What to do now?? (long)

[Athena1970]

I have been a RN for about 2 years in a very busy emergency room. To begin with, we are almost always short-staffed. On the particular night in question, I initially had 4 patients in the critical care area. The area is split into 2 sides, one side having 10 beds, the other having 7.

I happened to be on the side with 10 beds, of which 9 were occupied. The other side had only 3 patients with one having a clean room and ready to go to the floor.

The idea is that I would split 5/5 with one other nurse; however, she had 2 very critical (ICU holding) patients so I was not able to give her report on 2 patients that I already had as well as pick up the other 3 from the nurse who was leaving. That left her with 3 patients, 2 of whom were very critical, and me with 6 patients, one of whom was critical. There were 2 nurses on the other side, and between them they were caring for the 3 patients over there, none of whom were critical.

I initially spoke to the charge nurse about moving one of the other nurses over to our side, (because really there are supposed to be 3 nurses there anyway), and the two nurses on the other side were opposed to this so nothing happened.

An hour later, I received yet another patient who had to be intubated, go to ct scan, etc., still received no help from the charge although I requested assistance again.

Finally I went over to the other side where the charge nurse was with another nurse and said, "why can't one of these nurses come to help us on our side???" This is usually what is done in a situation like this, but this charge nurse deferred to the other two nurses, neither of whom, wanted to go to the other side??!! This certainly is not safe patient care and the whole mess could have been avoided if they had just moved one nurse to the other side as they have done regularly in the past when something like this has happened.

I notified the manager the next day about this. Then I get called into her office about 10 days later and am told by her and the assistant nurse manager that my peers do not like working with me, I am intimidating, and "out of control".

Of course, this is the first time I have ever heard any of these terms used to describe my behavior. I even asked for an example of me being intimidating and out of control and neither the nurse manager nor my assistant nurse manager were able to give one.

The other thing I should mention is that both the nurse manger and assistant nurse manager are new in these positions. The nurse manager "hand picked" the assistant nurse manager, who has never been in a management position prior to this, and has no experience with management. The assistant nurse manager has managed to eliminate at least 4 nurses who had been there for years by conveniently changing the circumstances to fit her side. She had announced that "there will be a lot of changes around here, and I am here to stay" in the first staff meeting she held.

She is manipulative and right now we have 3 travelers who are not going to be re-contracting because they refuse to continue to work with her. I feel as if I am being targeted next because not only did this meeting have nothing to do with being constructive about the issues they brought up, but also this woman has barely spoken to me since last summer when there was an incident that I confronted her about, and while in this meeting she kept calling me, honey, etc. and acting like she was friendly with me.

We do not have a union and I am not sure what to do next. I do know that I have spoken to a few of the nurses I work with and they all feel that she is bullying me and they also said that I am not "out of control" nor am I "intimidating".

Someone else I mentioned this to that knows the assistant nurse manager told me that she is trying to get me to quit and knows that I will start second guessing myself after hearing that no one likes to work with me, etc.

Any advice is welcomed!

Thanks,

A

[SDS_RN, RN]

I'm not even really sure what to say. That is terrible. The NM did not even address the issue at hand w/ you she basically attacked you personally. I would take this to the next chain of command since your NM apparently does not want to hear your side of the story. Stand your ground because you obviously did not do anything wrong you were trying to advocate for your patients by allowing them to have safe care. I hope everything turns out well for you.

[barefootlady, ADN, RN]

You did nothing wrong in asking for help or reporting the actions of the CN and other staff during a difficult time on your unit. You know you are a target now for every little thing that goes wrong on a shift you work. My advice is to start looking for another unit or a new job. I think it is clean sweep time in this ER and you are going to be miserable if you stay. Good luck.

[jamminworld]

I would probably take this situation to risk management. Let them know that you feel that you are concerned with the safety of the patients. Having 2 critical care patients and 4 more regular patients is NOT safe. You are unable to provide safe care and what would happen if one of those patients had coded. I have spoken to risk management a number of times over the year and I have to say they are very helpful. Make sure you say something before there are any further problems with your manager. Good Luck

[fins]

You don't have a union, and your nurse manager and assistant nurse manager are targeting you. If they can't get you to quit, eventually they're going to trump up something to get you fired. You need to find some place else to work now. Administration is going to back up the manager, not you.

[NurseNora, BSN, RN]

You could involve your Human Resources department in this. Ask for someone from that department to be present at any future meetings with your Manager to act as mediator.

Document future situations when you ask for help and don't receive it although it seems to be available. What is your chain of command? Did you ask anyone other than the team leader for help, and why didn't she come over to your side to see what your situation was. Were the docs aware of the unsafe conditions that night? What about your house supervisor? And a previous poster's suggestion about involving Risk Management is also a good one.

Does your professional organization have staffing standards? AWHONN has standards for how many OB patients of various acuities that a nurse can safely care for. If you go way beyond those standards, and there is a law suit, your hospital won't have a leg to stand on. You need to document your efforts to improve the situation (notifying your Team Leader, House Supervisior, Department Director, whatever you CoC is) in order to put the responsibility where it belongs--on their heads.

I have a friend who survived having the new Manager try to get rid of her and she continued to work in the department she loved. It was unpleasant for a while, but she outlasted them. Good luck.

[jellybean_1]

wow awful, you would think the NM would care about pt safety....such a good example of stupid management....

[angelwingsamy]

i am sorry to hear this. good luck to you and i wish you the best.

[RN BSN 2009]

You don't deserve to be treated that way. It's probably better to hit the road and find greener pastures before this one decides to make false accusations and fire you.

[Athena1970]

Thank you everyone.

I did contact HR and will wait to see what comes of that. I have the computer printouts of my assignment that shift and gave a copy to HR as well. HR seemed very receptive when I spoke with them, but like others say, I wonder if now if I will be purposely set up to fail. Not to mention, I am certain that my NM and ANM will not be pleased at all to find out that I contacted HR regarding this and I am worried about just how miserable they can make my work environment. It is disconcerting to say the least.