To Whom it may Concern:

There is an urgent patient safety matter at hand. I have been a registered nurse at Bayfront Health St.
Petersburg for over seven years. Bayfront nurses have been described as gritty, resourceful, strong, and
hard-working. In a reputable organization, when a nurse states, “I have a safety concern,” it should be
met with support and guidance by management and administration. The meeting on May 29th between
MSICU/COVID unit nurses and administration highlighted nursing concerns about infection control
practices, the crisis involving very sick COVID + nurses in MSICU, PPE availability, and unsafe staffing.
These red flag issues were brought to administration’s attention, yet after the meeting, upon voicing a
patient safety concern, management is now threatening nurses with termination and using scare tactics
to pressure nurses into accepting an unsafe assignment.

Situation: On June 7, 2020, I arrived at work to take care of patients in the designated COVID positive
unit in A2 MSICU. Upon arrival to the unit I discovered that myself and one other nurse would be the
only caretakers of the unit of patients. The other nurse and I expressed concern and used the
appropriate chain of command to attempt to remedy the unsafe staffing issue. We contacted the MSICU
charge nurse, the administrator on duty (AOD), and our nurse manager to request another staff member
(nurse, patient care technician, unit secretary). We also informed our manager that we were unable to
accept report/assignment from the off going shift until safe staffing was provided. The manager called
myself and the other oncoming nurse to inform us that not accepting report is “absolutely not allowed”,
she stated it would constitute abandonment of the patients, and if we did not accept report/the
assignment we can clock out and not come back to our place of employment.

Background: The COVID unit is located in building A which is isolated from the rest of the hospital
located in building C. We were informed that there was not a rapid response team on duty due to illness
on this particular day (note: our manager staffs the COVID unit, MSICU, and the rapid response team).
The restroom and breakroom for the COVID nurses is located outside of the physical COVID unit.

Assessment: There were six COVID patients in the unit, one of which was emergently intubated seven
hours prior, and demonstrating severe respiratory instability even after intubation. With only two staff
members assigned to this unit it was not safe to accept responsibility of these patients. We would be
unable to provide proper monitoring, interventions, or tend to the basic needs of the group. If one RN
had to use the restroom, eat, or drink, one RN would be left alone in the unit with all six patients. The
COVID nurses are currently tasked with answering calls from concerned patient relatives (now unable to
visit, prompting longer and more frequent calls), providing nursing monitoring and interventions, and
have also been in-serviced and allocated the duty of housekeeping services inside the COVID unit. All
responsibilities are in addition to the necessary donning and doffing of PPE appropriately and the use of
an N95 mask for a continuous 12 hours. On this particular day, it was clear that the unit required a third
staff member to ensure proper nursing care, PPE use, restroom use for nursing, and the ability to call for
help from the other building should any of the patients have an emergent medical need (as evidenced
by the shift prior).
Recommendation: First, my nursing cohort should be aware of legislation guiding nursing practice in the
state in which they are licensed. According to the ANA1, abandonment must reveal “a severance of the
established nurse-patient relationship”. If a nurse does not accept responsibility of the patient and that
relationship is never made, then it is incorrect for management to infer that abandonment of a patient
has occurred. I encourage nursing to educate themselves in regards to legal terms and liability within
their scope of practice so that an informed decision can be made when faced with false claims meant to
coerce you into accepting an assignment that you know is unsafe for your patients, against your better
judgement, or morally wrong. However, if you do refuse to accept the unsafe situation, be aware that
Florida is a right to work state and an employer can terminate you. So be prepared to “clock out and not
come back”. Second, threats of termination after voicing a safety concern promotes a culture of non-
reporting, reduces staff morale, diminishes retention, and ultimately hinders the overall quality of care.
The dismissal of fears for patient and staff well-being is not congruent with the idea that “Heroes” are
working here.

Unfortunately, this is not the first time that nursing safety concerns have reached a dead end at the
management and administration level. After the meeting between nursing and administration on May
29th, I was hopeful these issues would be addressed. Instead, a nurse was faced with the choice of
endangering patient safety or accepting job loss. I am ashamed of the fact that this organization may
have lost sight of its mission. Considering the recent threats by management, I have no reason to believe
that shedding light on this situation will not result in retaliation. Out of respect for my profession, and as
a stand for patient and nurse safety, I have attached my letter of resignation, effective immediately. I
welcome an exit interview or any other interview regarding this matter.

Stefanie Davis, BSN, RN, CCRN

MSICU/ A2-MSICU

1
American Nurses Association. Patient Safety: Rights of Registered Nurses When Considering a Patient
Assignment