ICU RN let go after 3 months

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Worked at a Level 1 Trauma Center, great learning experience. Floor orientation lasted 11 weeks total. 7 weeks working 2 twelve hour shifts/week on the floor and the rest of the 80 hour pay period being in the classroom. After finishing the class work, I worked 4 weeks on the floor working 3 12's/week.

My whole goal going in was to try to soak up as much as I could from my experience as possible, when on the floor I used a notebook to write down important notes about the unit. Always studied at home after work as I am single and had the time to do it so I would know the pathophysiology and fill the gaps of when I had questions medications, procedures, or conditions. I had it down so well I was able to draw the circulation of blood from the aortic arch to all the cerebral arteries where strokes were common (not too hard). Got to know and continued learning the different types of aneurysms, procedures, how they were done, I learned so much everyday... I always tried to help other people when asked.

However, I didn't get along with and tried to get along with my preceptor but personality wise we were just different. I asked a lot of questions as I am new, but with every question my preceptor always asked "why/what do think is going on?" so I would be in the middle of trying to figure out multiple drips for a patient and ask for tips on how to hook them up and get the "how do think they should be hooked up?" question back for example. I wouldn't know and eventually my preceptor would help me after trying to figure out how while family members of the patient in the room watched me struggle to figure it out. Looking back I should have asked for a different preceptor. Anyways, towards the end of my probationary period, I asked my preceptor how I was doing, and got the answer that I would be on my own in a couple of weeks. Then come to find out, my last day of my probation period, my preceptor didn't show up, called in "sick". Later in the day, I was called to the unit managers office to be notified that I wasn't a good fit for the unit. Much to my bewilderment, the main reason cited is that I didn't understand the pathophysiology and conditions well enough. I was so shocked at the moment and was basically speechless and didn't see any use in arguing with my manager about it considering that whose word would my manager take someone who has worked for 8 plus years or someone who worked for 11 weeks? However, I was referred to another unit within the hospital, but I still want to be in an icu and my manager said that I couldn't use them as a reference to get in another icu. Long rant, but would I be crazy to apply to an icu at another hospital and how do I sell my story?

A second interview? Geez, sounds like a prestigious hospital and or nursing position. Don't know many places that require a second interview. Yah, hopefully you will get a position that you like and is a good fit. It's difficult to tell how well a interview went. Sometimes it may be they have already selected the candidate, but have to interview a certain amount of people for some HR policy the institution has. I know one thing for sure after having a few interviews, is everybody asks the same questions. How important is customer service? Give me an example of when you went above and beyond to provide customer service. What is your greatest strength? What is you greatest weakness? Give an example of when yourself and a coworker has a disagreement and describe what happened to resolve that disagreement. Why should we select you out of all the other candidates for this position?

Funny thing is when I had my interview for my previous ICU position, it was one on one with the manager of the unit, lasted less than 30 minutes, then I went on the unit for a while to see what it was like. That's it. My other interviews (for med/surg and tele units) have had two or more people asking all the awkward interview questions with a duration of at least an hour or more. Then a tour of the unit.

One of the better questions I had was from a one of the senior nurses that was invited in on the interview that works on a med/surg unit she asked "What would you do if somebody needed to go to the bathroom but couldn't get out of bed?" I had sort of a confused look on my face as I thought it was maybe a trick question, but replied "I would put them on the bedpan." I guess she was trying to see if I was going to ask for a nurse aid to do it because she explained that a lot of nurses ask the nurse aid to do that even when the RN can easily do it them self.

I took the contingent offer and gave myself a few weeks before my start date in hopes that I can find something with benefits before that. I know the pay is on the low side considering the hospital is a trauma 1 center in a major metropolitan city, and also is a good drive from my house. Not to sound pompous, but hey, if they want to keep the nurse retention saga going, I'm going to contribute to it.

Pay nurses right, give us reasonable acuity ratios (I think there ought to be a country or at least per state patient ratio based on a easy to follow formula based off acuity) and compensate loyal nurses. From what I have already have heard from nurses who stay at their position for many years (like 8 or more years) is that they get paid a lot less per hour then someone who jumps around every year to a different hospital. Unless you work in an area you absolutely love. Whats the point in keeping a job other than getting your check to pay off the bills. And yes you are making a difference by helping other people and that feels great, but in what nursing job would you not be making a difference?

