how do I tell my boss if she doesn’t fill the empty position I’m covering, she’ll lose me too?

A reader writes:

Seven months ago, I got promoted from an entry-level client-service position at a medical facility to my current position as a case manager for hospitalized patients. The way our office works is that each case manager works for between one and three departments, and the responsibilities vary pretty widely depending on which department(s) you work for. My position is a little unique, because it’s one of two identical positions that work the same hours and share the same responsibilities during the week and cover alternate weekends. Historically, both positions have been filled by long-term employees.

However, almost immediately after I applied for the first open position, the second person announced she was leaving for a job in a completely different field. In the past seven months, they haven’t been able to find anybody to replace her.

For the first few months, I tried my hardest to cover 100% of the responsibilities for my three departments. This ended, not too surprisingly, in a full-on sobbing breakdown on the floor of the isolation ward. The next week, I sat down with my supervisor and our department head and they really encouraged me to set boundaries in how much I take on. Since then, things have improved (no more tears) but I’m still completely swamped at least 2-3 days a week, to the point that I sometimes become dizzy from being unable to take my break to eat for 6-7 hours. I am totally exhausted and have basically given up on work-life balance. I’ve been having health issues that have worsened due to not having the energy to cook for myself or exercise.

I enjoy the actual work I do very much, and I am excellent at it. I get positive feedback across the board on a regular basis. The problem is that even after cutting back, it’s just too much work for one person to handle. Physically and emotionally, I’m burning out.

The department head has told me they’re very selective about who they hire for this position, and they’d rather have the position empty than hire someone who’s the wrong fit.

I can’t keep working this hard with no end in sight. My shift doesn’t overlap much with my supervisor’s, so I’m not sure if she’s aware of how much I still have to take on.

Do you have any advice on how to explain to my boss that I’m losing my ability to meet the core responsibilities I’ve been asked to cover for the two positions, and that if she doesn’t hire someone soon, she’s going to need to replace me too? I’ve started idly fantasizing about moving into positions in other departments that I used to think were too slow-paced and boring to even consider.

My normal advice in this situation is to figure out how much you can do in a normal amount of time, lay out for your boss what will and won’t be getting done, and ask if she wants you to reprioritize anything (with the understanding that moving something up on the list means something else moves down or off the list entirely — not that everything just gets crammed back in). Here’s a much more detailed version of that approach.

And you might be able to try that here. But in a medical facility, I’m guessing it’s likely that a lot of the stuff on your overflowing plate are things that must get done, period, because patients are involved and it’s not an option to say “we just won’t dispense medications / change bedpans / feed patients for now.” If I’m wrong about that and you can put some of your work on the back burner, then great — your approach is linked above. (And it might be that when your supervisor and department head told you to set boundaries in your work, this is what they intended you to do — and it’s even possible they assume you’ve been doing it and they don’t realize how bad things are because you haven’t spoken up since then.)

But assuming you can’t use that approach, then yeah, the message you need to deliver is that you’re at the end of your rope and need help urgently or they will lose you too.

Here’s how I’d say it: “I need to talk to you about my workload. I appreciated you and Jane encouraging me to set better boundaries a few months ago, but things like XYZ absolutely must get done and I’m still completely swamped most of the week, to the point that I’m often unable to eat during the day, am totally exhausted, have no work-life balance, and now am having health issues from the strain. I was glad to pitch in when Lucinda left, but it’s been seven months and I’m at the point where I can’t do two jobs any longer. I wanted to give you a heads-up that I’m close to a breaking point. Jane has said she’d rather have Lucinda’s old job stay empty than hire someone who’s not perfectly right for it, but if we don’t bring in someone else to take some of the load very soon, we’ll have two positions to fill instead of one — because this won’t be possible for me much longer.”

If your boss is a decent manager, she’ll hear what you’re saying and take more urgent action. But if you hear anything other than that immediate help is on the way, then say this: “I want to make sure you understand what I’m saying. I love my job and I want to stay here, but I need you to know that I’m seriously considering moving on in the near future if we don’t get more help in here.” (Normally I don’t recommend spelling that out so explicitly — the subtext is usually enough — but in this case the risk of them pushing you out over it is pretty damn low, and the potential payoff high.)

And when you say that — mean it. It’s okay for you to start looking now. You don’t owe this job your health or your peace of mind. Giving your manager a heads-up that you’re at this point more than fulfills your obligations to keep them afloat during the (very old) vacancy — and from there, you get to do what’s right for you. (In fact, you get to do what’s right for you even if you don’t give them a heads-up — but know that this fully relieves you of any obligation you might be feeling.)

{ 273 comments… read them below }

  1. Jadelyn*

    OP, you have my sympathies. You’ve done far more than anyone could or should be expected to do for an employer, and it’s entirely reasonable for you to decide to take care of yourself, too.

    My go-to phrase for situations like this is “This is not sustainable.” Most managers – good ones, anyway – won’t want to rely on “unsustainable” workloads any longer than they absolutely have to because they know it means losing good people, and it can often prod them into stepping up recruiting efforts (or restructuring, or whatever they do to alter the workload for you).

    1. Artemesia*

      And regardless of the outcome of such a conversation you need to be job searching. It takes a long time usually to get a new job; this sounds like it may well not resolve the way you like any time soon. So get that job search underway so if they don’t come through, you have better options. In your field, surely the competition has similar roles and you know how hard they are to fill.

    2. OP*

      This is very helpful wording, and sounds like something my manager would respond well to – thank you! And thank you as well for your kind words, they are very helpful in putting things in perspective.

  2. Yvette*

    If they are that picky, could they hire a temp to at least be your assistant and do a lot of your drudge work? Most jobs have aspects that could be done by any reasonably intelligent person, filing, dropping off stuff to another department, answering your phone and taking messages, returning phone calls and the like. Who knows, maybe they will even find a suitable replacement in the process.

    1. Tim Tam Girl*

      While this is true – and as noted below, there are temp RNs and other specifically medical temps who may be useful – my other concern is that when any new person is appointed, I suspect that the OP will be expected to train them… while also continuing to do both their jobs until the new person is sufficiently trained, however long that takes.

      This situation may be too broken. I’m sorry, OP.

        1. paxfelis*

          I wonder if the OP was hired because the other person, who was probably assigned to cover both positions, quit after giving the same sort of situation report.

    2. People Person (not)*

      Not familiar with the medical industry, but there may be an exchange where already-trained people are available for hire on a temp basis?

      I’m very angry on your behalf, OP.

    3. AnnaBananna*

      Thank you! As someone working for a research hospital, I know for a fact that there’s a temp pool or an agency that they work with, otherwise they would greatly impede patient safety in other roles that go absent.

      OP, I’m going to give you the advice that was given to me when I was going through EXACTLY what you’re going through. Which eventually turned into panic attacks and fibromyalgia (the gift that keeps on giving).

      Stop caring. That’s it! You are trying to please too many people at the expense of yourself, and you’re the only one to blame. Think about it: if you stopped being Mighty Mouse they would be forced to hire someone, so you’ve saved them $40k and dug yourself an early grave, and for what? They wouldn’t do the same for you, because it’s a truly unhealthy thing to do.

      And you know who told me to stop caring? My boss. Even he could see that I was creating my own hell by being everything to everyone at my own expense. Is it at all possible that your bosses meant the same when they insisted on better bounderies?

      I hope you the most luck climbing out of this, it’s a tough transition, but the other side is soooo much better (and sustainable). And maybe book a 2 week vacation a few months from now as a goal to reach once this is all sorted it out. And stick to that timeline! :)

      1. RecoveringSWO*

        Yes, AnnaBananna! It’s so counter-intuitive, but in those stressful, “everything is on fire and a priority” jobs one of the best forms of self-care (and survival!) is to train yourself to stop caring. You can’t immediately free up your schedule, but you can free up a tiny bit of stress by not caring/being the martyr over your employer’s poor hiring timeline. Good luck!

      2. Rayray*

        This x100000000

        I once was working somewhere where I had too much on my plate. I was stressed and it was taking a huge toll on me. I finally decided that if I wanted to leave after 8 hours, I would. And guess what? Everything was fine.

        Definitely talk to management though. It’s their duty to make sure everything is covered.

      3. OP*

        This is a really insightful comment- my boss did give similar (if not as direct) advice to care less. I’ll try to be more aware of what I’m taking on for actual practical reasons vs what I’m taking on because I feel like I have to.

        I’m sorry to hear about your health struggles, but I’m glad it sounds like things did improve for you!

      4. TardyTardis*

        But in a medical situation, not caring is *very* difficult–because you’re in the field because you do care.

        Moving out is her best bet.

    4. Bagpuss*

      Also – it looks as though OP supports three departments but that there are other people in a similar role supporting other department. They could look at spreading the additional workload over all of the people in OPs role, rather than having her do 2 jobs while everyone else does one, until they can get a new person in.
      If that isn’t possible because everyone else is overloaded as well, then that may be proof that the situation is not going to change any time soon, and that she needs to get out.

      1. OP*

        One of my colleagues has been helpful in this regard, a few others seem to be at max capacity, and the majority of the rest of them project a very strong “not my department, not my problem” mentality, I wouldn’t feel comfortable approaching them to ask for help without direct backing from my supervisor.

    5. OP*

      At my last meeting with my manager and department head, they did give me permission to leave tertiary and some secondary work undone as needed and leave it to a couple of my colleagues in other positions in our department to pick up the slack. It’s a bit awkward because they both are more senior, so I don’t really feel like I can delegate to them. Mostly I just inform them of the relevant work I won’t be able to complete, and they either do it themselves or reset expectations with staff/clients so there won’t be backlash later. It’s not an ideal system but it helped with some of it. Unfortunately the primary, non-negotiable, time-sensitive combined workload of both positions is still too much for one person.

    6. Kuddel Daddeldu*

      Would it be possible to redistribute the work? You write that you work for three departments; could you hand over one of them? That would be a fairly easy way of setting boundaries – “until we hire a replacement for Linda, the Llama colic department is handled by Wakeen and Charlotte, I’ll do the Alpaca Ob/Gyn and Dromedary ophthalmic wards”

  3. Elenia*

    My advice is to practice this speech in the mirror. I know it sounds corny, but delivering a speech like that when I was already tired and frustrated and beyond my limit would DEFINITELY result in tears, and I HATE crying at the office. I have found rehearsing your speech really helps keep it level, concerned, and important.

    1. SheLooksFamiliar*

      This is not corny at all, it’s great advice! It’s hard for people to – kindly and professionally! – push back at work, or speak to specific issues when they’re frustrated. The OP sounds close to the breaking point, which makes this discussion even harder to have. Having a script in mind, and practicing it, is great preparation. Good luck, OP!

      1. Antilles*

        Agreed.
        Also in your script, you should think through how you’re going to react if (when) they gently push back with vague reassurances of “working on it” or the same generic “hard to hire quality candidates” excuses, so you’re not caught off guard.

        1. Hey Karma, Over Here*

          Yes. Ask for specifics.
          Is there a plan to hire someone?
          Oh yes.
          Is the job posted?
          Well, yes, it’s been posted. We just haven’t seen any…(wait for them to finish)
          When is the next round of interviews?
          if you get something like this: Well, we are planning to start looking through/it’s a rolling process, when we see someone…
          you can ask this: Do you have a list of people to call or are you just pulling a name out and doing one offs?
          But realize they are telling you no, they don’t have a plan. They are hoping the staffing fairy puts Mary Poppins RN on their doorstep and all will be saved.

          1. Leela*

            “They are hoping the staffing fairy puts Mary Poppins RN on their doorstep and all will be saved.”

