Toxic floor morale

[IRN2011, ASN, BSN]

Hey all,

I've been in the medical field for the past 6 years as various professions (paramedic, nurse extern, nurse) but have only recently started working as an RN about a year ago. Per my contract we gain 4.4 hours of PTO bi-weekly and work 3 shifts a week. It has always been our policy that if we call out sick on the weekend we need to make up the weekend shift within a month if PTO was not used. Recently our unit and our sister unit who share the same director has gone through major staff changes with many nurses either retiring, quitting, or being fired (about 2/3 of all the nurses I started with not even a year ago are gone). Now we are severely understaffed and morale on the floor is waning... We host 33 beds and have a total of 6 full time RN's and 1 Care partner maxing at 8 patients each at night.

The reason why I'm writing this is because I'm curious as to how other's have to deal with sick time and PTO. Recently my director decided to change the PTO rules on a whim due to our lack of proper staffing (Although she doesnt seem to think we are understaffed at all) and sent out an email to the whole unit listing every nurse who called out sick, when they called out sick, and the reasoning they gave the ANM when they called and proceeded to state that ALL called-out shifts must be made up within a week regardless of reason for calling out, and even if you took PTO. Many of us called HR to figure out the validity of this new 'rule' as it seems to be only on our unit, and HR stated that its a per-director discretion for how to use PTO in the hospital. What I don't understand is how you can be forced to 'make-up' a shift that you claimed PTO for within the next week... that would mean you would have PTO and OT on the same paycheck, which I didn't think was possible.

My unit has such low morale that it's unfortunately a normal occurrence to hear discussion of disgruntled nurses putting in applications, or the countdown to when they retire/contract is up. We've had two nurses submit their 14-day notice and told to not bother showing back to work in the last month, and another breach their ethics agreement and walk off the unit mid-shift, abandoning their assignment due to low morale and unfair staffing ratios/acuity. The floor really has become toxic, but all administration seem to be blind to it. Unfortunately I still have 1.5 more years left on my 3 year new-grad contract, and would owe the hospital $10k if I was to break my contract and search out a different unit... I can't even transfer within hospital to a new unit until my contract is up.

[Flatline, BSN, RN]

I suspect if she is setting it up so that a nurse can have PTO and overtime on a single pay check that the policy will be overturned fairly quickly.

I would also check on your state laws regarding mandatory overtime for healthcare workers, some states have strict rules regarding this.

Just say no, you cannot work extra next week. No need to give a detailed excuse or explanation. Just say it would cause unacceptable familial or financial hardship and keep it at that.

[IRN2011, ASN, BSN]

Unfortunately Florida does not have any laws for PTO nor for mandatory OT, from what I've researched administration can make their own policy and change it at anytime without notice.

[Flatline, BSN, RN]

Unfortunately Florida does not have any laws for PTO nor for mandatory OT, from what I've researched administration can make their own policy and change it at anytime without notice.

What does your contract look like? Do you have to repay if you are transferred or terminated?

Most of my graduating class took contracts with IASIS and almost all of them did not finish out the contract and were simply let out of it.

[IRN2011, ASN, BSN]

What does your contract look like? Do you have to repay if you are transferred or terminated?

my contract is a 3 year contract with an 8K signing bonus. They put all new-hires in a 'class' which lasted for 3 weeks that was pretty much an orientation to the hospital with rotating speakers from different departments and drug manufacturers coming in and telling us about their latest research about the medications their company manufacturers and why we should be using their brand of medications over others. The Hospital valued this 3-week education as worth $10k... plus the 8k signing bonus(we get it in installments.. 3 the first year, 3 the second year, and 2 at the end of the third year, which must be repaid if I terminate my contract within 3 years at a prorated rate... So at any time I decide to terminate my contract, I will owe the hospital over $10,000. The contract is assigned to my unit itself, so I'm unable to transfer to another unit until the contract is up. From what I understand after talking to other nurses who have been here longer than 3 years.. When I was in the interview process, I asked about why the educational fees were so high, their response was along the lines of : the hospital uses the contract as a way to maintain retention for newer nurses as majority of new-nurses in the past before they started this class transferred or quit within the first few years... and since we are the only level I trauma center within 50+ miles, they needed retention.

