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  1. Brooke, Simpson APRN, MS, JD

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I've just started a new job-and already I want to leave. The staffing ratio is far worse than I was told it would be. I can't provide safe patient care under these circumstances, and I feel as if I'm risking my license every day. I'm tempted to leave without notice-but I don't want to abandon my patients. Which is riskier for me legally: to give notice and continue working for 2 weeks, or to leave without notice?-S.R., MISS.


You're wise to leave an employer who knowingly puts patients at risk through inadequate staff support. If you had a written employment agreement that included the staffing ratios you were told to expect, the hospital would be in breach of the employment agreement, and you could leave without giving notice. Oral agreements are difficult to prove and won't trump written materials you received when you were hired.

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If your employee handbook states that you need to give 2 weeks' notice to quit, do so. You don't want to be the one breaching the agreement you made by taking the job under the terms of the employee handbook. You may have thorny reference difficulties in the future if you just walk out.


Give written notice of your intention to leave, and list the reasons for your decision. Keep a copy of this document for your own records. This is notice to the employer of the unsafe environment, which could serve as evidence of your attempts to get better staffing support for your patients.


During your final 2 weeks (or whatever length of time you're required to remain), document your protests of your assignments daily if needed and carefully document the care you give your patients. If a patient is harmed, your documentation will support you as a reasonably prudent nurse who tried to provide safe care and who didn't want to abandon patients even under unsafe conditions.