            Oh man I’ve worked with so many Hiring managers who are obsessed with finding that exact perfect person, who requires no training at all and also doesn’t negotiate for a higher wage, who went to the schools they like to see, who has that exact perfect internship and they wouldn’t move on anyone in case that person dropped into our ATS or (more likely) goad me to extract them from the position they’re in and happy with elsewhere…all while losing perfectly viable candidates that just didn’t give them that “they’re the ONE!” feeling, leaving other people on staff in OP’s position for months or longer than a year

            1. TardyTardis*

              Ah, the old purple unicorn candidate, with a PhD, ten years experience, and willing to work for minimum wage (and doesn’t have a rap sheet).

          2. Marmaduke*

            Definitely start a job search, because everybody’s capable of lies. However, when I went to my boss at my breaking point and told her I’d have to leave if things didn’t change, her response was, “I can’t give specifics, but there is a plan in the works.” When I asked for a timeline, she told me to give her a month. I started job searching immediately… but within three weeks, they’d found a way to get me help.

          3. Observer*

            Don’t bother.

            Unless you get told “we’re ramping up the search and reducing our expectations, and hope to have someone in place shortly”, start looking for a new job. Sure, you can consider moving to a new department, but I’d be willing to bet that your department head will block that “temporarily”.

            Also, even if they give you the right answer, if you do not get an announcement withing a few weeks – no more than a month, start searching. Even if they are honest about making those changes, it’s on them that it took them so long to make it happen.

            1. Ann Onny Muss*

              Agreed that management blocking an internal move would be a major concern. Definitely look externally.

      1. NW Mossy*

        I’ve been known to do this in my car while driving to/from work, as well as in the shower. Hearing yourself say the words helps you spot those turns of phrase that come off with a tone you didn’t expect or areas where you’re meandering too much.

      2. Farrah Sahara*

        Agreed! Not corny at all and it’s useful to practice saying these types of phrases over and over again until it feels comfortable.

        I used to do this same thing with my dog. He was my test audience for practicing my tough conversations. I would sit him down and say whatever conversation I was rehearsing to have with a boss or coworker. He would patiently sit and listen to me and I’d get a kiss at the end too, so I didn’t mind these rehearsals!

        1. Not a cat*

          I’m a writer and have been known to read copy aloud to the dog. I also get a kiss at the end :)

    2. Lizzy May*

      This. I recently had to have a very similar conversation with a boss who is so new to the role that I’d only met him once before. I prepared and practiced what I was going to say. It was a phone call as he is remote so I even jotted down notes. I still teared up because I was already stressed and overwhelmed and not in a good place anymore and saying it to someone else made me feel like a failure. Practice it to a mirror or to a trusted loved one if you’re comfortable doing that. These conversations are hard but so very necessary.

      1. Kuddel Daddeldu*

        I practice giving presentations to my potted Ficus Benjamini. The plant is fake, so there’s a metaphor in there somewhere…
        It also helps to record myself to catch my tone and body language. A smartphone or webcam is definitely good enough for this.

    3. Starbuck*

      This is good advice, but also – I think the supervisors deserve to see just how bad this situation is for OP. Tears (if authentic!) would probably help illustrate that.

  4. cmcinnyc*

    Stipulating that I don’t know exactly what kind of work the OP does, there *are* temp agencies for the medical profession. You can get a temporary Registered Nurse signed up in a matter of hours. You don’t have to hire the temp as a permanent employee if they’re not the right fit, but your manager is making the perfect the enemy of the good and it’s a fool’s move in any industry with a relentless work flow. If there is work that truly cannot wait until next week or next month, then hiring can’t wait either. I’d be very blunt about my limits on this. I’d also start looking for other work because you have bad management.

    1. Mama Bear*

      This. ^^

      There’s being picky and then there’s letting your staff burn out because you can’t make a decision. Let them hire a temp for 3-6 months and see if it’s a mutually agreeable situation. We are a different industry, but have hired several of our temps (and interns) as positions open up. We’d rather hire someone we already know.

      I once covered my job plus my coworker’s job PT while they were out on medical leave. When it was clear that the client did not want the coworker to return, my company offered me the job FT. However, I had already decided it wasn’t for me, so I respectfully but firmly declined. They hired someone else and life went on. I agree that the OP needs to draw the line for their own well-being. Let the company figure it out. You don’t owe them your soul.

      1. annony*

        Yep. There are three solid options:

        1. Hire a temp. May or may not be feasible for this job. Probably not ideal but seems better than nothing.

        2. Pull someone from another job to temporarily cover lucinda’s job. Not ideal but probably doable.

        3. Supervisor can take on some of the overflow. It’s easy to say that you want to wait for the perfect person but when you are doing two jobs and the perfect person isn’t applying, there comes a point where you say good enough. That point is farther away when someone else is doing two jobs.

        1. Realistically speaking*

          In medicine 3 is often not realistic. My supervisor realistically can’t do me job because she’s not licensed to, she has a pretty good working knowledge of how to do most of my job and could follow my “if I’m hit by a bus this is how to do things manual” but but someone licensed would still have to check and sign off on the work. How is that possible you ask? easy her job is to be a director of the whole department which is much more an administrative position than my highly technical position, of course it would be ideal that she could step up to do any job but that’s not always the way it happens. and in medicine the need to have a CURRENT licence and current skills is very important if you’ve been away from it for too long it can be very difficult to get that back.

      2. Bunny Girl*

        What’s annoying is if OP leaves, they’ll probably magically find someone right away. At my old job, I was doing all the work required for my role, an empty role, half of the role that was supposed to go to an intern because they didn’t show up reliably, and half of my boss’ work because she was lazy. She went through several rounds of interviews but had problems with everyone. I met a couple of the people she interviewed and they had really strong personalities and she probably thought she wouldn’t be able to dump all her work on them like she was doing to me. After I quit, she magically had two people to fill the roll on the first round of interviews! Imagine that.

    2. You Can Find a Temp*

      Yes, this sounds exactly like the sort of roles my husband recruits temporary contract workers for. Your hospital’s vendor management system likely already has an agency like his in it and could quickly get someone into this role.

  5. Jaid*

    Are you even getting paid for the extra work? I wonder if they’re dragging this out so they can keep their costs down.

    1. Autumnheart*

      Right? It pisses me off when a company has one person doing the full-time jobs of two people, but acting like hiring a second person requires a UN resolution. I bet OP isn’t getting two paychecks for doing two jobs.

    2. RKMK*

      I worked in the medical field and this is absolutely what is happening. Doctors and senior hospital administrators are notorious, in my experience, for grossly underestimating the workload and overestimating their employees ability to cover more new projects/covering for another worker and hiding behind “so-and-so is so great we don’t REALLY need to hire someone else, let’s budget that money elsewhere for now.” I personally was the victim of a foot-dragging rehire situation and after a year and a half of waiting, snapped.

      It’s not worth it, OP. They’re using your personal professional standards and care for your patients while flattering you that people like you are just so hard to replace to manipulate you into overwork for their own benefit, and I’d put folding money on them morphing into a blame-the-victim framing real soon – like the problem isn’t they’re understaffed, it’s that you take too much on/can’t handle the workload like your predecessor/have bad boundaries/need to work on your stress management/maybe you’re just not right for this type of work if you can’t handle this, they thought they could rely on you to handle this/ any and all of the above. Do not let them gaslight you on this. If they give you any pushback, walk out.

      1. Red Reader the Adulting Fairy*

        I actually just asked my boss whether the powers-that-be consider the fact that I’m essentially being team lead/administrator for two teams of medical coders, when I was hired for one, to still be exceeding expectations when I’ve been doing it for two years now.

        (Disclaimer: The extra team, I don’t have any HR or management responsibilities for *at all*, like they’re overseas vendors so I have a single point of contact with them and exchange one email daily, so all my work for both teams is administrative, and in fact I actually like the extra-team work better than most of my work with my official team. So I’m definitely not interested in STOPPING the extra-team work – I just want them to expand my job description and, preferably, my salary to include it. It’s just review season, and I want to know where the official benchmark is for “expectations” so I know how much I’m exceeding it. :P )

        1. Red Reader the Adulting Fairy*

          (Also disclaimer, my boss agrees with me and is going to bring it up with our director, who is the one who handed me the extra team.)

      2. Lynn Whitehat*

        YES. My step-daughter used to work at a fast-food restaurant that was chronically understaffed. They called her in all the time. She would close up and then open again 6 hours later. She did stuff like try to repair electrical wiring (!) I told her, “eventually you will make a mistake that results in people getting sick or hurt. And when you do, they will blame you and ‘millenials’ generally. They will not get introspective about whether over-work and fatigue contributed. Nothing will get fixed until the problems make the national news.” The restaurant? Chipotle. So either I have the gift of prophecy, or I know how corporate jerks operate.

    3. SH*

      Yeah, my first thought was “they don’t mean they’re selective in hiring, they mean they want to see if they can get by with only LW filling this position.” It’s so, so common these days for departments to downsize and shift all the extra work on the remaining employees with no compensation, while the employees are supposed to work harder for fear they won’t get another job. If LW is secure enough to say “I cannot complete the required tasks in the hours allotted, hire help or I quit” then she absolutely should (and really should be asking for back pay).

      1. Beaded Librarian*

        Oh man our city administrator is trying to do that after saying that they wouldn’t bump up my title to account for work that I was doing ‘because I shouldn’t be doing it’ but when an important position opened up that they want to do differently all the sudden all the staff should be able to large parts of that specialized position with no increase in pay.

    4. OP*

      I am not, although I do get paid overtime for staying late or missing my break. I do plan to ask for a higher raise at my upcoming annual review than is possibly with the default pay rate system. We’ll see how that goes!

  6. CatCat*

    A+, if no immediate help is on the way, get searching.

    I told a supervisor that I was job searching because I was burning out. When I proposed some changes, we talked about it, but very little actually happened as result. Supervisor was actually somehow surprised when I put in my notice and wanted to talk about the issues I raised months before. But at that point, it was not my concern nor was I willing to entertain sudden immediate attention to issues that there had been plenty of chance for her to address previously.

    Good luck, OP! There is a job for you that won’t burn up your physical and mental health. Hopefully, it can be this job since you love the work, but if not, I bet there’s another great opportunity for interesting work out there for you.

    1. Antilles*

      Supervisor was actually somehow surprised when I put in my notice and wanted to talk about the issues I raised months before.
      Of course. It’s the classic line of “you didn’t care when the issues affected me; you only started to care when it affected you”.

      1. SheLooksFamiliar*

        Yep. I think most employees care about doing good work, and they don’t want to let things drop. Management ‘knows’ things are challenging, but they don’t really know it. Once they understand things are collapsing under the weight of their unrealistic expectations and lack of support for their overwhelmed staff, wow, suddenly they can come up with solutions.

      2. SeluciaMD*

        I hate how true this is. Many years ago I worked for a small local non-profit that I loved and where (I thought) I was really well-respected and appreciated. We were a team! We were a family! (What a red flag that is now……)

        When we were fully staffed, we were three full-time and two part-timers. The end of my last year there we were having money problems and were down two staff so I was pulling double duty all over the place, working 14 and 16 hours a day, 6 or 7 days a week. And then we didn’t get paid one Friday because there was a cash flow issue. As it happened, our Board meeting was two days later and at the end of the meeting – after my boss failed to bring it up – I was like “Are we going to talk about the fact that no one got paid on Wednesday?” Which prompted a brief discussion about how bad things were, and people owed them money, yadda, yadda, yadda. And then the Board chair ended the meeting by saying “We should definitely talk about that next month.”

