Background: I am a new grad RN. Graduated with my RN in may, received my LPN in may of 2011. I currently work in a LTC facility though I have considered other jobs because the facility where is work is very stressful. The nurses are frequently required to work short staffed. Many days, there is only one nurse for 40 residents. When I started work there right after I got my LPN, my training left much to be desired. I'd never worked as a nurse and the training was awful. They never gave me a choice to continue training, they just gave me three 12 hour shifts of training and then I had to be charge nurse on my own. Anyway, two weeks ago, a resident fell. The CNA caring for him was from agency and she transferred him with an assist of one when he was a two assist. She also claimed he became angry with her and sat down on the floor himself - which is likely since he is a hothead. Anyway, I had meds in my hand and I instructed the CNAs to obtain vitals and not move him and then I'd be down. When I got down there, they already had him up and he was MAD. Refused to allow me to assess him, though I did look at his back, legs, and bottom. I documented everything I could and that was the end. There was no s/s of injury or anything. He c/o general achiness a couple times t/o the day but apap helped and that was that. The next day, when I was off work, he c/o severe pain in his right leg. They sent him to the hospital and he had a hairline fx of the distal femur. I go in to work and my boss helps me write up a statement about everything I knew that happened. Then, a couple days later, I'm called in her office and told that I'm being written up because I failed to complete a head to toe assessment on the resident immediately after the fall and I failed to document said head to toe assessment. I'm also being written up because some CNAs complained that I'm at the nurses station too much, I'm not a team player, and I need to help them out more. Seriously? Most days, I'm the only nurse and it's all I can do to get my charting, meds, faxes, and treatments done. And with all that, I help out as much as I can. I take residents to the bathroom, I get them up or lay them down, I comb their hair, etc. I just don't do it when I'm busy with nursing tasks. Plus, the CNAs have full staff and that's what they're hired for! And I already documented that the resident who fell refused a head to toe assessment.
Then, my boss calls me today on my day off and demands I come in tomorrow on my day off to meet with her. She refuses to tell me what this meeting is about and is determined I show up. I spoke with a former coworker of mine and she said that they can't ask me to come in for a personal meeting on my time off - if it was a staff meeting, then yes; personal, no. She said they can't write me up or anything if I can't come in on my personal time. She said this almost exact same sequence of events occurred to another nurse several months ago and she was fired in the personal meeting. She advised me not to meet on my time off and if they're going to fire me, they can do it during work hours and find someone to cover the rest of my shift. She said I should let them fire me so I can claim unemployment.
What do you guys think? It sounds suspicious, right? I don't know what to do. All I know is I did everything I could do and I don't believe I'm at fault here. I almost don't care about being fired - I'm actively searching for new employment but I need the money and was counting on the income until I can find a new job. I also don't like being accused of something I didn't do.
Dec 27, '12
Please, people...I'm going in tomorrow morning!
Dec 28, '12
I suggest you go to the meeting, because it is inevitable. Secondly if you really feel that you did everything you could for that resident, and you felt comfortable with your nursing decisions, then you need to stand behind them adamantly. I am not sure if you are unionized but if so,make sure you have a union rep with you, and if they do fire you and you really feel strongly that it was unfair, take it to labour relations. I do think it is important to stand behind your nursing decisions, your a nurse and they pay you to make them, if you feel strongly that you did the right thing, stick up for yourself!
Dec 28, '12
I think eventually you will need to meet. I agree with the above poster. If u are fired don't sign anything and put it in you own writing what you believe happened and what you believe is true. Did you call the physician about the fall?
Dec 29, '12
Yes, the md was notified of the fall per facility policy. The poa listed on the chart was called as well, but I left a message on her answering machine as she didn't answer. The nurse who worked the shift after mine even corroborated my side of events stating that there was no s/s of injury during the night and he never c/o pain during the night.
Anyway, I went into work on Monday at 6am and they fired me. Not for the fall/injury investigation but because on Friday, I signed off that I changed a resident's band aid and the wrong date was written on the bandaid. They never said anything about the fall and they said I could lose my license for writing the wrong date on the bandaid. Several months ago, a colleague of mine turned in a coworker of ours for signing off that her treatments were done but she never actually did them. She had proof - drsg changes that were signed/dated by the previous nurse, witnesses that never saw creams being applied, a&ox3 residents who claimed never to have gotten their treatments. Knowing this really leads me to believe they were looking for ANYTHING to get rid of me so when state does their investigation they can show they did something about it. My DON also stated, "I've been suspecting for a long time that you haven't been doing your treatments correctly." Which is bs as I always do my treatments and I have witnesses who have seen me do them. Plus, if she's suspected that, isn't it her duty to speak with me about that to ensure I am doing my treatments?
