I got fired today... - page 5

1. 
   Dec 8, '12

   Quote from imintrouble

   You and I are on the same page. The default is 0900 and 2100, but there are other selections such as 0600 and 1800, 0900 and 1500....
   that have to be entered manually. The problem is unit secretarys that don't pay attention to the prior order and administration times.
   
   Because I've been hung by the above scenario a time or two, I'm careful about checking those drugs that are customarily weaned. But it takes alot of time.

   Any way the RN can override the secretary's order entry? Or to note on the order in red ink that the new times should be 06 and 18 before the secretary gets it? If everybody does their due diligence then this shouldn't be an issue.
2. 
   Dec 8, '12

   Quote from Mulan

   It seems like the pharmacy sound be responsible for knowing when it was last given and adjust the time accordingly, that's been my experience.

   
   Pharmacists go home at 7P. Arrive at 9A.
   Small rural hospitals don't have the luxury of around the clock pharmacist. Therefore, what happens when they're not there, doesn't get verified until well into the AM.
3. 
   Dec 8, '12

   It's unfortunately that the manager of your unit didn't think about re education for you, instead of just termination. Many new nurse and experienced nurses make a medication error and mostly of the time education is what is needed. Also the preceptor should have been more focus on your professional development as a RN. As a new grad, you will need to speak up for yourself and always ask for clarification on things even it appears dumb or stupid to (you) new grad.
4. 
   Dec 8, '12

   Quote from samadams8

   The whole thing sounds screwy. Betcha somehow you weren't liked or they found someone they liked better for some reason, or there is some kind of game going on. Your mistakes were not Fire-worthy in the bigger scheme of things, especially for being a new nurse.There's a game afoot. I've seen this at other places.This sounds like a potentially toxic environment. Seriously. The whole thing is asinine, and I wouldn't want to work there....and I'm a very good nurse. Something is wrong there.Considered yourself blessed. Write a strong letter to admin and appropriate people w/i this place, and then don't look back.I'm not saying you were right, but I have seen much worse mistakes, and nurses and doctors that have made them grew to be great in their roles. This is a bad environment. The way it sounds, they would have just continued to make your life there miserable. You can do much better..seriously...I'm not talking sour grapes, sweet lemons.

   a similar situation happend to me getting terminated in my first 90, i suspected there was some dislike of me for some reason...i dont know why, hadnt really been around long enough for them to get to "KNOW" me...
   
   i was getting ragged on for MY documention. howwever the nurses who have been there for many years with MANY MANY years of experience, would not even do an assessment, well at least it wasnt charted but they were still around. whatever dude.
   
   i think that things happen for a reason, and im destined for something better and so is the OP.
   
   we just gotta keep our heads up so we see that great opportunity coming for us
5. 
   Dec 8, '12

   Quote from janfrn

   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.

   
   You are correct. This is a system's error/ FAILURE, which one single nurse paid dearly for. This is a Nursing Informatics problem. The Informatics nurse(MSN) needs to either redesign the electronic MAR or go to the IT department for them to make changes the electronic MAR.
   
   Here is where a bigger blame lies- will that facility's nursing administration ever go to that nurse they fired and tell them that---NO!!! The admistration is never that accountable or responsible for their screw up's or mis judgments; Which we all know. This is why I post nursing administrations and hospital administrations are negligent. Never do they do any kind of self reflection on where they possibly could have screwed up or failed. It's always "the nurse"!! I call it like I see it.
   
   Oh, The Nursing" powers that be" that manadated in my area that all nurses must have their BSN's to gain employment, are going to be sorry they shoved this old diploma RN into getting their BSN. I now know about the world of Nursing Informatics, I'm getting "edgiee cated".

   Last edit by kcmylorn on Dec 8, '12
6. 
   Dec 8, '12

   Quote from Merenda

   It’s unfortunately that the manager of your unit didn't think about re education for you, instead of just termination. Many new nurse and experienced nurses make a medication error and mostly of the time education is what is needed. Also the preceptor should have been more focus on your professional development as a RN. As a new grad, you will need to speak up for yourself and always ask for clarification on things even it appears dumb or stupid to (you) new grad.

   Here's another novel though- Wouldn't it have been more logical and more ECOMONICAL to get the education depart on this and have them spend time with this new nurse- Oh NO, We have to give the nursing managment practice in filling out termination paperwork because isn't that what it's all about, filling out the papers correctly and spending/wasting more healthcare dollars on orienting a second nurse to fill the same spot so we can continue to cry and belly ache to the government and Congress that we are not getting enough money from the CMS for reimbursement. And go have some horses's behind from the American Hospital Association tell the Congress how poor we hospitals are. We need more money to run a hosital and need larger reimbursement from the CMS- I say get out the ink pen and slash some more funding to these hospitals. Find out what hosptial all those AHA members who signed that pertion this week and slash some more money, budget cuts to their hospitals for wasting taxpayer time and money listening to this dribble.
   
