When to change jobs???

[Galadriel724]

Pardon long post, felt that explanation of situation was necessary.
I love my job, in general, but lately due to circumstances that are somewhat beyond my control, things are breaking down. Trying to describe what I do without leaving a bunch of clues that could, conceivably, identify me should a coworker happen upon this site will be hard.
I am an RN, and I work with the most difficult psychiatric patients that exist. They are often in jail, most are active drug users, and almost all of them have some sort of psychotic disorder that has not really improved for decades, even with meds, community support, etc. Some of them are homeless by choice, which says a lot about their state of mind.
They cannot navigate the healthcare system or even reliably take meds. Most have multiple medical issues.
The team provides intense support with the goal to keep them in the community by assisting with the major issues. We have case managers (CM’s) that specialize in stuff like housing, transportation, and independent living skills. They actually ride the bus with them if they don’t know how to get from point A to B until they learn how o do it on their own.At least that is the goal.
I am responsible for administering their injections (most are on long acting antipsychotic shots bc they won’t take pills), complete annual assessments and labs, provide education about health stuff, assist the CM’s with coordinating medical appointments. It is their responsibility to provide transportation to my appointments and medical ones. They are supposed to follow up with helping people get into detox, day activities etc.
Thing is, morale sucks and the clinical coordinator just got sacked for political reasons that we don’t understand. Burn out rate is high and we have more than half of the CM positions vacant.
That means that my patients are not able to come to appointments with me because they forget to transport them, or don’t communicate. Same with the doctor. These ppl are court ordered and must be seen every 4 weeks. We do home visits (the doc and I) with about half when needed but the other half are in situations or have records that would make it unsafe to do so.
When I took the job, it was because of the awesome teamwork, an assistant who kept track of who was due for what, and made my schedule. I actually can’t do my own schedule bc nurses don’t have that permission in the system.
It’s not getting done. The problems are coming from everybody- can’t blame any one person. I am not able to do my job, and am concerned about pt safety and liability.
I noticed that there is an identical position on another team posted online. Problem- my ADHD is severe and this has been the first job that had the external supports and organization that covered my deficits. I don’t know if the other position has these types of things in the way that my current one does. Or used to anyway.
So, do I wait for them to hire a new coordinator and hope it gets better or jump ship now. I can’t really ask too many questions about the other job without someone finding out that I am looking….
If I didn’t have ADHD and so much trouble coping in the workplace it wouldn’t be as tough to decide.
Opinions?

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[kc5jck]

It sounds like you are in a job that had supports to help “cover your deficits” prior to the problems and that now these supports are gone or not working like before.  They may or may not come back.  Don’t bet your future that they will.

You have apparently been successful with the support you received.  Perhaps you can replace these supports, whatever they may be, through your own or outside resources available to you and by developing your own coping mechanisms and “helps.”  This would allow you to become more independent and evaluate the two jobs not by what supports they can provide, but upon the merits of the job itself.

Don’t let the fear of the challenge and unknown hold you back.

Another thing to consider is that with the under staffing, there is a greater chance of errors and mistakes which can jeopardize your license and career.  And . . . being the last to jump ship may make the swim a lot harder.

Good luck.

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[Patte Rosebank]

@Galadriel724, ADHD is a disability, under the laws in many places. By not giving you the supports you need, and by piling more work onto you, you employer may very well be violating Disability laws.

You owe it to yourself to find out if ADHD is covered by Disability laws in your jurisdiction. Contact your provincial/state/federal Disabilities Office; explain your situation, and ask for advice. It may be necessary for the Disabilities Office to send a letter to your employer, advising them of their responsibilities.

The other issue is that you were doing very well when you had supports and a reasonable workload. The high-turnover of staff is not only hard on you, but extremely hard for the vulnerable patients being treated. They need the stability and security that comes from a familiar team that understands them (and vice-versa). Otherwise, their symptoms will become more unmanageable, which will lead to more caregiver stress and more turn-over.

So, maybe it’s not so much your ADHD that’s the problem; it’s the lack of any control over your situation, and the feeling that you have to follow whatever orders come from the people at the top—who have no clue whatsoever of what’s really going on “in the trenches”. No wonder there’s such a high turn-over!

And turn-over is very expensive. It costs about 3 times as much to recruit, hire, and train a new employee, than it does to keep an existing employee.

So, if your employer is smart, they’ll want to find out why there’s such a high turn-over, so they can do something to stop it, and reduce their expenses, while improving patient care.

If you’re smart, you’ll find out where you stand under your Disability laws, ask for advice from your Disabilities Office, and put out feelers for new jobs.  Better to do it now. The axe may not actually fall, but, if it does, you’ll be prepared.

 

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[Galadriel724]

Sorry for the late reply… I’ve been busy with… you guessed it- work.
After the clinical coordinator (CC) was sacked, it was looking bad- he did a lot of the administrative stuff, such as writing the court docs necessary to enforce the court ordered treatment plans. He should have been making people do this stuff for their own caseload and making sure it was done.
People got lazy. Now the upper management have been sitting in on daily meetings and specifically holding the CM’s responsible for their stuff and people seemed to magically remember how to do their jobs.
That makes things easier for me. I can concentrate on overseeing the medical care and appointments and not being responsible for all of them. I am still busy but have a better handle on things.
I have also started holding people (like the program assistant) accountable for getting the right people into my office when they need to be, and not when it is convenient for the CM’s. It is looking better. Amazing how things get done when you CC the grand poobah on emails.
As far as accommodations, it is not a good idea to request them in my field. At least not the ones that require that extra personnel be hired or existing ones inconvenienced. I think that making people do their jobs and not leaving me to cover everybody will be enough. I’m going to give it a chance anyway.
I did request an accommodation at one job and it helped a lot. It was just a matter of posting a sign on the med room window that told the patients to leave me alone while I poured meds and ask the other nurse for help if they had an emergency. I also got to wear earbuds while I prepped the meds for the bedtime med pass. It ended up helping everybody. Distactions were a big issue for all staff and it reduced them.

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[blackdog]

Unfortunately, understaffing, burn out and high turn over go with the territory in such a high stress job. I’m amazed that you can even do the job in the first place. I don’t think I could. You obviously really care about your patients and want what’s best for them. And the support you provide is invaluable.

 

The others already gave you the best advice possible. So I’ll just say be strong and don’t be afraid to do what you need to do. I know how scary it is to look for a new job. I just lost mine and I can’t even think about going out and looking for another. Fortunately, my doctor agrees. But you have to look out for yourself and if the situation where you are doesn’t improve then the negative effects of the stress might start to outweigh the benefits.

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