I have had many interviews also and those were a lot of the same questions I had.. But the bedpan one! Good logical answer and I think any good nurse would get her hands dirty and would have no problem doing that for a patient! So yea... A second interview ?! This is a first and it's a great position in a great hospital but this is a first for me. I've had interviews with 4 people at one time or Several the same day and one after the other. It's crazy but I'm getting better and better at interviewing ! I agree about the ratio and also the pay! But the key is to get a foot in and get experience and then either go where you want to really work or where the money is. I love being a nurse but where I am at the average entry level pay is 26-28.00 an hour so If i have to drive far to work, I would want to make that or more to cover travel!

It's funny how God give you what you need to hear I to just finished Orientation and was told it was not working.... I was upset @ first and starting douting my skills I've been a nurse for 6yrs on the same unit and I needed to grow and learn because I felt stagnated. I was no longer learning anything new, so I took a chance and left my first a job, that was like home to me but this baby needed to fly and explore needless to say it didn't work out I was let go in the middle day on my last day of orientation. I have not told any one but my Husband because out of shame and embarassment.... I feel like ------ But anyway I know I have to come to grips with this and let people know but just not yet ..... Still a little sad

Learning21 , sorry you had to go through that. I felt the same way as you, I too didn't tell only but a few people. I'd think that with 6 years experience you shouldn't have any difficulty finding another job or even going back to what you did before. I wanted to wait a little before applying for jobs, but the sooner you go back to work the better (at least it was for me). This may seem like a set back, but it's probably for the best. You would think that there would be a better way than to let you go in the middle of the day. Just wondering if you got any warnings for your work performance. I did, my manager was vague saying that "I needed some more support" handed me a sheet, which had a checklist of tasks she wanted me to fill out throughout the day like having my plan of care/head to toe assessment done before 10am. Looking back, I didn't harm anyone, I had no medication errors. I believe that when I was let go there was no other reason than personality differences. I didn't have much in common with many people at work, so I didn't know what to talk about with them. I wanted to just go to work and do just what I thought I was hired for - to work - not to try to make friends.

If there is one thing I did learn, it's important to quickly assess how cliquey the unit is that you are working in. If it is really cliquey, than some how you need to find a way into the group. Talk about things you aren't interested in, do what ever you have to do, stick it out, put your time in (to at least make it long enough to get another job) than get the **** out of there.

You might be questioning yourself right now, don't, the sooner you get back to working the better it gets.

Specializes in Public Health Nurse.
I would like to begin my reply by stating that I have been an RN for 33 years ( next month), have an MSN in cardiopulmonary nursing ( teaching option ) from SLU , and have 16+ years working in critical care, 16+ years in hospital supervision, and 8+ years teaching nursing clinicals ( incl. critical care nursing clinicals ). That being said, I am extremely sorry something like this happened to you. I am very deeply disturbed about your experience, both from critical care nursing and from educational points of view ( even though incidents like this occur more and more frequently ). Nearly each sentence you wrote contains management and education " red flags". I am a firm believer that nurses should not " eat their young" and you were not only eaten, but devoured and digested. I only hope the horrible scars of this incident do not permanently damage you !!!! First I want you to remember that not all nurses should be preceptors/educators. It takes a special person to be an educator. You must possess nurturing abilities as well as abilities to UNDERSTAND and abide by principles of adult learning. Too many times preceptors are chosen simply because they " have worked there a long time ". Unfortunately they do not understand or have been exposed to adult learning theory. The responses given you by your preceptor ( while trying to stimulate critical thinking) were inappropriate given the fact you are new to critical care. You were not an experienced critical care nurse ------ if you would have known the answer, you would not have asked the question !!! No question is stupid, esp when it comes to orientation!!!!! Another problem I have is with what happened your final day of orientation. I would sum it up as unforgivable ! I want you to always remember that a cardinal rule of management is that items brought up on an evaluation should NEVER be a surprise to the employee!!!! Clearly feedback to you about your performance was clearly lacking. You should have received WEEKLY evaluations from your preceptor that should have included strengths/ weaknesses, areas for improvement, and goals for the upcoming week. If you were not making satisfactory progress, your preceptor should have been communicating such information to both you and the nurse manager and appropriate interventions should have been developed by both the nurse manager and your preceptor. If you were not going to satisfactorily complete your orientation, you should have known about it LONG before the last day of an 11 week orientation !!!!!! In addition , your preceptor should have been present when you were given the bad news in order to provide feedback !!!!! I hope this helps you in some small way deal with the horrible psychological trauma you experienced with this situation and can move on and become the really good ICU nurse you can !!!! I would gladly be willing to talk to you more about this situation on the phone if you would like. . Sincerely , Bruce M. Pomeroy, MSN, RN. God Bless and wishing you continued success !!!!!