[Double-Helix, BSN, RN]

I'm sure you understand now why the hospital was offering sign on bonuses and requiring such a long contract.

I agree the situation seems unsafe and toxic, but if you're financially stuck, try to make the best of it. Report unsafe staffing levels by having the charge nurse call your manager and the house nursing supervisor. If you're going to get additional support, the remaining nurses have to band together to try to get the attention of administration. While I wouldn't hold high hope for change, at the very least it might inspire a little camaraderie among the remaining staff. If you can do little things like bring in coffee and doughnuts or order pizza for you and your co-workers, try to do so to boost morale a bit. If there's only 5-6 nurses per shift, it shouldn't be too expensive.

Also, it sounds like you might have opportunity to pick up overtime. Do so, and save as much money as you can. Get a lawyer to look over your contract and see how much you would really be on the hook for if you leave. That way, if things go even further south, you've got the savings and you know exactly how much money you could be on the hook for. Paying the penalty may be well worth saving your career.

[Ruas61, BSN, RN]

I have a real problem with discussing one's absences and reason for such in a mass email. That should be shut down real quick.

[llg, PhD, RN]

I would be planning my exit. Work some overtime ... set the money aside ... look for a new job. Once you have a new job, use the money you saved from the overtime to buy your freedom.

[thecrossfitrn, BSN, RN]

I'm guessing you're not part of a union, because I smell grievance written all over this type of situation. Does your contract actually say your manager can override the weekend rule if you claimed PTO or is that hearsay from your co-workers? Because it sounds like you may need to involve HR if your contract is being breached on the whim of short staffing. And while it's hard to discern tone from the written word, I'm not trying to be snotty at all when I say this, but now you get why sign on bonuses usually come standard with big red flags. Yikes. I'm sorry you're in this situation. I agree with other people that say to work overtime and buy your freedom. If I were in your situation and HR wasn't backing me up, I'd find a way out no matter what it cost.

[ClaraRedheart, BSN, RN]

Any reasons to stay? Do you have any investment in the floor... Lots of friends, really like the manager, etc? How about the hospital, location proximate to your residence, etc.. If not, I'd bail. Just sayin'. Life's too short to work somewhere that you hate. If the pro's outweigh the cons, be the change that you want to see. I was going to say that all it takes is a positive attitude to turn things around, but that's not true... It sure doesn't hurt though, and CAN make a big difference.

Things that will help are finding things to discuss that are not destructive. I'm a Christian, so there is a go-to Bible reference that has always come to mind when thinking of this Philippians 4:8- Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable--if anything is excellent or praiseworthy--think about such things. Doesn't hurt to hold your conversation to this standard either.

If you want to stay, don't be gossiping with the rest... choose to be positive. Don't hesitate to protect yourself and your license (for instance, call Safe Harbor if applicable and truly needed) but don't help to bring the morale down. If there is more negative than positive with no hope of change, find greener pastures. Sometimes it's best to water your own lawn and wait for spring though. Best wishes with whatever you choose!

[Jedrnurse, BSN, RN]

I have a real problem with discussing one's absences and reason for such in a mass email. That should be shut down real quick.

Yes. I gather that in Florida workers have no rights whatsoever, but this type of privacy breach must flout federal labors laws. It's worth researching...

[compassionresearcher]

I think most nurses who have broken contracts have not been forced to pay the money because it's too time-consuming for the hospital to go after them. Plus, it sounds like they changed the rules mid-way and you didn't sign the contract under the changed PTO rules. Plus publicly announcing people's sick-call reasons is a violation of privacy. I recommend contacting a nurse attorney and see what they say. A few years ago a hospital tried to keep my 1-year bonus because I left 3 weeks after the 1 year was up and they didn't pay me before I left. It took one letter from an attorney and my check was in the mail and the VP of human resources called me to personally apologize.

Good luck!