Toxic floor morale

[IRN2011]

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.

[foggnm]

You could probably search the forums here and find several versions of your story. They would talk about the issues nurses have when using sick leave, pto, vacation, unpaid leave, forced overtime, etc. All I can say is that as 'wrong' as your manager's actions seem, I'd take upon myself to look for another job. In most decent sized cities, nursing jobs are easy to find. You deserve to be treated well at work and above all else you have to look out for yourself in a job. The contract issue over the $10k is basically you've taken out a $10k loan from the hospital and are paying them back with your labor. I'd just eat the $10k and move on to a better job.

[HouTx, BSN, MSN, EdD]

"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."

This is a blatant HIPAA violation because the message include PHI (illness information & name). If I was OP, I'd be making a formal complaint via the organization's compliance hotline.

Overall, looks like yet another instance of manager incompetency. SMH

[Flatline, BSN, RN]

This is a blatant HIPAA violation because the message include PHI (illness information & name). If I was OP, I'd be making a formal complaint via the organization's compliance hotline.

Overall, looks like yet another instance of manager incompetency. SMH

LOL. No it isn't.

Not unless that nurse sought treatment from the facility they were working at and the employer was divulging protected information from that fact.

[Double-Helix, BSN, RN]

2. Do I have a right to have my medical information kept private in the workplace?

Your employer has a number of ways to obtain medical information about you, whether it's because you volunteer it when you call in sick or tell co-workers, or because you provide requested information on health insurance application or workers compensation claim forms. However, just because your employer has the information does not mean that it should be shared with everyone in the workplace, especially when you have not chosen to do so.

The basic legal principle that employers should follow is not to reveal medical information about you unless there is a legitimate business reason to do so. But because that standard is fairly vague, there are laws which more specifically protect the privacy of your medical records, such as the Americans with Disabilities Act, the law which makes it illegal to discriminate on the basis of an employee's disability. State laws may also provide additional protection.

The HIPAA Privacy Rule may control how a health plan or covered healthcare provider discloses protected health information to an employer, including your manager or supervisor if you are a patient of the provider or a member of a health plan. However, it does not protect your employment records even with respect to health related information. Therefore, the Privacy Rule does not prevent a supervisor from asking you for a doctor's note if the employer needs the information for administrative purposes such as sick leave or workers' compensation. However, your employer cannot obtain information about you from your health care provider directly without your authorization, unless other laws require them to disclose it.

Medical Privacy - Workplace Fairness

[Rose_Queen, BSN, MSN, RN]

This is a blatant HIPAA violation because the message include PHI (illness information & name). If I was OP, I'd be making a formal complaint via the organization's compliance hotline.

Overall, looks like yet another instance of manager incompetency. SMH

When the information is provided by the person in question and not found through the chart, no HIPAA violation has occurred. If I tell Suzy Q that I had a bout of norovirus and Suzy Q goes and tells coworkers about it, still not a HIPAA violation. She did not learn that information through the performance of her job nor through simply looking through charts. Am I going to trust her with that kind of information again? absolutely not, but there's no actual violation. It doesn't matter if Suzy Q is a manager or fellow staff member.