Does this sound like my boss is getting ready to fire me?

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I recently began a job on an observation unit. A patient who was a retired nurse submitted a note to my supervisor stating that in her opinion, I was not competent to be a nurse. I had trouble with a faulty manual blood pressure device. When I attempted to use a second manual BP device, it too malfunctioned. I expressed my frustration that the equipment wasn't working properly and didn't manage to get a blood pressure on her until later. 

My boss called me in and discussed this incident and has now put me on orientation for a month. I have been a nurse for nine years and have worked in a variety of units. She basically said that if the orientation does not go well, I will be put on a performance improvement plan. Is she just dotting her eyes and crossing her tease so she can terminate me?

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2 Answers

Specializes in Tele, ICU, Staff Development.

Since you're a seasoned nurse of nine years, a faulty blood pressure cuff shouldn't be a reflection of your competency. However, the blood pressure should have been taken immediately and not later.

While we can't know your manager's intentions with certainty, putting you on orientation for a month instead of jumping directly to a performance improvement plan (PIP) is positive, and could be a few things:

  • Support and training. Your manager might see this as a learning opportunity rather than an indication of poor performance. Since you've been a nurse for 9 years, the equipment issue was likely an isolated incident, not a reflection of your overall abilities. A month of orientation gives you time to familiarize yourself with the equipment and protocols in your new setting.
  • Additional assessment period. Since a complaint has surfaced, she will use this time to assess your performance further. 
  • It shows a more understanding, corrective approach. Managers often reserve PIPs for patterns of poor performance or ongoing issues, and your performance doesn't warrant that. 
  • She is showing confidence in you. By putting you on orientation instead of a PIP, she may be signaling that she believes in you and wants to help you succeed rather than simply punishing you for one mistake.

Your Strategy

It seems that the ball is in your court. This is an opportunity for you to improve without facing formal disciplinary action. Stay open to feedback instead of becoming defensive. Use this month to show that you are willing to accept constructive feedback and are committed to enhancing your performance.

First, make sure you, your manager, and your preceptor are on the same page. If you haven't had a conversation with your manager about what specifically she wants you to focus on during this time, do so ASAP.  "What would my performance during orientation look like if I were to improve?"

You really need specific goals. Specific goals make it clear exactly what is expected. It's only fair to you, and without measurable goals, how can you know if you've succeeded?

Ask your manager for a check-in before that time. "Can we meet weekly to make sure I'm on track?" 

Specific Goals

You should be provided with SMART goals. SMART stands for:

  • Specific
  • Measurable
  • Achievable
  • Relevant or Realistic
  • Timely

Here's an example:

Goal: Improve competency with manual blood pressure measurements.

Specific: I will improve my ability to measure blood pressure using manual devices accurately.

Measurable: I will practice taking manual blood pressures at least 5 times per shift with a colleague or supervisor, ensuring I correctly identify any errors.

Achievable: I will familiarize myself with the equipment and request assistance from a more experienced colleague if I encounter malfunctions or difficulties.

Relevant and Realistic: This is important for my success on the observation unit, as it impacts patient care and my overall performance.

Time-bound: I will show improvement by the end of my one-month orientation period, at which point my supervisor will assess my competency.

By making it SMART, you're demonstrating proactive efforts to improve and giving yourself clear targets to hit. Does something like this resonate with your approach to this situation?

Preceptor

Likewise, have a plan with your preceptor. Don't passively wait for feedback if it is not forthcoming. You don't want to get to the end of the month only to have your preceptor say something vague, such as, "It didn't go well" or "You're just not cutting it."

You should be given ongoing, constructive feedback. Try to walk out with your preceptor at the end of your shift. At the end of every day, ask your preceptor, "How was my performance today? Is there anything I should have done differently?"

In short, use this orientation period to demonstrate your competence and reassure her that you can handle the job.

Also, during this time, maintain perfect attendance.

Good luck! Very best wishes,

Nurse Beth

Specializes in Critical care.

Was anything done about the malfunctioning B/P devices?   Are you keeping your own documentation of what is going on?  

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