Fired for expressing concerns about patient safety and care!

[hkrntobe]

I need help please. Just not sure what to do now. Getting right to the particulars.

I was working in a So Cal Hospital in a Psychiatric unit. I was assigned a set schedule.

1) I was suddenly assigned to work 8 days straight Wed - Wed (8 hour shifts / this schedule would also mean that I would be working overtime without getting paid for it.) I consulted my union rep. and at her advise requested my set schedule back.

2) After numerous AWOL's and patients attacking each other, I expressed concerns on patient care and patient safety when probed by my manager. Within 4 business days of these two incidence I was called in the office and told "You are not a good fit." "You did not pass probation."

3) Come to find out that there are people have expected for some time that the Union was in-bed with administration. The union rep stalled for almost two weeks before telling me that my start date was my hire date.....regardless of the date I had on the paperwork from HR stated. I have never received a complaint from anybody for any reason. After bringing to HR's attention that 90 calendar days from the "date of hire" had passed, HR stated they would get back to me after hearing the managers side of the story.

After several days I am advised that my date of hire was not until my first day I hit the floor. They refuse to address the ethical issues or the fact that I have signed paperwork from HR which clearly states my date of hire as documented by the hiring HR representative.

I was Fired because I was a good nurse and attempted to prevent further issues with patient safety. I was fired because I questioned why I was working 8 days straight. I was fired NOT because I was a poor nurse or because I lacked critical thinking skills, but because I was not a Quiet Nurse.

I am just floored! I have a child to take care of and feel that he is now suffering for my decision to do the right thing. Should I really have to sacrifice patient care and POTENTIALLY MY LICENSE in order to provide for my child? Advice would be appreciated please. What are my options from here?

[hkrntobe]

One thing I'd like to point out is that I'm sure many (if not *all*) the experienced nurses the OP worked with warned her the consequences of rocking the boat and getting in over her head. Don't fall into the newbie trap of thinking "they're just grumpy and mean". Wise advice that is well-intentioned and freely given is a valuable thing.

In fact they did not! They where the first to speak up and even began training me to cover for days when they where the charge nurse. I received the highest complement any NYSE can pay another I was told "If I where a patient, you would be the nurse I want" Nursing is a labor of love and if your just in it for the money you will never last long.

[evolvingrn, BSN, RN]

In fact they did not! They where the first to speak up and even began training me to cover for days when they where the charge nurse. I received the highest complement any NYSE can pay another I was told "If I where a patient, you would be the nurse I want" Nursing is a labor of love and if your just in it for the money you will never last long.

Do you get how ironic that sounds?

[Redriot]

Hi hkrntobe,

I will start by saying that I am sorry that this has happened to you.

Now to the nitty-gritty:

To those nurses who have said that as a new nurse you should "fly under the radar", "keep your mouth shut", etc. I can only say that they should be ashamed of themselves. Is it not part of the Nursing Code of Ethics that we advocate for our patients and their families? And yes, it is political. All health care workplaces are politically driven, especially since implementation of the new CMS regulations (aka Obamacare). Of course you should protect your license also.

But all of that is an aside of the question originally asked.

As a new nurse, or an experienced one, it is overwhelming to integrate into a new work place and culture. I would cause a major riot if they tried to schedule me 8-in-a-row. That is NOT acceptable anywhere unless you are the one picking up extra hours or agreed to that schedule. If you were hired with a block schedule, then that is what you should be working. They are pulling one over on you and I would go back to HR and ask for copies of the policies. Then take that and copies of your hiring contract to a lawyer for a free consultation.

Union reps are a waste of time when the dirt hits the fan. And please don't anyone reply to me to try and convince me otherwise. I am entitled to my opinion which I base on my experiences at both union and non-union hospitals. The start date is the day you start with the organization and NOT the day you start on the floor. You should ask yourself "what day did they start paying me?". Again, I think it is worth consulting a lawyer to get the details from HR if you are needing to pursue this.

