A Nurse faces retaliation for safe staffing


A Nurse we will call “Tom” has reported to me that he was fired from a midwestern LTC facility because he stood up for his Residents.

I-love-story-time Let me tell you a story.

No, you will not like this story.

Tom is a very experienced nurse who was working nights in a LTC facility. The building has about forty Residents, nine or ten of which are safeguarded in the locked CCDI unit. At night, they were staffed with a barely manageable four people total. One nurse, and three CNA’s.


One person has to remain in the locked unit at all times. It can never be left unattended.

At some point, the administration stopped scheduling a third CNA. Naturally, Tom filled the holes in the schedule so he would have the appropriate amount of staffing. He called people and offered them shifts, and filled the holes. Like charge nurses do.

A few weeks into this, Tom was told by the management team that they were no longer staffing a third CNA on nights. Tom said it was rough, but they were getting through it. And then……. A new Resident, we will call her “Jane” was admitted to the facility. Let’s just say Jane’s conditions make her more than a handful to care for. In fact, her plan of care called for her to be a three person assist. So, here we have Tom, one CNA, and…..images (1)

Oh wait, the other CNA cannot leave the locked unit. Tom asks what happens if they have to move this Resident? She is in excruciating pain because of her ailments. How can she be safely moved with only two people? For that matter, what if a FIRE starts in her room or if she falls to the floor? The care plan clearly says she is to be a three person assist.

Tom naturally spoke to his supervisor immediately about this, and explained that because he was unable to do what the patient’s care plan called for, he could not take responsibility for the shift.

Tom was forced to take his objection to the next level. The Administrator, we will call him “Jack” was adamant in explaining to Tom that the facility was fully staffed (with a total of three), and professed he and his management team had discussed Jane’s needs amongst the other nurses – and aides – and determined it “shouldn’t be a problem” to run with just three staff (two actually, the third is on the unit). Tom couldn’t believe he was being asked to run with one less person than was – required – according to the plan of care for Jane!

Tom put his foot down and said he was standing up for safe staffing then politely refused to accept the shift. Sometime later Jack stated he could come in that night – to be the fourth person – and added that by doing so Tom’s issue was solved. (Mind you Tom was already late for work because of this).

Tom had worked with Jack once before, as the nurse, when Jack came in to cover an open CNA position on the locked unit during Christmas. So Tom, always willing to compromise, agreed to come and work his scheduled shift. However, Tom was still annoyed by the whole situation because he had made it clear earlier that day, upon finishing his shift from the night before around 0700, that the schedule for that night was short (actually short two CNA positions), and Tom had arranged for both slots to be filled. Tom had called the facility around 1900 to confirm the two empty slots were filled.

It was then that the DON, let’s call her “Sue” told Tom they weren’t filling the fourth position which is when Tom first objected. So here was Tom, an hour and a half later, still in a standoff between Jack, Sue, and himself, which could have been resolved well before Tom would have been late when Jack finally agreed to be the fourth.

Tom arrived to work at 2330 and Jack arrived shortly after. Within about an hour Jack told Tom, “Call me if you need me”, as he walked off to the back of the building to crash, Tom didn’t see Jack again until 0550. No accidents happened; however, that isn’t really the point, is it? Jane was not safe. She could not be immediately rescued from danger in her room, she could not be lifted, and they needed three people to turn her to provide care because of her conditions.

What LTC facility leaves two people responsible for 30 residents, several of whom are total lifts, with at least one like Jane who needs three people to help her? She is in pain, for heaven’s sake.

This LTC facility.

Tom was off the next day, the following day Tom was told by Sue that she had revised the schedule. Going forward Tom was to report for 2nd shift instead of 3rd. Sue had removed Tom from the night shift and put a nurse who ‘didn’t mind the staffing plan’ on nights.

So, a nurse who didn’t know better? A nurse who would not advocate for himself or his Residents? Instead of Tom, who cares deeply about his Resident’s safety, and understood that Jane was not safe on nights in that facility. Their decision was to force Tom out – instead of providing the required amount of staffing!

Here was Tom’s response, “I decided that the action of changing my schedule was clearly an attempt to avoid scheduling enough staff to safely care for the Residents Nursing-Home-Staffing– according to the plan of care – and as such it was my duty as a Mandatory Reporter to report same under elder abuse/neglect. I called the state DIA and told them everything. Then I told Jack and Sue that I had reported it, reminding them I had tried to work it out internally first.”

Twelve hours later Jack called Tom. Tom was no longer needed.

So, he was fired for advocating for his residents.

FIRED.Retaliation Green Road Sign on Dramatic Blue Sky with Clouds.

This is a true story, as you have probably guessed by now.

My question for you is, are you ready to go to bat for this nurse? 

Will you protest, write letters, call state agencies, talk to the news, and bring this problem to the public eye?

Or are you going to keep sitting there?

Let me know.

