got fired for "clinical issues"... will I find a job??

Mulan · Sep 12, 2011

What was the lab? Did any harm result?

I would think that would make a difference, a simple explanation may be all that is necessary.

However, isn't that a big JCAHO thing, calling a critical lab? We have a special place to document it and I think it's audited what time the lab calls it, and then what time the nurse notifies the doctor.

joe17 · Sep 12, 2011

So, six weeks ago I was fired from my LTC position for not reporting a critical lab value within one hour.
I was told by a recruiter last week, that I might as well stick with small nursing homes and/or "rehab" facilities,
as no one else is going to want to hire me since I've had "clinical issues".
Is this true in anyone else here's experience?
I have an interview on Thursday at a psych facility where I have worked before. I left on very good terms and my manager, who was actually the ADON when I left, loved me. Do I have a good chance of being rehired, or will they turn me down because of my... "clinical issues"..

Im very interested of what LAB. TEST? YOU MISSED TO REPORT.?? and what happened to your patient and the consultant???secondly normally you will get a warning for this error..unless it caused death or dissability to your patient.....most LAB VALUE THAT IS CRITICAL LEVEL THE PATHOLGY REPORT IT DIRECTLY TO THE CONSULTANT THEMSELVES,,,in your case it seems not,,,

my adviced is dont beat up yourself go apply for a job and dont hesitate to sell yourself to them,,,this serves you a lesson and it will only do you good in the future and im sure will ake you a much better nurse...we are human we made mistakes,, that mistakes will make us stronger///GOODLUCK AND GOD BLESS

OCNRN63, RN · Sep 13, 2011

I am going to start an emergency savings account just in case so while i am looking for another job, at least my rent will be paid, very scary and some of us are walking on eggs, you never know.

You should have at least 6-8 months in emergency savings, period. I don't mean retirement fund, either. That's totally separate. You never know what can happen to you.

nurseryRN14 · Sep 13, 2011

I find critical results all the time when I check lab results. The am shift don't bother to check most of the time, so at night, I make it a habit to check. There have been many critical results missed or fogotten, because nurses get busy. Luckily no one has gotten hurt because of it. Usually the manager will just writed that person up and give them a warning, but if you keep making the same mistakes. She fires you. As soon as I get the critical result, if its not an emergency, I try to go ahead and call the MD before it gets too late, because I know I will forget and I want to go ahead and get any orders for that pt if any.

allnurses Guide · Sep 13, 2011

Well, the bottom line is that I didn't follow policy, and I've learned from my experience.

ALWAYS FOLLOW POLICY.

My problem is that I'm NOT a trained robot, and I don't always follow policy right to the letter.

If someone had a HGB of 8.1 (non critical, depending on the facility) yesterday, and today it is 7.9 (critical), I will call the doctor, but I may not necessarily do it within ten minutes.

If it were 13.0 yesterday, and 7.9 now, I'm on the phone right NOW.

Now, what happened in this instance... I used a finger-stick monitor device to check a PT/INR on an old lady with hands with very poor circulation in them... I had to milk the finger, which we are taught NOT to do but the lab just wouldn't be gotten otherwise... the result that I got made NO sense whatsoever when compared to her last like, ten PT/INR's. She had been on the same dosage of Coumadin for the past two months or so. She wasn't on any antibiotics or anything like that. The result I obtained made NO sense, but I didn't know what to do. It was four in the morning; I had no supervisor to advise me. I decided to go ahead and report the lab, but didn't do it until 6:30 in the morning... most of the time, critical PT/INR's were just reported before the end of the night shift; non criticals were reported that day.

Nothing bad happened, as far as I know. I got fired over the phone; never even went back in to work. I should have went ahead and reported the lab when I obtained it.

It was just a big "cluster", a total lack of judgement on my part. I pray that I use better judgement from here on out. Heck, I'm praying that I can find a decent job.

RazzleNdazzle · Sep 13, 2011

Heck, I'm praying that I can find a decent job.

For your sake I hope you do find a job. I've seen nurse manager lap dogs stay after doing much worse than failure to report a lab 5 minutes after a "critical." I've also been on the receiving end when a group of med surg RNs had a patient on a heparin drip that was mismanaged to the point the patient was brought to the ICU and the PT/INR couldn't be measured because the blood simply wasn't clotting. Needless to say I have ZERO respect for those RNs who caused this.... Bottom line, if really bad RNs don't suffer consequences, the nursing gods should be kind enough to find you a new facility and give you another chance over this single incidence of less than stellar judgement.

