I feel rotton

DeLana_RN, BSN, RN · Oct 13, 2006

I cannot believe the number of threads lately about nurses being fired. In orientation, no less. I just can't understand this -- nobody expects new grads to know everything, just to be able to function safely and competently and know when to seek help. Unless someone makes an egregious error or has proven him or herself unsafe in multiple situations, I just don't understand why any facility would turn away an orientee they have taken the time and expense to orient.
Or at least help them find a more suitable placement within the facility.
I don't get it.

My situation (as posted above) was very similar to that of Romeo4u-RN; I assure you that I was neither ignorant nor incompetent, or I could hardly have gotten my BSN magna cum laude. Nor did I make any serious med error or any serious mistake like you infer. I worked hard and had a very positive experience with the very challenging patient population we had (mostly CA, AIDS, and sickle cell crisis).

Sadly, the same cannot be said for the staff - a head nurse who was an antisocial bigot and her minions (who either agreed or at least went along with it; although some of her charge nurses and especially one assistant manager were nice to me in private, none of them warned me or stood up for me when it mattered).

My short-comings were typical ones of new grads: lack of time management, but how was I supposed to learn it anyway? The "orientation" method consisted mainly of: first week, "this is where everything is". Subsequent weeks: increase the patient load by 1 or more until the maximum (7) for day shift was reached. That was basically it. Another word for it: Throw them to the wolves.

Why does this happen to new grads? In some ways they're more vulnerable than seasoned nurses. Unless they worked on the floor or unit they want to start in as a PCT or extern (highly recommended!), they usually lack the inside information about the place; this head nurse's rep preceeded her - but I was totally oblivious to it. When I asked my nursing instructors, the best I got was "She runs a tight ship." That's an understatement... I can't understand why they weren't more explicit.

New grads can also be dangerously idealistic and naive - just out of school, they might just do what they were encouraged to do and make suggestions about improvements on the floor; dictators don't normally appreciate this kind of thing that I'm undoubtedly guilty of. Mind you, I wasn't young (35) and had been in the business world for years; but nothing there prepared me for the reality - and politics - of nursing.

Why didn't I immediately put in for a transfer when I first saw that all was not well in Oz? First, I was in some kind of denial (this can't be happening when she made a statement so outrageous - sorry, I can't put it on a public board, I doubt anyone would even believe it). However, she was undoubtedly trying to get me quit right then - however, I was not to stay in her hospital (which happens to just be the major one in this area). And I frankly didn't want to go anywhere else... ironically, I ended up having to do that anyway 'cause she made good on her promise that I would not be able to transfer internally

Let's not forget that this happened in '98 - I sure hope this kind of head nurse (she insisted on using this archaic term when everyone else was nurse manager) is not tolerated anymore today. But if it is, and one of you new grads happens to (by some very bad luck, I assure you) end up on such a floor, please listen to your inner voice and RUN when you can and before she can fire you or force you to quit (for years, I had to endure the question "Have you ever been fired or been asked to resign?" on applications. Thankfully, most employers have now dropped it.)

In hindsight, I think I would have been fine if I had been able to transfer internally, if there had been reason to suggest that I leave my original position (and help to find a more suitable position); it was very different from the situation OP finds herself in, and yet, I do understand her disappointment.

Hica19, I wish you the very best. Please don't let this discourage you. It's hard right now, I know, but you will soon feel better.

DeLana :)

wonderbee, BSN, RN · Oct 13, 2006

I cannot believe the number of threads lately about nurses being fired. In orientation, no less. I just can't understand this -- nobody expects new grads to know everything, just to be able to function safely and competently and know when to seek help. Unless someone makes an egregious error or has proven him or herself unsafe in multiple situations, I just don't understand why any facility would turn away an orientee they have taken the time and expense to orient.
Or at least help them find a more suitable placement within the facility.
I don't get it.

I think that too much is being asked of hospital floor nurses in general, and it's getting worse instead of better. Throw into that the higher acuity of the inpatient population and the popular notion that every new grad can transition straight from nursing school into a critical care unit. It's a recipe for failure.

I also like the idea of a didactic year of school, and two years of nothing but clinical experiences before graduating, and a wider variety at that such as more OR time. I only observed one case. We're only being exposed to snippets of the truth. It does not do us or the profession justice. School is easy. The hard part is everything that comes after.

