When To Just Not Go Back For The Next Shift...

Covidnursedropout · May 14, 2021

2 hours ago, KalipsoRed21 said:

So my career in nursing is very piecemealed. If I liked an institution I would end up having to quit for personal reasons (I.e one job was 65 miles from my husband, another could/would not accommodate the time I needed to go do fertility treatments....it is rather last minute when you know you have to leave so I get it, but a life without a child would have just been worthless for me.) And the other half of the time I quit because the job was asking to much from my life (Salaried but working 60 hours a week to do a good job, home care was great except for the non-ending nature of it.) Only one time in the last 13 years have I quit a position because I just couldn’t go back to even complete a two week notice due an unsafe work environment. I believe I am there again. I started this job 8 weeks ago and I’ve had 3 serious near miss incidents. No this place is so crappy that they wouldn’t even care if I didn’t fill out the IRIS report, but I do because that is the kind of person I am. I have given notice, but I’m not sure I can go another shift. I need the money until I find another position, but I could just throw up thinking about having to go to work tomorrow. I know that there really isn’t anything more to say (yes I have reported this place to state) but just knowing I’m not alone in this experience is helpful. Everyone at this job has been working this way so long that they don’t even see the danger in what they are doing anymore. It makes it very hard on the person doing the right thing when most of the responses from supervisor roles are, “I’ve worked way worse situations than this, and with less an orientation you’ve had.” (Which I highly doubt because I didn’t get an orientation but even so, just because one gets put in a situation that provides crappy care doesn’t mean that’s the standard we should be aiming for right? So for any of those that are young in nursing, here is my advice for knowing when you should quit a facility regardless of your lack of experience:

1) The orientation is hard to follow, lacks direction, and organization.

2) You are not even close to being out of your orientation period and the place tries to give you a team of your own (even if it is only 1-3 patients) due to short staffing.
3) People are angry with you for being slow and behind and asking how to do something you have been shown. The average adult learns and RETAINS 5 new things a day. There is no way you aren’t going to need to be shown things more than once....for at least a year.

4) Your orientation does not have a checklist of skills you need to demonstrate proficiency in with your preceptor. Or there is a list but no one takes the time to sign it, or ensure that the times were reviewed.
5) There is a sign on bonus. Take it, but don’t spend it so you can give it back if it isn’t safe.

6) Finally, if they are using contract nurses and none of them are renewing their contract, that is a big tale about how bad the culture there. Especially if 50% of their staff is contracted.

Good luck! Hope everyone has a better experience than I have had at this CHI St.Luke’s at Brazosport in Lake Jackson, TX. Don’t go there if you are traveling. Super scary. I had hired on as regular staff and moved for this position, just an unsafe and scary disaster waiting to happen there.

You know it's time to leave when you start having thoughts like the ones you're having. It's not normal. You shouldn't dread anything to this extent, work included. Not liking it, or not wanting to go in because you're tired is one thing. Everybody goes through that occasionally. Absolutely dreading it, like hoping you get into a car accident and die on your way in so you don't have to do it. Time to quit. ASAP. Don't put 2 weeks notice in at a place like this. That's a death sentence in itself. They already treat you like crap to the point where you would rather die than go in, and now they are going to treat you even worse because you put your 2 weeks in. I know you think it couldn't get any worse but it can and it does. They wait for you to make a mistake, they look for mistakes in every thing you do. This sounds exactly like the hospital I just left myself. 2 staff nurses, 8 contract nurses, and 25 travelers? They treat the staff nurses like *** because staff nurses are a threat to their contracts. In their eyes, you are a threat to their job especially if they've been there longer than you. When a hospital has enough staff nurses, they have no need for contract nurses or travelers. Right? Finding a new job is a lot of work for a staff nurse. It's harder for a traveler. And now the pandemic is over so the travel market is drying up. Yep. Run. Use the 2 weeks to find a different job and don't even put that job on your resume. If they ask you why you haven't worked in 2 months make something up.

