Might be let go during orientation? Need advice.

[luey87]

I apologize for the very lengthy post. But if you have the patience to read and offer some advice, it would be very much appreciated.

I am feeling great deal of distress.

I received a job offer to work part time 0.8 in a Kaiser CV-ICU. Job posting requirements stated "One year recent experience in a Cardiovascular ICU or in a Critical Care Unit caring for post-operative cardiovascular surgery patients." It has always been my dream to work in a dedicated Cardiovascular ICU.

Just some background information regarding my experience:

4 years mixed ICU (patient demographic includes treatment and caring for patient's with Sepsis, ARDS, Cardiac and Neuro patients). My experience in the cardiac aspect included taking care of patients CABG POD #1 (1 year), CABG POD 0 (3 with preceptor, 2 on my own with backup for resource) ECMO, IABP, management of PA catheters and hemodynamic monitor via Vigilance II monitor. I was completely transparent with the manager.

As I got into the unit and the orientation, my manager gave me some advice to inform the preceptors that I have no prior experience in taking care of Open Heart patients. I did as I was told. My first week of orientation consisted of shadowing my am shift preceptor as my HealthConnect (Epic), GRASP and Glucose ID was not ready. I admit I could not independently take a two patient assignment at this time and was slow at task. My evaluation for the week was done by the manager and ANM (Assistant Nurse Manager) and they expressed concerns that my performance did not match my experience. "We expected you to take care of two patient's and it seems you are not able to do that." In addition, the manager accused me of not taking her seriously, I assured her that I did take everything she said very seriously. I explained my inability to have any access with Epic/GRASP/Glucose made it challenging to take care of two patient's independently, in addition to not being familiar with the hospitals policy/procedures. They agreed and expected better performance in the weeks to come.

My second week, I worked my scheduled evening shift with two different preceptors. Everything seemed to be going better. Gained access to Epic and GRASP (still not Glucometer access). Independently took care of two patient's with the occasional question regarding their protocols. I asked for daily feedback regarding my performance from the preceptors and got them in writing. My preceptor #1 only concerns were how slow I am with charting and preceptor #2 is how quickly I finished charting and how she wanted me to do a more thorough assessment (assess extremity strength despite seeing them ambulate). I took all their criticism into consideration and adjusted accordingly. However, my second week evaluation with the Manager and ANM was worse than the first. They said "You are fabricating your assessment, slow to chart and you turned off patient alarms." I denied the fabrication of my assessments. I told them I may have failed to check the alarm setting but my preceptor educated me to check it regularly as some of their staff are notorious for turning off alarms. They said these comments are concerning as they feel I am unsafe and these are serious red flags. And I still have not met their expectations to taking care of patient's because my preceptors have expressed that they feel they still have to hold my hand. None of this was reported to me. I felt I was able to take care of two patients, titrated drips accordingly and finished tasks in a timely manner. They say that may be true but they don't feel I would know what critical values and conditions to report to the MD if faced with a situation. I requested for complete transparency from my preceptors and the ANM said "in a perfect world that would happen". All comments regarding my performance, the ANM said the preceptors would like to remain anonymous.

They are giving me another week to deliberate but per my preceptor despite his opinion regarding my performance at bedside the manager seems to have made up her mind. Per the preceptor, the manager states "They don't want you to be the weak link in this unit." Despite the promised 5 week orientation the ANM compared what should be my training with that of travel RN hired in their facility, which is 1 day orientation in CVICU and 1 day in ICU.

I have until next week for my evaluation. And will request union representation during the deliberation. I have started seeking new employment. But this whole ordeal is so dishearting.

Begging for advice:

1) During the meeting, should I quit/ wait to be let go/ request an extension/ asked to be transferred?

2) Will this orientation hinder/affect any future applications in all Kaiser facility?

3) Should I include this orientation period in my resume?

[purplegal]

This sounds eerily similar to what I experienced during my orientation on a cardiac unit...constant criticism with little advice on how to improve, conflicting opinions from preceptors, going behind your back, and worsening performance reviews. I may be wrong, but it sounds like there's really nothing you can do to satisfy them. Unfortunately, I think someone, or multiple people, have decided they don't want you on this unit, making it nearly impossible for you to succeed. With that said:

1. I would first ask if transferring is a possibility. Do it before it's too late. I made that mistake. Do not wait to be let go. Try and have as much control as you can. I wouldn't recommend asking for an extension in orientation, as it sounds unlikely their expectations would be met. They sound like they are difficult to work with.

2. I am not familiar with Kaiser facilities but unfortunately it really could hinder future jobs within them. Ever since I lost my position, I have been unable to obtain any other nursing position within the same organization.

3. I would not include this on your resume. You didn't make it through orientation and it doesn't put you in a positive light. I did not put my former position on my resume and I think it's for the best.