Mr. Pomeroy, would you be my preceptor? :bowingpur

As newly licensed RN (found out this Monday I passed the boards), I am coming here to allnurses very frequently in the last few days, to congratulate those who also just passed, to be the cheerleader to those who will soon take the NCLEX, but also to become more informed and prepared to what I will soon face when looking for a job.

I have read so many posts where new nurses are not getting the amount necessary for orientation, or being precepted by new nurses themselves. One even posted stating he was being precepted by an experienced LPN who just got her RN-license about three months ago herself, but had been working in that unit for several years - how can she be precepting when she is learning a new role herself? The preceptee was also terminated for making errors - did not even get to 90 days if I remember correctly, and this person also stated that he was not assigned one preceptor but several during his short orientation.

How can I; well we, newly licensed RNs, make sure without sounding arrogant, that we desire to be properly trained and oriented by a preceptor with the qualities you describe should have? I have read also that when getting the job they are told of ratios that in reality are far greater - an issue that really concerns me as well.

I ask, because my biggest fear is signing on the dotted line (everyone here requires a contract), to then go through what this O/P faced or others and not have the ability to even leave because of the contract.

I want to be a safe nurse, I want to work for a facility where patient safety is their priority and not profit. Is this unrealistic too?

My termination on the last day of orientation was similar to rn_wee's. It came as a complete surprise and shock from two managers who never spoke to me more than "Hi, how're you doing?" during my entire orientation. My preceptor was totally surprised when she returned to work the following week and found I was "gone." Bruce, you are absolutely right. It was a psychological trauma, and though I am a new nurse, I knew intuitively that what they had done was just plain wrong. There were no formal evaluations at frequent intervals, only my preceptor's concern that "you're not progressing as fast as expected." And "you need to keep working on time management and charting to speed up your work." etc. Thank you for your kind words to rn_wee. I'm going to copy your post and pin it above my desk. Thank you, thank you, thank you!

Specializes in LTC.

I was let go after 3 months from a LTCsituation. I have a BSN but could find no other work I live in NY and no hospitals, home care agencies respond to resumes. I have applied within 100 mile radius. When I was let go I was told it was because I had faxed the wrong med list into pharmacy, which was interesting because I only had that one patient's chart in front of me AND my unit manager handed me the list as she was ostensibly trying to help as it was my first admit on my own. Stupidly, I trusted her and did not look at the list in detail. During my firing, I was never shown the list and the unit manager was not present. In addition, I was accused of being 45 minutes late on a tube feed that same night. I was also having to deal with a resident who had recently fallen and who was continually trying to stand and walk from her wheelchair. I had discussed this problem with the nursing sup the prior Friday and since our unit was always short staffed for aides, I was told that an aide could be brought from another unit while I did my med pass. The resident in question had known osteoporosis and I was terrified of her falling and determined it would not happen on my watch. The following Monday, the night of the supposedly wrong med list, a different sup was on duty and I was told that no aide could be brought from another floor as they were all short staffed chronically. I was told that I must bring the resident with me on my med pass while I ran in and out of resident's rooms giving meds and listen for her chair alarm which meant she was trying to stand. At that point I had to drop what I was doing and run to protect her. All of this restulted in my getting my first and only needlestick injury. By the way I had 20 residents to care for, multi dressing changes etc. My point is that I only received one feedback session from the DON during the 3 months I was there. It was apparently not the UM's responsibility. The only feedback I got from coworkers was how was I doing working on my speed. After reading your very informative post, I now realize that there are so many new grads that no one cares about training us properly or what terrible experiences as above will do to our psyches going forward after the firing. The fact of the matter is that they can find 20 more who look just like you pounding on the door begging for a chance. To add insult to injury, I began receiving dunning.notices a few months back for a workers comp case I had with that facility. A few days prior to my firing, the same resident had assaulted me and I wound up with a sprained wrist. The facility one year after the fact had never paid the doctor thru workmen's comp and the doctor was trying to bill me $321.00. I have no insurance now and have only been able to find a part time clerical job (in a hospital where they were not interested in me as a new grad nurse). I had to fight them like a tiger but it seems now that it has finally been paid. Initially they tried to claim there was no incident report. Of course, I knew there was and when I started threatening them with NYS workers comp board then they suddenly found it. Like I said it appears that it does not matter to anyone how new nurses are treated because you are easily replaceable and expendable.