Covidnursedropout · May 14, 2021

And everything you listed as a red flag, is indeed a red flag. Look for them when you interview. It makes everything a lot easier.

Covidnursedropout · May 14, 2021

They can't take whatever part of the sign on bonus they gave you back and you were smart for holding on to it. Chances are they will just keep your next paycheck. So why bother showing up?

KalipsoRed21, BSN, RN · May 15, 2021

Thanks for the responses. Other things that would clue in a new nurse on a job you should just run from. No two weeks notice needed. Just finish your shift and email your notice to the supervisor, save a copy, ensure that you put that your last day will be end of shift on whatever day you are turning it in.

1) Your director does not know the mission statement of the facility when asked about it by you during the interview process.

2) When you ask the supervisor and the director what they like most about working at the institution you are interviewing for the best answer they can come up with is, “It’s close to home.”

3) Other more senior staff who are orienting you tell you to not clean up your patients or do any ‘CNA’ work because “that’s their job.”

4) Your director acknowledges that the assignments are frequently heavy and actually tells you “sometimes it is so busy all you can do is put in a note about the shift at the end of the shift instead of doing all the charting.”

5) Anyone regularly doing questionable actions to get through the shift. For example at this CHI St. Luke’s Brazosport, there were several times that there were not enough working computers. So some nurses would take scanners off working computers, put them on computers at the desk, and scan patient labels and their medications this way after passing all their meds. Totally defeats the purpose of using a scanner to pass meds. And when you bring up the issue 1-10 times, it falls on deaf ears.

Don’t tolerate unethical behavior from your employer or your co-workers. That is how Derek Chauvin was able to murder George Lucas surrounded by witnesses and NO ONE did anything. Speak up, speak out, and do not be silent when this happens to you. It is unacceptable. I don’t care if there was a time when someone could safely take care of 13-15 med Surg patients....that is not today’s world and saying no to stupid is how lives are saved.

Covidnursedropout · May 15, 2021

Is it a for-profit hospital? The one I left was.

Covidnursedropout · May 15, 2021

If so, it probably isn't a coincidence that we had similar experiences.

Covidnursedropout · May 15, 2021

I'll never forget something our manager said. Our catheter infection rate was high, we had like 8 CAUTI's in one month. Our manager was upset because foley care wasn't charted every shift on those patients. The next month, our catheter infection rate was 10, higher than the month before. My manager commented on how it was weird that foley care had been charted every shift for each of those 10 patients, but instead of going down, the number of CAUTI's went up. I said it's "because most of your nurses think that charting that you did something means you don't have to physically do it. They do it with everything. Central line dressings, oral care, turning and positioning." She shrugged and said "Oh well. At least we look compliant on paper." I could not believe my ears. I've never felt bad for forgetting to chart something I physically did. Yeah it may look bad on paper, but as long as you physically did the task, it isn't going to hurt the patient. But charting that you are doing something and then just not doing it because, whatever. You didn't feel like it and nobody will notice. Patients are going septic from CLABSI and CAUTI and dying, and you aren't concerned because the nurse "charted that they did it." The numbers don't lie. The charting went from 50% to 100% with no change in infection rate. The infection rate went up when it should have gone down. Places like this attract the worst of the worst when it comes nurses. They don't even pretend to care.

Covidnursedropout · May 15, 2021

You know the ones. They leave a permanent *** indention into the chair they have claimed as their own, while “delegating” their job to others.

They are given students or baby nurses to teach, because they have been nursing since the Mesozoic period and have learned more than most others combined. And what do they do with these bright, shiny new lights in the healthcare world?

They teach them it’s OK to sit on their phone while delegating tasks to others. They tell them “the CNA does that” or “the unit clerk will do that”. These decrepit old bags teach these new babies how to get by with the bare minimum, and it’s pathetic.

