I got fired today... - page 5

by patrickh_rn | 17,955 Views | 64 Comments

I'm officially fired from my first RN job today. My manager suspended me starting from last Thursday due to my medication error, which happened on Sunday, 25th. I made two errors during my orientation period, and those two errors... Read More


  1. 1
    To bbuerke
    No, just these two incidents. The manager would do a review with my preceptor every week to see my current progress. Except those two incidents, the manager told me that small things such as prioritizing, group several tasks into one visit per room, walk in and walk out the room fast, morning rounds, and shift report will be difficult at first and they are pretty common among new grads.

    So yeah, critical thinking such as whether to administer BP meds if patient's bp is 106/80 (Turned out that I do have to follow the parameter for that, if the order says hold if BP < 90 or HR <60 I hold. If not, give it. So yeah that's one thing I learned, no mistake happened here.), take Vitals before giving any BP/HR meds, check BS 8, 12, and 17, assess pain for every patient Q4/Q1 after pain med, the 8 rights of meds. Yeah, I learned a lot from this.

    I thought I was doing really well and I was about the change to night shift next week. So... well, things happen and I just have to adapt to this fortunate/unfortunate event quick, find a new job and move on.
    There were a lot of nurses who I met that stopped and asked me where I was going and what happened when I clocked out. Something squeezed me so hard that I have to smile and tear out at the same time. They helped me a lot and this is how I'm going to repay my gratitude? =( I developed a great relationship with the CNA and some RN's there. Dream shatters, that's how we create a new one, right? hah..

    Thanks, I will do my best. I'm still somehow sad and have doubts about my own characteristic. But I'm sure I will be fine soon.. Thanks for the support guys =D

    Quote from Ntheboat2
    I didn't read every single post so this may have already been said, and I might be way off...

    But...is there a language barrier issue involved here? Some of the things I read made me say, "huh?"

    So, I wonder if when you asked the nurse and "she said it was okay" if she didn't really understand what you had asked? If that's the case then she did have the obligation (to the patients if nothing else) to clarify what was being asked no matter how awkward it would've been. I was just talking to a former classmate the other day and even after asking questions, I never had any clue what she was talking about. Luckily, it wasn't anything important so I just nodded and said "yeah."

    I just wonder if a language barrier played a role in all this.
    Possible, but in this case, not really. I still have to work on my grammar in writing, and I do have times that people cannot understand my words when I talk too fast. Yet it's been the 9th time I work with her and I believe the preceptor understand what I was saying. She will clarify with me when she cannot understand what I said and I will say the same thing again to her just to make sure she understands.

    Quote from LilgirlRN
    Sounds to me like you should have had a better orientation. When you hear the words "nurses eat their young" consider this an example. The solumedrol... that extra dose probably helped your patient! I'm not saying that you weren't wrong in giving the double dose but its not something that you would have gotten into major trouble for. If the patient is on oxygen just sitting in the bed then they need oxygen even more when they are up walking around. Hindsight is always 20/20. I know here in Birmingham, AL at UAB they have nurse internships for new grads. Maybe someone has something like that in your area?
    I liked the orientation, pretty informative. Still, I guess the main reason that they terminated me was because, like what others replied in this post, I was still in probation and can just let me go easily. That O2 patient was actually weaned off from the oxygen for 2 hours and her O2 was around 93-94%. (She didn't like that thing on her nose and kept taking it off, so we decided not to put it back and it seemed like she was doing okay) So yes bad me I should have just waited for my preceptor and tell the doctor that I wasn't comfortable doing this and I have to wait for my preceptor.

