fired! how to approach interview

[mauvered]

I've read so many posts on this site regarding this topic but still feel unsure on how to approach my situation from what i read on this site.

I deeply regret and wished i have acted differently. I worked at my last job for a year and a half. anyways, i have taken care of a pt for two shifts in a row. the first shift i had the pt. thorough skin check was not due to the pt's critical condition. Pt. was DNR becoming more lethargic and blood pressure dropping. But the pt. had full on proper device, limbs elevated and turned multiple times. I have other things going on with my other patient, had a discharge and 2 admissions. Needless to say it was a busy night. I clocked out on time, to meet floor policy of clocking out in time because i was certain i'll finish as far as charting is concern what i had left out the previous shift in the next shift. Big mistake. Next shift was just as busy. The same nurse who endorsed me the same pt. from the previous shift mentioned nothing about skin issue. skin check could not be done due to a family member. nursing supervisor had to come talk to family member. so when i was endorsing pt. to the next shift, this time a different nurse. there was dti on the patient. unfortunately i panicked.

felt so embarrassed and incompetent at that point. management asked me if the previous shift new out of frenzy i said yes. big big mistake. had a couple minutes to check charting regarding skin condition on pt. none. again in a frenzy panick mode, i charted for previous shift and current shift. big mistake of course. did not trust management about being honest at that time. so hence i acted the way i did which i know is foolish but it's crazy when you're put on that spot, logic just goes out the window.

was planning to resign that day. but did not. heard of another nurse from a different floor that resigned while under suspension but was rejected by nm. the nurse however was allowed to go back to work but resigned anyway. again i was not thinking straight. could nurses resign while under investigation?

long story short, i was let go

now i have a upcoming interview, i want to be upfront about my situation based on the dozen of comments i have read here. however i'm at lost on how to word my situation. i feel like no matter what explanation i give it'll still make me look bad.

i really appreciate any insightful comments you guys could give. i still am depressed about this. and again i wished i hadn't done what i did.

[cleback]

I had a difficult time understanding your post... dti? Full on proper device? If the patient is crashing all shift, I would probably not prioritize a full body skin check either.

[mrsboots87]

A skin assessment is done while completing the head to toe. Did you not do that either? In most patients, this take less than 10 minutes and should be the first thing you do in a shift so you have a baseline of patient condition. I check skin while assessing each body system. While I'm checking radial pulses, I'm looking the arms over then check the elbows before moving on. While listening to lung sounds, I check the chest and back. While it's too late now, PLEASE make assessment a priority. DTI's are usually preventable.

As for the test, you sound like you were stressed Or and need to work on being calm under pressure so you don't dig yourself these huge holes you can't get out of.

For future interviews, if pressed on why you don't work there, you could go the honest route if you word it properly, or try to glaze over it.

If honest, try something along the lines of you didn't make a priority out of the skin assessment and had to learn the hard way just how important it is. You now plan to make a full assessment a priority in the beginning of the shift routine to provide the best patient care.

If if you are going to try and glaze over it, just do the regular, the unit wasn't a good fit for you and apply to other types of units.

Then em take whatever job you can until you have good work history in your resume again to get over the termination. Maybe even see if you have any coworkers at the previous job that you had a good rapport with who might want to give you a good recommendation. It looks good if you can get references from employees where you no longer work so they know you weren't a terrible nurse or bad coworker.

Good luck.

[Here.I.Stand, BSN, RN]

A skin assessment is done while completing the head to toe. Did you not do that either? In most patients, this take less than 10 minutes and should be the first thing you do in a shift so you have a baseline of patient condition.

Not sure what type of unit the OP works in, but it can be much more difficult to do a full skin check than lung sounds or a neuro check. I mean elbows and heels can be checked easily, but if the pt has a CTL device on with an unstable spine, or is immobile and 400 lbs, it might be a while before you can round up the 3-4 staff members you need to remove that device or turn them to see their coccyx. And like cleback said if other pts are crashing, the skin assessment won't be the priority.

To me the issue isn't so much that the OP missed the DTI but lied about other staff knowing about it when discovered, and sounds like may have falsified documentation --

unfortunately i panicked.

felt so embarrassed and incompetent at that point. management asked me if the previous shift new out of frenzy i said yes. big big mistake. had a couple minutes to check charting regarding skin condition on pt. none. again in a frenzy panick mode, i charted for previous shift and current shift. big mistake of course. did not trust management about being honest at that time

[traumaRUs, MSN, APRN]

Moved to Nursing Interview forum

[Wolf at the Door, BSN]

A skin assessment is done while completing the head to toe. Did you not do that either? In most patients, this take less than 10 minutes and should be the first thing you do in a shift so you have a baseline of patient condition. I check skin while assessing each body system. While I'm checking radial pulses, I'm looking the arms over then check the elbows before moving on. While listening to lung sounds, I check the chest and back. While it's too late now, PLEASE make assessment a priority. DTI's are usually preventable.

Backside skin checks are unrealistic at the change of shift. If hospitals want to prevent DTI's they need to hire muscle to round on patients and not leave it as a nursing duty.. Another approach have ceiling lifts for every room to encourage turns without needing another person. VA hospitals nationwide practice this. Until then DTI's will continue.

[cleback]

Ceiling lifts really only help with turns... if you need to look at the skin, you have to get the sling off and then it's just you and your muscles holding the patient in place. Sometimes it's really challenging to assess the skin no matter your tools. My facility also changed their policy that on the medsurg floors a head to toe is only required once every 24 hours. Whether or not that's good nursing practice is another issue... but maybe the op could say in interviews there was a misunderstanding in expectations and she's learned from it, etc.