        About two weeks after that meeting (still no pay – I was job hunting like crazy) my old boss (who I adored) had an opening at her organization and asked if I could come work for her and start right away. Needless to say, I jumped on that offer and tendered my resignation. Both my Executive Director and the Board Chair were *SHOCKED* because I was “so dedicated to the organization” and “such an important part of the team” and they couldn’t understand why I would quit with virtually no notice! I reminded them that I (and my coworker) hadn’t had a paycheck in nearly a month at this point and they demonstrated their concern for us by tabling the discussion for how to get us paid for another month – and that made me feel, you know, NOT VALUED.

        One was “understanding” and the other was “disappointed” in me because apparently both thought that I could pay my bills, eat, and stay housed through the magic of my sunny disposition. Or something.

        So yeah, don’t equate your personal dedication to being a good worker with doing *all the work* regardless of the circumstances. Right now you are making their problem feel less like a problem and you are doing it at your own expense OP. Time to make it their problem again – either by only doing your actual job (so they have to feel the ramifications of the absence of a 2nd person) or by leaving. You don’t owe them your health and mental well-being.

        Good luck!!!

      3. TardyTardis*

        Been there, done that–I wasn’t told how wonderful I was at the library till I gave notice. (and I was kind of gleeful that the person who spent a couple of hours each gossiping with the boss was actually going to have to do some work for a change).

    2. Former Usher*

      Once when I resigned from a job, my manager actually said “I knew you were unhappy, but I didn’t think you’d leave.”

      1. Close Bracket*

        That’s why Alison’s scripts spell out that OP will leave if they don’t get help. Spell it out. If you are really going to leave, use the word “leave” at some point.

        OTOH, I had a manager who knew I was unhappy, who used the words to me, “unhappy people leave,” and then was surprised when I gave my two weeks notice on the date that I had told her I would need to make a decision by. To be fair, I don’t think I did actually spell out that I would leave by using the words, “I’m going to leave.” Nevertheless. She had all the information she needed not to be surprised.

        1. 2 Cents*

          I had a manager do the same to me. Told me, if he was in my position and X situation happened that was out my control, he’d leave. Was somehow still surprised when I gave my notice after saying for 6 months “I can’t do this anymore.”

      2. CircleBack*

        I was surprised when I gave notice at my last job how many people in leadership were *totally understanding* of why I would leave, which was such a jolt considering how clueless employers can be. These guys kept hemming and hawing over raises and perks like working from home, making me feel like they thought the situation was fine and that they valued me and the job I was doing so little.

        Still makes me kind of laugh to remember meeting with a director in another department (who filled in as my boss for a few months the year before) – he asked me what made me take the new job, and I said “honestly, they’re paying me a *lot* more money.” His response? “That makes sense. Good for you.”

      3. call centre bee*

        I had a manager say, “Please don’t leave, I can stop shouting at you!”

        Like oh… so you did realise you were doing that. And it was in your control all along. Nice. I’m gone.

    3. Holy Moley*

      Yes CatCat! Same thing happened to me. Told supervisor I was drowing, offered ideas on how to help (make other employees actually do their jobs!) but nothing changed. When I left I got the same “Why are you leaving?” talk. OP save yourself. That company will continue to abuse you as long as you are there.

    4. Blueberry*

      This. OP, I used to work in medicine, where I learned that a good case manager is worth her weight in gold. You can find someplace that treats you better. I’m cheering you on!

  7. Antilles*

    Seven months is too long for a critical vacancy.
    I don’t care how much you want to “hire the right fit” and “we don’t want too much turnover” and etc – if you really wanted this job filled, it wouldn’t take seven months. This isn’t being selective, this is a flawed hiring process in something like:
    1.) The position actually isn’t important to them, possibly because they just see everything getting handled and assume they were overstaffed in the first place.
    2.) They have a wild mismatch between “what we pay” and “what the market demands for this skill set”.
    3.) They have no idea how to select candidates.
    4.) They are so bureaucratically slow that good people get (and take) other offers in the time it takes them to make up their mind.

    1. Marthooh*

      Or 5.) The job is cursed! Cursed, I tell you!

      Since, remember, one of the two positions opened up and the OP was hired internally; then the other position opened almost immediately when the other person left to work in a different field. And the department head hasn’t been able to fill the role in seven months! [Flash of lightning, roll of thunder, suddenly the lights go out]

      1. Shadowbelle*

        Or 6.) There is a reason why the other person left to work in a completely different field, and it has to do with the demands of the now-vacant job.

      2. Avasarala*

        Somehow they managed to fill the Defense Against the Dark Arts professorship every year. Not that they did a great job hiring for it but they did fill it!

        1. TardyTardis*

          Fortunately for Dumbledore, Umbridge was so awful she made him look good. No wonder he left her there to do whatever she wanted for as long as he did.

    2. TurquoiseCow*

      7.) They don’t really have the budget for another person and are either hoping OP works it out on her own or they’re busy fighting higher-ups for the budget.

      1. SamKD*

        ^^^ Yes. That. If there were money the temp would have happened. Every month the position stays open is another month of not paying its salary. And healthcare? Of course broke. (I’m in the field myself.)

      2. Kelly*

        As someone who works in public higher ed and has been fed that particular line for a number of years now in response to a need to increase our student worker budget, its not entirely true. All of our salary funding, both student and permanent staff, come from the same source and are split into different budget lines. There was money in the budget even after a historic budget cut to hire multiple admin positions paying 6 figures. This was after all units took a 10% cut to their student budget lines that has not been restored. We need that increase plus more in order to fund a campus mandated student wage increase.

        The plus side is that said line was overused under the previous big boss that it’s not really believed. The new big boss seems to have a better sense of the general pulse and attitude on the ground than their predecessor did. They’ve done something that’s new and radical – they’ve had listening sessions where we can be honest and candid about how we really feel about work, morale, and the future of our division. There’s only so much you can say with your supervisor and colleagues around without offending them (supervisor) or hurting their feelings (colleagues). The ones who may be indirectly responsible for morale issues may either not recognize their culpability or be completely aware that they don’t contribute to a good team environment. It’s a good step forward.

    3. ThisColumnMakesMeGratefulForMyBoss*

      This could all be very true, but let me offer the other perspective. Maybe the company doesn’t want to hire just anybody to fill the position because they don’t want them to leave or make it worse on the OP because they’re not qualified for the job. I’m not saying what’s happening to OP is even close to being okay, but it’s quite possible this isn’t just because they suck or they don’t care about OP. I’m currently working on a big project and we need more developers because we have an unmovable due date and if nothing changes, we’re not going to make it. They’ve been looking since August and have yet to find anyone good enough, and it’s not for lack of trying or being too picky. It doesn’t make sense to get someone in there that’s going to cause more problems than they’re going to solve.

      I think OP needs to document what they do on any particular day and lay it all out for their supervisor. A lot of times seeing it on paper makes a bigger impact than just talking about it. And then go with Alison’s suggested script. I’m not sure if OP is in the financial position to quit on the spot without another job lined up, but they might want to consider that as a possibility if nothing changes after speaking to their supervisor again.

      1. AnotherLibrarian*

        Yes, I’ve had to hire for hard to find skills and even with polls of over 70 candidates, we’ve had trouble finding folks who really A: Want to live in our rural location or B: Actually have the skills we need. It’s not an easy prospect to hire for certain types of roles.

        1. MsSolo*

          I think the problem here is that if this applies, then the institution needs to re-examine what kind of care it can offer. If you can’t provide sufficient patient support for all the specialities you offer (or even just all the patients you see under general care) then you have to let something go. If you can’t treat patients safely, you should send them to someone who can. Safely isn’t just about doctors and nurses – a hospital that doesn’t have enough cleaning staff is putting lives at risk and shouldn’t be allowed to take money from patients until they sort their budget out.

          I also suspect, if the institution suddenly had to face not being able to offer, say, Oncology, because they don’t have enough case managers, having to justify letting go of specialised doctors because they can’t get enough skilled non-medical staff is going to suddenly make them reconsider what exactly it is they’re looking for in a case manager, and whether there are other ways to redistribute the role or offer the necessary training to guarantee there’ll always be skilled staff available.

        2. TardyTardis*

          Have you ever considered paying more money?

          (I can hear the laughter from here, I know library budgets).

      2. Antilles*

        Maybe, but the obvious counter to that is that at some point, you need to recognize that you *can’t* find a tailor-made candidate (at the price you’re willing/able to pay, anyways) and adjust your expectations to a lower bar.
        Yes, that might mean the newbie actually makes your life a little harder for a couple months while they catch up. But in the bigger picture, if OP’s company had hired someone “decent but teachable” a few months ago, that person would probably be firmly into “acceptable” category today after on-the-job learning and development. Instead, they’re stuck in the same spot today as they were months ago waiting on the ideal candidate…and there’s still no guarantee you won’t still be stuck months from now.

      3. Colette*

        And I think it’s possible that management doesn’t realize that there’s a big problem. They told the OP to set boundaries, and they don’t know that that’s not working (or her boundaries are not in the right place, and more needs to drop).

      4. Paquita*

        Yes to the documenting! I was in a spot where the supervisor had no clue why I couldn’t get everything done each day. I wrote down everything I was responsible for and how long each process took to do. It was about 12 hours of work in an 8 hour day. She had no idea time-consuming things were because she was making a lot of assumptions. (She didn’t even know how to do most of the things in the first place.)

    4. Joielle*

      I was on the other side of a #4 (and kind of #2) situation once – I was interviewing for a new position that would help someone who was completely overworked and burned out, but the process was so slow that after I interviewed for that job, I interviewed and was hired at another company and hadn’t heard anything at all from the first company. When I told them I was withdrawing because I’d accepted another position, they asked several times if I would please reconsider, they were planning on offering me the job, they were just working out the salary and position description, etc etc… but by then it was too late, and the whole process hadn’t given me a good impression anyways.

      I feel bad for the burned out person at the first company, but I also feel like I dodged a bullet. They still haven’t hired anyone for that position, and it’s now been 6 months since I interviewed. The position description was overly specific/demanding and salary was too low, so I don’t know how they’ll find anyone. And in the meantime, that poor overworked person is just continuing to get by, I guess. Not a great way to run a department.

      1. 2 Cents*

        Was recruited to apply for a job, made it through all the interview rounds, was told the opening was “urgent.” Radio silence passed the February “we’ll make a decision by” date. Got a form letter in October that year letting me know they went with someone else. Glad I didn’t hold me breath for that place!

        1. Julia*

          My last job needed someone “urgent”, but let weeks pass between communication and interviews. I got another offer, emailed all the other companies I was technically still a candidate for to ask for a response within 48 hours, and got one at the last possible minute saying they wanted to offer me the job, but weren’t sure about my skills. Um, thanks? They also wanted me to start immediately of course, and were pissed when I needed some time to sort stuff out at home first.
          I took it anyway because it was a Big Name that would look awesome on my resume, but their HR didn’t give me the best impression even after I started working there.

    5. Aggretsuko*

      Oh, we’ve had this going on for I’ve lost track of how long. We’re told it’s problems with HR.

      1. Krabby*

        Haha, I had the super fun experience of dealing with an employee who had been fed that line over and over. He finally decided to take matters into his own hands and scheduled a meeting with me “to discuss strategies on how to expand our candidate pool.” He had a really great list of niche job boards we could post on, and had some ideas

        Watching him get steadily more frustrated as I explained to him that his manager had told us to rotate the job posting out of our active listings because it was, “non-essential,” and “can wait a few more months because I don’t have time to review all those resumes right now,” was very upsetting. He quit a month later and I have never been more sincere wishing someone good luck in their exit interview. And then my boss used the notes from that exit to finally get the guy’s manager canned (yay!).

