I Am Being Disciplined: What Now?

[jadelpn]

Every nurse at one time or another loathes the words "HR needs to see you" or "You need to go speak to the manager" even if you are well aware that you made a mistake, and that you are going to have to answer to it. There are some nurses who set themselves up to purposefully wreck havoc. This is not the norm. And if you are one of those nurses, you should seek help far outside a disciplinary process.

Most nurses are full of good intentions and always doing right by their patients. But contrary to any hero worship, we are all human. And we are bound to make mistakes. Human error to policy and procedure loopholes, chances are in one's career, they may have at least one "talking to".

Most facilities no longer have "merit based pay" however, still go through a process of evaluations each year. These are important. It outlines what you do really well, and may include places that you could improve. If you get a "needs improvement" it is in your benefit to perhaps focus one of your continuing education requirements on whatever subject matter this pertains to. Copy the certificate of completion, and have it added to your personnel file. This shows that you have made effort to improve on whatever "weakness" that you may have in practice.

Each nurse should be mindful of the facility's policy on discipline. For the Union folk, well aware of the contract language regarding discipline. Really know your options and rights going in. This can only help you to negotiate. If you are a union facility, a delegate should accompany you. Don't hesitate to take notes during the process to assist you on staying focused on the issue. This should never be a character assasination. No matter how "wrong" you believe the content to be, do not say anything right away. When you have heard all of the content of their complaint, ask if you can take a moment to think about things before you respond. Take a moment, leave the room, look at your notes, and form and answer, as well as what you may be willing to do to change things. This could include (and for the most part should include) any practice changes that could prevent the mistake from occuring again to you or someone else.

This is just one example. Some things are not clear cut, sometimes managment has some sort of ulterior motive that goes beyond just you. Sometimes you can assume, and maybe rightly so, that you are the "fall guy". But remember, a number of complaints are perceptions. And are subjective. So to get emotionally upset and lose control can only strengthen the perception. So as difficult as it is, deep breath.

In the most extreme cases--diverson, patient abuse, major infractions, then you need to really take the information in, and get assistance outside of the HR office. With that being said, each and every nurse needs to have malpractice insurance. It will be the best $100 a year you spend. They are a wealth of information and assistance.

If the decision is made to terminate your employment, negotiate what you can. Ask for a copy of your personel file. In it would have all of your accomplishments, what you have done well, and will only strengthen your search for future jobs.

And finally, this is not reflective of one as a person. This is not an attack, although it may feel like one. Be sure to take a deep breath, look at the situation objectively, and don't ever believe that there's no options. The options may not be ideal, but in the end could be better than one could hope for initially.

[Chisca, RN]

. So stay on the safe and narrow and avoid drugs.

Good advice but be aware that even a negative drug screen won't clear your name. I have known 2 nurses that were falsely accused of stealing narcotics, the state board got involved and the investigator from the state told the nurses it didn't matter they tested negative, they could be selling the drugs they were accused of stealing. The attitude of the board was guilty until proven innocent. The culprit was eventually caught and it wasn't either of those initially accused.

[sistasoul]

Yes, sometimes there is favoritism. I have been written up with out my side of the story being asked. The write up was already in place and then I got to tell my side of the story but it did not seem to matter.

[armyicurn]

Unless you rock the boat. I wrote a letter to the director of nursing pointing out the danger to patients by assigning 5:1 in the step down unit. I was called to the directors office where they thanked me for my concern and oh, by the way, we have reviewed your charting for the past 6 months and there are a number of "discrepancies". The message was clear. Not only could they fire me, right to work state an all that entails, they could cause harm to my licensure if they wanted to call the board of nursing. In the field of nursing management has huge power and you are kidding yourself if you don't think you will have conflict at some point in your career. A nurses highest obligation is to their patient, not their employer. And the employers highest goal is to make a profit, safety be damned.

Seems to me like your management team is made up of a bunch of POS's! You point out something serious and in return they sugarcoat your discovery and also give you an "ultimatum" that basically says don't )))(;:;(@& with the management!

[New_Man_Nurse]

I've had 3 positions since I became a ADN-RN. Two of those companies were unethical, and likely medically incompetent to be treating patient's. One of those 2 was really good, except for the DON telling me in my first meeting in front of my LPN's that my new shirt made me look like a child molester. I'm not impressed with management, I'm only impressed with those people I've met that get the job done for the patient, that put their patients concerns before those of their facilities. There are good Doctor's out there, good nurses, good CNA's, good LPN's, good volunteers. Any RN's I went to school with will self-correct long before a patient becomes jeopardized. I don't worry about them.

So far I'm not impressed with 85% of the personnel in the facilities I've worked in. So far what Ive seen mostly is incompetence from Administration and RN's that are pill pusher's, mostly the bottom line is money for the physician's and facilities, and most of the nurses I've worked with.

[kf15]

Great! I could not have said it better. This country is a 100% pro corporate environment, which means corporations (which are now "people" thanx to Justice Roberts and his republican Supreme Court) and corporations have a single goal- profit. So do right by the corporation and keep the patient in mind as you go along, and you should be fine. But think of yourself as you perform your job b/c NOONE else cares about us. Not the company, and not the patients. It's not all so bad once you get used to it, it's just modern reality, and it's the SAME in all fields.