Lastly, if you truly feel that there are some serious patient risks in the care given and/or the safety of patients I would strongly recommend reporting it to your State Department of Health. It is done anonymously and they are required to follow up on any complaint filed. Give concise details and specific dates if you can to identify incidents of compromised care and patient safety.

Just remember, there are some of us nurses who will also stand up for what is right. You will find another job and continue to be a good nurse, take what positives you can from every experience you have, and don't let the politics of healthcare ruin your enjoyment of what you do. US healthcare is complex and frustrating and unfortunately that will not change anytime soon. Good luck with all you do!

[tami101481rn]

Patients attacking each other and nurses is part of psych nursing unfortunately. Its part of ER too, I get kicked, slapped, spit on, hit all the time. Its a hostile enviroment in both, and you really have to roll with the punches, no pun intended. If its not something acceptable to you, then maybe that wasnt the best fit for you, and maybe thats what they saw. On another note, 8 days in a row iscrazy. The hospital I work for has a fatigue management policy that states you cant work more than 4 12 hour shifts at a time, no matter what week they fall on. You must have one day off. But I will say when I worked psych they worked you like a dog. Also your hire date and start date are 2 seperate things, and probation doesnt start until your start date. How would they gauge your abilities if you were not working? I work in texas, which is at an at will employer, they can fire you whenever they feel like and dont have to list a reason. Look into the scheduling policies for your next job before accepting it. See who does the scheduling, or is it rotation work. See if they have fatigue policies in place.

[txnursie4you]

I think when we're hired, our hire date is of course the day we were hired. But when we are to do a 90-day probation, I think it doesn't begin until we're actually out there working. The 90 day evaluation usually occurs after 90 days on the floor.

As for speaking up, as nurses, against poor standards of care, that is certainly our responsibility. In 17 years I've seen my share of poor care but, fortunately, mostly great care.

Yes, we need to speak up. But as a new grad, first job, within the first 3 months I think there is a time we are to observe and learn. What we see in reality is not as clearly delineated as in the textbooks and the classroom. If you, as a brand new nurse in a brand new job, see obvious signs of neglect or abuse, then yes!! By all means... speak up!!! But if you're walking into an environment with established nurses and decide that their way of doing things is risky for patients and staff, try to think how that's gonna sound when you call it to their attention. The OP didn't go into great detail about what she felt was wrong with the safety measures of the unit, so it's hard for us to know exactly what happened. Perhaps she had legitimate reason for complaint. I do think, however, that nurse management is not likely to restructure patient care and staff coordination on the advice of a brand spankin' new nurse.

Those 90 days are not just for probation, they're partially for orientation as well. It's to see how well you fit into the department. If you walk in from the beginning months telling them how to effectively manage patient safety and care, staff coordination and scheduling, then follow it up with a complaint to the union about your own schedule, all within your first 90 days on the floor, don't be surprised if it's not met with a warm reception.

There is a time to listen and learn. After years of walking the halls and paying your dues, your suggestions are far more likely to be met with open ears.

I would encourage the original poster to approach the next job having learned from the first experience and to weigh her comments, suggestions, and complaints, carefully. Good luck, I hope you find a job that is a much better match for you.

[Blackcat99]

I should be ashamed of myself for keeping my mouth shut and keeping my job? So if I do the right thing and get myself fired for not having sense enough to keep my mouth shut what are you going to do about it? Are you going to be sending me all the money I will be needing for my rent, food, utilities etc etc etc.

[Guest343211]

Hi hkrntobe,

I will start by saying that I am sorry that this has happened to you.

Now to the nitty-gritty:

To those nurses who have said that as a new nurse you should "fly under the radar", "keep your mouth shut", etc. I can only say that they should be ashamed of themselves. Is it not part of the Nursing Code of Ethics that we advocate for our patients and their families? And yes, it is political. All health care workplaces are politically driven, especially since implementation of the new CMS regulations (aka Obamacare). Of course you should protect your license also.

But all of that is an aside of the question originally asked.