          1. Sacred Ground*

            Useful for the company sure, but not too useful for the departing employee. I still don’t get why someone leaving due to poor management would give an honest exit interview. The benefit is entirely and only to the employer while the departing employee risks burning a reference if HR is as dysfunctional as the rest of the org. I’d just say something bland about seeking a change, yadda yadda, and move on. They can figure out their own problems, I’m leaving.

            1. Observer*

              Well, it doesn’t look like the rest of the organization was that dysfunctional. That [articular boss was, but apparently there was a enough sense in the rest of the leadership that when a clear problem was documented action was taken.

              Whether or not to provide information in an exit interview really depends on the circumstances. But as this example shows, companies are smart if they make it low risk to provide the information.

    6. Solana*

      It took MUCH longer than that to hire another head cashier at a famous bookstore. I was doing two people’s jobs, trying to ring up customers while also doing projects and displays of books by myself. They kept telling me that the applications they got in weren’t good. Oh, yeah, and I also had fibromyalgia and depression and anxiety that were flaring up during that time.

    7. OP*

      Number 2 is absolutely true. Number 1 is a possibility, although I certainly hope not, as I’ve heard from staff in other departments that on my scheduled days off core responsibilities aren’t met in a timely manner. Number 4 is also a possibility although I really don’t know.

      1. TardyTardis*

        Run. They won’t get that area well staffed till they have to. And they’ll definitely guilt you into working yourself to death. (they do the same to teachers).

  8. Ann Nonymous*

    The advice, ” if we don’t bring in someone else to take some of the load very soon, we’ll have two positions to fill instead of one ” should be edited to, “YOU’LL have two positions to fill…” Put this on management to solve. I know if were me, I would inform them that as of Monday I will only be doing the one job that I’m being paid to do and not two. I would also strongly suggest that I be back-paid the second salary for doing the second job. (I talk tough online.)

    1. Ask a Manager* Post author

      I don’t disagree, but I’m also a big fan of using “we” when you are delivering serious statements of consequences for an employer (like “we could get in a lot of legal trouble for this” … when I sue you) because I think it often helps preserve the relationship / lets everyone feel like you’re all on the same side.

        1. Blackcat*

          This is an excellent time for the passive voice. Mirror their lack of action with your grammar.
          “There will be two empty positions”
          “Two positions will need to be filled”
          etc

        2. MistOrMister*

          That was my thought too. I understand using Alison’s suggested ‘we’ when you will still be working at the place since it makes things look more collaborative. But when it comes down to you’ll be leaving, at that point it’s you vs me and to me, ‘we’ seems disingenuous. I think ‘there’ is neutral without being combative so that’s that I would use for this situation.

          1. Jedi Squirrel*

            You can also use these to escalate:

            “We will have two positions to fill.”

            “There will be two positions to fill.”

            “You will have two positions to fill.”

            If they don’t get it at that point, they probably will when you hand in your resignation.

            1. Armchair Expert*

              “We will have two positions to fill. And by we I mean you. Because I won’t be there. Because I will have quit.”

        3. Joielle*

          Yeah, I’d go with this. I usually like “we” for serious conversations, but in this specific case where OP will be leaving if nothing changes, I think “we” sort of confuses that fact. “You” seems too forceful, but this passive construction is perfect.

      1. Jadelyn*

        ^^^ This. If you can keep the tone collaborative, even if the message itself isn’t, you’re less likely to put people on the defensive right away and you can buy yourself a little more room to keep them engaged with what you’re saying instead of retreating and throwing up walls the way people do when they feel attacked.

      2. Phil*

        Don’t say “you.” It’s the magic word. Dragging baseball into it, when you see someone getting tossed during an argument with an ump it isn’t the curse words that get you tossed, it the word “you.” That was a forking bad call is OK, you made a bad call gets you thrown out.

  9. EgyptMarge*

    And if they DO promise to hire someone soon, get them to commit to a timeline. As others have suggested, temp help is available immediately. Having them tell you they’ll work to hire someone in the second position is great, but they presumably have been doing that all along anyway. They need to fully understand the urgency and commit to getting it filled by a specific date or in a specific number of weeks (maybe days, if they’re going the temp route).

      1. 2 Cents*

        I was just thinking that joe is a excellent time to use up those PTO hours you’ve accumulated.

      2. Carlie*

        My exact thought was wondering what they would do if LW was out sick for a few days. Not just a couple, long enough for the work to really pile up. This is truly unsustainable.

        If they won’t even hire temp or part time help, push on redistribution. At least one department can be shifted st someone else, or spread out.

    1. Cathie from Canada*

      Or, if workplace familiarity is important, they can do a temporary transfer from elsewhere in the workplace – Ill bet they could find someone internally for a temp position if they put out a call for a nurse or an administrative assistant who might be interested in doing something new on a temporary basis, say for 6 months, and ALSO promise a temporary bump in pay! — then hire a temp agency replacement for the other position.
      And if the response is, sorry, too complicated, no pay bump (or if the pay bump would actually make the temp appointment better paid than the permanent position) then the OP definitely needs to start looking for another job because management isn’t really interested in doing anything to sustain their employment.
      During my working years, I sometimes saw the situation where someone was overworked and underpaid,then when that person left in despair, the new person simply wouldn’t stand for being treated this way and suddenly management would improve the position – hire an assistant, sort out the workload, etc etc. I came to believe that the old person had been expecting management to figure out what kind of help to provide; while the new person has less personal investment and so could approach the job with more clarity, figure what needed to be done, and then tell management to do it.
      Basically, the old person was letting the job manage them, while the new person set out to manage the job.
      So I also suggest that OP needs to start pretending to be the “new person” around there – if she was just starting the job, what changes would she make to her position and to the responsibilities of the whole work area to make sure the job is getting done better?

      1. Kuddel Daddeldu*

        Absolutely!
        I was in that situation the last two years, building a new service line that’s hard to hire for (requiring a quite unique set of skills).
        We hired two new employees half a year ago and they are getting productive now, but the increase in workload outpaces the increase in capacity.

        I used my annual evaluation to reduce my contractual hours so I’ll work four-day weeks for half a year – and suddenly, I’ll get an assistant starting in six weeks! Okay, half an assistant as I’ll share him with a coworker, but he was an intern before in our team and is really great. So I have good hope that the workload will be back to a sustainable level soon.

  10. SpecialSpecialist*

    If OP has done a pretty okay job handling both jobs, then managers might think one person can do it and there’s no rush to get a second person handled.

    It may be worth checking in with your supervisor daily for a week or two to say:
    1. Here’s what I got done yesterday
    2. Here’s what I wasn’t able to get to yesterday
    3. Here’s what’s on my plate for today
    4. Here’s what I realistically think I can get done today
    5. Here’s what I need help with

    1. Happy Lurker*

      and
      Here’s my request for time off!
      OP remember to take care of yourself. If you have some time coming to you, please take it to rest and hopefully recharge. The more days in a row the better. Two consecutive weeks might show your supervisor how much you really do!
      Also, echoing the advice above about following up on a timeframe for expected coworker relief.

      1. Hmmm*

        Putting in PTO is one of the best ideas. Not only does it give OP a much needed and deserved break, it puts the org on notice in a very tangible way about all she does. I was in a similar position to the OP and when I put in for a week vacation, that’s when my company finally decided to get serious about filling the 6 month vacant position I had been covering for. Prior conversations about how the situation was untenable had only yielded, “Yeah we need to get on that” with no action. Once I was on vacation, suddenly there was action.

      2. HumbleOnion*

        Such a good point. The OP doesn’t mention this, but I can’t imagine she’s been able to take any vacation time. When you’re in a job like this, taking one day off means double the work the next day. Taking a vacation day, or even a sick day, doesn’t seem worth it.

        This is a classic “What would happen if the OP was it by a bus?” situation.

        1. OP*

          I’ve been able to take a day here and there, and the occasional weekend, but nothing close to a full week. I absolutely need to, although I have a hard time imagining my supervisor approving it.

      3. HerGirlFriday*

        I would also note how much OT or PTO has been accrued and put a monetary value on it. They could be losing a lot of money paying out OT or maxed out PTO. My office had this problem – 3 of the 7 team members (including our supervisor) have maxed out their PTO and its affecting our departmental budget.

    2. Another name*

      This is an excellent idea. I’ve been in a similar position and learned the hard way, after ruining my health, that as long as you are able to demonstrate to bad or mediocre managers you are capable of doing the jobs of two people, you will continue doing the jobs of two people.

      It only stops when you show you can’t. Make it their problem to deal with.

  11. Marthooh*

    The department head has told me they’re very selective about who they hire for this position, and they’d rather have the position empty than hire someone who’s the wrong fit.

    Then the department head can get busy and help you get the necessary work done every week. If you’re too overwhelmed to take breaks and too tired to take care of yourself, then you are too tired and overwhelmed to do the job to standards.

    1. Parenthetically*

      Right?! FFS. “I’d rather leave this position vacant and thus destroy the health of an excellent employee than hire someone who is the wrong fit, because so far it’s not inconvenient enough TO ME to do differently.”

      OP, that is a smelly dead rat of an idea from your boss, and you need to deposit it lovingly on her doormat every single day until she gets it.

      1. Happy Lurker*

        smelly dead rat of an idea from your boss, and you need to deposit it lovingly on her doormat every single day
        So great! So glad I wasn’t drinking coffee – I would have choked.

        1. Shadowbelle*

          “That’s your plan? Wile E. Coyote would come up with a better plan than that!”
          John Crichton, *Farscape*

      2. whingedrinking*

        “I’d rather leave this position vacant and thus destroy the health of an excellent employee than hire someone who is the wrong fit, because so far it’s not inconvenient enough TO ME to do differently.”
        This this this. My jaw dropped on hearing “we’d rather leave the position empty” while the OP is running herself ragged. Having bad employees/coworkers is a giant pain, but it’s a risk you have to take at least some of the time to *get the damn work done*.

    2. Hey Karma, Over Here*

      SERIOUSLY!
      That’s not helping OP, that’s not helping the department, that’s not helping the company/hospital. There’s a point of diminishing returns on due diligence.
      And as I already posted above, I don’t think they are really looking for anyone. Has there been a round of interviews or are they reviewing resumes FOR HALF A YEAR?

    3. A Simple Narwhal*

      Ugh I was in a similar position to this last year, the OP has all my sympathy. Our team was down from four people to two and the higher ups were dragging their feet on hiring a single replacement person. Their excuse was essentially “we want someone with a very specific new skill and the ability to hit the ground running immediately”. Meanwhile, my remaining coworker and I are drowning, thinking they could have brought in a much less specialized person, which would have allowed us the time to learn the new skill sometime in the 8 months the position was open. But nooooo they wanted someone perfect. When my coworker mentioned job hunting offhand I semi-panicked, thinking that I would 100% not be able to stick around by myself.

      Honestly, the only way things got better was our department head finally had enough of our whining (and we had started sending people directly to him) that he decided to humor us by looking at our workload – he was absolutely shocked. Things got turned around so quickly that it’s semi-insulting that we had to “make do” for so long, but I’m honestly just glad we have a better system in place along with our higher ups’ buy-in on things now.

      All of my good thoughts to the LW, I hope their boss sees the light and makes some hasty changes.

      1. 2 Cents*

        This is a good idea too. OP, do not take on anything additional, but refer the requester to your boss…every time.

        1. A Simple Narwhal*

          They see no problem now, why should they fix it? 100% make it their problem.

          It shouldn’t work that way, but unfortunately sometimes you have to make people care.