I am very sorry to hear you are going through this. It's devastating to realize that no matter what you do, for some people, it's not enough. I am still struggling after my own loss and it's been almost 2 years. It's a shame there are so many unsupportive nurses and nursing units out there. You do have experience elsewhere so that suggests that you can be a successful nurse. Just, maybe, not on this unit. Best of luck to you.

[luey87]

Thank you so much for the response and advice! Yes, you are correct. There is very little support from fellow nurses to a newcomer, especially when those nurses have worked in that unit for many years. I don't know why that is the case but I have learned that an environment like this usually has high turn over rates. I hope things get better for you. And thank you again!

[rkitty198, BSN, RN]

They probably won't give you an extension. If they felt you were improving (based on their assessment) then they would consider it. Let's face it, they probably don't want to spend anymore $ on your orientation and it sounds like they have made a decision already.

I would quit, or ask that you be transferred.

I think it's probably a blessing in disguise, probably would be a unit from hell to work for. Don't give up on your dreams. Find a job where you can get a new to speciality orientation. I wouldn't work for Kaiser anyways, unless it was the only hospital or clinic near me and I had to work there, that's based on personal reasons.

[guest52816]

This sounds eerily similar to what I experienced during my orientation on a cardiac unit...constant criticism with little advice on how to improve, conflicting opinions from preceptors, going behind your back, and worsening performance reviews. I may be wrong, but it sounds like there's really nothing you can do to satisfy them. Unfortunately, I think someone, or multiple people, have decided they don't want you on this unit, making it nearly impossible for you to succeed. With that said:

1. I would first ask if transferring is a possibility. Do it before it's too late. I made that mistake. Do not wait to be let go. Try and have as much control as you can. I wouldn't recommend asking for an extension in orientation, as it sounds unlikely their expectations would be met. They sound like they are difficult to work with.

2. I am not familiar with Kaiser facilities but unfortunately it really could hinder future jobs within them. Ever since I lost my position, I have been unable to obtain any other nursing position within the same organization.

3. I would not include this on your resume. You didn't make it through orientation and it doesn't put you in a positive light. I did not put my former position on my resume and I think it's for the best.

I am very sorry to hear you are going through this. It's devastating to realize that no matter what you do, for some people, it's not enough. I am still struggling after my own loss and it's been almost 2 years. It's a shame there are so many unsupportive nurses and nursing units out there. You do have experience elsewhere so that suggests that you can be a successful nurse. Just, maybe, not on this unit. Best of luck to you.

Wonderful advice. Follow it, and good luck. Sorry that this is happening to you.

[Crush]

With what you said about comparing your "training/orientation" to that of a travel nurse I would question their policies. I work float pool and got a few days on each unit, with a day or two longer for ICU and ER. You have to do what is best for you though. If it were me, I would seek out a transfer or find a nurse residency program. But only you know your situation, what's available in your area and what is right for you personally. Weigh out the benefits vs burdens of different scenarios. Best wishes.

[Been there,done that, ASN, RN]

I apologize for the very lengthy post. But if you have the patience to read and offer some advice, it would be very much appreciated.

I am feeling great deal of distress.

I received a job offer to work part time 0.8 in a Kaiser CV-ICU. Job posting requirements stated "One year recent experience in a Cardiovascular ICU or in a Critical Care Unit caring for post-operative cardiovascular surgery patients." It has always been my dream to work in a dedicated Cardiovascular ICU.

Just some background information regarding my experience:

4 years mixed ICU (patient demographic includes treatment and caring for patient's with Sepsis, ARDS, Cardiac and Neuro patients). My experience in the cardiac aspect included taking care of patients CABG POD #1 (1 year), CABG POD 0 (3 with preceptor, 2 on my own with backup for resource) ECMO, IABP, management of PA catheters and hemodynamic monitor via Vigilance II monitor. I was completely transparent with the manager.

As I got into the unit and the orientation, my manager gave me some advice to inform the preceptors that I have no prior experience in taking care of Open Heart patients. I did as I was told. My first week of orientation consisted of shadowing my am shift preceptor as my HealthConnect (Epic), GRASP and Glucose ID was not ready. I admit I could not independently take a two patient assignment at this time and was slow at task. My evaluation for the week was done by the manager and ANM (Assistant Nurse Manager) and they expressed concerns that my performance did not match my experience. "We expected you to take care of two patient's and it seems you are not able to do that." In addition, the manager accused me of not taking her seriously, I assured her that I did take everything she said very seriously. I explained my inability to have any access with Epic/GRASP/Glucose made it challenging to take care of two patient's independently, in addition to not being familiar with the hospitals policy/procedures. They agreed and expected better performance in the weeks to come.

