Threatened to be Fired for "patient safety" issues.

[crimson and clover]

Hi, I am a new grad looking for some advice or opinions on this issue I am having. I have been working for 6 months at a hospital and have been having some problems there. At my interview, my NM for some reason told me that it annoys her when people call in sick to take care of their children and questioned me about my race because I have an ethnic last name. I thought she was strange, but decided to accept her job offer anyways a couple weeks later. Anyhow, I discovered I was pregnant with my first child shortly thereafter. I felt it my duty to inform my upcoming NM about the situation and she was very apprehensive, asking me how much time I would need off for leave and if I still planned to work full time day/nights. I told her not to worry, my job would come first.

Once I started orientation, my doctor placed me on a 25 pound weight lifting restriction due to the pregnancy. My NM told me that if I brought in that note, I would not be able to work at all because I no longer fit the job description of being able to lift a minimum of 50 pounds. I consulted with my union and then opted to not bring in the note.

Shortly thereafter, I was rear-ended by another motorist on my way to work and placed on a 5 pound weight lifting restriction for 2 weeks. My NM was less than pleased. She placed me on leave without pay for that time. She said she probably could have accomodated me, but was not required to, since it wasn't an on-the-job injury.

Needless to say, I was not on my NM's good side. I was also exhausted from my pregnancy and not always feeling well. However, I dutifully came to work everyday.

After working with a preceptor for 2 weeks, I was placed on my own with the most difficult patient on the floor. I made a medication error at this time. I did not know the procedure for removing fentanyl patches and removed one early. After that, I was placed back with a preceptor for an additional 2 months or so. I made one more medication error (gave wrong dosage of tylenol) and then made a medication error in conjunction with another nurse. It was another nurse's patient and she had set the IV pump to end early. It was the night shift and I didn't see that there was still about 75 ml of medication left in the bag as it was also covered with foil to protect it from light. This was over the course of 3 months or so.

During this 3 months of orientation, my NM suggested that I look for jobs elsewhere and that the other nurses did not like me. She told me there was no positive feedback about my performance. I knew that there had been, however, because I had feedback from other nurses who told me that they had gone to my NM with positive feedback. At the time, I told my NM that I was not going to quit and that I felt she was creating a hostile work environment for me. She let up and gave me a positive review at my 3 month review, saying that I was "right where I needed to be".

Things were going well for a couple months. There were a couple times that I didn't know the policy for my floor regarding certain situations. For example, I didn't know that after a patient falls, we were to institute neuro checks every 15 minutes for so long and then every 2 hours for so long. I also didn't know that insulin would have to be double checked by another nurse to avoid giving the wrong amount.

But once I made one mistake, especially a procedural mistake, I never made it again. I always learned and never did something the wrong way twice. I put a lot of effort into my nursing practice. Later on, I ended up disconnecting a patient from an IV for a half hour to take him to the bathroom, then found out I wasn't allowed to do that.

About a month ago, my NM accused me of making some kind of boundary violation with a patient because I had visited him during my shift to see how he was doing while he was on another unit temporarily. The patient confessed that he had a crush on me and I told the charge nurse, who rather than advising me to no longer accept him as my patient, told my NM that she felt that I was encouraging him. Turns out she advised me incorrectly and I should have refused to work with him again after that. I went to the union about this and they totally reamed my NM out. About a month later, I gave Vicodin to a patient too soon after he'd had his last dose and my NM put together a packet of allegations and threatened to fire me.

I was told by other staff recently that my NM had been collecting this information from day one, asking people to write down mistakes that I made. She kept a personal file on me and then denied me access to it. A couple things in the packet were never brought up to me. No positive information about me was included in the packet.

So, now I am up for a hospital board hearing to determine my future with this hospital. My feeling is that I've made mistakes, but none of them has been serious. The last one was probably my most serious mistake because rather than giving this patient another dose of vicodin, I should have called the doc to ask permission. That one is probably inexcusable, but the others I feel were genuinely education-related.

My gut feeling is that my NM has not liked me from day one and the fact that I have made mistakes has been great for her because she's been collecting evidence. She doesn't like the fact that I started pregnant, that I've gone to the union several times, and probably just plain doesn't like my personality.

So my question is, have I really been that unsafe that I should be fired? How many and what sorts of mistakes do new nurses generally make? I really want to learn from this experience and have been doubting my nursing practice. Thanks.

[SuesquatchRN, BSN, RN]

I think that it doesn't matter if the allegations are fair or not. She is mad that you are pregnant.

I'd be looking for another job. When stuff like this has happened to me the NM always won. Unless your union is VERY strong you're toast.

I think that you should have asked about procedure before doing certain things. I certainly would have asked about the procedure for a fall, removing an IV, removing a fentanyl patch, and I would never again become familiar with a patient off-hours.