OP, I am having a similar experience with my critical care position and am getting out. I don't think of it as a mistake but rather a learning experience. I've learned that 1) there's a nursing shortage for good reason; 2) It may take a while to find that right niche as a nurse, and 3) listen to my gut. I KNEW I was in over my head a while back and it would have been better to act on it then.

There's no shame in all of this. Don't let it get you down. There's a big world of nursing out there and you will find your little corner of it.

TXNurseBSN · Oct 13, 2006

I cannot believe the number of threads lately about nurses being fired. In orientation, no less. I just can't understand this -- nobody expects new grads to know everything, just to be able to function safely and competently and know when to seek help. Unless someone makes an egregious error or has proven him or herself unsafe in multiple situations, I just don't understand why any facility would turn away an orientee they have taken the time and expense to orient.
Or at least help them find a more suitable placement within the facility.
I don't get it.

I agree. Plus, they should at least let you finish all of your orientation, not just half. Those 4 weeks could have made a big diiference in your abilities!

jjjoy, LPN · Oct 13, 2006

It upsets me to see new grads throwing in the towel and accepting lower acuity assignments when all they need is, usually, a little extra precepting and nurturing.

And what ARE "lower acuity" assignments? When I was let go at the end of my 2-month preceptorship (which comes out to only about 14 actual shifts), they didn't offer to find me something else in the hospital. They suggested something "less acute." When I spoke with a couple of people in subacute units, they immediately made the point that while the patients WERE less acute, the work was just as demanding and anyone who had trouble on a med-surg unit wouldn't do better there (I wasn't interviewing at that point, just information gathering). I later took a job with a LTC facility. Very low acuity, but impossible to do the job without cutting corners that shouldn't be cut. I figured we had no more than 4 minutes/patient to pass meds to folks who needed BP readings, pills crushed, etc. No support or suggestions, just a dismissive "everyone else manages, you should be able too." I quit after a few weeks. I didn't want a clinical job that badly.

Pediatric Critical Care Columnist · Oct 13, 2006

...they should at least let you finish all of your orientation, not just half. Those 4 weeks could have made a big diiference in your abilities!

There may be a contractual reason why that wasn't what happened. Our collective agreement in Alberta provides for a probationary period of 503.75 hours worked, during which time either party may terminate employment without recourse. So if Nancy Nurse isn't performing at the required level at hour 400, having had an evaluation previously and given opportunity to adjust, she may be returned to her former position if she had one, or go elsewhere. Or if Nancy Nurse decides at hour 502 that she's not really cut out for the job, or it isn't what she thought, or she doesn't like the paint on the walls, she can return to the position she vacated or go elsewhere. No recriminations, no excuses. That said, if no one has made the effort to communicate their concerns over Nancy Nurse's ability to perform the job at hand until hour 504, then it's too late and there's nothing that can be done.

This happened a couple of years ago to me. I was preceptoring someone, a new grad with a stellar educational pedigree, who wasn't making the grade by midway through her orientation period of 16 weeks. I communicated this to the educator and to the nurse herself. At around this time she made a lot of switches to her schedule and I didn't work with her again until just before her 16 weeks were up. She had not made any further progress to that point and I was gravely concerned that we were going to have a problem with her. I communicated all of this to the educator and management, in writing, but basically the horse wasn't only out of the barn, it was halfway to the next county. A few months after she completed orientation, she nearly killed a patient. She no longer works in our unit, but it was her choice to leave, not anything we were able to do.

ortess1971 · Oct 14, 2006

Were you working on a PICU? And weren't you aware of the level of acuity when you accepted the position? I'm not trying to be a pest, here, I'm just genuinely curious why you would accept a position, and why the facility would hire you, for something that you admit you can't handle.
What were your shortcomings? Time management? Prioritization? All these things come with time. It upsets me to see new grads throwing in the towel and accepting lower acuity assignments when all they need is, usually, a little extra precepting and nurturing.

Many high acuity areas are following the new trend of hiring new grads into their areas. These new grads can do well but only if the unit realizes that they've hired a new grad and are prepared to truly help them succeed. Many DONs and staff are inadequate at orienting someone properly and are still caught up in the "I got a trial through fire, why shouldn't you" method of precepting. To the OP, you will surmount this. Like someone said, it's happened to many people. This feels horrible now, but it will make you wiser and stronger.