I am getting terminated tomarrow

Dorito, ASN, RN · Apr 14, 2008

Maybe they aren't going to terminate you. Maybe they will just put you back on probation. Maybe the ER isn't the right match for you. Hang in there- I'm sure you'll find future employment and maybe even a better department for you.

oramar · Apr 14, 2008

Oh you poor thing, best of luck to you. Not like you are running about trying to make mistakes, that business of failing to recognize how critical a patient was due to labs. What about the doc? Why is that only your fault.

queen777 · Apr 14, 2008

This door might be closed, but another will open as it did for me. I got fired too. An elderly lady in her 90's went into CHF while I was off the floor with another pt. Other nurses I worked with were supposed to help watch my patients.

Anyway I left and worked with an agency. I liked working with an agency because of politics. You don't have to go to their meetings, just go to work. Plus you paid a lot more than being on staff.

Good luck.

shellsgogreen · Apr 14, 2008

have they given you any warnings?

also, if you a part of a union, maybe you can talk with a union rep prior to the meeting.

best of luck to you, hope tomorrow goes ok.

leslie :-D · Apr 14, 2008

the charge nurse questioned why an icu bed wasn't ordered by the doctor?

although it would have been a good catch on your part, i'm not seeing where this should affect your performance/evaluation.

it 'shouldn't' lead to termination.

it really shouldn't.

if you decide to sign anything tomorrow, please, only agree to signing about pt getting wrong contrast...nothing else.

big hug to you, and a boatload of blessings.

leslie

PMHNP10 · Apr 14, 2008

and there is also the option of quitting; if you are absolutely positive you are gonna get terminated you could give your resignation so you don't have to report that you got fired; or maybe start your conversation by asking for a transfer before the meeting occurs and if they don't allow that, have a typed letter of resignation available to hand them immediately; I dunno, just throwing out some ideas...good or bad

NURSEOK5 · Apr 14, 2008

you go into that meeting with your head up and listen to what is said and know that you did the best job you could do with those 2 cases. we as nurses are human, and the contrast not being water soluble, well who ordered it? as nurses we can not just randomly say "oh i guess i 'll try this today" as for the labs, i have worked er for 2 years and the only person making descions on the lab reports have been the docs. if your hospital is putting you in that decsion makeing position shame on them. why is the charge nurse asking you why didnt the doc order an icu bed? she needs to ask the doc or make that judgment call, she is the charge nurse. communication with other nurses and docs will help you be more comfortable in your environment, i do not know how many times i have asked how,why and what is going to happen with this treatment, i have learned alot by observing and listening to what the doc's need. if you stay in this dept. try to observe the doc's routines, usually the cases that are similar are treated the same. another question, why are you giving contrast, does your radiology dept. not handle that? i wish you the best of luck and maybe you can get an er quick reference book, i carry a book with me most of the time, it helps with quick facts and info. there is alot of facts out there and bless the person who knows them all. :coollook:

rn undisclosed name · Apr 14, 2008

Sorry this is happening to you. I may have done the same thing with the contrast. I didn't know there was more than one type of oral contrast. I've had people from ct deliver contrast to me for the patient to drink. I am assuming it was the correct one to have the patient. I'm sure I'm not the only one.

As far as sending a pt to the wrong area I don't understand how that is your fault. I have received patients from the ER on several occassions that should have gone to the ICU. You are not the one making the orders and I think the doctor should be held accountable. I have even called down to the ER to see if they could instead send the pt to the ICU and the nurse checks with the doc and I have never been able to have it changed.

I know you don't want to make any mistakes and do the best you can but sometimes things just need to be a learning experience. No one was hurt by your actions and sometimes that is why you have so many people involved in a pt case so that what one person doesn't catch another person can catch.

Good luck!

queen777 · Apr 14, 2008

you go into that meeting with your head up and listen to what is said and know that you did the best job you could do with those 2 cases. we as nurses are human, and the contrast not being water soluble, well who ordered it? as nurses we can not just randomly say "oh i guess i 'll try this today" as for the labs, i have worked er for 2 years and the only person making descions on the lab reports have been the docs. if your hospital is putting you in that decsion makeing position shame on them. why is the charge nurse asking you why didnt the doc order an icu bed? she needs to ask the doc or make that judgment call, she is the charge nurse. communication with other nurses and docs will help you be more comfortable in your environment, i do not know how many times i have asked how,why and what is going to happen with this treatment, i have learned alot by observing and listening to what the doc's need. if you stay in this dept. try to observe the doc's routines, usually the cases that are similar are treated the same. another question, why are you giving contrast, does your radiology dept. not handle that? i wish you the best of luck and maybe you can get an er quick reference book, i carry a book with me most of the time, it helps with quick facts and info. there is alot of facts out there and bless the person who knows them all.

amen!

kristenncrn · Apr 14, 2008

Amen!

Same!

Head up, stay calm... and if they do try and fire you - have a plan. Ask if you can resign instead. Stay strong. Point out that an ICU transfer is a shared responsibility at most... and say that you will certainly go to HR to question the decision if they insist on terminating you, especially if you weren't on a warning!

Just a thought... sorry you have to go through this.

TiredMD · Apr 14, 2008

I gave the wrong contrast to a pt going into ct scan. the conteast was supose to be water soluable. That perticular contrast is not carries in the ER and I had never used it before, but since the patient had a possible perliferated bowl that is the contrast I was to use. The pt ended up fine, but I made the big mistake.

Common enough mistake, it happens.

I can't help but wonder why the ED even had non-water soluble contrast on hand at all.

the charge nurse got ahold of the chart half way through the shift and asked why the pt was not ordered a ICU bed by the docter. I had failed the recognize how critical the pt was by his labs.

You're responsible for determining where the patients go after admission? If you're in the U.S. I find that unlikely. It was the ED doc's responsibility to determine how critical the patient was. And it was the admitting doctor's responsibility to determine if the patient warranted ICU admission. While nursing plays an important role as a safety valve to catch errors like this, it is not ultimately your responsibility.

Personally, I don't think your mistakes are as big as you think they are. And they're certainly not uncommon ones. You should see some of the stuff I've done . . .