    4. annony*

      Exactly. I have been in the position of not wanting the wrong person hired for a position because it would end up being more work for me in the long run. I was the one to cover the job until we found someone.

    1. C*

      Sorry, it sent before I was done. I was in a similar position, extra empty position I was filling for 8 months and used something similar to Allison’s first script. Another month went by and nothing happened, then I used Allison’s second script and someone was hired very quickly. It took another couple months and some time off to feel like I bounced back. I really hope once someone is hired you can get a good break to reset and return refreshed.

      1. Jem One*

        I feel at this point they need to fill the second vacancy AND hire a temp for a couple of months to give OP a proper holiday and a lighter schedule until she’s recovered. If she’s not been paid any overtime (or even if she has!) she’s more than earned it.

  12. Sarah-tonin*

    I have nothing to add here, but kudos to you for sticking with it this long, although you should not have had to. I hope you’re able to talk to your manager, but I also hope that you’re able to find a better job (in terms of management and workload and work-life balance) ASAP. <3

  13. Rey*

    OP: I’m so sorry you’re in this position. You deserve so much out of life, and right now, this job is not it. You do not owe your health to your job. It sounds like you have ended up with a very different workload than you originally interviewed for, and it’s totally reasonable to recognize that and move on. Ultimately, put yourself as the top priority (no one else will) and do what you need to get what you need.

  14. Properlike*

    How do they get the job done when you go on vacation?

    (Yes, I think I know the answer to this. But maybe it’s time to take that two-week vacation and create the immediate need for them to take action.)

    1. CM*

      I really like this idea — I would give them a month’s notice that you’re taking a week off, emphasize that you are already beyond capacity and will not be able to work extra to compensate for this vacation, and let them find a solution. That may help with the stress too.

    2. whingedrinking*

      Every time I read a story like this, I think of the hypothetical bus (ie, at any given time, any given person might be hit by a bus and be unable to work for anything from a day to forever). Mostly this is because I’m a teacher and the maintenance of the sub list is a day-to-day reality, but it still amazes me how there are people who seem to wander around thinking it’s totally fine to have no hypothetical bus backup plan for their staff.

      1. Oh so very anon*

        This. Just an hour ago my assistant got a phone call saying her FIL had died unexpectedly. BOOM, she was outa here to take care of family business. How will I manage without her? My problem, not hers.

      2. Sarah-tonin*

        on a much, much lesser scale, this is kind of what i’m experiencing at one of my jobs (i work 2, and i am a librarian). i work a specific night of the week, and i’m generally the only person who works that night. a few months ago, i asked about switching off with anyone else, and was essentially told no, in part due to our staffing issues and there isn’t anyone else who can work that night. which is fair, i guess, but eventually at some point i’m going to leave (for a full-time job, which i’m very much hoping happens sooner rather than later) and then they’re going to have to find someone else to work that night.

        1. I edit everything*

          On the plus side, you can listen to audio books with cologne-ad covers without fear of offending a coworker. ;-)

    3. The pest, Ramona*

      I was more thinking along the lines of taking a week or two of sick leave, which they cannot deny if your doctor will back you up on the need for it.
      Nothing like no one doing the job to point out the need for a back up person.

    4. alligator aviator autopilot antimatter*

      I like this idea. If you have any vacation time available, take a vacation or staycation that’s as lengthy as you can manage, ASAP. You need a break from the burnout and your employer needs some help understanding the consequences of their understaffing.

      (Not that this should take the place of the conversation Allison suggested!)

    5. The Man, Becky Lynch*

      This is a question they ask when you’re trying to get dismissed from jury duty due to claiming employer hardship. So it’s an excellent point and 100÷ agree the OP needs to book that PTO.

    6. Aggretsuko*

      I’d guess the job doesn’t get done while OP is on vacation, that’s how it’s worked in my job for the last year.

      (Though literally today I’ve been told I’m getting transferred back to my old team, who will have to take on my workload while I will also have to take on theirs. That’s how backup works.)

    7. WS*

      Yes. One of our staff members was involved in a near-fatal farm accident (and has not been able to return to work four years later and probably never will). We had back-up plans in place and while there was a bit of shuffling around the first two weeks, we had someone filling her position at all times and a part-timer moved up to full-time shortly after that. It was very stressful but at least the stress could be about whether she was going to survive and how to help her family rather than drowning in work.

    8. OP*

      My understanding is, on my scheduled days off or the few 2-3 day vacations I’ve been able to take, that the work does not get done in a reasonable timeframe. It still gets done at a level that doesn’t compromise patient care, but it goes so slowly that it does weigh down the administrative functioning of the hospital. And pisses off clients.

      1. The Bookwyrm's Lair*

        Waahhh. Tell your manager to stick it up and get some medical leave. This is what happens when they manage ineffectively.

        All my love and empathy to you. Don’t let them destroy your health worse than it already is!

  15. Rebecca*

    Ugh OP- you’re giving me flashbacks to some bad case management jobs I’ve had. I don’t know if you have an official license (like social worker or nurse) but if you do not being able to fully and properly address your case load could potentially put your license at risk or result in the hospital itself being cited or sued. These may be important things to consider as you bring issues to your manager’s attention. Medical jobs and case management jobs tend to be understaffed and intense and unfortunately you may often have to advocate really hard to be heard within a system designed to get by on less. It’s also difficult emotionally when you know people need help and it’s your official job to help them but you can’t- you’re not being immoral by setting boundaries or potentially quitting, the system is immoral for not being set up in a way where you can succeed.

    1. La Dame Va se Fâcher*

      Yes, healthcare is especially bad for this! I worked for years in veterinary clinics, and can only imagine how much harder it must be in human medicine. Much like some startups or non-profits, there’s this attitude that you’re in it for the passion, and if you’re not going above and beyond at all times it must be because you’re just not a caring enough person. This leads to understaffing, overworking and burnout, and people feeling like they aren’t allowed basic workers’ rights.
      The number of times I would hear my co-workers complain-bragging about how seldom they would actually get their lunch breaks made me want to scream.

  16. new kid*

    I’ll admit not being anywhere near healthcare or a similarly time critical industry, but it’s hard for me to imagine that the ‘here’s what I can reasonably do, how do we reprioritze/redistribute the rest’ convo wouldn’t be appropriate here. Because – what would happen if you were sick? If you up and quit without notice? If the work really is essential and immediately time critical, then there must be some plan in place to make sure it’s always covered, yes?

    I have a ton of sympathy reading this letter, so please don’t take this the wrong way but I do think sometimes people get in their own way with thinking ‘well, if I don’t do this, it won’t get done’ when that’s really a collective responsibility with at least your department but really your whole organization, especially if ‘x doesn’t get done’ has major impacts, such as to patient care.

    1. snoopythedog*

      Ha. If only critical fields such as healthcare worked in this way. There is not always a plan for critical positions to be covered. The expectation is that you work yourself until you collapse and it becomes someone’s job to do the same.
      This is why I really appreciate Alison’s special consideration that ‘how do we reprioritize/redistribute’ conversation doesn’t always work in healthcare.

      1. new kid*

        But the alternative is that OP plans to quit and then the role won’t be covered at all, so I’m really confused why it hurts to start with the solution that seems to me like a much better resolution for both sides?

        1. Krabby*

          Because they can pay lip service to reducing your workload all day, but if a patient is next to you crying or yelling about something that you can help them with, you’re going to help them. No matter how you were told to prioritize, you will do it to make their quality of life better.

          HR is obviously very different, but I’ve experienced the same thing. Yeah it’s not life or death, but if someone pulls me into a side room and starts crying about how they need time off to go to their grandma’s funeral, I’m going to sit there and listen for the full 30 minutes they want to talk and not tell them to f* off and check the Bereavement Leave page in the wiki so that I can get back to finishing my weekly recruitment report.

      2. Anonariffic*

        Unfortunately, I’ve seen more than one post on reddit from caregivers who have been working 24+ hour shifts because their relief didn’t show up, the boss either isn’t answering the phone or keeps telling them to wait, and they’re trying to figure out what they can do without potentially getting criminally charged with neglect for walking out the door and abandoning their patient.

      3. Arts Akimbo*

        Ugh. I recently watched Fritz Lang’s Metropolis and am picturing the scene with the worker on that utterly pointless-looking clock face machine, where the worker had to make the hands point to the lightbulbs that went on, where he literally worked himself until he collapsed and another worker took his place. Employers should not be using Metropolis as a management model, and yet many seem to want to.

    2. Friendly Regional Government Worker*

      It’s true, though. Until recently, I worked in a critical-necessity public safety agency in a public-facing role. There were never, ever, enough people in the public-facing role, even though it was low pay and high stress with 5 out of the necessary 8 employees. When we were down to 2 people, I asked my supervisor what would happen to our work if both my colleague and myself had emergencies. She said she would have other departments’ employees cover our work.

      After I left, I learned a significant portion of our work was redistributed to other departments. But those departments already have their own public safety responsibilities. Our work is now largely rubber-stamped and the safety of the public is compromised. Sooner or later, the negative consequence will hit the news- and another department will take the fall for it, when the problem is truly the lack of staff.

    3. OP*

      That’s an absolutely valid point, and I definitely find myself thinking in the way that you describe. If I were to vanish tomorrow, the essential work would primarily be covered by another department. It doesn’t usually get done within an appropriate time frame, but the issues that stem from that are client service issues rather than patient safety issues, at least for now. If I were to be gone more consistently or for a longer period of time, I worry that the prolonged strain on the other department would eventually compromise patient care. Which is very much not my problem to worry about, and a way of thinking I should try to correct!

      Thank you for your insight and sympathy

  17. BadWolf*

    My shift doesn’t overlap much with my supervisor’s, so I’m not sure if she’s aware of how much I still have to take on.

    Your supervisor is not aware. Or is vaguely aware, but you are handling it enough that it’s not enough of a problem to light a fire under a second hire. If your supervisor is acutely aware and doesn’t care, then definitely leave.

    Most places, from a big picture, operate on a “it’s working, nothing to fix” even if you zoomed up close, you would see the “working” is one hiccup away from not working.

    What happens when you are out sick? Or on vacation? There’s no backup for what sounds like an essential position? That’s not sustainable even if you weren’t working like crazy.

    1. AnotherLibrarian*

      Yes, I think the supervisor needs to really have what the person is trying to juggle spelled out. I manage people and while I adore my staff and I think I know them well to be honest, when it comes to the nitty gritty of what they do all day- I have no real clue. I know what major projects they are working on and what standing duties they have, but I don’t really know how much of their time is absorbed in which parts of which duties. I think a lot of managers are in this position.

    2. Maseca*

      This! This is one of those situations where the boss doesn’t personally feel the pain, so the pain doesn’t get treated. As long as you’re somewhat holding everything together, there’s no urgency for them to solve your issue. The trick is finding a way to make the boss personally experience enough discomfort that they have to act. And make sure to keep the pressure on — I’ve also let situations like this linger because as long as the work is getting done, the boss doesn’t have any impetus to act. They may empathize or think they understand that it’s “difficult” for you — but you’re getting the work done. There won’t be any urgency on their end unless you create it, and understandably you’re not in a position where you can just let the work slide to force their hand. So you have to be vocal and persistent and make them feel the pain you’ve been enduring until they Do Something.

    3. Ann Onny Muss*

      I suspect the answer to “What happens when you are out sick? Or on vacation?” “PTO? LOL. You’re way too busy to take PTO.”

    4. OP*

      Another department covers the work, I have been told there are frequently significant delays that can make clients very unhappy but don’t compromise patient care. It’s not ideal or sustainable, but it provides backup when, as an example, I’m out sick for a few days.