Best of luck!

nhensleyLPN · Sep 13, 2011

I was fired six weeks ago from a LTC facility too. I failed to document on the narrative note that I had put O2 on a patient, but I had on the skilled nurses note portion. My boss confronted me with the night shift nurse and asked, "Why didn't you report that your patient was SOB all evening? So-and-so told you several times!!" ( This person NEVER told me about the patients change in condition, so I couldn't report something I was not aware of)

The only problem I can see for both of us is if your potential employer asks your past employer if they would hire you again and they say no. It sounds like you will be fine, though. Your "new" employer sounds like she knows you and will just blow off any negativity your last boss has to say.

nhensleyLPN · Sep 13, 2011

For your sake I hope you do find a job. Bottom line, if really bad RNs don't suffer consequences, the nursing gods should be kind enough to find you a new facility and give you another chance over this single incidence of less than stellar judgement.

Yes, we are all human, for goodness sake!! Part of the stress caused in this profession is from good nurses being made to feel as if we have to be perfect all the time!! I hope I can curry the favor of the nursing gods, too!!

mazy · Sep 13, 2011

wow.
perhaps i should elaborate on reporting criticals.
first, i always compare these labs to prior ones, if applicable.
if pt had wbc of 25k last wk, and this wk it's 20k...then no, it's not critical.
but just to cover myself, i follow p&p. (duh)
we nurses aren't trained monkeys where we mindlessly report lab values w/o trying to use some judgment here.
but i do assess the labs and know which ones that need to be immediately reported.
other than that, i take these labs seriously.
maybe i'm the underdog here...
no matter how baffling i find this whole laissez-faire attitude.
leslie

I agree with you, this is strange. I get a critical lab, I pick up the phone, no matter what time it is. Our facility policy is that even a stat lab needs to be reported right away, even if the values are not critical.

Well. Perhaps the OP had a brain fart, it does happen. I've had a couple of doozies myself. But it is a big deal at all the facilities I worked at. My experience is that a nurse who made that mistake would be looking at a write up and some serious re-education. It does seem extreme that the OP would have been fired without a track record of similar errors.

allnurses Guide · Sep 13, 2011

Well, I appreciate every reply. Sorry that I've forgotten to give "kudos".. you all get them, MWAH! :redbeathe

In ten months at this facility, I made two notable errors. First, I almost gave the wrong cholesterol pill to an A+O woman who's family has a history of trying to make a lot of trouble. I did have problems, verbal problems, with this lady when I came back (from being suspended).. I was not abusive, but because this lady is perfectly A+O, I did have a couple of words for her. I didn't want any problems with her; wanted to be able to just give her her meds, her treatments, and leave her room. It didn't happen that way. Wrote a letter to the DON just venting to her about the situation and asked not to be assigned to this lady, or her hall, anymore. I think this whole incident really left my DON with a "bad taste in her mouth", as far as I go.

Secondly, the lab that I didn't report within an hour.

*sigh* I don't know. I'm not going to profess to being the world's best nurse; in eight years of being a nurse I still feel like an idiot. Part of my problem I guess, is that I've moved around so much... maybe. I don't know. All I know is that I feel like I've learned from this experience, yet again, and I PRAY that my old employer will welcome me back!!! I really did like working there, a lot.

Thanks, y'all.

carolmaccas66, BSN, RN · Sep 14, 2011

I worked with a EEN and an RN the other night. The EEN didn't report a pyrexic patient to the RN and the RN just said: 'You should have told me earlier'. I think the EEN felt a bit cowed, cos she was following me around most of the night, even into the drug room and watching me (which was a bit weird). Anyway, no-one was fired or told off after that. She has learned her lesson. I don't see why someone should be fired, as it's the shift coordinators job here to print out and screen ALL the labs and bloods, and we hand over anything unusual.

I'd just be honest with my old boss, as we all make mistakes, and take it from there. Don't go into lengthy explanations re what happened; if ur old boss wants to know more he/she will ask for more details. Or, on the other hand, you could just not tell him/her and say you just decided to leave the other place for personal reasons.

I don't see why anyone should get fired for one mistake - your old facility could have instituted some extra training. Maybe they just wanted to get rid of you?