    Can you clarify this part? I don't think the one I had is considered as internships. It would be much longer.
    "Hindsight is always 20/20. I know here in Birmingham, AL at UAB they have nurse internships for new grads. Maybe someone has something like that in your area?"
    Last edit by NotReady4PrimeTime on Dec 8, '12
    echoRNC711 likes this.
  2. 0
    First, I am very sorry you lost your job. As a new nurse, that can be very discouraging. The key is learning from you mistakes. We all make them but paying close attention to MD orders are CRITICAL! If I have a doubt about a med order, I usually call the MD but if the MD is an intern (I work at a level 1 trauma center) I call the pharmacist. Typically if an order is modified for the same med and it's been administered already, I just give the new dose at the next time interval. Essentially, that's what should've hanppened here. All of this believe it or not will make you a better nurse. As for your preceptor, she should've been more prudent and reviewed the MAR with you. It would've have taken a few seconds and would've prevented this from happening. ...Stay encouraged and as a new grad...please have a drug reference book with you! I cannot stress this enough. Btw, I am an RN with 7 almost 8 years experience but the bulk of my experience was in case management. After being bored and a souring job market, I decided to go back to the bedside. I spent 11 months on a trauma med/surg unit and I was blessed to be hired in the trauma/surgical ICU. So essentially, I feel like a new grad. I am okay with that because it has humbled me to really learn and not be afraid to ask questions or look stupid. I feel I will be rewarded in the end and will become a better nurse overall. I think you should consider that, dust yourself off and try again..Peace and blessings to you!
    Last edit by traumaicurn73 on Dec 8, '12 : Reason: pressed enter too soon
  3. 5
    Quote from LilgirlRN
    Sounds to me like you should have had a better orientation. When you hear the words "nurses eat their young" consider this an example. The solumedrol... that extra dose probably helped your patient!
    If the patient was so in need of an extra dose of solumedrol, then why did they start weaning it and cut it from TID to BID?
    imintrouble, dudette10, BelgianRN, and 2 others like this.
  4. 0
    Not to stir the pot .... but on orientation, and even now, I find some of the best resources are asking pharmacists and the doctors ( most of them are less likey to run to management everytime you don' t know something). Orientation and new jobs are hit and miss , I have seen preceptors with worse judgement than yours so they wouldnt care about most errors, But there are ones that take note of every thing and there are indeed new grads who are pretty good with clinical skills and very good with critical thinking and implementing it. nurses are a dime a dozen. maybe you were let go for other reasons you might not even know about? maybe someone who was important enough or in management just didnt like you? or knew of a better candidate? all those are part of "fit" and why many places require a peer interview. Good luck next time
  5. 1
    OP, I'm very sorry you were fired. It seemed that your workplace did not have an effective plan to nurture and train new grads. I can relate somewhat to your post. I made mistakes during my time in ICU, but my primary preceptor was awesome and we worked out the kinks.
    It was some of the other nurses on the unit that weren't so forgiving and felt that my asking questions was a sign of incompetence. Always, always, always asks questions. If you get that feeling in your gut that something isn't right, please ask. I learned the hard way as well. I am a natural leader as EchoRN described, so it was very hard for me to ask. Then, I had to reevaluate and realize that I had to have enough insight to know what I know, and know what I don't know.

    Even, with my mistakes I still was not fired. I did eventually resign, because I felt I was not a good fit with the unit and I'd rather resign than to get fired.

    Don't let this keep you down. Own what you did, and request to be transferred to another floor. Request a meeting with HR and your boss. I think a less acuity of patients would be great.

    Nothing is more painful then your first RN job not panning out. However, you have learned from this.

    Take care, and you WILL be okay.
    bbuerke likes this.
  6. 0
    I am sorry about what happened to you but remember but there's a good side to everything and something precious to learn. I am a new nurse too and what I noticed is that there are lots of hidden traps in nursing, things that only matter when **** hits the fan otherwise they look like these anal retentive things. Training is poor in nursing as I'm finding out. Some nurses, older and experienced and willing to teach will make sure you learn these traps others will not tell you at all almost like they want you to fall right in it. There are a lot of hidden ones in charting...you must CYA all the time in the minimum details. Things like if you have a TO/RB I write exactly what the doctor said like in quotes, if you note some order make sure all the orders are completely functional and don't assume that they are and there are a million of other ones. I never heard of this one with the O2...wow.
  7. 0
    The Solu Medrol mistake happens alot where I work.
    Every 6 hrs, 0000, 0600, 1200, 1800 means a dose is given at 0600 by nights. They leave, the MD changes order to BID, that defaults to 0900 and 2100. The day nurse then gives a dose at 0900. Double dose, and nobody on days is the wiser.