As a new nurse, or an experienced one, it is overwhelming to integrate into a new work place and culture. I would cause a major riot if they tried to schedule me 8-in-a-row. That is NOT acceptable anywhere unless you are the one picking up extra hours or agreed to that schedule. If you were hired with a block schedule, then that is what you should be working. They are pulling one over on you and I would go back to HR and ask for copies of the policies. Then take that and copies of your hiring contract to a lawyer for a free consultation.

Union reps are a waste of time when the dirt hits the fan. And please don't anyone reply to me to try and convince me otherwise. I am entitled to my opinion which I base on my experiences at both union and non-union hospitals. The start date is the day you start with the organization and NOT the day you start on the floor. You should ask yourself "what day did they start paying me?". Again, I think it is worth consulting a lawyer to get the details from HR if you are needing to pursue this.

Lastly, if you truly feel that there are some serious patient risks in the care given and/or the safety of patients I would strongly recommend reporting it to your State Department of Health. It is done anonymously and they are required to follow up on any complaint filed. Give concise details and specific dates if you can to identify incidents of compromised care and patient safety.

Just remember, there are some of us nurses who will also stand up for what is right. You will find another job and continue to be a good nurse, take what positives you can from every experience you have, and don't let the politics of healthcare ruin your enjoyment of what you do. US healthcare is complex and frustrating and unfortunately that will not change anytime soon. Good luck with all you do!

I certainly didn't say to not speak up. I am saying pick your battles. If you must stand, be prepared to accept that the consequences may be harsh or unfair. In the employment game of nursing, FAIR is not a part of the system. The sooner nurses learn that the better. I say stand for what is right, but have a back-up; b/c the world is unfair, nursing is often quite unfair, and it is often VERY capricious with its dealings with nurses and employment-based decisions.

For those that think you can't get axed after probation, it's not so.

Most states and places function under At Will Employment. Under AWE, you can be terminated for cause OR FOR NO CAUSE AT ALL. Most applications or even letters of job offers specify that they are to not be construed as a contract. Only when you work under contract do you have some protection from capricious decision-making in terms of your employment--an even then, loopholes can be found and used.

I believe there was unfairness with regard to the OP, b/c I have witnessed this many, many times in nursing over the last two decades.

One wonders if in a number of instances, orientation/precepting evaluations are assigned nominal values simply b/c the employer, mgt, nursing in general want to limit legal backlash from capricious dismissal of nurses--and that ole line that so often falls under the often bogus, "not a 'good' fit." It seems like a reasonable explaination, but I have seen so much abuse of that line, it makes me want to barf every time I hear or read it.

If more objective measures were in place, they'd be a little more nervous about screwing with people for capricious reasons. But they Oh So love their capriciousness.

Nursing doesn't truly employ scientific approaches and metrics when it comes to evaluating nurse employees. They may well have the bulk of the benefit with AWE in most instances, but it makes them more vulnerable to lawsuits if it is clear that they really don't have any valid or objective reasons for terminating a nurse. Yes, on one hand, mostly they don't need a reason to fire someone, but legal departments know that if you have a good nurse and there is potential for him or her making a strong legal case, they don't want to 1. Go to court over it, 2.Receive bad press from it, 3., Have to pay to settle out of court. Either way, potentially they could stand to lose money and face.

Geez, some many places and units function like those ridiculous, idiotic, and obnoxious people on one of those "Real Housewives of..." shows. But at least on those shows, they are out with their lunacy to make dramatic points and ratings. Nursing usually involves a lot of doublespeak, backstabbing, and unhanded politics. Sure this isn't true everywhere, or all the time, thank God, but work in for a while. You will NOT be able to miss the whole Real Housewives nonsense--it's just more subtle or sneaky.

Half the time I have to wonder how lazy certain nurses are. They have all this time to start trouble and play games, but they wouldn't if they were doing their job to the best of their ability--with excellence and care--every single day. (If this doesn't apply to you, don't get bothered by it. I wonder when people get bothered, b/c they know on some level that they are playing this game, and they want to rationalize their behavior--or b/c they, on some level, really get something out of their nonsense--as opposed to really focusing on working with excellence and incorporating tolerance and support for other nurses--whether these other nurses are cookie cutter versions of them or not.)