Specializes in Psych, Informatics, Biostatistics.

Sorry to hear of everyone's experiences. Just supports my thoughts that 'nurses eat their young.' Unfortunate, but true.

I'm permanently burning Bruce Pomeroy's post into my brain for future reference(!)--Thank you Mr. Pomeroy!

So glad others have experiences similar to mine. I worked in a SNF for two years and an LTACH for two years before taking a level one trauma ICU job and ended up resigning. Albeit, the LTACH I worked on had many ICU components (drips, vents, tele, bedside procedures etc...), but I originally was given five weeks of orientation, then extended to ten weeks and then I was asked to resign being that my manager still did not feel I was ready to be on my on and HR would not extend my orientation. I had a performance improvement plan in place which I met all my goals in, took into account the constructive criticism I received and was supposed to move to night shift, but one day I had an awful day, got behind and made some charting mistakes (first job using any computer charting system, mind you) and accidentally delayed reporting an elevated temperature because I was behind. No ill effects that I know of occurred from this (I believe I would be told if so). I had two different preceptors during my orientation. My second preceptor taught me to organize and time manage better, but was also very hard on me. Most staff on the floor, including my preceptor, made me scared to ask questions because with five years of experience they considered me "an experienced nurse" and would either stare at me or tell me "you should know this by now". After my first 5 weeks of orientation, my manager did consider moving me to step down, however the manager of step down did not like that I wanted to eventually return to ICU and my own manager decided against the move as well based on the fact that the patient population on step down was so different from the current ICU I was to come back to. I had been scheduled to work the week they asked me to resign. I have been able to apply to the hospital as an internal candidate, but the only interview I've had was one with a smaller ICU and, although I thought the interview went well, I did not get the position. I was encouraged by the manager of the smaller ICU I interviewed with to continue to work on the ECCO course through the hospital for the future as the membership is active for a year, but I found the hospital recently cancelled my subscription. This honestly makes me feel embarrassed and anxious. I am content with moving to even med/surg within the hospital, but I don't get calls for interviews. I also would really like to increase my knowledge of critical care while right now I'm out of a job, but my ECCO was cancelled. Very frustrating, especially since my manager made it sound like they want to rehire me and HR is aware of the issue (I have tried to reach out to HR and I am getting no responses). I really hope things get better. I would like to stay working for the current network I am in and gain skills in a lower level of acuity and work my way up.

The best reflection of how well a preceptor or educator is performing at their job, is the overall or general outcome/success of their student or students. If more than one person isn't performing to their expected standards, or aren't showing signs of improvement and growth, then in my personal opinion their teachers have not been effective.

Specializes in ICU, PACU.

Sadly, some nurses are unhappy people and take it out on new people. it just is. Next time, ask fewer questions, listen more, and give yourself time to absorb. Not all nurses are like this. you will show your competence in your actions. Never bad mouth your last job, even though you believe you were treated unfairly. take the high road. we don't have to love everyone, but we do have to work together.

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