    As far as the O2 goes, that's simply a judgement call.
    I'm sorry you were fired. Very few things make you feel lower.
    Lots of us have been fired, and still work as nurses. Good luck.
  8. 1
    Quote from imintrouble
    The Solu Medrol mistake happens alot where I work.
    Every 6 hrs, 0000, 0600, 1200, 1800 means a dose is given at 0600 by nights. They leave, the MD changes order to BID, that defaults to 0900 and 2100. The day nurse then gives a dose at 0900. Double dose, and nobody on days is the wiser.
    That strikes me as a system problem. If it's happening all the time then perhaps there needs to be an alternate BID standard administration timetable.
    ProfRN4 likes this.
  9. 0
    Quote from OnlybyHisgraceRN
    OP, I'm very sorry you were fired. It seemed that your workplace did not have an effective plan to nurture and train new grads. I can relate somewhat to your post. I made mistakes during my time in ICU, but my primary preceptor was awesome and we worked out the kinks.
    It does seem like that to me as well. Although, I have seen things applied inconsistently; so likeability and favoritism is also a sad factor.

    Objective systems, applied consistently, invoving everyone--NM, preceptor, nurse, and nurse educator, should all be on board and consistent.


    Personally, I don't agree that a nurse on orientation, should be necessarily discussed, in terms of behavior and evaluation, apart from that nurse being present as well.

    Keep things uniform, objective, consistent, and reduce the levels of subjective nonsense. MAJOR PROBLEM IN NURSING. . .MAJOR. Orientation and "precepting" programs have seem to have gotten worse over the last several years. If there is not a system that is primarily objective in analysis and evaluation processes, it is JUNK. UTTER BS.

    Time must be allocated for extra documentation from all parties--that's another problem I see. There is overload during the orientation process for the preceptor and the preceptee. It's funny that nursing so often fails to use the nursing process when it comes to educating and orienting their own.

    So remove the stumbling block of adding more or higher acuity patients, until things get more streamlined with the new orientee. That means meeting certain criteria--specified, and objectively analyzed. But still keep things objective, uniform, consistent, professional. Don't put off prognostic indicator evaluations for this week until next week. Nurses on orientation, please hear me. DO NOT let them turf these evaluations. If they aren't willing to invest the time, objectively, professionally, consistently each and every week, THAT IS A HUGE RED FLAG. I don't care what is happening on the floor or unit. If one day it's kill-zone, make sure it gets done the next day. Scan everything for subjectivity. Yes, you can't avoid it entirely, but it's important that it be limited. IMHO, too many decisions are made in nursing mgt with people on orientation based predominately on subjective nonsense.
    Last edit by samadams8 on Dec 8, '12
  10. 0
    So you made some errors...and I'd say they were pretty "minor" ones and def no grounds to have been fired. Ur preceptor and u d/c the pt's O2 2 hrs ago which meant the preceptor was aware of the change. You took the pt for a walk, she/he got SOB, you got help, sat the pt down and wheeled her back to bed. Which is the right thing.
    Ur preceptor def failed you I wld say...feigning ignorance or memory loss when interrogated....as a preceptor, she sld be equally responsible. Ur in orientations where mistakes are EXPECTED TO HAPPEN, not encouraged obviously, but it is expected and when it happens, your preceptor sld help you learn from it.
    I agree with the others who said that there were other reasons they dismissed you...you prob did not fit in their "clique" (yes some ppl never leave high school).
    I had a preceptor who I was positive wanted me fired, spoke to me so condescendingly, and wld write a full blown essay about what i did wrong. Then there was the other who told me that I din have to bother counting liquid narcotic from the Pyxes (I blame myself for this) and o'cos my dumb ass didn't and the next day my manager interrogation me like i was a drug dealer. Ugh awful.
    But don let this affect you negatively. You are still learning and it is a shame that more experienced nurses on a power trip cldnt be bother to guide us newbies more effectively. Better urself as a nurse, think hard n think smart of every task u do...it will become second nature eventually and will only improve ur nsg skills. Appear confident, not cocky, at all times, even when asking questions and always let ur preceptor know what u know so that they know that u are thinking hard n smart about it.
    Fake it till u make it they say. But remember, pt safety comes before everything!!!
    Not the most diplomatic or cohesive comment but hope you get my point. All the best you u!


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