  18. Anne Elliot*

    “The department head has told me they’re very selective about who they hire for this position, and they’d rather have the position empty than hire someone who’s the wrong fit.”

    Wow, does that sound familiar. I had a job several years ago that looked like my dream job in terms of great subject matter, office, and coworkers, but within two years I was dying under a crushing workload, and when I begged for help I was told a variation of this same statement. I told my boss, “When a person is drowning, they don’t want to hear that you won’t throw them a life preserver because you’re trying to build a boat.” But nothing changed, and shortly after that, I cried in the car on the way home on the day I realized I would have to leave. I quit, and have a great job now, so all I can say is do what’s best for yourself, and remember that however perfect you thought this job was (or should have been), there’s something else out there that will be just as good but won’t suck you dry.

    1. SierraSkiing*

      Ooh. I love the idea of OP responding, if her boss says, “well, we’re working on hiring somebody someday…” responding with, “I’m drowning, and you’re telling me you’re building a boat that will pick me up someday. I need a life preserver I can hold on to now.”

      1. Aggretsuko*

        “Well, I guess I’ll be dead by the time you finish building that boat, then!”

        This doesn’t even shock me, honestly, it’s what we have going on here.

    2. Hey Karma, Over Here*

      “When a person is drowning, they don’t want to hear that you won’t throw them a life preserver because you’re trying to build a boat.”
      Hell yes.

    3. snoopythedog*

      I love the metaphor. The non-metaphorical version is basically “great, I hear you are in the hiring process; while that happens, what is the plan to ensure my workload is adjusted now?” (and then be silent until your manager outlines steps for how things will change for you right now, or you if they need to go higher up, you have a firm deadline of when they will get back to you (within the week)).

      1. corporate engineering layoff woo*

        Seven months without recognition of this… Definitely “adjusted now” but more like 5+ months ago.

    4. Phoenix from the ashes*

      I now have a one-cry policy for issues. Work issues, people issues, all of it. You make me cry, there’s going to be some big changes, and they’ll be for my benefit, not yours. Like many other people on here, I learned the hard way about what happens if you ignore all the warning signs and soldier on.

  19. HailRobonia*

    I’m dealing with a (luckily) less-intense but unsustainable version of this.. my team is understaffed and the replacement hire we have is effectively (though unofficially) assigned to another team. The problem is that my boss herself is covering multiple roles… her boss left and that position has not been filled so she is doing two jobs as well. Because she is relatively new she seems reluctant to escalate this problem to our executive director.

  20. ManagerInNameOnly*

    Hoo boy, I can sympathize with the OP. I worked as an RN for years, before leaving the profession and going back to admin/accounting/process work.
    There is a very strong tendency for management at medical facilities to get the maximum work done with the minimum number of people. (Insert rant about broken health care system here). My last nursing job was as Core Measures Coordinator (think case management, but from a Medicare/Medicaid compliance perspective rather than from a patient perspective). I saw the hospital ruthlessly fire many employees who had decades of tenure, for ‘performance issues’ that they had not been informed of, and coincidentally these employees were nearing retirement and vested in the old pension system that was probably out of money. I saw them reward my coworker nurses in case management for their exemplary performance, then weeks later bring in a ‘consultant’ who recommended they be fired. And they were. I told my manager that it appeared we were either going to close the hospital for lack of funds, or we were being bought out. Her answer – I can’t talk about that. So I found another job, and weeks later the hospital was bought out.
    I say all of this to tell you that things could be going on behind the scenes that you are not privy to, involving a buyout or closure. It’s one possible reason for them to refuse to fill openings and overwork existing employees. There is a lot of disruption and consolidation going on in the industry, and that’s not likely to change soon.
    My best advice to you is to take care of yourself above the needs of your employer. There are many great suggestions by other commenters here to limit your work load and let your boss know you’re struggling. But your boss may not have any real options either, if a closure or buyout is imminent. You may have to bail.
    It made me sad to leave nursing, but it probably saved my life. My health was in shambles, and I had several life-or-death episodes while all of this was happening. I make less money now working for a small company, but my health is better and I’m much happier. And I’m the unofficial company nurse, which gives me a lot of satisfaction for helping my coworkers.

      1. ManagerInNameOnly*

        Yeah, I should write a book. The few details I gave are only the TINY tip of a GIANT iceberg called Why It Sucks to Work in Healthcare.
        You go through a grueling and highly competitive educational experience, to work in an industry that is struggling with long term shortage of qualified employees, only to be treated like dirt. Meanwhile if you make mistakes, your license is at risk.
        Sigh… I love medicine, but hate the healthcare industry.

        1. Blueberry*

          I would buy that book and tell everyone I know to buy it, to warn them and to shout in agreement as I read it.

          1. ManagerInNameOnly*

            Solidarity, sister!
            It’s heartbreaking to come to the realization that this industry chews caring people up and spits them out.
            But I refuse to completely turn my back on my impulse to help people. I’ve become the go-to nurse for my extended family, friends and coworkers. It forces me to keep up with new information, and chases away the feeling that I wasted my education and career.
            I sure hope the industry wakes up, but sadly I believe they won’t.
            OP, I hope you are able to find a way to stay in the career you love while saving yourself from burnout. My heart goes out to you.

          2. Pomona Sprout*

            I would LOVE to read that book! I really hope you write it and that you announce it here at AAM.

  21. Please Don't*

    I find it very interesting that at the time OP applied for this job the other employee put in her notice. How long was the other person doing all this work alone? I suspect she was also burnt out especially as she left for a different field of work. Maybe she realized the only anybody would get hired would require her quitting.

    1. Hey Karma, Over Here*

      The plot has indeed thickened. Victim #1 stuck it out until they hired someone new then hit the road. VERY telling.

    2. The Man, Becky Lynch*

      I’m cynical enough to believe this plot.

      But I also personally hate the healthcare industry because it exhausts me. So I can think of 900 reasons the last person bounced to another industry.

    3. OP*

      The other employee was actually only in this position flying solo for a few weeks! I think the two previous employees got along well and worked very much as a team, so I think the timing of them both leaving was related, but not in that way.

      The one who gave notice when I was hired was very honest with me about her reasons for leaving (primarily compassion fatigue).

  22. Jeanne*

    If this is an inpatient facility, you can say that you will continue to meet the core requirements, but that patients will have to stay in hospital longer or under the care of the facility longer while you process all the work that you need to do for each patient. It doesn’t take many patients staying one or two nights longer for the costs to mount up. If you can put some figures together so you supervisor understands how much more it is costing the facility to have only you there, that may push them harder to fill the other position.

      1. Specialist*

        No, the patient doesn’t pay. The insurance will decide that the extra days aren’t reimbursable and the hospital eats the cost.

        1. Dragoning*

          …Not in the US.

          The insurance won’t pay it, the patient is getting a patently ridiculous bill.

          1. Specialist*

            I am a US attending physician.
            The patients won’t pay that bill, doesn’t really matter what anybody thinks. Ends up getting eaten.

            1. Andy*

              I am a former paralegal assisting consumers and attorneys with bankruptcy. People lose their homes, their credit scores and therefore clearance and jobs, their kids need to leave school midsemester for foreclsure, because of medical bill bankruptcy. Are some bills eaten? sure! But enough aren’t that people are impoverished. Sick people.

            2. BookishMiss*

              Insurance professional here. It depends on the denial. If the extra days are denied as non-covered, the patient could well be billed. It all depends on provider agreements and networks.

        2. Red Reader the Adulting Fairy*

          The attending physician also has to certify a medical need for continuing inpatient care beyond the original order, which will be run past the insurance company for approval anyway, so it may not even come to that.

      2. hbc*

        Unethical for the management in that case, but perfectly ethical for OP, no matter who is paying. She can’t leave a patient bleeding on the floor because she’s tired, but she can leave them in the competent care of others when she goes home for her shift.

  23. Heidi*

    I would start asking around about these slower-paced department jobs. It’s very common for employees to move around to different roles in different departments within a hospital system. You might find something where you can keep doing the enjoyable parts of your job without the stressful parts. People at all levels of healthcare are often working through one crisis at a time, and it’s possible that your supervisor and department head are just going to put hiring anyone on the back burner until your departure shoves it onto the front burner.

      1. Hosta*

        They also require you to be in good standing and not have any reprimands on your file for things like…..ohhh… Not providing care in a timely fashion, not discharging patients quick enough, not taking too much overtime because you had to stay late to chart the work you did, not getting patient complaints because there’s only one of you doing the work of two people and you’re too show for people who expect to be discharged now now now….

  24. Entry-Level Marcus*

    So how long is it reasonable for employers to ask someone to take on a significant increase in workload/responsibilities in a pinch? It seems like the consensus here is that refusing pitching in at all is (usually) unreasonable, it’s part of being a professional and team player, but that being asked to do so for 6+ months is not. Where is the line?

    I feel like being asked to do essentially two jobs for even a month or two is a lot to ask of someone. It can really mess with their work life balance and (both physical and mental) health.

    1. WellRed*

      No one should do two jobs, but if someone needs to fill in, there needs to be a conversation about what aspects of each job NEED to happen, and what can be put on the back burner.

    2. new kid*

      100% agree and I think the biggest thing for me is whether there’s a set end point and whether I see concrete effort to resolve the situation by those above me.

      For example, I recently ‘pitched in’ with a serious hit to work/life balance for several weeks on a time critical project that went underwater unexpectedly – but the difference was that with supportive teammates and executives it actually fostered a sense of camaraderie, there was an end point in sight (project go live), and the executives were appropriately apologetic and there was some level of compensation/acknowledgement of the extra effort + a debrief to avoid a repeat in the future.

      1. Ama*

        Yes, I have been at two different workplaces where I was asked to take on a bunch of new responsibilities. One time it was because there was a project just getting off the ground and the hiring processes were notoriously slow if a new position was being created– I was asked to fill in until they made their hire, which I was told would be 3-4 months. The only problem is, I was already overloaded and because I was doing the work pretty well they had no urgency to work on the new posting. The senior bosses ended up dithering around about what they wanted for well over a year, during which time I got fed up (they’d also been in complete denial about how overworked I already was even though I’d been asking for more help for two years) and ended up finding another job and giving notice the day they finally posted the new positions. The day I left my boss said to me “I’m trying to find a way to keep your position from being the dumping ground for everything,” and all I could think was “if you’d done that two years ago, this probably wouldn’t be my last day.”

        At my current job I had to step in when my then-boss had a serious health issue and went on medical leave for several months, and a few years later covered the duties of two people for a full summer when the person who had been doing some admin for my department left and it took longer than expected to fill my new admin position. Both times I got a ton of help and support from my colleagues and the senior bosses and also a nice spot bonus as a recognition for the extra work I did (I also ended up getting a big promotion and raise the first time because I did so well covering for my boss). I’ve now been at this employer more than twice as long as I was at the previous one and it isn’t because the workload hasn’t been challenging at times — it’s because when it is I feel like the extra effort I put in is both acknowledged and the senior bosses are trying to alleviate it as quickly as they can.

    3. hbc*

      It really depends on the details. I’ve covered two jobs for more than two months, but I did the bare minimum on the covered one, offloaded pieces of my normal job (at which I was a veteran) to others, and trashed any non-mandatory stuff that I would otherwise be working on. I didn’t have to put in many extra hours. And in some jobs, it just means your projects take twice as long, because you have to do both the graphics and the copy. Half the workforce, half the throughput.

      In this case, moving from alternating weekends to every weekend is, like, six weeks max. That’s before you get to extra hours on days you’d planned on working and skipping lunches and such.

