What to do when there's no one to turn to?

I'm in need of some advice. I've been working on the same floor for six years now and I'm to a point where I have ethical problems with what occurs. Before I even begin explaining- the simplest answer is if I don't like it, leave. However, my concern isn't for myself- instead it's where do you get help/support when you can not go to your manager because there in itself lies the problem? I've seen and heard a lot of things lately that makes me cringe but most recently I'm extremely troubled by the attitudes/treatment of the opposite shift towards another nurse on the floor. I know there's "always" been an epic struggle between dayshift and night shift, and yes, no matter where I go I will probably run into that same conflict, but where's the line? I do not know how to deal with the "special" treatment of one specific shift over another or what seems to me the blatant disregard for when there are obvious issues that are not addressed. I don't even know if there's a rational, logical approach to this- and I don't just want to *****. But I'm troubled and concerned. I don't know who to turn to. There is no such thing as no reprecussions for bringing a concern to light. There is always backlash. I know that there isn't suppose to be, and that I'm suppose to go up the ladder... and again, the simplest answer is leave... but when is the line crossed that someone should step in and changes should be made either within the management or the staff on the floor? Here are some examples of what's been occuring: I'm apart of our unit based council and we've done several audits on different things such as vital signs- making sure the are being done correctly to see if we needed to change our floor policy on vital signs. The figures were reported, along with the chronic offenders as requested per manager- three months later... the same thing is happening. The same with how certain nurses chart- we have a separate charting screen for an observation pt- and yet the same nurses over and over again do not chart on that screen because they don't "feel" like it. They have been brought to the attention of the manager several times- however nothing has changed. I feel as though there is no accountability. When serious concerns are brought to the attention of the manager nothing is done. It makes it even worse when there is a serious concern brought to her and she makes you tell who it is (there are no generalizations) because she says she can't fix it if she doesn't know who's doing it. However, when the person you reported now makes snide remarks and gives you hell during report, what exactly did it solve? Not to mention, the issue that was brought up still isn't resolved. My charge nurse has encouraged me to go to the Omnibus person, but even then, I don't trust that there won't be some sort of retailation. I'm just not sure what to do? Am I being delusional to think I should be able to work in an enviroment that when a standard is laid out by administration everyone will be held accountable to it, not just a certain few individuals? Last edit by dianah on Sep 26, '10 : Reason: Terms of Service
join the crowd. quit and work some where else for a while. best case scenario you are young enough to go back to school and get some resume muscle (ie. an MBA or masters in nursing or even Phd)

If your manager's "playing for the other team," you may have to quit, if you can find another job. I hate to say that, but it's so true. It's next to impossible to break that inner circle at times. I just wanted you to know that someone else has been there, had that happen, and is so sorry for you that you're going through the same thing. I wish that it would end soon throughout the profession as a whole.

Not yet a nurse (may never be), so can't speak from that perspective.However, have recently left a position (to move), and would have left anyway, as on my unit there was no accountability, no discipline, and no followup. Near as I could determine, it had been that way for at least a decade, through several managers.

Quote from chloecatrnIf your manager's "playing for the other team," you may have to quit, if you can find another job. I hate to say that, but it's so true. It's next to impossible to break that inner circle at times. I just wanted you to know that someone else has been there, had that happen, and is so sorry for you that you're going through the same thing. I wish that it would end soon throughout the profession as a whole.

I've been there and felt very alone too. Even with the most incredible staff I've unfortunately felt this way. I can't imagine it in the environment you described.When there is no one to turn to, I've focused on my care for my shift, left it there, clocked out.... came in... did my care for my shift clocked out. I repeated this until I had time enough to decide if management or I needed to go. There is a difference. A bit back, I decided I was burnt out from poor management and still could be happy where I was... so I waited it out.. showed up, clocked in, did my shift, clocked out. There are ways to hide, keep your nose underground and go about your patient care then if it can keep you whole. Here is where you really learn what you are all about... is it enough? Do you need more? Do you need a more cohesive nursing peer environment, do you need managerial support? Most people bail before giving it a try, I was just comfortable and not at a life point to take on the added stress of a job change and rode it out because it was easiest.Can't promise anything to you, but we did have a management change, and I've gone from giving up nursing, to hanging in there and really trying to do my best. I don't know if this management change will be the "fix" of MY issues, but so far it's looking wonderful, and I a touch renewed to keep trucking along.The worst that could have happened was that I decided I was done, and a new chapter of my nursing career began, or I found something different. But I did give it a chance to not knee jerk and maybe make an even worse mistake.Just breathe, see if you can find your own way to be happy and not fight every battle that will still loose the war in the end, save your strength for your own patient battles, they are too many as it is. Ignore that other crap, it's not yours to fix or your problem to carry. Nurse to your own degree of quality, and let others do as they do. You are facing a battle of things out of your control. Reign it in and focus on you and your patients. You just may find yourself happy. Crazier things have happened. If not, move on.

You can report the issues to the Joint Commission and they will investigate if there are truly issues regarding quality of care and affecting patients outcomes, etc....

There used to be an Ann Landers axiom, "Are you better with him, or without him?" Use that here. Are you better off with this job, or without it? Are you better off making a big wave in the pond and getting the repercussions, or are you better off gliding through the pond each day on your way to the timeclock? Only you can decide.

You could always switch to part-time or per diem and get a second job or go back to school. When you are not full-time staff it makes a difference in your perspective and you don't have to care so much because you are "just part-time here", or "just per-diem". When I went back to school I would say, "I only work here on the weekends". It just makes a big difference in your mind.

When there's a problem with management, you can try going over their head...but that only makes them lash out even more against you. The simplest answer is to leave the facility...of course, secure another job first. Good luck.

Thank you everyone that has replied. I've actually got my MSN- ironically, though, I've been unsuccessful at passing the ANCC certification test. It has rattled my confidence so much that I'm afraid to take it again (third try). But maybe this is a way of showing me that I need to get over my fear and test.