So...I applied for unemployment and I picked up some hours through the temp agency I used to work for. When I find a steady, full time job I plan on reporting my boss to the BON. I have several books full of documentation from when I started working there. There was once a med error on a narcotic medication (pharm sent too high of a dose) that lasted 3 months (it was on a different unit's cart) and she covered it up. I also have a voicemail message where she states she couldn't give a you know what about what happens to one of the residents (the one who fell, to be particular). I'm not going to fight my firing because I'm actually relieved to be out of there - something's going to happen and someone is going to be in lots of trouble.
Anyway, thanks for the replies. What does everyone think about all this?
Dec 29, '12
If I were you, I would just consider myself well rid of them and move on. Getting into a tangle with your former boss and the BON will probably not wind up working out the way you want. If the facility is that bad the state will trip them up and then she may very well be under the eye of the BON.
Wrong date on a bandaid? That's laughable.
Dec 30, '12
I agree with the PP. Move on. Thankfully you have your agency to pick up hours. FWIW, I'm recovering from the same injury. I did it while running, and it didn't start bothering me until 2 days after my run. 4 days later I could barely walk. My ortho thought it was a meniscus tear. It took a frigging MRI to diagnose me. Even if you had done the assessment, you wouldn't have found this.
And seriously.....who dates bandaids??? I hope you find something soon because that place is ridiculous.
Dec 30, '12
I just have one word of advice most states require terminated nurses names be sent to their board of nursing. The state can (and will!!!) require an investigation. I know of this because it happened to me. I hired a lawyer because you can be "done" before you know it. Good Luck and God Bless.
Dec 30, '12
I am sorry for what happened and unfortunately most NF's are staffed that way
I would say you are well rid of them and I hope you can find a better position!
Jan 1, '13
Well...the DON said she wouldn't report that I was terminated to the BON. I guess my state (Iowa) just requires you let them know when your employment ends. I went online to the IBON website and filled out a form to let them know I was no longer employed through that LTC facility and the form didn't ask if I was terminated or laid off or anything. So here's hoping I'm in the clear.
Jan 1, '13
I live in Iowa and i've never reported end of employment. You ltc sounds much like the one I was at when I worked as an lpn. I had 3 training shifts and left with 35 residents. I was always short on aides and it was pure crazy! I gave a two week notice and my boss tried to make mr work as an aide for those two weeks. In iowa you cant do that if you have a nursing license. State was at that facility every month. Ive found a great job since then and do not miss it. Im positive you will find the same!
Jan 3, '13
I think you should count your blessings that you are done with that place! I don't know if it would help or not, but it seems you have a responsibility to report this facility as being an unsafe place for patients. On the matter of nurses who are terminated being reported to their State Board of Nursing this assumes one has done something wrong. I have never heard of such a thing. I just checked my BON and could find nothing like that in my state. One has a responsibility to report a change of address or a name change and that is it. Examples of issues to report and not report are given.
Putting a wrong date on a BandAid is riduculous!!! Basically they were looking for an excuse and now they have lost another good nurse! The BandAid excuse demonstrates what a good job you did of documenting the situation with the 'fall'.
It is not unusual for nurses to be terminated. It does not mean such termination was valid or that the employer was in the right. Unfortunately, there are bad employers and poor managers and you have been experiencing one. If you could afford an attorney you could sue them for wrongful termination, but probably the wise thing to do is to focus on finding a better position and put this experience behind you. You sound like a responsible nurse and a person of integrity. I wish you the best!
Jan 3, '13
(gently) I do not claim to be familiar with day-to-day operations of a typical LTC facility, but when a patient falls, the RN responsible for their care should always conduct a full assessment. If the patient did "refuse" due to anger at the time of the incident, there should have been (documented) follow up when the patient had calmed down. The number or availability of CNA or other adjunct staff does not enter into the decision - it is an RN responsibility.
That being said, I agree with PP that the OP is probably better off not working for the facility in question. However, if the OP knew of fraudulent practices or clinical errors that occurred on a regular basis (implied by claims of "evidence") & did not report it - this is also a violation of most states' NPA. This behavior could be interpreted as collusion by virtue of failure to take appropriate action & the OP could be caught up in a very serious situation if this came to light.
"Don't rock the boat" is never justification for violation of legal and ethical nursing responsibilities. If any employer asks you to, it's time to leave.