My second week, I worked my scheduled evening shift with two different preceptors. Everything seemed to be going better. Gained access to Epic and GRASP (still not Glucometer access). Independently took care of two patient's with the occasional question regarding their protocols. I asked for daily feedback regarding my performance from the preceptors and got them in writing. My preceptor #1 only concerns were how slow I am with charting and preceptor #2 is how quickly I finished charting and how she wanted me to do a more thorough assessment (assess extremity strength despite seeing them ambulate). I took all their criticism into consideration and adjusted accordingly. However, my second week evaluation with the Manager and ANM was worse than the first. They said "You are fabricating your assessment, slow to chart and you turned off patient alarms." I denied the fabrication of my assessments. I told them I may have failed to check the alarm setting but my preceptor educated me to check it regularly as some of their staff are notorious for turning off alarms. They said these comments are concerning as they feel I am unsafe and these are serious red flags. And I still have not met their expectations to taking care of patient's because my preceptors have expressed that they feel they still have to hold my hand. None of this was reported to me. I felt I was able to take care of two patients, titrated drips accordingly and finished tasks in a timely manner. They say that may be true but they don't feel I would know what critical values and conditions to report to the MD if faced with a situation. I requested for complete transparency from my preceptors and the ANM said "in a perfect world that would happen". All comments regarding my performance, the ANM said the preceptors would like to remain anonymous.

They are giving me another week to deliberate but per my preceptor despite his opinion regarding my performance at bedside the manager seems to have made up her mind. Per the preceptor, the manager states "They don't want you to be the weak link in this unit." Despite the promised 5 week orientation the ANM compared what should be my training with that of travel RN hired in their facility, which is 1 day orientation in CVICU and 1 day in ICU.

I have until next week for my evaluation. And will request union representation during the deliberation. I have started seeking new employment. But this whole ordeal is so dishearting.

Begging for advice:

1) During the meeting, should I quit/ wait to be let go/ request an extension/ asked to be transferred?

2) Will this orientation hinder/affect any future applications in all Kaiser facility?

3) Should I include this orientation period in my resume?

" will request union representation during the deliberation. " I worked at Kaiser as a traveler. My understanding was I was not accepted into in the union for one month. Are you sure you qualify for union representation? There is no comparison between full time employee and traveler orientation.

Please clarify what week of orientation you are in, and how many weeks orientation you signed up for. Sounds like they are desperate for warm bodies, and making you hit the street running.

Of course you will be slow to chart! EPIC charting take a long time to learn. I feel you have a preceptor that is power tripping and setting you up for failure. You have excellent experience. If you do get union representation... go to that meeting and hold your head up high. They are lucky to have you.

If the powers that be are dumb enough to let you go, leave it off of your resume.

Best wishes.

[JBMmom, MSN, NP]

I don't have much experience in your position, but I want to let you know I was let go during my orientation from my first job and since then I've gotten a better job where I have been recognized as being an asset to my new unit. Somethings even bad things happen for a reason. Maybe if you're let go it will be for the best. Don't let it get to you too much, I really started questioning whether I could be an acute care nurse at all, and it turns out it just wasn't a good fit for a number of reasons and I was meant to end up where I am now. GOod luck!

[luey87]

To update. During the meeting with the union, the manager agreed to the proposition union suggested which included having me transferred to a different KP hospital. Unfortunately, per the union, HR did not agree to this and planned to terminate my employment after the week ends. I have turned in my resignation, per unions advice, to prevent from being ineligible for rehire in KP.

I guess the silver lining is, despite what I went through in the past 3-4 weeks and now left without a job. The manager ensured I'm eligible for rehire in KP.

[guest52816]

I truly wish you all the best as you begin your job search. Is it possible to contact your former employer and go back to your old position?

Even though I haven't been a nurse for very long, the one hard truth that I have learned is that if you aren't fitting the mold for ANY reason, you will be let go. And I do mean, ANY reason. It could be as simple as not fitting in with the "group think."

Thanks for updating us, and again, best wishes. There is something better out there just waiting for you.

[cleback]

Sorry it didn't work out. Sounds like a unit from hell though. I'm glad you are still eligible for rehire.

[purplegal]

To update. During the meeting with the union, the manager agreed to the proposition union suggested which included having me transferred to a different KP hospital. Unfortunately, per the union, HR did not agree to this and planned to terminate my employment after the week ends. I have turned in my resignation, per unions advice, to prevent from being ineligible for rehire in KP.

I guess the silver lining is, despite what I went through in the past 3-4 weeks and now left without a job. The manager ensured I'm eligible for rehire in KP.

I am sorry to hear this was the outcome. However, this situation was so similar to mine, it doesn't surprise me. That's great that you made the decision to resign instead of being terminated, as it gave you some control over the situation. I'm glad that you're eligible for rehire, but realistically it may not happen within this organization. Technically, I'm also eligible for rehire in the organization I left, but after over 50 rejections, it hasn't happened. Yes, you're eligible for rehire, but there's a good chance they won't actually do so. But, good luck on your job search. You have 4 years of successful ICU experience, so there will be something out there for you. Best wishes!