Link to Press Release #NursesTakeDc .http://conta.cc/1WdiI2M





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Author Janie Garner

More posts by Janie Garner

Join the discussion 44 Comments

  • Sarah Mott says:

    Unbelievable…Well, no…. Unfortunately, it is believable because most of us have been put in similar situations at some point during our career. Thankfully, there are nurses like Tom who are willing to stand up and advocate for their patients and fight for safe staffing. Really, a nurse “who does not mind the staffing plan” or who “doesn’t know any better” is not acceptable – Every Nurse needs to know that working short staffed is dangerous and they need to “care” because in the end they are only hurting the patients and themselves.

  • Melissa Brown RN says:

    You already know my answer, Janie. I’m ready. Let’s get a plan set up.

  • Lisa says:

    I’m ready Janie! I’ll write, email whatever is needed to support Tom. Please give details (if you can). Also, I actually spit my coffee out all over my iPad when you chose to call the admin Dick.

  • NurseMalone says:

    I’m up for it. LTC nurses are desperate for an advocate. I’m at an assignment now with 45 patients and 1 CNA. One resident requires 1:1 care due to her constant fall risk and 8 of them are rehab patients that require a lot of assistance and pain meds. Not to mention the other LTC residents that are total care and require lifts.

  • Rosanne RN says:

    unfortunately this is going on in too many LTC, SNF, etc. I’ve been a nurse in IL and TN and see it in both states. Administration only cares about the bottom line=budget. They don’t get the fact that it costs more in the run when injuries occur- too the patients and/or staff. Who can we write to in support of Tom?

  • Belle says:

    This is beyond absurd. I’ll be in DC but I want to know what to before the March. Do I write my congress people ( they are quite used to hearing from me which may not really be to SMYS’s benefit ); ) ? Do I invite people to join us? – done. What else can I do?

  • Tracey says:

    This is THE REASON I left nursing homes. We always worked understaffed and residents suffered. No time for their weekly shower, no time to properly encourage them to eat, sickens me.

  • Traci, LPN says:

    Janie, I LIVE THIS. More often than I care to think about. I work a dementia/ memory care locked unit and it is common for call offs and no one to fill in, or unfilled holes. My floor is about 50 residents (my assignment is 27 currently). It is common for us to have 3 or 4 CNAs, sometimes shockingly less. They find a way to fill in, but we never hit ideal ratios. Of course with poor staffing comes increase in pressure areas. Our QA nurse maintains that because there are “only three or four” CNAs is not a valid excuse. I would leave the facility, but it’s the same everywhere and I feel I would be doing a great disservice to those I care for. I have developed anxiety and have been picking up extra shifts when I can. Exhausted to the point that I feel asleep in my car parked in the driveway with the engine running. I’m running on fumes and cry easily. Please pray for my residents and my staff…throw one in for me too.

  • Monica says:

    I quit s facility in November of 2015 for the exact same reason. And, that facility got fine by state for doing the exact same thing. And, they wonder why they can’t keep good people. I hope he goes to the EEOC and has his termination in writing so he can sue the shit out of that facility.

  • Maggie RN says:

    I’d gladly stand up for this caring nurse. Just say how!

  • Chanda Lowhorn BSN RN says:

    I’ll back ‘Tom’ any day. We’re SUPPOSED TO ADVOCATE for our patients. Especially the ones who have no voice. Tom, this nurse has your six.

  • Diane kidder says:

    Im so ready to stand up for this population of residents who are many times forgotten by their families, our government and now our own profession. When did “first do no harm” become only when it’s convenient. #fedup#angrynurse.

  • Sue says:

    I will write too! We all need to stand up for Tom. I have been in that position and it needs to stop!

  • Martie Becker says:

    Janie let’s start saving nurses’ lives as well. Count me in! What do you need?

  • Brooke says:

    I recently had a friend, a fellow RN who had cancer, who suffered in the receiving end of this issue. She was sent to a care facility to “get on top” of her pain with medication changes. She was supposed to receive medication every morning at 3 AM. Several days in a row, she did not; in fact, she saw no one all night and woke up in terrible pain. Her family had several meetings with staff and administrators, and was always promised better (one night, it sounds like the person responsible for her care was in a lack down unit and couldn’t get to her if they wanted to). It didn’t happen, and the family brought her home to care for her for the last 2 weeks of her life. It breaks my heart that this dear, sweet woman who always took the best care of her patients received such horrible treatment herself.

  • Lisa Bowers says:

    Tell us what to do Janie!

  • Louise Franklin says:

    I remain amazed at how dedicated to short staffing management is, and the incredible lengths they will go to, in order to screw the nurses and the patients. Let me know what I can do to help.

  • Deborah says:

    I will write letters or make calls. Please send me the plan of action and count me in. We have to stand up for each other as we stand up for safe standing or they pick us off one at a time!

  • Laura says:

    Yes, tell me how!! I work in a LTC facility and would have done the same thing!!

  • Stacie says:

    I’m in! Understanding that this a nationwide issue, but feeling like we should target legislators and media in the “story” stare to get a fire lit….can u give us that much so we can start our writing and horn tooting with them? If we can get media to assist it would be great! Everyone can relate to having a loved one who you want to believe is well cared for and safe….public opinion will help shine some focus here.

