I am a new nurse, graduated May 2010. My first job was in home health, I was then offered a job at the local hospital 3 months later and I snagged it. I work on the cardiovascular/telemetry unit for 4 months before my husband received orders to move.
I started my new job on the PCU in December. I just got off orientation 2 weeks ago.
The day of the incident: The day was going great, I had four Pt's I had the day before so I was fairly familiar with them. I was actually caught up with all of my documentation (for once!) by midday. I was then told 2 of my Pt's would be transferred. As I was finishing giving report, the ED was beeping in to give me report. Anyways, one Pt came in at 1700, the other at 1800, this is where it all went to chaos.
I should have prepared early and gave my 5 o'clock meds at 4, but I didn't. So after admitting the Pt's and doing their assessments, answering family member's questions (you know the drill) it was 1830, the night shift was starting to come in and I haven't filled out the report sheet yet. After I do that, I give report and it's now 1925. I have completely forgotten about the 5 o'clock meds, and I start working on my admission paperwork. I then see that I didn't give my meds. The night nurse asks me about it and I tell her I haven't given them yet, it is unclear whether she says she will give them or not. So I wrap up my paperwork (Which I shouldn't have done...putting paperwork ahead of care). I notice on the MAR that the night nurse didn't give the meds and she is very busy with the Pt's I gave her. I head to the pyxis, double check to see if she has taken out the 5 o'clock meds and she hasen't. So I take them out and give them to the Pt (klor con, long acting insulin). I then head home, making sure my cell is by me all night in case the night nurse has any questions, assume everything is ok when I went to bed that night.
The next afternoon I receive a call that there was a "medication situation" and my floor manager wants to talk tomorrow morning. She says she is concerned about my errors, lack of time management and critical thinking, and suggests the possibility of putting me on orientation again. The nursing supervisor then comes in and says that I would be better off on a med/surg floor. I asked if I was getting fired and she said not yet. They will meet with the HR and the VP and let me know tomorrow.
I am quite sure I am getting fired though because the nursing supervisor was set on it. I have never even received a warning. I know I ended up giving the meds 4 hours late, but it was long acting insulin (note: his sugar was 409 that AM, and he's a diabetic that just had limbs amputated b/c of his DM) and PO klor con. THe big issue was the night nurse gave short acting insulin a half hour later.
By no means do I not feel completely accountable for my actions! But I think half the reason I was fired is because I am too passive, I didn't put up a big enough fight for them to keep me. Quite frankly, I wasn't expecting to have to fight to keep my job, I thought I would get written up. I am so confused, hurt and disappointed and I don't know what to do next. Should I put this job on my resume? Have any of you been fired before?
Feb 17, '12
Quote from Vespertinas
You also shouldn't pursue your case at the expense of sounding argumentative.
meant to say, "at the *risk* of sounding argumentative."
Quote from betterlatethannever
you were focused on the paperwork instead of treating the patient
In today's environment, she would just as easily get in trouble for doing it the other way around. I'm afraid the takeaway lesson here may be "if it comes down to it, your documentation goes last" which I only WISH were the truth. A new grad may take that quite literally without understanding the dangers.
Quote from Deredain
In regards to being on probation and the facility being able to dismiss you for "any" reason is against the law.
Ever heard of "employment-at-will"? Yeah, it's a doozy.
edit: yeaaah sorry, didn't see that someone already covered that
Last edit by Vespertinas on Feb 17, '12
Quote from PeepnBiscuitsRN
I had a lot of trouble with time management and getting my critical thinking skills up to snuff when I first started working in a hospital (I had a year "off" while I searched for a job, and became more and more pregnant). I never got written up or a warning, except my educator telling me quite sternly that my preceptors were not giving positive feedback. That was after 3 weeks. I'm saying that because I can sympathize about getting overwhelmed, I can. However, your nurse manager mentioned several things on top if this med error. She mentioned time management, critical thinking and med errors
. So...have there been other med errors besides this one? It sounds like this might have been the straw that broke the camel's back, so to speak. You understand now in hindsight you should have done the meds an hour early. That's good, you see that now. Or when your admits came, you could have popped your head in to see if they were stable, and if they were, you could have just said "hey, I'll let you get settled a minute and I'm just going to make sure my other patients are good before I come back and give you the third degree
. That's generally how I handle it when I come on at 2300 and am presented (whoopie!) with an admit at 2310.
Maybe your supervisor will be surprisingly willing to help you get onto a new floor, especially if she senses that you're truly trying to make it work. Never underestimate a good attitude. (I'm not saying you don't have one...I'm just saying sincerity goes a loooong way.)
Just to clarify, this was the first med error I made (typo). When I was coming off of orientation, we talked about time management because I kept running behind, but everything would still get done, it would just be paperwork that needed to be done. As for critical thinking, she would always mention not too worry, that it would come with time. This is the first time prioritizing was mentioned and I was the one to mention it when we were talking about what I should have done.
Thank you for understanding the chaos of being new and for the tips on what to do with an admit... I will definitely do that next time!
Last edit by TheCommuter on Feb 17, '12
: Reason: quotation blocks