirms that I haven't missed any positive changes. She also confirms that no, I am not negative, I am realistic and the reality is that it is dangerous here. She was told by the assistant manager to stop mentioning the ENA recommendations because we weren't going to staff by them and the assistant manager was tired of hearing about them.

There are 10 people that are trying to find a way out of this department. I am one of the lucky 2 that so far have. It is bad enough in our department that one of that people with 15-35 years of ED experience are saying it is unsafe an looking for jobs.

One day, after reading something here about staffing ratios what popped into my head was "Shame on them for putting me in a position where my patients and my license aren't safe, but shame on me for allowing them to do it day in, and day out."

So, thank you to everyone who has ever contributed to threads about staffing ratios since I found in March. If it hadn't been for this site, I would have never gotten up the courage to take a stand. I would have bought into the philosophy that 1) Staffing was like this all over so I just needed to suck it up. 2) If I didn't take the extra rooms, I would be making more work for everyone else. 3) A good nurse would be able to handle this and not even complain.


847 Posts

Unfortunately in most if not all work situations if we don't protect ourselves no one else will volunteer for that precarious full-time position. As a nurse you did what you needed to do to protect yourself and bring serious violations to the attention of your management. If you decide to take it one step further you could contact the BON for your state, or even social services regarding the safety of the patients in that unit. Good luck with your new position and in your new life.

Altra, BSN, RN

6,255 Posts

Specializes in Emergency & Trauma/Adult ICU.

Congratulations Ariesbsn. :bow::caduceus:

Well done.

And thank ypou for all of us. Your victory and stand is meaningful to every nurse out there.

Has 29 years experience.

Kudos to you. The only piece of advice that my mom (RN 30+ years) gave me the day that I graduated from nursing school was "You are a nurse in America, you can ALWAYS get another job but NEVER another license"

Specializes in med/surg/tele/neuro/rehab/corrections. Has 13 years experience.
"You are a nurse in America, you can ALWAYS get another job but NEVER another license"

Wow great quote from your mom! Thanks I'll remember that. :)

ebear, BSN, RN

934 Posts

Specializes in Med-Surg/Peds/O.R./Legal/cardiology. Has 37 years experience.

YOU GO GIRL____and don't look back!! ;)



104 Posts

Thank you all for the kind words and thoughts. My hope is that another nurse at some point in their career will think "If she did it, I can do it." It is rather neat to move from a position of feeling trapped and frustrated to feeling rather liberated. I can also say that I loved the expression on the charge nurse's face when I told her at 2100 that I noticed we only had 4 nurses on the schedule at 0300 and that I wanted to let her know in plenty of time that I would be happy to take an assignment that fell within the ENA recommended staffing ratios or clock out and go home; which ever she felt would be the most helpful thing for me to do was fine with me. I truly do believe in giving people as many choices as possible, ya know?


320 Posts

Specializes in US Army. Has 14 years experience.

You make me proud to be a nurse. Keep up the good work. You rock!!!

Indy, LPN, LVN

1,444 Posts

Specializes in ICU, telemetry, LTAC. Has 5 years experience.

I'm proud of you. More nurses need to be confident enough to insist on safe staffing. I like the professional way you handled it. I dealt with a unit manager who was so emotionally labile that I decided not to approach her with the problem at all; this turned out to be wise. I did speak my mind to the nurse each day who would do staffing, and since that position rotated, by the time I left, everyone but the manager knew why. I simply let everyone know that poor staffing would be a deal breaker for me and that I would not hesitate to find another job if it continued.

And for me as well as the OP, the inspiration to handle the situation came straight from this board.


832 Posts

kudos to you. the only piece of advice that my mom (rn 30+ years) gave me the day that i graduated from nursing school was "you are a nurse in america, you can always get another job but never another license"

my momma said the same thing !!


104 Posts

In the 42 years that my mother practiced as a nurse, she always talked about how busy she was and how physically demanding the work was, but not about being short staffed or worrying about safety issues and her license. It really is good advice.

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