Afraid I'm going to be fired

jadelpn, LPN, EMT-B · Mar 5, 2015

Unfortunately, your unit manager's staffing issues are not your concern. And they are making it your concern. Which is wrong, and speaks volumes as to how poorly run this unit is.

With that being said, I would not take into account directly what other nurses say out of poor morale. I would make that decision on your own. It is unfortunate that you have been unable to get precepted properly. Perhaps a solution to that is a "go to" person. If you have taken one patient completely on your own, did that work? Did you have enough training to be able to care for the patient? If you increase to 2 patients for a week/10days, then to 3--is that something that is feasible due to lack of one specific preceptor?

Seemingly, most all medical/surgical units are the same across the board. Little staff, lots of patients, some with more complex needs than others. What is the timeline that you are looking at for taking a 7/8 patient load?

I also would think seriously about looking elsewhere. This kind of punitive/manipulative managing is stressful, and will not help you to be a successful practicing nurse. Going forward, I would not ever say that you are looking to transfer elsewhere. What I would concentrate on is the present, what you need to learn to be a successful practicing nurse, and how can that be accomplished with how the facility is choosing to have you move forward.

Remember, HR is not your friend. Your nurse manager is not your friend. Sounds like they will manipulate you into compliance, and then start up the bus and run you over should you not get on board with them.

My best advice to you is to get malpractice insurance TODAY. Start looking at any other opportunities in your area. If you enjoy med surg see if you can do per diem somewhere once you are settled into a full time job. Going forward "the culture of the unit was such that it conflicted with my practice goals" would be what you could use in future interviews--do not trash the unit. the facility. And if you meet a group who tells you to run, don't walk as their unit stinks? "I am new, I will take it under advisement, and bless your heart for thinking of me and my goals"....and go about your day.

HouTx, BSN, MSN, EdD · Mar 5, 2015

I believe there may be a lot more to this story.

I'm a bit confused by the statements "On my first day on my unit several nurses and techs told me it was habitually overstaffed and that if I could, I should try to go somewhere else. " and subsequent " The nurse I was paired with called out three shifts in a row and because my unit was so short staffed out of the 8 shifts I have had, for 5 I was given tech duties"... It seems that the orientation process is not well organized. I understand the manager's concern if a new graduate who has completed 3 weeks of orientation has not yet successfully managed more than one patient. I would advise OP to be more assertive - ask to be assigned more patients; ask for the specific training or assistance that is needed.

FWIW, Non Retaliation policies are intended to ensure that staff are not afraid to report compliance, quality or safety issues - not squabbles with co-workers, problems with interpersonal skills or job performance.

NaiveNewgrad · Mar 5, 2015

Thank you both for your responses. I was assigned a specific preceptor but I ended up with her only once and different people all the other shifts. I immediately purchased malpractice insurance after hearing even experienced nurses express fear of losing their license. I have been in close contact with the new grad coordinator and she has been very sweet and understanding. She agreed that my concerns are valid (the inconsistency of being with a different person every day, being told they are too busy to teach and being assigned tech duties instead, the very short staffing and the poor morale of the staff) and agreed that it is not a very good learning environment for a new grad BUT she is not over my unit manager so there is not much she can do for me. My only option would be to go over my unit manager and based on my experience with HR, I doubt that would do any good. I really wanted to work at this facility and workers are happy in most units. I never had med-surg clinicals at this facility so I had no clue what I was walking in to. I understand that things happen and units are occasionally very short but I had not yet experienced a unit where that was normal and it is the first unit I have been on that had to hire travel nurses to fill positions because so many of the more experienced nurses have transferred or taken positions at other facilities. I don't know the details but the float pool nurses went to my facilities CEO about their complaints about this unit on Monday so I can't help but wonder if that had something to do with my unit manager becoming so angry with me. There are four new grad orientates including me to this floor. I am the only one on nights. One seems happy, one I haven't talked with much and the other has also been frustrated by having multiple preceptors and said she feels she made a big mistake by taking this position. In orientation we were all told that they want us to be successful and that they wanted us to come to them (the unit managers and new grad coordinator) immediately with any problems or concerns so that they could help us be successful. I am very sad and extremely disappointed that I believed this to be true. After 8 weeks orientates are expected to take a normal load on that floor which is 7 to 8 patients at night and 7 during the day. They want you to be at the level for 4 weeks so you are more comfortable when you are no longer necessarily scheduled with your preceptor. Thank you for explaining what a no retaliation policy meant because from reading my companies " All employees, including supervisors and managers, have aresponsibility to create a work environment where concerns can be raised, openly discussed and reported without fear of retaliation" so I thought it may include my situation. I am so stressed and dreading my shift tonight that I'm sick to my stomach. I know my days are numbered and am debating resigning. Is it better to resign rather than wait to get terminated?This has been a valuable learning experience for me and I hope my next position will be a better experience and better environment for learning. Thanks again to you both for your feedback. I appreciate you taking the time to answer me :)

P.S. I was never given the opportunity to take on a patient until my 6th shift because the nurses claimed to be too busy for me and they and the charge nurses had me acting as a tech. Occasionally a nurse might let me give some meds or take some blood but it was mostly tech duties. I was eager and thrilled to finally get a patient and was excited that hopefully I would start getting some consistency and take on patients every night so I could start building my skills and confidence as a RN.I told my unit manager that I had enjoyed that night having a patient and that I was hopeful things might start going better but that my initial experiences had not been good at all.