But woe is nursing, b/c unfortunately this IS the way the game is played.

Let each nurse function by way of her/his own conscience and ethics--hopefully they are and will stay strong in higher ethics, caring, and support. Nonetheless, b/c the hospirtal or institution or unit/floor culture may not roll that way, however, these nurses with backbone and integrity must be prepared for potential backlash.

I am really hating how nurses feel like they are over a barrel and take on the old, "If you can't beat them, join them" mentality. In two decades, it has been very rare for me to see nurses stand together enough in order to do what is most right for patients and for their "profession."

Please, please stop judging this nurse--the OP. We weren't there. We don't know the whole dynamics. I give this nurse the benefit of the doubt primarily b/c of having seen so much compromise, abuse, and capricious behavior in nursing and healthcare, it makes me truly feel ill. I could be wrong in this instance with this particular nurse and situation, but again, I wasn't there and neither were the others here--other than the OP.

&%*$. What will it take for nurses to be supportive of each other???? Give the person the benefit of the doubt.

The OP is probably better off if it truly was a house of horrors, as many of these type of facilities can be. If indeed she overreacted, she will have learned to pick her battles more carefully and hopefully have another job as a back-up in the future.

Again, most of my colleagues and I will NEVER work only one nursing position--or for one employer again. I want to be in the position to say, "This is outrageous, wrong, idiotic, or whatever, and I refuse to work this way." I want to be able to use my sound nursing judgment, and if it pizzes the wrong person off and they want to try and weed me, fine. I have another position.

At will employment looks good on the surface of things, b/c it is supposed to mean either party can terminate at any time for any reason. The thing is, you have to work somewhere, and employers definitely feel like they are "Giving you a job or a position." No, I am offering you a service as well--and a quality one at that.

The reality is, without a sound contract, the benefit of AWE, hands down, goes to the employer.

Why is the world do you think that physicians work under contract, reviewed by several lawyers and such, unless they own their own private practice?????

[PacoUSA, BSN, RN]

Good Lord! A year? I wish you all the best.

Thanks! 9 months to go!

[anotherone, BSN, RN]

Obviously I did't realize that being a good nurse and trying to improve a bad situation would cost me my job! From what it sounds like, this conduct and behavior is common practice for administration. Lesson learned.... You may now continue with the bashing.

These issues are present in any job. NOT ALWAYS LIFE AND DEATH. but still there. and in other realms of life. You have to know that you will not win most battles. Very few people do unless they are popular enough martyrs or wealthy/powerful people. You have to decide what do you value in life: a job/money/food/clothes/house or integrity. You will rarely , probably NEVER, be the only nurse in a facility who realizes something is wrong. Part of the moral distress in nursing.

[DEE S.]

First of file for Unemployment even if you don't think you will get it. File, bring your paper work that indicates when your hire date is. Really most policies for probation is usually from the date you started so they can evaluate you for a length of time.

You did the right thing about the patient safety. I would have sucked up the hours until I had passed probation (lesson learned for all of us). However lesson learned again about probation and politics for all of us. File an unemployment complaint, then go above your union reps head for clarification, you may have to get a lawyer. I would also "grieve" this through your union and maybe see if it can go to arbitration if not settled at the table. You are dues paying union rep (I hope) and your contract should have a policy on terminations and how to grieve it.

[nancynurse12, BSN, RN]

Unless it is something black and white an d immediate safety is a concern you don't make waves while on probation. This is a way they use to see if you will fit in or be a "problem" and make waves. If it is a threat to your license with unsafe conditions you wouldn't want to work there anyway.

[nancynurse12, BSN, RN]

Date of hire is not your start date. It has always been the first day of orientation. Date of hire as a start date and your first day as an employee can be months apart because you may have to wait for a spot in orientation.