I was fired for refusing to give injections incorrectly! - page 4

Hello, my name is Katherine. I have been an LPN for 10 years. I am an experienced clinition and have won awards for my excellence in clinical practice. I worked in an office for 10 years which gave... Read More

  1. by   camay1221_RN
    Katherine,

    I almost fell over when I read your post about the two syringes being taped together!!! And someone asked the question that came to mind...How do you aspirate?

    I worked in a pediatric clinic for five years, and I think anyone who would even think of giving immunizations the way you described should be the one without a job, and back into a continuing education program for skills development!

    Good luck to you! There is another pediatric clinic out there just waiting to get their hands on you!
  2. by   norinradd
    Sorry it didn't work out but you don't want to work were you don't feel safe. On paper at least they can let you go in the early stages for any reason. If they stated why on paper maybe, but face it, it's not a place you want to work. As for,"From what I understand the department of health got word of this and has since gone in to correct the situation." Wink, wink.
  3. by   gajalama
    [font=Book Antiqua]You should count your blessings that you are out of there! I have been a RN for almost 31 yrs and have a MS in nursing. I have never heard of such nonsense: taping syringes together! Go back to school and get your RN, you sound like a bright and dedicated nurse. You will find another job, be sure to interview your interviewers when looking for another job. All the best to you!
    Quote from katlpn6
    Hello, my name is Katherine. I have been an LPN for 10 years. I am an experienced clinition and have won awards for my excellence in clinical practice. I worked in an office for 10 years which gave me a vast amount of experience, from family practice,internal medicine,pre-op teaching,pediatric nursing to urgent care. I take pride in my skills and am dedicated to doing it right for the benefit of my patient. I loved my job but felt it was time for a change so I took a new job in a pediatric office, this office served patients from birth to 18 years old. When I discovered the nurses in this office were giving IM injections with a 5/8" needle I requested that they order some 1" needles, which they did. When the nurse who was orienting me told me that she "tapes syringes together" to give immunizations I almost fell over! I told her that was not clinically appropriate and I would not be doing that. I worked there for two weeks and was brought into the office managers office after work one evening and told that it wasn't working out and they would have to let me go. When I asked why she told me it was because I was too set in my ways and obviously was not willing to do things their way. As difficult as this has been for me, I feel proud that I stood my ground and refused to do it wrong to just keep my job. From what I understand the department of health got word of this and has since gone in to correct the situation. Unfortunately it was at the expence of my job but at least I know the children are being properly immunized because of my sacrifice. Now I'm off to the trenches again to find a job that appreciates a skilled and dedicated nurse!
  4. by   chickamauga4
    Quote from katlpn6
    Hello, my name is Katherine. I have been an LPN for 10 years. I am an experienced clinition and have won awards for my excellence in clinical practice. I worked in an office for 10 years which gave me a vast amount of experience, from family practice,internal medicine,pre-op teaching,pediatric nursing to urgent care. I take pride in my skills and am dedicated to doing it right for the benefit of my patient. I loved my job but felt it was time for a change so I took a new job in a pediatric office, this office served patients from birth to 18 years old. When I discovered the nurses in this office were giving IM injections with a 5/8" needle I requested that they order some 1" needles, which they did. When the nurse who was orienting me told me that she "tapes syringes together" to give immunizations I almost fell over! I told her that was not clinically appropriate and I would not be doing that. I worked there for two weeks and was brought into the office managers office after work one evening and told that it wasn't working out and they would have to let me go. When I asked why she told me it was because I was too set in my ways and obviously was not willing to do things their way. As difficult as this has been for me, I feel proud that I stood my ground and refused to do it wrong to just keep my job. From what I understand the department of health got word of this and has since gone in to correct the situation. Unfortunately it was at the expence of my job but at least I know the children are being properly immunized because of my sacrifice. Now I'm off to the trenches again to find a job that appreciates a skilled and dedicated nurse!
    Way to go!!!!! I applaud you for having pride in your work and yourself. Those children are safer for your sacrifice. Thank you for being such a good and attentive nurse.
  5. by   Fun2, RN, BSN
    How old was this nurse? I am 31, and was lucky enough to miss out on the booster shot that had a million needles. :chuckle

    I am just wondering if this is how that nurse came up with the idea to tape the syringes together. I have never done that, nor thought about it....and I surely was never told to do that. I have always asked another nurse or medical assistant to help, or gave multiple injections/opposite legs myself.

    As for the needle size, it all depends on the person (child), but did they use only one size needle on EVERYONE????? I've never heard of a "one size fits all" needle! I can't imagine them not using different sized needles without you having to ask them to order a different size!!!

    WHEW!!! Good luck with your job search, that was definately not a good job for a good nurse!!!
  6. by   NoCrumping
    Quote from JOHNGA
    Katherine-

    Your professional ethics are sound.
    Perhaps it would have helped to show the orienting nurse a professional reference on correct techniques of pediatric IM injections. For instance, a book on clinical skills and procedures. Sometimes if you can articulate why a certain technique should not be performed, the other nurse can modify their administration technique appropriately.
    FYI: the word 'clinician' has no 't' in it.
    *another FYI*
    the word expense has no c in it.

    In order to not "rock the boat" so to speak, could you just have been oriented to the office, and then when on your own , done things your own way? While I agree the taping of needles together thing is not common practice (to my knowledge) , but if you think about it, is it really harmful to a pt? Its not like she told you something crazy like... "we give our im injections by mouth here" Sometimes people dont want you around if your only willing to do things your own way, complain about the way they do theirs, etc....
  7. by   NoCrumping
    Quote from camay1221_RN
    Katherine,

    I almost fell over when I read your post about the two syringes being taped together!!! And someone asked the question that came to mind...How do you aspirate?

