application problem

sallyrnrrt, ADN, RN · Dec 9, 2014

ok what were the things they were asking you to do that "you were not trained to do?" what is the working environment, as acute care, LTC, etc?

the reason i ask is i am attempting to help you formulate an answer.

grammy57 · Dec 9, 2014

Patients coming off ventilators. Not trained to care for the trach tubes. Told not to touch them. RT said it was their job.

Here.I.Stand, BSN, RN · Dec 9, 2014

Did this refusal happen immediately when you realized there were no RRTs, expressed that you NEED training on traches, and were then denied the training?

You have to be honest on the application. If you lie and are found out, they could very well revoke any offer. Is there a place to explain any disciplinary action? If you are given the chance to explain, I would just say that you had serious pt safety concerns so refused. If you were proactive about requesting the training first, rather than refusing first, I'd think this would help your cause. Be very clear about what you've learned from it and what you would do differently in a similar situation.

Going forward, I do think you need to know that this is BLS. The trach is their airway, and you do need to know how to keep it patent and how to rescue "breathe" (bag) through it. This is true even if there ARE RRTs present. Their airway/breathing cannot be dependent on them...again even if there are RRTs, they have a LOT of pts. Were I work, there are 2-3 of them divided between the SICU and MICU. They also get called to the ED when a pt is intubated and coming to us. They might simply be off the floor to have lunch. The RN might not be the expert that the RRT is, but you CAN'T just stand there not knowing what to do when a trach pt can't breathe.

xoemmylouox, ASN, RN · Dec 9, 2014

I agree you have to be honest. I would also inquire about getting trained with vents and trachs if you have patients with them. It is a skill that everyone should have even if you have RT on site. Emergencies happen and they might be busy with another emergency and unable to be present for yours.

psu_213, BSN, RN · Dec 9, 2014

You absolutely cannot lie on the application. Unfortunately, you are in a bit of a tough spot. Even if you are given a chance to explain why you were disciplined, it is not going to look very good to say "I refused to touch trachs because only respiratory therapists could touch them." Plus, handling trachs was a part of nursing school…I didn't have any specific on the job training about how to handle trachs.

grammy57 · Dec 9, 2014

I want to make one thing perfectly clear, and I don't mean to sound rude or mean, but, I absolutely did not lie on the application. I was asking for help on how to deal with it.

icuRNmaggie, BSN, RN · Dec 9, 2014

The application might be asking if there has ever been any disciplinary action from the Board of Nursing.

Pretty much every nurse has been counseled not disciplined by an employer for something such as absence occurences, tardiness, a missed medication, a box not checked or a family complaint..

Future employers don't need or even want to hear about every little human error.

To me, progressive disciplinary action by an employer means oral warning, writtten warning, suspension and termination.

If you had no experience or training with trach patients and ventilators then you did the absolute right thing by saying I have never done this before.

Now if it comes up in the interview say I was suspended because I felt it was unsafe for me to accept trach and ventilator pts.

I have no experience with trach and ventilator patients and I was not inserviced on ventilators and trach care.

Anyway it's over and I hope you find a new position which is a good match for your skillset and abilities.

Grammy it will be alright, this will all work itself out. You sound like an honest and cautious nurse. Your good qualities will shine through and you will be an asset to another and probably much better employer.

grammy57 · Dec 9, 2014

Thanks. There is way more to the story than I am able to tell.

Here.I.Stand, BSN, RN · Dec 9, 2014

I want to make one thing perfectly clear, and I don't mean to sound rude or mean, but, I absolutely did not lie on the application. I was asking for help on how to deal with it.

Oh no no, I didn't think you had done that at all! I was just putting it out there...I took your question as "what do I do about this question on the application?" is all. Good providence--I do hope all goes well for you, especially after this bumpy start. Hugs!

grammy57 · Dec 9, 2014

Thanks. Stressed.

Altra, BSN, RN · Dec 10, 2014

Agree with the above poster who pointed out that the question on the application was very likely referring to disciplinary actions on your license, not internal employer corrective action.