  25. it_guy*

    I would definitely start by taking some much earned and most likely never taken vacation! Take at least a week and let them see how much is done by only you and see what happens.

    This will also give you a chance to decompress and recenter yourself.

    1. Aggretsuko*

      I’m thinking more along the lines of “Make it obvious that this is a sick leave because you are exhausted.” Then watch all the dominoes fall down while OP is out.

      Though…yeah, that might make the workload even worse when OP returns.

  26. hbc*

    Tell the department head that they need to move their selectivity bar from “we’re getting by, let’s get the best person” to “there is nobody to do this, get the next person in who won’t punch a patient.” Because they will be in that position sometime soon, whether it’s because you get another job or you suddenly go catatonic in the supply closet.

    I don’t think they’re deliberately counting on you running yourself ragged, but either way, the best thing for you, them, and the patients is for you to make clear that this literally cannot continue.

  27. Lisa*

    There is an immediate solution here that any hospital manager is aware off… Agency or Travel staff. Your manager can call in an agency case manager on a daily or weekly basis at a cost of 1.5x pay. Or, for improved consistency (because agencies wont necessarily send the same person, causing the need for you to frequently orient a new person), they can get a travel staffing CM for a 13 week contract at 2x pay.

    1. Blueberry*

      I was just trying to remember that term. I’m really glad you brought this up.
      OP, this this this! If there’s a staffing office at your place of work, go by and ask them about this (which agency they work with, etc).

  28. That Girl from Quinn's House*

    My experience in working places where we were “temporarily” short-staffed or in a crunch, was that they never change it. They like having their cake and eating it too, far too much to ever rectify it. They’ll just let you burn yourself out, and then shut down when you inevitably leave, because they’re figuring they’ll just milk you for all you’ve got before they make the decision to make service cuts.

  29. Specialist*

    The nation has a shortage of providers and hospital staff. The requirements for documentation in electronic medical records (much of it needless) and the inherent problems in the programs themselves (yes, Epic, you suck) means a loss of about 30% of productivity in a best case scenario. Insurance companies are now putting many more hurdles in the payment process. The last post op note I dictated shows that it took more than 6 months for the insurance to pay, and required additional letters to finally get reimbursement. It is not a good situation.

    Tell them you will need them to hire a traveler to fill the additional spot until they find the right permanent person. Spell out what you can and cannot do, and comment that the facility will be losing money on the additional length of stay. Schedule a vacation.

    They could have been swinging in people from other areas to cover some of the work.

    1. Lana Kane*

      I’m in healthcare and I cosign on all of this. This is an endemic issue in the industry and they will continue to let you be the only person, and look away as you eliminate all your breaks and work yourself to the ground.

      Stop skipping breaks, talk to your manager to let them know what you can and can’t do within the length of your shift. And as Specialist mentioned, see if they can get a traveler or someone else from the facility to help in the meantime.

      1. Perpal*

        Here I am, working on notes and chemo orders, 10 pm… I started at 7am… every day @-@ It doesn’t seem like it should be so much but all the time gets sucked up in coordination, documentation, etc
        When does the research happen? IDK.

  30. Jennifer Thneed*

    > I sometimes become dizzy from being unable to take my break to eat for 6-7 hours

    OP, please eat!! If the work will be unfinished when you go home regardless, then acknowledge that and *eat*your*meal*. I don’t know if you work at a desk: if so, eat while you work. Maybe you can’t take 30 minutes, but give yourself 10 minutes!

    Some people can miss a meal and just be very hungry, but others — like you and me — have stronger reactions, like getting dizzy, or getting headaches, or getting super-cranky. Your job is grinding you down, yes, but you don’t have to help it kill you.

    1. Ama*

      This stuck out to me, too.

      I have been in positions where it felt like I had to work constantly but like Jennifer I can’t miss meals or I get a pounding migraine. But I’ve also found when I am in a period of overwork forcing myself to leave my computer for at least 30 minutes, walking to go get lunch, and eating away from my desk (outside if it is nice enough, in the staff kitchen if it is not) is *crucial* to maintaining my sanity. If someone is going to get upset with me for taking half the lunch break I am entitled to (my employer’s handbook says our pay is based on a one hour lunch) then that’s their problem not mine — and also, OP, even though the previous sentence is what I tell myself to quiet my anxiety, no one has EVER begrudged me a lunch break even at my most dysfunctional employers. You are allowed to eat and take breaks!

    2. pamela voorhees*

      The problem is that the “unfinished work” might be stuff like “making sure someone is scheduled for surgery” or “making sure drugs aren’t interacting” – it’s simply not an option. It’s still incredibly important to prioritize yourself and you still absolutely should eat, but I don’t blame you for feeling like you can’t.

    3. Friendly Regional Government Worker*

      OP might be physically unable to eat if she isn’t at a desk… or if she’s at a desk with 50 “urgent” voicemails, plus calls coming in, plus an admin staff or subordinate who sees/knows OP is at her desk and transfers calls from people who urgently need to speak to OP.

      I’m not criticizing your point at all. I’ve been in a similar position to OP’s, where I was drinking protein shakes rather than eating solid food because I could answer the phone/review voicemails if I was in the office, or sneak the liquid meal in an opaque water bottle if a site director decided that ‘we’ were ‘working through’ lunch at my public safety agency. I point-blank refused to interrupt a colleague’s milk-expression breaks but some staff grumbled about ‘waiting’ for her.

      I honestly don’t know what would happen if an employee at my agency developed, say, insulin-dependent diabetes.

    4. silverpie*

      Agreed. Plus, if your blood sugar is going low enough that you’re getting dizzy, there’s a good chance it will affect your mental functioning. Which leads to getting things wrong, and it sounds like in this job, doing a bit wrong is even more dangerous than not doIn it at all…

  31. a1*

    they really encouraged me to set boundaries in how much I take on.

    It doesn’t sound like you’ve done this aside from the initial stab at that one meeting. Definitely talk your supervisor and department head again and tell them this needs re-calibrating. That you’re still doing too much. And yes, that you’ll leave if it keeps up. But I don’t think they can be blamed for not knowing, even if you think it should seem obvious, since you haven’t continued to re-calibrate and have these conversations.

  32. Indy Dem*

    I’m a case manager, but not in a hospital setting. Many of my current colleagues were hospital social workers/case managers, and sadly, this happens often. There are, in my state, nursing ratios that have to be maintained, but none for case management. I agree with Allison’s advice on letting your managers know what you are able to handle, and what the priorities need to be. And if the departments complain about your availability, refer them back to your manager and department head.
    Please also realize that there are case management jobs out there that are less stressful and more money than hospital based jobs, and that are still about helping people who need help, if you decide to move on.

    1. BeckySuz*

      Uh yes. My aunt owns a case management business (she’s an RN). She makes BOATLOADS of money. And the nurses that work for her are very well paid. Heck she has nurses that have other jobs but work for her very part time when she has too many patients. If you are good at your job you are very valuable. Start looking now while you wait for them to either fix it or blow you off.

  33. MCane*

    I burnt myself out at my previous job by never, ever saying no and doing whatever it took to fulfill the ridiculous expectations that were placed on me. Toward the end, I just broke and stopped caring. This taught me a couple of lessons:
    – I am the only one looking out for me.
    – Say no early and often. It is harder to argue you cannot handle increased work if you pick up the slack elsewhere in the organization.
    – My favorite motto is “this is a management problem.” I am doing the best I can, but I am done taking things personally and eating up my personal time to get work finished. If the company doesn’t want to listen to me, that isn’t my issue. I can only do so much and me taking it personally and burning my personal time on work problems when no one else cares, only hurts me.
    – I take a full lunch. Always. If I am expected to be in the office for 9 hours a day, I will be taking a full hour lunch. If I cannot get what needs to be done in 8 hours, that is a staffing problem, which is a management problem.
    – If a thing isn’t done at the end of the work day, that is a tomorrow problem. If a thing isn’t done at the end of a work week, that is a next week problem.

    I don’t live to work. I work to live. By many aspects of today’s society I seem unambitious, but I am not. I want to be very good at what I do and make a good living doing it. But I am not my job. I work so that I can do things with my family and friends and enjoy their company.

  34. Saielna*

    While not in the healthcare field, I was recently in a similar position. I managed for three months of receiving tech support calls at all hours, being expected to return to site after my normal work hours for needed assistance, programming equipment I had no familiarity with, and constantly having the workload of two people assigned to me.

    And it all built up. I was exhausted, working an average of 14 hours a day (side note – salaried exempt position that I was too quick to accept) . Never taking time to eat or take any breaks. Receiving calls as early as five am and as late as midnight. I was worn out. Crying in my office often. And the it happened.

    I had a panic attack driving home. I rolled my car but (thanks to my seatbelt) suffered no injuries other than bruises and relatively minor abrasions. I called my bosses to let them know I’d had an accident and that, due to my car being non operable because of it, I’d need to be off at least the next day, possibly the day after. They said fine. But it wasn’t.

    Instead of being human beings about it, their response was that a work truck was sent to my home at six the next morning to pick me up. And when I called and told them I COULD NOT be at work that day, because of how sore I was and needing to talk with insurance re my car, I was told that “anyone with a bit of training can do this, so get in here or you’re fired.”

    I quit instead. Three weeks later a former coworker was chatting with me and mentioned that they had to hire three people to replace me.

    1. A Simple Narwhal*

      You rolled your car and their only response was to send someone to pick you up??? They really thought the only thing preventing you from coming to work after an accident was a lack of transportation????? My jaw is on the floor.

      Good for you getting out, I hope you’re doing ok after your accident.

      1. Saielna*

        Yeah. Two of them even drove by me on the side of the road while I waited for assistance, and when I called mentioned that they’d seen me and thought it looked bad.

        The fact that neither of them tried to stop or check on me should’ve told me all I needed to know.

        And thanks, I’m much better. In a lower stress position at a reasonable workplace, and now the only people from old job I talk to are the few I liked. I still occasionally have an employee from old job call and ask me to provide tech support for them because “these guys aren’t as good”, and I take great pleasure in telling them it’s not my concern and they need to lose my number.

          1. 653-CXK*

            Second on that last sentence…it’s hard to tell desperate people to “lose [your] number” but not your circus, not your monkeys anymore.

            1. Pomona Sprout*

              No matter how desperate they are, though, it seems kind of … whackadoodle to me to call someone who DOESN’T WORK THERE ANYMORE to beg for help! Someone who is being paid by another company to do a job for THEM is supposed to drop everything to do work for YOU that they are NOT getting paid to do? Really!?

              These people need to stop and think, just for a moment, about how banana crackers that sounds.

  35. Lady Heather*

    Your manager ‘would rather the position stay empty than that hire the wrong person’?
    Is she wilfully blind or very unintelligent? The position isn’t empty, as evidenced by the fact that the work is getting done – because YOU’RE doing it!

    Sorry, OP. I feel for you. And I’m angry at your manager. If you don’t want to risk hiring the wrong person, that’s your call – find a solution. Ideally ‘picking up the slack yourself’ but ‘distributing the two dozen duties over two dozen current persons’ will do.

    Oh, this makes me angry.

    I hope things get better.

  36. OysterFellow*

    Don’t put your health in jeopardy for a corporate job. You’re not fighting bush fires, you’re ultimately lining the pockets of exec and shareholders. That’s NOT something to risk your health over.

    I was like you when I was young. Over the years, in HR, I’ve witnessed how companies will throw you away when it works for them. You can give them long nights, tears, and your heart and soul. But that doesn’t matter. Sure, there are great managers out there who will go to bat and try to keep you, make exceptions for you, or help you. But in the end, Acme Co sees you as a number and doesn’t care that you’re not eating lunch. In fact, they’re really happy that all this work is getting done for the price of one headcount!