    I worked in a pediatric clinic for five years, and I think anyone who would even think of giving immunizations the way you described should be the one without a job, and back into a continuing education program for skills development!

    Good luck to you! There is another pediatric clinic out there just waiting to get their hands on you!
    How do you aspirate??? the same way you would aspirate for one, i imagine?
  8. by   blondebritbrat
    I am shocked by what I am reading! You are the type of nurse that I aspire to be and good for you for standing up for your patients! I am sorry that you lost your job but since the health department has come in since then its probably safe to say that you probably don't want to be there in the aftermath. I haven't even started nursing school yet but I am just shocked. I have never heard of "taping" like that nurse tried to teach you! Plus that just sounds lazy and could lead up to a lot of infections on the injection site. Way to go!
  9. by   BRANDY LPN
    I applaude you for sticking up for your pts, but what happens after the dept. of health completes their investigation? Most likely (God willing) this nurse will be fired, but that doesn't stop the problem she will just go on to get another job where she will most likely NOT change her practice. You really need to report this nurse to the BON, they are the only ones who can discipline her license and prevent her from cont. to endanger pts.
  10. by   pmchap
    Quote from NoCrumping
    but if you think about it, is it really harmful to a pt?..
    Well yes it is harmful to the patient - what if one of the needles hits a vein? when you draw back - how do you do so. Localising two needles within half an inch of each other has got to intensify the feeling for the patient. If the patient has a reaction (rare but it happens) - which syringe was the cause of the reaction? & finally taping doesn't really allow for a decent grip on the barrel - if the syringes enter at different angles there will be potential tearing friction against the skin.

    If you are working in a area so short staffed that two staff arn't available it may be just possible that you need to give two injections (scary for peads I know) but mum or dad are there to comfort (usually). Its not the best situation but a few more tears is better then a double whammy into one arm....
    Last edit by pmchap on Jan 31, '05
  11. by   NurseFirst
    Quote from skm-nursiepooh
    you did good by sticking to your code of morals :hatparty: ! i'd look for another position first...of course...then go after that practice for wrongful dismissal! you should have no problems with winning & they would have eat your legal expenses too.

    good luck ~ cheers!
    moe
    in my parents' unfortunate experience, even a "sure thing" isn't so sure. my parents were convinced by a lawyer to go after my dad's former partner who had absconded with money from the partnership account after he had been told not to. what my parents got was two years of sheer misery, a judgment which was basically non-commital--and a huge lawyer bill. there's a reason mental health professionals ask if you are in litigation as a possible cause of (di)stress...

    nursefirst
  12. by   4theBetterGetter
    I have never heard of such a practice! OMG! Good luck in your next position!
    Quote from katlpn6
    When she gives immunizations such as DTaP and say Hep B....she tapes the syringes together to give two injections at the same time. This makes it so two injections are given less than a 1/2 inch apart...clearly inappropriate landmarks.
  13. by   NurseConnieR
    Quote from katlpn6
    I told her that was not clinically appropriate and I would not be doing that. I worked there for two weeks and was brought into the office managers office after work one evening and told that it wasn't working out and they would have to let me go. When I asked why she told me it was because I was too set in my ways and obviously was not willing to do things their way. !
    I think there's another way to look at this situation, another perspective. Many of us have been in clinical situations where the practice ranged from "not supported by research" to "unsafe". I wonder if the time had been taken to build rapport and trust with your new coworkers if you couldn't have made a tremendous positive impact on their practice? Could you have closely watched and listened to your preceptors instructions and then done it the way you knew was correct anyway? Show rather than tell? No one likes being TOLD they're doing something wrong, especially from a new employee who they don't know or trust. At the same time, I have never met a nurse who purposefully wanted to harm a patient (although I've heard about them on TV!).

    I have a fundamental philosophy that I strive to use in every situation, it's simply to "believe the best" about people. No matter how I want to question motives, etc. I try to remember that most people WANT to do a good job. This is how I would apply this to your situation: First, I would believe that my new place of employment wanted to provide great patient care to their pediatric patients. I would approach each day with a "what can I learn from my new coworkers" attitude and how can I provide the best patient care possible. I would seek to ASK QUESTIONS rather than to TELL. I would not compromise what I know to be safe patient care while at the same time being respectful of others. For instance, instead of TELLING your preceptor her practice is "clinically inappropriate" and you would "not be doing that". What might have happened had you ASKED her questions like "I've never seen that done like that. What's the benefit to the patient?" and look like you're INTERESTED in the answer. She may have been told to do it that way by an LPN with 20 years of experience or she may not even know why she does it. But you created an opening. Then you can start a dialog and you never know you both might learn something. Regardless, you've not created an enemy, you've shown that you ARE willing to do things differently and you begin building trust with your coworkers so that you can ultimately impact the care given to the patients.

    I realize I'm making a lot of assumptions based on one brief email (as all the other posters have done as well) but I would guess that your preceptor, even after the health department came to "straighten them out", still has her job. Ask yourself if it wasn't the fact that you refused to do things their way that you were fired what could it have been? Is it possible it could have been your attitude? Was there ANY other way to handle the situation besides TELLING or REFUSING - both of which don't invite trust but do build walls that prevent good communication.

    I highly recommend two books to everyone - "Crucial Conversations" and "Crucial Confrontations" both by Kerry Patterson. Excellent books on communication.

    Best of luck to you.

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