[cuhome]

"Rarely does anyone get blindsided with a disciplinary action. Most of the time we know if we screwed up. What is wrong with accepting responsibility for what we have done and move on? Not often is someone fired for a "first offense", unless it is something major. In that case they deserve to be fired."

Well, this is quite naïve. Having been in the nursing workforce for 20 years, I can tell you that people do get fired for a "first offense", and they don't always "deserve to be fired". In addition, people can easily get blindsided. Watch your backside, document as though your career depended upon it (because it might). As one MD friend of mine said once, "When somebody sues somebody in the medical field, they'll blame the janitor if they can, just to avoid taking the hit themselves." You-know-what runs downstream. HM-8404, I'm sure your intent was good, but consider what I've said. It will serve you well.

[kf15]

...

So far I'm not impressed with 85% of the personnel in the facilities I've worked in. So far what Ive seen mostly is incompetence from Administration and RN's that are pill pusher's, mostly the bottom line is money for the physician's and facilities, and most of the nurses I've worked with.

I hear your dissatisfaction w/ a profit-driven workforce. I too was there, but I quickly got over those feelings after I was "released" from my 1st RN job of 2 yrs when an LPN on my shift made a medically unrelated, non harmful administrative infraction. I would learn afterwards that mgmt politics was driving the issue, but for me the result was my immediate dismissal by "human" resources OVER THE TELEPHONE on a 3 way call the next day.

I was thrown out of my position like a bag of garbage by "human" resources and my DON, who wouldn't spend an ounce of energy in my defense. Only 2 yrs later would I rejoice when I learned that that DON was fired the same way, for an equally invalid reason.

This is what happens in a "right to work" state. This is what profit driven corporations do. To bemoan the attitudes of the RNs laboring in this system is to miss the big picture- people are slowly developing the attitudes of their bosses and employers, mainly b/c noone feels secure. And they feel insecure for good reason, b/c corporations make sure that workers know they are replaceable.

Oh, and many if not most patients are looking for someone to blame for any little thing. They complain about and berate the very people who keep them healthy and alive, and actually expect good smiling service in response.

So basically, it is people at all levels who are responsible for the "attitude" we see everywhere. Only when the country changes en masse wil things improve.

[kf15]

Very well said. In school we are taught the Pollyanna "patient comes first" and in the reality of the workforce we learn (usually the very hard way) that the employer is the boss and you had better please the corporation. I educate the medical staff that reports to me, in a professional and intentionally vague way, to do right by the company, mgmt and the patient.

The wise staff understand & work wisely, & in their best interests. But there are plenty who continue to see patients as wonderful needy humans simply in need of care, and not consider them as potential career enders. They are both, and should be treated appropriately as both.

That said, I still like my career.

[HM-8404, BSN, RN]

I need to get a list of the non-right to work states. I want a job where everyone is patted on the back and handed a cup of coffee as they walk in the door. I want a job where my job is never on the line, unless I intentionally kill someone of course. I want to live in a state where going to work is like coming home.

I want to work for a profit driven company. I know what it is like to come to work on Wed and be told, "We are closing Friday. The economy has just gotten to bad for us to be profitable." It wasn't the economy, it was **** poor management.

I hear your dissatisfaction w/ a profit-driven workforce. I too was there, but I quickly got over those feelings after I was "released" from my 1st RN job of 2 yrs when an LPN on my shift made a medically unrelated, non harmful administrative infraction. I would learn afterwards that mgmt politics was driving the issue, but for me the result was my immediate dismissal by "human" resources OVER THE TELEPHONE on a 3 way call the next day.

I was thrown out of my position like a bag of garbage by "human" resources and my DON, who wouldn't spend an ounce of energy in my defense. Only 2 yrs later would I rejoice when I learned that that DON was fired the same way, for an equally invalid reason.

This is what happens in a "right to work" state. This is what profit driven corporations do. To bemoan the attitudes of the RNs laboring in this system is to miss the big picture- people are slowly developing the attitudes of their bosses and employers, mainly b/c noone feels secure. And they feel insecure for good reason, b/c corporations make sure that workers know they are replaceable.

Oh, and many if not most patients are looking for someone to blame for any little thing. They complain about and berate the very people who keep them healthy and alive, and actually expect good smiling service in response.

So basically, it is people at all levels who are responsible for the "attitude" we see everywhere. Only when the country changes en masse wil things improve.

[Xerxes801]

I am in the same boat you were in.So this must be a common thing in this field. Soon as the state left I got suspended on some off the wall reason. Smh.

[hospicern030363]

Believe me - often we are blindsided and often we are attacked by management.

[hospicern030363]

Please - don't tell me what works best for pain management. If I have a Rx from my doctor for a med and test positive for it, my employer can't do a thing about it. Not all who use pain meds get addicted. And for pt's with bone cancer NSAIDs are used at times in addition to a narcotic.