  • Ashley says:

    What can I do to help?

    I am a cna who was fired from a ltc facility due to retaliation after reporting an unsafe abusive nurse.

  • J says:

    Toms a whiner. Figure it out, quit being a pain to the people who pay you. He could remove the lockdown employee for 5 minutes to move a patient.
    I’d fire him too. Being difficult.

  • ANNA says:

    I also was recently terminated for standing up for patient safety. I started at an outpatient adolescent psych day program on Feb 3. I was given no training (was told there’s your desk, start working). I had a LVN who was also new. Within an hour I noticed several safety issues. I was given no contact info for who to contact. I reached out to a friend who is the CNO sister facility. I told the administrator there were many unsafe practices going on. I was reprimanded for this. On Feb 5 I was left completely alone with approximately 60 patients. On Feb 10 I went into the break room, after telling the LVN. The administrator, who had ano education background, came in and started yelling at me. I told her I needed training, I needed help. She told me to get my stuff and leave. I was terminated on Feb 12 for insubordination.

  • Barbara Macfie RN MSN says:

    Tell us how to help -I work nights at a long term care facility. Barb M. RN MSN

  • Wini says:

    I see this happening frequently where I work, and have been very distressed by it. Not only do I feel unsupported as a staff member by the institution I work for, but I also see the risk this places on both the residents and staff. The only answer I ever get when I try to address the issue is do you know anybody we can hire. I don’t feel that my position qualifies me to take the responsibility of trying to find staffing. That should be an administrative responsibility. Many very qualified people have gone elsewhere to work because of being squeezed out and burned out. That has left a void which is being filled by less qualified less caring people. Personally, I wonder if there aren’t other issues underlying the issue of understaffing.

  • Julie says:

    Who do we write to?

  • Julie says:

    Why, why, why is this even still a problem in the year 2016? Whom do I need to write? Where do I need to sign? I am glad there is someone like Tom out there willing to advocate to “the point of no return.” It is ridiculous that a nurse this dedicated gets rewarded for his dedication with termination. Let it NOT HAVE BEEN IN VAIN!

  • Annie says:

    OK Janie-tell me what I can do from central IL. Am willing to drive to deMoines ,write whatever I can do.

  • Crystal says:

    Ohio here – I’m in – let me know what I can do!

  • Cathy Wolf, RN says:

    Yes, I will help. Just need details.

  • Lisa says:

    Long story short…. Basically, something extremely similar happened to me. I voiced my opinion about taking a third critically ill ICU patient and the safety implications of it. I took the patient and was later wrote up. The corrective action stated that I attempted to refuse a patient. I turned in my 2 week notice and worked the entire 2 weeks. Now 3 years later I have been bànned as a rehire at all 6 of this hospital’s facilities!! I thought as nurses we were supposed to be patient advocates. Nurses are supposed to have integrity, show morals, show ethics. As far as I am concerned, for nurse management to ban or terminate another nurse for situations as these… they are not showing integrity at all.

  • Grace says:

    Long story short, a similar incident happened with me. I voiced my opinion. I accepted the patient. however, I was given a corrective action right up stating that I attempted to refuse a patient. I gave my two weeks notice. I worked my whole two weeks. 3 years later, I applied at another facility owned by this hospital and found out that I have been banned from all six of this hospitals facilities as a rehire! Unreal. I thought as nurses we should have integrity, morals and ethics. When nurse management BANS or terminates another nurse for advocating for a patient then management is not showing integrity at all

  • Tammy Lamm says:

    I am in. Just give me the details. My mom was in a LTC facility and she experienced an unfortunate event due to poor staffing. We reported it to the state and nothing was done. Luckily we were able to move her to a better facility but I know not everyone has that option. So yes, absolutely, without a doubt, I am in.

  • Melanie says:

    The same thing happened to me. Almost to a tee! Except I quit before they could fire me or worse, but the DON was retaliating against me, wrote me up for being absent when I miscarried my baby (but was back to work within a week), and verbally threatened to have my license and report me for abandonment when I told her I had already stayed well past my 12hr shift and was at 18hrs and I needed to leave. I also worked nights, would have anywhere from 36-50 residents on just my load. And sometimes only 1 NAC for 36 on long term and 1 NAC for the rehab/med A side. When I started refusing keys to other units carts and standing up for patient safety, she started coming after me. I documented everything, after all, documenting is a big part of my job. I called state and I emailed the administrator so they knew I had proof of retaliation in case she tried to come after me when I quit. Every day I think about the residents, my residents, and hope they are OK.

  • Dawn Teal says:

    Please provide info so that I can lobby on “Tom’s” behalf.

  • This monster was just rising from the waters when I retired. What are they trying to do? Normally nurses were working 20-30 years the were either fired or they quit because of severe arthritic problems. They got worked until they were worn out and if hearing or visual problems arose. My hearing, equilibrium, and arthritic problems forced me out. The hospital did not care about how or why I got into the physical shape. They started stressing me out until I finally made a mistake that they could fire me for. There will never be any punishment for nurse abuse by upper managers. And, in my situation, Upper management were my “friends.”

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