    Hence the phrase “it’s not a problem because it’s not a problem.” Why would they hire another person when the work is getting done sufficiently with one? Where’s the problem?

    1. BrendanM*

      Everything you wrote, I’ve been thinking about lately.
      There are people at my company who seem to like “having” to work unpaid overtime all the time. In my group if we have a project manager come up to us way late in the process asking us to move heaven and earth to complete their project by their deadline, we like to say “we’re not saving an astronaut on Mars here”. What we do isn’t THAT important.

  37. TimeTravelR*

    I had something similar happen… more and more was piled on my plate. I kept telling them I could’t do it all. It was only when I just said, “OK these things will not get done” that they took me seriously and started hiring for a whole new separate position to do those things. Something I had been pushing for for a while. sigh.

  38. Viette*

    OP – I strongly agree that you should start applying for new jobs immediately. I’m a surgeon, and I was once in your position — I joined a 2-man practice and the person I joined promptly left for reasons unrelated to me. It wasn’t planned for, and it took 9 months for the administration to get anyone in to replace my partner. I was working at least 1.75FTE keeping up with patient care, and I told my administration flat-out that I couldn’t keep doing work at that level for more than 3-4 months. At 4.5 months, nothing had changed, so I applied for other jobs, and got one. At 9 months, I left, and was replaced by the new person. They were then scrabbling to hire someone to replace me.

    It’s easy to feel bad leaving a hospital because, when you’re massively overworked, you often reap massive rewards emotionally: patients and staff are incredibly grateful for what you’re doing and how hard you’re working for them. They *love* you for it! Don’t let it keep you there. Other places need you, too! They will also love you, and they will let you take a lunch break.

    Finally: I’m not trying to sound paranoid here, but don’t trust the administration when they say they’re so appreciative, and sorry, but please keep working like this for however much longer. They’re choosing to be “picky” about who they hire (maybe picky, maybe cheap, maybe lazy) despite your situation. That’s a choice they’re making. You get to choose to do something else.

    1. Friendly Regional Government Worker*

      I don’t doubt a word you’re saying, but it still baffles me that a SURGEON (as in, you’re a physician qualified to cut people open and sew different parts together to fix a problem?! That requires, what, a total of ~25 years of education in the US, from first grade to completing residency?) is treated this poorly by administrators. I can put a Band-Aid on a papercut in an office emergency, that’s it.

      1. Viette*

        You would think, but healthcare is a weird place. It’s normalized to be overworked, and there’s a real culture of, “if we tell you how incredibly grateful we are, that’s motivation enough”, as if there aren’t lots of ways to help others without being miserable all the time. And some healthcare workers do enjoy being “the hero” — wildly overworking themselves and getting adored for it. I was constantly told how amazing I was for doing all that work, which would have been very meaningful to some of the folks I’ve known over the years.

        Also, it’s very expensive to hire a surgeon, and it takes a long time, and it really sucks if you get a bad one. So they had a lot of good excuses to drag their feet.

  39. Anon for this*

    At my last job, there were typical 1-2 vacancies on a small team at any given time. In one case, the job was open for at least 18 months. The situation was not so critical as described here, because it didn’t involve taking care of live human beings, but the company’s perspective was very much of the opinion that they had to have an extremely high quality candidate before they would be offered a job. People were rejected for rather nit-picky reasons, in my opinion.

  40. Friendly Regional Government Worker*

    “ But in a medical facility, I’m guessing it’s likely that a lot of the stuff on your overflowing plate are things that must get done, period, because patients are involved and it’s not an option to say “we just won’t dispense medications / change bedpans / feed patients for now.”

    As usual, Allison is wise and sensitive on this aspect of OP’s problem. The ‘must get done’ problem applies to many (even all) jobs with core duties of serving/supervising vulnerable populations. Corrections officers, public defenders or prosecutors, emergency dispatchers- it’s typically not possible to use temp workers in these positions (though nurses/therapists in some state prisons can be required to serve shifts as guards, which is outrageously unfair and dangerous), so any work that can’t be completed by the assigned employee has to be “covered” by an existing employee or real people suffer immediate harm. And “covered” may mean “completed, but not as thoroughly/carefully/attentively if the employee wasn’t overworked and partly distracted.”

    It seems weird to say, but hiring shortfalls /management refusal to focus on hiring breaks my heart.

    1. OP*

      And “covered” may mean “completed, but not as thoroughly/carefully/attentively if the employee wasn’t overworked and partly distracted.”

      This is definitely something that I feel concern over, although I know it’s not actually my responsibility. Thank you for articulating it so clearly!

  41. Rick Tq*

    Contact the facility’s accrediting agency ASAP and report the chronic under-staffing issue. If your position is important enough for 7 day a week coverage on multiple shifts it is important enough to be correctly staffed

    Getting outside heat on the problem may be the only way to get it solved.

  42. Julie S.*

    What’s worse than having one employee do the job of two people? Having zero employees do the job of two people. If the employer promoted LW from a customer service position then why can’t they do it again? I know some jobs are hard to fill but that sounds like an excuse. My guess is the employer isn’t compensating LW for the wages/benefits for both positions. And who is liable and will be blamed for mistakes? The department head or LW? I’d start job searching as a backup plan because the employer might be giving lip service without a real desire to fill the second position. I wouldn’t want to start a job search after getting blamed. There’s also a big risk if the employer receives grants or public funding. Malpractice is another issue. I used to think that I owed my employer allegiance. Now I see it as an employer-employee relationship where I’m compensated in exchange for my labor and skill set. I highly appreciate a good employer and work hard but I’ve learned that I don’t owe anybody my health or well being. The LW might have the same duties as before but it’s not the same job that LW enjoyed.

  43. Been there done that*

    I work in the medical field and IMO, facilities understaff on purpose to keep costs down. They’ll never hire a second person if they think you can/will do all the work by yourself. If you don’t let them know that the current situation isn’t sustainable, they will just keep the position vacant.

    I’ve seen this happen so much.

    1. Julie S.*

      The medical field has to be the worst industry to understaff. So many critical jobs from the hospital orderlies to doctors. Everybody has a role in patient care and this stuff can be life or death.

  44. PSU RN*

    Chronic understaffing is a huge issue in healthcare. Also, the acuity of patients is much higher, and ancillary resources have greatly decreased. There is no nursing shortage, just a shortage of licensed nurses willing to work in hospital under abysmal conditions risking their license with no support from hospital administration. I am a long time reader and would be curious to see a health care related AAM thread…those are the stories that would curl your toes! Married department head physician sleeps with 18 year old care technician, she ends up pregnant and fired. RN goes on patient transport on 7p to 7a shift and gives up assignment with the promise that when she comes back at 6 am she won’t have an assignment. The ambulance gets into a fender bender and the RN returns at 6:30 am without eating lunch to be told, sorry you were in a car accident but we need you to take this urgent stroke patient. The RN takes the patient and finishes her shift, then goes down to the ER to get checked out at 8 am. Pregnant RN water breaks and labor begins, she finishes the last 3 hours of her shift and gives report before going down to maternity. Angry physician throws charts. Angry surgeon throws surgical tools. Angry patients assault nurses. Angry family members assault nurses. These are all events I have witnessed or been the RN. Also, hospitals hire new grads at the lower end of the pay scale because they don’t want to pay the salaries for older more experienced RN that have the maturity and experience to push back when things are dangerous. This is the culture of employment in healthcare, so this is what the letter writer is dealing with.

    1. PSU RN*

      And don’t even get me started on calling in sick when you work in healthcare….you must be dead before you can call in sick. Literally.

    2. ManagerInNameOnly*

      Add my vote to the calls for a healthcare thread!
      Allison, if you want weird/disturbing/horrifying stories, healthcare is a gold mine. I was an ER nurse for a while, and was assaulted by patients or visitors at least once a week. We had to add a new code (in addition to Code Red, Code Blue, etc) for doctors assaulting the medical staff. See PSU RN’s comment about doctors throwing charts and instruments.
      She’s also right on the money about hiring new grads. But it’s more than that. Experienced nurses like me get fed up with the assaults, risking their license, and administration throwing them under the bus. So we quit patient care. This is a big contributor to the shortage issue.
      So why don’t I just go into teaching? I would have to go back, at my age, and get a Masters degree. OK, I could do that if it was worth it. So how much do nursing instructors make? Far less than I make now as an admin/bookkeeper/process guru, working for a small company. And so the nursing shortage continues until the system either changes or falls apart.
      And this matters so much, because people’s lives are literally at risk here. Pretty much everyone will eventually be admitted to a hospital at some point in their lives. If you only knew what went on behind the scenes, you would be horrified.

  45. Zach*

    OP, I hope that this situation improves for you and that they do hire someone else!

    That said, looking for a new job is never a bad idea. A friend/former coworker of mine had this happen to him when we worked together (in a totally different industry). They never replaced the person he was covering and repeatedly refused to give him a raise even though they kept implying they would do both. Just saying that so you don’t get strung along with false promises.

    Either way, good luck!

  46. OP*

    Hi all!

    Alison, thank you for your insightful advice, and thank you to the commenters for your thoughtful and sympathetic responses! I wasn’t able to reply to them yesterday as I was at work, but I actually already have an update!

    I had been hearing for months that they were trying to bring someone in as a part-time temp to help cover some core, time-sensitive responsibilities during our busiest hours- I hadn’t really expected it to ever become a reality at this point (thus leaving it out of the letter entirely), but I got the good news last week and she actually started yesterday!

    It’s not a permanent solution but it definitely gives me a reprieve and time to be thoughtful about my next steps.

  47. Rust1783*

    I was in a very similar situation, and it still angers me to look back on it. I was a fundraiser for a special program at a big university with a rigid administrative structure. A colleague in a slightly higher position left and I was basically assigned all of her duties, which included big financial targets and stuff like gift planning that I had never done before, with no salary increase. At the time I was at the bottom of the scale at $50K and the person whose job I inherited had been making $125K. The job was overwhelming but I managed it pretty well, working frequent 10 hour days and weekends with lots of travel.

    When I advocated for a title and salary change, I was shot down with practically no discussion by my boss’s boss, the dean, because “that’s a director level position and you are currently an associate” as though that was just the end of it, and my actual boss, our department head, bizarrely had no influence to do anything. Yet I was actually doing the director job, and very successfully, in addition to my other duties.

    After about 18 months of me doing two jobs myself, they finally reassigned someone who already had the director title to our department, and my department head quickly made me report to her instead of him. I was so mad about it that I quit soon after and I made my reasoning very clear to the dean.

  48. Former Crisis Field Manager*

    OP – I’m curious as to how long your position was open before you were hired? Did your coworker experience the same thing you are? Glad for the positive update- as a former crisis worker, I can relate to how terrible healthcare management can be as well!

  49. Tim C.*

    I am commenting a bit late but I hope it helps. I have been in this situation as have others.

    You need to think of some self preservation. I am guessing you are in a licensed position. This means there are rules and outcomes you would be held accountable for. While trying to manage the chaos, you make a bad error. I doubt anyone will come and lay blame on management for the workload or conditions. State regulators could place all the blame on yourself. You may become unemployable while trying to recover from terrible guilt.

    Set the limits your boss has mentioned. At the end of the day, email a list of things not accomplished. Address the most pressing and no more. Refer complaints back to your management. Go home on time, take your breaks. You are not winning anything by trying to make this situation work. Nobody takes advantage of you without your permission.

    I would rather face unemployment than make a mistake.

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