Fired for giving Med late

  1. 0
    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?
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  3. 42 Comments so far...

  4. 2
    I assume that this facility is not unionized.

    Anyhow, most workplaces have a probationary period of either 90 days or 180 days. During this period of time, management can terminate your employment at any time and for any reason that they see fit. Moreover, the employee can resign during the probationary period at any time and for any reason.

    The probation period is supposed to be an opportunity for both parties to test the waters and see if the employee is a good fit for the organization and vise versa. This is why I advise all people to be on their very best behavior during the first few months of employment at a new place. Once the probationary time frame has elapsed, management will have a more difficult time getting rid of the employee because the process of progressive discipline will need to be utilized and documented every step of the way.

    Personally, I would not count on any coworker to finish a job that I have left undone, especially at a new facility where they do not know you well. Regardless of the outcome, good luck to you!
    joanna73 and DixieRedHead like this.
  5. 2
    You should be able to describe your situation without sounding defensive. I think it's important that this situation is documented in your words. You also shouldn't pursue your case at the expense of sounding argumentative. I would offer a willingness to go back on orientation just to spare your job. If the job market were different, I'd say that maybe you could look elsewhere but being a new grad with 2 brief employments, your prospects wouldn't be good after this.
    aachavez and KelRN215 like this.
  6. 0
    You need to review your policy manual or employee handbook to see if this type of situation is covered. Your union or bargaining unit might have some suggestions for you as well. The failure to give a med error might be a "critical error" that is listed as an offense that you can be terminated for.

    In regards to being on probation and the facility being able to dismiss you for "any" reason is against the law. They have to have due cause to fire anyone, even those on probation.

    Good luck.
  7. 1
    I see this as an opportune incident for the employer to decide you were not the employee they wanted. I doubt that you could have argued your way out of it. It goes without saying that you will need to be more careful in a future job.
    SuesquatchRN likes this.
  8. 13
    With my user name being betterlatethennever its only appropriate I respond. So here it goes. Giving meds 4 hours late is not acceptable under any circumstances. This is not late its a med error. You mention the big issue was the night nurse gave a short acting insulin 1/2 hour later after you gave the long acting insulin. I don't understand how this is the big issue. The big issue was you gave important meds (especially diabetic blood sugar in the 400's in the am, what was it when you got him,already suffered complications from diabetes with recent amputations,remember DKA) you were focused on the paperwork instead of treating the patient. I seriouly doubt your NM fired you for being passive. There is always more to the story. You did not prioritize. Nobody is perfect we all make mistakes but the people who can recognize,accept and learn from them will show growth. Pick yourself up,dust yourself off and keep it moving. And yes you will need to list this on your resume. Best of luck to you
    Bortaz, RN, joanna73, sharpeimom, and 10 others like this.
  9. 2
    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.)
    paddler and beckster_01 like this.
  10. 3
    Quote from Deredain
    You need to review your policy manual or employee handbook to see if this type of situation is covered. Your union or bargaining unit might have some suggestions for you as well. The failure to give a med error might be a "critical error" that is listed as an offense that you can be terminated for.

    In regards to being on probation and the facility being able to dismiss you for "any" reason is against the law. They have to have due cause to fire anyone, even those on probation.

    Good luck.
    Sorry, the above (bolded) is untrue. If you are an "employee at will", either you or the employer can terminate the employment relationship for any reason or no reason at all. Certain states have laws that provide more protection to the employee, but not all. Not all nurses are covered by union contracts.

    At-will employment - Wikipedia, the free encyclopedia

    I do not know where you or the OP practice, but this is how it is in the US.
  11. 3
    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
    SuesquatchRN, KelRN215, and fiveofpeep like this.
  12. 0
    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


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