TheCommuter, BSN, RN · Mar 5, 2015

I would attempt to find another place of employment. In your case, a transfer to a different unit might not be good enough because you have developed a negative reputation that will likely follow you to whatever unit or floor to which you transfer.

My advice will be controversial, but here it goes. Next time, keep your mouth shut during the orientation period. As a new grad, pretend you are happy with the unit. Wait until you are off orientation before making waves. Complaining any earlier will get you branded as a new nurse who is difficult to deal with.

In my personal experience I've found that many managers do not really want to hear about the problems that plague their units.

VANurse2010 · Mar 5, 2015

Frankly, HR should be backing you up re: being given tech duties during your RN orientation. The fact they are not is a major red flag that the problem is the hospital and not the unit.

NaiveNewgrad · Mar 5, 2015

Dear theCommuter,

I don't think your advice is controversial at all. I was fooled into believing that my unit manager sincerely cared about my concerns and about how I was feeling. It never occurred to me that she would become so angry and hold what I said against me. I had thought and hoped that she would understand why I felt the way that I did and that she would reassure me that things would get better and help me have a better. I learned a very important lesson and will not make the same mistakes again. Thank you for your feedback.

Dear VaNurse2010,

The meeting with HR was not for me to voice my concerns. It was for my unit manager to "Make sure her & HR were on the same page regarding my lack of commitment" as she put it. It quickly became apparent that the HR manager was not objective and was on her side so I didn't say much. I am disappointed that the organizers of the new grad program couldn't do more to help me but perhaps they too immediately saw me as a troublemaker for voicing concerns and unhappiness regarding my unit.

One of the new grads who got hired for another unit (that is much better ran) quit during her orientation at another local hospital because of a similar precepting situation. I know some people are fine with a different nurse every shift and that may have been okay had there been time for them to teach me and supervise me. Teaching and showing someone the correct way to do was something most of them didn't have much time for. They were doing the best they could just to keep up with caring for their patients. I realize now that it is pointless for me to stay at this hospital and though it's doubtful that it'll do any good, I plan to submit a detailed letter of my experience to the Chief Nursing Officer with the hope that someone else doesn't have such an awful experience. The new grad orientates on other units seem to have been having a much better experience than me so it appears to be my unit.

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Thank you both for your comments :)

TheCommuter, BSN, RN · Mar 5, 2015

I realize now that it is pointless for me to stay at this hospital and though it's doubtful that it'll do any good, I plan to submit a detailed letter of my experience to the Chief Nursing Officer with the hope that someone else doesn't have such an awful experience.

I would refrain from sending the detailed letter of experience to your CNO if I were you.

Nursing is a small world. Nurse managers, CNOs and DONs socialize on social media and outside the workplace. You do not want your name to be mentioned. You do not want your reputation to spread outside the walls of your current hospital, especially before your nursing career has gotten a chance to take off.

In other words, you do not want to be unemployed because you have been blackballed without your knowledge. Hence, do not send the letter to the CNO.

NaiveNewgrad · Mar 5, 2015

Thank you again TheCommuter :) I will not contact the CNO and I will just try to let go of my bad feelings, learn from this experience and just move on.

LadyFree28, BSN, LPN, RN · Mar 6, 2015

Dear theCommuter,
I don't think your advice is controversial at all. I was fooled into believing that my unit manager sincerely cared about my concerns and about how I was feeling. It never occurred to me that she would become so angry and hold what I said against me. I had thought and hoped that she would understand why I felt the way that I did and that she would reassure me that things would get better and help me have a better. I learned a very important lesson and will not make the same mistakes again.

The BEST thing moving forward is that you have learned your lesson about the working world.

A few pearls:

The only person that "cares" about you is YOU; never fall into the trap that even if management or senior staff "cares", their intentions may be good, however as the saying goes, "the road to hell is paved with good intentions"-granted, no unit want to have rotating staff, and inconsistencies; it doesn't do the patients any good and it is a major safety issue, and the only focus you need to concentrate on is developing your OWN practice-and that's not coming overnight, and certainly not with someone else telling you what to do; you know how to practice safely because of nursing school; focus on practicing safely, know where the policies and procedures are and you have resources; work from there and everything will fall into place.

Another pearl is run your own race-your own nursing practice-you can hear what other nurses feel and the like, but attempt to take control of your own practice-you are too new to discern of what nurses may or may not be having an issue with their own practice to make such comments; only nod, say thank you, and then sift through the information during a time away from the floor and pick apart anything that would be of use to better your own practice, and plunge forward.

Another pearl is going around with a tech is NOT a bad thing; learning what their job is is a great tool in case you don't have a tech, or if a techs is busy and you have time; it will also help in know what their role is in order to make your shift and your course of action for the shift more manageable.

Best wishes.

jadelpn, LPN, EMT-B · Mar 6, 2015

"You would like to discuss my lack of commitment to your unit? OHHHHH, I thought this meeting was about YOUR lack of commitment to orient me completely and competently to your unit." (This is a huge amount of sarcasm. DO NOT say this....just being a little fresh here...)

You can't commit to what you are unclear on. Move forward and start getting those resumes out.

VANurse2010 · Mar 6, 2015

Thank you again TheCommuter :) I will not contact the CNO and I will just try to let go of my bad feelings, learn from this experience and just move on.

As cathartic as I'm sure that letter would be, this is the wisest course of action.