But all of that wouldn't matter to her if she didn't have it in for you.

[WindyhillBSN]

You guys don't have MAKs or a machine to scan the patient's bracelet and scan the medicine to avoid errors? Personally I think you were poorly trained and if I could, would take some time off to rest and get my brain together, then start over as a new grad at another (better)facility. At my facility we have an 8 day orientation, 2 weeks with a resource nurse and 8 more weeks with a preceptor. I asked about this during my initial interview. Ask a lot of question like these in order to know if it's a decent facility to work at.

[SuesquatchRN, BSN, RN]

And you can use not wanting to leave the facility in the lurch after the baby came.

[crimson and clover]

Thanks for your replies. I realize that there have been other nurses on my floor that have made much more serious mistakes and are still working there. I have actually caught other nurses' mistakes a couple times. The patient that I had visited was only temporarily transfered to another unit and I had been appointed his "primary nurse". I visited him during my shift. Of course, you're right, I will be much more careful about that sort of thing.

We DO have a scanning system at the hospital, and I honestly don't remember how I ended up giving the wrong dose of tylenol, it was so long ago. But the situation with the vicodin was that this patient had something ordered for migraines, which was not stocked and he was in severe pain, so I gave him vicodin, which he'd had an hour and a half prior. I shouldn't have and that is error that is probably inexcusable. As far as the rest of the stuff, the scanning system didn't help with the procedures and I honestly didn't know when to ask if there was a procedure! Of course, now I know that there is a procedure for everything!

[SuesquatchRN, BSN, RN]

Of course, now I know that there is a procedure for everything!

As I said, I think this is personal, not your job performance.

If you can afford to leave I would take that option and spend some time with the baby. You have a great excuse for furture interviews.

And good luck.

[CaLLaCoDe, BSN, RN]

I feel for you! Sounds like you have an uphill battle on your hands. If you can do so, seek work elsewhere and hide the fact that you worked at this facility. And if your future employer asks you why you omitted this information, tell them that you were still on orientation and did not think to list this employer. Or seek legal council and document everything she tells you everyday you are there! Take the NM to court and see where you stand!

[Spidey's mom, ADN, BSN, RN]

hi, i am a new grad looking for some advice or opinions on this issue i am having. i have been working for 6 months at a hospital and have been having some problems there. at my interview, my nm for some reason told me that it annoys her when people call in sick to take care of their children and questioned me about my race because i have an ethnic last name. i thought she was strange, but decided to accept her job offer anyways a couple weeks later. anyhow, i discovered i was pregnant with my first child shortly thereafter. i felt it my duty to inform my upcoming nm about the situation and she was very apprehensive, asking me how much time i would need off for leave and if i still planned to work full time day/nights. i told her not to worry, my job would come first. .

you are new, but my advice is to never ever let your job come before your family, your children. this is how nursing shoots itself in the foot - by putting up with being treated as less than human.

you should get as far away from that place as possible. your orientation was dreadful if you were not taught simple things like neuro checks after falls and insulin checks.

also, it is illegal during an interview to ask questions about children and ethnicity.

take time off to be with your child. rethink, research, take time to get strong in your values and do not ever let anyone make you choose a job over a child.

your nurse manager is a terrible nurse.

steph

[NurseCard, ADN]

I simply would not continue to work for a NM like yours. Transfer to another unit in the hospital or quit. This woman is not going to change and she is not going to leave you alone.

[crimson and clover]

Thanks again for the supportive replies. I was really thinking that maybe I'm totally irresponsible, but it seems like the consensus it that I wasn't trained very well. I have this board hearing in a couple weeks. Two weeks before my due date, actually. If I want to go and argue for my job or to clear my name or whatever, I can appear with a representative. At that time, I assume I will be given an opportunity to explain myself. I am really nervous because I think it will be like a trial and also nervous that I may get reported to the BON for my med errors, even though no one was injured.

I am actually debating whether or not it is worth it to even put the effort into going. Right now I am basically suspended from my position with pay until the hearing. From what I understand, the board generally sides with the NM.

I also have a consultation with an employment attorney this week. I do believe that some of this is personal and some of it is discriminatory. However, I don't want to delude myself that I haven't made any mistakes. That's mainly why I posted. Do I really deserve to be fired for these mistakes? Sounds like maybe not.

[FireStarterRN, BSN, RN]

This sounds awful, I'm really sorry you have to go through this. Your worst mistake was giving the Vicodin after only 1 1/2 hour. Your manager sounds very unethical, unprofessional, and sociopathic. I don't know what the best course of action is, but the whole thing sounds terrible.

[AirforceRN, RN]

I just want to say that its really nice to read a post asking advice from someone who is willing to admit their mistakes and tell the whole story...not just one side of it. Whatever happens at this job or the next, your honesty and willingness to accept responsibility will carry you far. Best of luck.