   I can remember screaming about this very thing on this site months ago.Cost them less money to remediate a nurse than to fire and replace. ( these a word we haven't heard in eonons- REMEDIATE) Gotta love these hospital CEO's and administrations. Spend spend spend and waste waste waste and cry baby, cry baby, cry baby. I hope they have lots of tissues in these budget hearings so these snot balls don't have to use their expensive suit jacket sleeves. This is why we don't have any money to hire more nurses and take care of patient's- Customer survey forms aren't going to fix it folks.
   
   And I look at it also this way, How many of us are going to continue to sit back and watch these multimillion dollar CEO wage earners bleed our Medicare money out of the system so there won't be anything left for us in 2,3,4,5,years when we need it. The hospital CEO's will have it all spent on their fiscal waste, mismanagment and continued frivilous spending sprees. Boo Whoo

   Last edit by kcmylorn on Dec 8, '12
7. 
   Dec 8, '12

   This seems like a good reseach project. Cost of termination and replacement of a nurse VS remediation of a nurse.
   
   Where's "Commuter" from Cowtown, she likes to do research projects. I think the results of this might be very interesting reading.
8. 
   Dec 8, '12

   Quote from ProfRN4

   I'm not disagreeing with the role development comment. However, students are (repetitively) given critical thinking questions, scenarios, and simulations (the Sims we do in our school are often more about thinking and problem solving than physical tasks, yet they all are dying to 'give' something.
   
   All new RNs are deemed (minimally) competent. Questions are so situational these days, requiring much more than memorization. While I don't dispute Benners theory per se, the current healthcare culture demands much more of new grads, do they need to be forced out of that task-oriented mentality.
   
   Regarding how competent the preceptor is: we'll never really know. We also cannot assume that this preceptor does not enjoy her job. perhaps she was given a full and/or heavy caseload, on top of precepting. the $value in many hospitals in inconsequential. I still maintain that the time change is something that is out of the realm of the recent graduate RN.

   ProfRN4- in the simulation labs, is it not the perfect time to be 'intensely' working on and right on top of these students if need be, to molding these critical thinking skills. Should that not be the repetitive drills. Put the breaks on their wanting to jump to "giving" something but drilling them over and over of why they are thinking in that direction, why are these things happening senarios. These drills in critical thinking should be as grueling as learning nursing tasks were in my nursing school days.I can remember back then, being asked why are you putting in that foley in this patient( the answer was not because the doctor said so)? , why are you inserting that NGT?, and what equipment do you need to do those things- right down to the safety pin for the patient gown for the NGT. Do you ever use Second Life in your instruction? Have them create the entire day in the life of an RN on a hospital unit from start of shift and on going.
9. 
   Dec 9, '12

   Quote from janfrn

   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.

   As I see it, the responsibility falls on whichever nurse is acknowledging the order. That nurse should check the MAR for the previous administration time and then reschedule the new orders to maintain the intervals.
   
   This is one of those problems that's created by the computerized system and default admin times.
10. 
    Dec 11, '12

    What was your med error?
11. 
    Dec 11, '12

    You got fired for THAT? Sounds unfair. Not to mention that you DID question the order with the preceptor who didn't seem very helpful. Whatever happened to remediation or extending the orientation. Seems a little harsh for a novice nurse.
12. 
    Dec 11, '12

    When I was a brand new nurse(a long time ago) there was an MD order written for Demerol 50 mg/Vistaril 25 mg IVP. So I gave it. Pharmacy caught the error(Vistaril is never to be given IV). No harm came to the pt, I had to attend a remedial pharmacology class, I was written up and I never ever made that mistake again. We are all human.
13. 
    Dec 11, '12

    Quote from funkmarv

    @EchoRNC711.
    
    Just read your response to the OP. I was moved by your wisdom and compassion. If everyone was like you in the global scheme of things ,the whole world would be a better place. God bless you.( My apologies if my spiritual leaning don't sit well with you)

    I totally agree, I am a new grad, working 4 months, and I would have absolutely loved to have a preceptor with your caring attitude for my orientation (if that's what you would call it-I got barely 4 weeks and I was only "closely supervised" for half of it). The nursing world would be so much better for new grads like us if our teachers were all like you!

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