Possibly Fired and Very Terrified in Inside My Head

I’m six months pregnant and Im possiblely about to lose my job. It took me so long to get pregnant. Im scared about what this kind of stress is doing to my unborn child. I’m terrified of losing my house and everything I own if I lose my job. I’m scared of losing all maternity benefits. I have no idea what to do with a newborn if I have to back to work immediately. We do not have family nearby to help. I just came off of a night shift (and have to go back tonight) and instead of sleeping my heart is beating out of my chest and I’m trying not to cry.

My job is becoming (has become?) completely unmanageable. I work as a physician assistant (PA) in a neurosurgery ICU. We used to have 4 PAs during the day and 2 covering nights. Now we have 2 PAs on during the day and 1-2 on on night shifts covering tbe same amount of patients we used to when we were fully staffed. We have 20 ICU patients plus floor patients. We are also in charge of admissions, transfers, discharges, and consults. We work 12 hour shifts (theoretically - they sometimes can be up to 15 or 16 hours) covering nights, holidays, and weekends.

In the past when PAs have left the doctors I work for have made sure to hire new ones. As people have been leaving over the past year, no one has been hired and the doctors I work for won’t disclose why.

The remaining PAs have worked harder and harder, but it’s becoming impossible. I had inquired about switching departments to internal medicine who offered me a job. They were nice enough to take me on a mere 5 weeks before I left for my maternity leave. I start October 20th. I will work Monday through Friday from 7am- 3pm or 8 am - 4pm with no night responsibility. I’ll work maybe one weekend a month. I thought that I was all set and had nothing to worry about. I would no longer have the stress of running an ICU alone or the horrific upcoming schedule.

Last night I made a gross error in patient management. His platelets dropped and I did not correct them. I completely missed it. He was in DIC so he had a lot if other lab abnormalities that I was correcting as well. I had 13 other ICU patients to monitor.

While it is my fault, there were other issues as well. The turnover for our ICU nurses is high so to correct this problem the nursing administration has been training floor nurses to come down to the ICU. While there are some decent floor nurses, most of which do not belong in the ICU.

The nurse Chuck taking care of my patient has a terrible reputation and the charge nurse gave him the sickest patient in my unit. Nurses and PAs generally work in a system of checks and balances. The nurses notify us with critical lab values. I was never notified. Again, the mistake was my fault, but it would’ve helped had I been working with a decent nurse. PAs examine patients maybe once or twice in a shift since we’re in charge of more than a dozen patients. Neuro nurses are supposed to examine the patient every hour since they care for only one or two patients. For my exam the patient was fine. In the morning the patient was found to be paraplegic. There is no mention in Chuck’s notes of a neuro change nor was I ever notified of any change in neuro exam. Chuck has a bad habit of watching Youtube videos during his shifts. I have a sneaking suspicion that after I did my initial exam last night that the patient was never examined again.

I was called by one of the doctors I work for and yelled that that I did nothing all night and didn’t do my job. He yelled at me while he was in the middle of the OR so people I know and work with heard this lovely exchange. When you have an understaffed PA team, floor nurses filling in as ICU nurses, a a known terrible nurse taking care of the sickest patient in the unit, how can you be surprised when complications occur?

I’m already scheduled to start working for the internal medicine department October 20th, but I’m terrified that if the neuro department fires me that I will not be allowed to work for internal medicine. If you get fired by one department in the hospital, but you already have a job in another department, do you lose both? I’ve Googled this situation but nothing comes up. I haven’t been able to sleep and can’t stand the thought of eating. I have no idea of what the fuck to do. I’m bitter and terrified. The doctors don’t want to staff us appropriately and the quality of our nursing ICU staff has gone down the toilet. Yes I had an oversight which was my fault, but it would help if we were staffed appropriately and had decent nurses caring for my patients. So now I may lose everything.

Last updated March 06, 2016