Fired Because of Lateral Violence

Nurses Stress 101

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I accepted a position about 6 weeks ago with a third-party healthcare staffing agency. Since it's during the school year, they assigned me to school nursing and I chose to be in the float pool. Sometimes I was temporary nurse for an entire school, sometimes I filled in for students who had a 1:1 nurse who needed time off for whatever reason.

This past week, I was filling in for a total care 4-year-old whose nurse was recovering but would be returning. Also working for my agency at this same school was this patient's overnight nurse (I'll call her K). The very first day I brought my patient off the school bus, K began to obsess over whether I had left my patient's splints on all day (against orders) in front of her parent. I spoke to my supervisor, who said they had had many complaints about this nurse inappropriately correcting other nurses while working. In the future, it was recommended that I simply go directly to my supervisor and she could handle it from there.

Tuesday and Wednesday's shifts went well, I thought. I learned a bit more about this patient's routine. I brought her into the nurse's office to do some mid-day care. She needed trach tie and dressing changes (at parent's request), a feeding, and some 1230 medications. I did her trach care and hung her feeding at 1215. K was also in the office caring for her own assigned patient. She looked at me and said loudly where the whole (busy) office could hear, "That feeding isn't until 1300. I wrote down her schedule for you." She came over to go through the patient's bag and fuss over how I was giving the feeding too early.

I did not engage. I happened to catch patient's teacher walking past the office and informed her what had just happened. She assured me she would go to her own supervisor. I completed the feeding and the medications. I returned the patient to her classroom and while they had a lesson called my supervisor to report the incident. My supervisor reassured me that according to standard of care, I have 1 hour before and 1 hour after the scheduled time to give a feeding, and I had a rationale (I did not want patient's stomach to be irritated as it would be empty if I gave meds first).

I thought everything was fine. Finished the day, felt anxious about being under this nurse's seemingly constant gaze and gave patient's 1430 dose of medicine as close to the actual time as possible (we began to dismiss at 1440), but got everything I needed to get done and brought patient home. Then I get a voicemail from my employer. Not only was my week-long contract with the school void and I was no longer welcome back for any reason, but they were reporting me to the state board of nursing. I was extremely confused and distraught; in nearly 5 years I'd never had this happen.

The school claimed I did not give the patient her 0900 feeding three days in a row (which I never saw in the MAR), that I left the nurse's office a mess, did not send her Ambubag home with her on one occasion, and left out her 1430 bottle of medicine. These last two were actual mistakes by me, which I admitted to freely in my statement, but insisted I had referred to her fresh MAR given to me by her parents and it only stated that during my shift she should have a 1300 feeding.

The next morning, it was decided I would not be reported to the state board, but I was fired on the spot. Completely. From the company. I explained about K and they agreed that I had correctly reported her behavior as I should have, but that I did not "do enough" that I should have "ignored her better" and her behavior caused me to make mistakes that could have been life or death. So I'm fired.

At no point did anyone attempt to bring any mistakes to my attention, counsel me, or remediate. I had had half a dozen successful placements before this one and was starting to find my groove. I don't ever deny that I make mistakes, but all I want is a chance to repair them. I found out my own mistakes a couple of times in the 3 days I worked with this patient and repaired them on my own, such as learning that parents preferred I send the used feeding bag home to be used again overnight rather than thrown immediately away.

I feel very demoralized and like a terrible nurse. It created anxiety so intense in me that I went to the psych ER last night and they wanted to admit me. I decided to instead followup with my therapist and psychiatrist to adjust my medication for PTSD.

I suppose I just needed to talk this over with other nurses who will get it.

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