I was terminated abruptly at the end of a 12 week orientation from my first RN job as a new graduate. During the final week, I attempted to take a full patient load with minimal supervision. During that week I had an accidental needle stick (to myself) the first day, spiked my own finger with an IV bag spike the second day, and missed a med pass on the third day (I think it was to one patient, I hope it wasn't more -- I don't know because I wasn't aware that it happened until talking to my preceptor after the termination). I attribute these errors to feeling pushed to go faster than I could safely manage. (I take full responsibility and am not blaming anyone.)
The following week I reported for my end-of-orientation meeting with the manager/supervisor and director and was let go. I never had a written performance appraisal or any meeting/input from the manager, director, or nurse educator during my entire tenure, just suggestions on improving from my preceptor. I was never warned that I could be facing termination. The reason given during the meeting was not progressing fast enough, not able to manage full load independently, and that unit was too fast-paced and too acute for my abilities. They were not willing or able to extend the orientation further. I was also advised on termination that other units in the hospital with less acuity would be more appropriate for my present skill levels and was encouraged to apply.
My preceptor told me at 8 to 10 weeks that I was not progressing as quickly as expected due to problems with organization, focus, time-management issues, and medications knowledge. At 10 to 11 weeks I asked her how she felt I was doing. She said "How do YOU think you're doing?" I said I thought it was going better, but that I still needed to get faster at charting, organizing, giving report, etc. She said she thought I'd made "a LOT of progress." During the following week, I continued to work on improving my speed and organization. She called me after learning of my termination and said it came as a complete surprise to her. We talked about the reasons for termination which she thought were the same issues as above -- meds, time management, focus, plus feedback from other nurses who'd noticed the same problems, and then the med omission the final night. She thought I should try long term care skilled nursing facilities as a next step to concentrate on meds and basic nursing skills in a setting with lower acuity.
My confidence is shot. I am fearful of having the same problems in my next position. I don't know if anyone will ever hire me again.
I feel I need to somehow rehabilitate my career. I am determined to somehow succeed as a nurse. In reading this forum, it seems like time management, organization, focusing, and confidence are common problems for the first 6 months to a year. I know that the experienced nurses on the unit also had trouble keeping up with the pace and acuity at times.
I have thought of asking HR for an exit interview to try and find out more about the reasons for termination, but have been told by others on this forum and other employment experts, that I may never know the real reason. However, not having any documented performance reviews leaves one to wonder if there were other issues involved. I am a much older worker and age could certainly have been involved. (I heard a totally inappropriate reference to my age during the last hour of my employment before termination... so one has to wonder what other employees were saying...).
The important thing for me now is to know how to fix what is broken -- is it my skills, my ability to focus and concentrate, my knowledge or lack of same? And how does one go about fixing these things, then convincing a prospective employer that you have addressed these issues....It all just seems so impossible at the moment.
I have purchasd a book on time management for nurses that includes CEU's and am working my way through it. I'm completing other CEU's, reviewing my nursing texts, skills, meds, etc. I'll put the CEU's on my resume and explain my other plans to remedy my deficit areas. I could use suggestions on how to communicate this to prospective employers.
Any other direction and suggestions would be much appreciated. I feel I am in the same boat as the poster on another thread who recently lost her job during orientation and questions her/his "hire-ability" -- I feel I have few options and a career that is swamped and sinking.
Thank you so much! Your words of support mean more to me than I can say. I am taking your suggestions to heart and your advice about moving forward, too.
Regarding the Brain Sheets: we printed off a a narrative written shift report at the start of each shift. It was a densely packed paragraph and not in any consistent order. I had trouble getting all the information sorted into usable, organized places. Plus there were orders to review, and other things to note from the electronic chart. This seemed to take more time than I could find, even though I came in up to a half hour early on many occasions.
No one seemed to be using a brain sheet, everyone did something different-- my preceptor just kept an hour sheet with times listed down the page and wrote "med" at the hours each patient's meds were due. Another just wrote little notes to herself on a scratch pad. Another had a list of charting areas and assessment items that she checked off as she went.
There were so many things that I just never learned to get organized and it seemed like there was never any time to do it. My preceptor seemed to be directing my movements, so that I never was able to look at the report and get it organized. It was weird. I always felt if I took a minute or two to try to organize my thoughts or my tasks, or look up a med, that I was seen as slowing things down. There were many times I was told, "No, don't do that, do this now." That seemed to undermine my confidence even further. Then I was told I needed to be more confident. I always felt like I was losing the game and didn't even understand the rules!
If I said there was something I didn't know how to do, but that I had been shown once, I was told, "Now, (my name), you KNOW how to do that." In sort of a scolding way. I'm sorry, but if I felt sketchy about something, was it wrong to ask to be shown it again, or given a chance to practice it a couple times with the preceptor? This happened mainly with hanging IV's -- I was just so nervous about making a mistake that I felt the need to go over it a couple times before feeling really comfortable doing it.
I know I'm venting... I hope I'm not excusing my own failings or placing unwarranted blame. I know they were all trying to help, but it just didn't seem to be working for me. I'm really just trying to express how I felt, so that I can try to figure out how to avoid these difficulties in the future. (As you can tell, I'm still a bit confused about the whole thing!)
Maybe our styles were just too different -- a mismatch between my learning style and the preceptors' teaching styles... And it's true that my preceptor had to take care of a full load with me in tow/ or vice versa. We were all under time pressure most of the time. I felt apologetic about taking bathroom breaks, and forget a real break. We would usually take a lunch break for up to a half hour after about seven hours of non-stop running, then go back to work for another 6 hours without a break. Sometimes it was 13 hours straight with no breaks or lunch. NURSING IS HARD!!
Last edit by Flatlander on Sep 7, '12