Covidnursedropout · May 15, 2021

They are getting paid $50/hr to chart, pretend like they actually went into the room. You go in to the room to do your assessment and all of the drips are just about empty, it was obviously too much work to even call pharmacy and say hey, could you send us another levophed, nimbex, and versed drip for Mr. Smith in ICU? They are almost empty. You already know what lies ahead. These nurses have reputations. You pull the covers back to look at their legs and your patient is covered in stool from head to toe. If you aren't going to change the diprivan tubing the least you can do is pull the sticker off that I put on almost 24 hours ago when I did change it. Their mouth is drier than a popcorn fart, their lips are cracked and bleeding, and you can tell by the odor and the fact that flies are landing on their tongue that oral care definitely wasn't done at 0600 as charted. The foley bag looks like a basketball, you check tube feeding residuals and there is almost 1400 ml, and the tube feeding is only running at 30 ml/hr. You turn your patient and find sharps laying in the bed. Instead of disconnecting an antibiotic that has finished infusing long before you got there and flushing the line, they just shut the pump off and left the tubing connected. Now the lumen won't flush at all, and the piggyback you need to run isn't compatible with any of their drips. The trashes are full, the linen bag is full, the room is a mess and the family called to check on the patient and wanted you to know they are on their way up and will be there in 15 minutes. The unit clerk got floated to the floor to sit with a suicidal patient, everybody in the ICU is tripled, and your other 2 patients look just as bad if not worse. You barely survive the shift, go home and pass out instantly, and you return in the morning and get report from the same nurse who wants you to know that you "forgot to chart that you did foley care on one of the patients." Sound about right?

LibraNurse27, BSN, RN · May 15, 2021

3 hours ago, KalipsoRed21 said:

I don’t care if there was a time when someone could safely take care of 13-15 med Surg patients

OMG was that the ratio?? I briefly worked at a CHI facility (7 months). All the red flags were there. Sign on bonus, moving bonus, tons of travelers/agency staff. We usually had 6-7 Med/Surg pts on days but they didn't seem like Med/Surg, more like Stepdown. ICU was always tripled so I think the house supervisor sent unstable pts to Med/Surg sometimes just to get them out of ER. One of mine arrived with a K of 7.8 after missing dialysis for 2 weeks and coded 5 mins after the ER nurses rolled her onto the unit.

Night shift was 7-9 pts. I had an 18 month contract and had to pay back my sign on bonus since I left before then. I did NOT care. I did put in my 2 weeks, and those last 6 shifts I just kept telling myself it was almost over. I wrote the check to return my sign on bonus and walked to the parking lot without even looking back at that place!! Sometimes I still think about it and how crazy it was there.

Covidnursedropout · May 15, 2021

1 hour ago, LibraNurse27 said:

OMG was that the ratio?? I briefly worked at a CHI facility (7 months). All the red flags were there. Sign on bonus, moving bonus, tons of travelers/agency staff. We usually had 6-7 Med/Surg pts on days but they didn't seem like Med/Surg, more like Stepdown. ICU was always tripled so I think the house supervisor sent unstable pts to Med/Surg sometimes just to get them out of ER. One of mine arrived with a K of 7.8 after missing dialysis for 2 weeks and coded 5 mins after the ER nurses rolled her onto the unit.

Night shift was 7-9 pts. I had an 18 month contract and had to pay back my sign on bonus since I left before then. I did NOT care. I did put in my 2 weeks, and those last 6 shifts I just kept telling myself it was almost over. I wrote the check to return my sign on bonus and walked to the parking lot without even looking back at that place!! Sometimes I still think about it and how crazy it was there.

Oh yeah. The patients get admitted where the bed is. All they care about are the times when it comes to admitting a patient. If a patient is on a drip and needs to go to ICU but ICU is full, they will just have the doctor modify the order to run the drip at a set rate and not titrate. They do it a lot with a lot of drips. Dobutamine, dopamine, amiodarone, cardizem. Run the dopamine at 2 mcg/kg/min and don't titrate. There now they can go to the floor. Hurry up or you're going to mess up our times. Poor floor nurses barely know why the patient is on the drip, or what to monitor. They push them into a room at the end of a long hallway and pray for the best.