Fired from first hospital job

[nurseblondie26]

Young nurse recently fired from big name hospital for med errors. extra unit of insulin for a patient, gabapentin dose was changed for a patient but higher dose still active in computer and Pyxis but scanned, 25mg instead of 12.5mg of phenergan. All errors self reported. Doctor reassured me that these were learning experiences and that I was doing a good job otherwise.

I want to say my floor was super catty and cliquey. Mixture of very kind nurses and mixture of women who won't even acknowledge me (and several charge nurses not willing to help a newbie out). I expressed my concerns to my managers about a couple of charge nurses. Then suddenly was fired for phenergan error.

I understand med administration is serious business but these were all minor and I emailed my manager about all of them. People make tons of mistakes on my floor daily but are too dishonest to report them.

I have my most recent preceptor telling my manager I've improved and she's proud of me but it makes no difference. I feel like it has been a witch hunt from day 1 because I don't engage in friendships with these petty women. my reputation is tarnished now and I am deemed incompetent by those nurses I reported to my manager.

I am knowledgeable and I am safe. I've just had a few hiccups. I had a year LPN experience passing meds before this with no issue.

now I am ineligible for rehire in this hospital system that dominates the state and I feel hopeless. How can a new nurse learn from her mistakes and get back on her feet into a hospital again ?

[nurseblondie26]

I made sure to separate the two issues (med error and the charge nurse) in the email. I wasn't insinuating anyone contributed to the error but me. I am very hesitant to stir the pot usually. My former preceptor was working with me that night and encouraged me to report the charge, as she has been talked to previously for these things. Maybe in hindsight I shouldn't have "put the target" on my back as one comment said.

[Nurse Kyles, BSN, RN]

I think you should really go back to the basics when you get a new position. Take your time so that you can do thorough medication checks. Double check medications with another nurse. The facilities I have worked in REQUIRE a double check for high risk medicines such as insulin. Do not allow yourself to be distracted while you are checking your medications. Ask questions! There is nothing scarier to me than a new employee that doesn't ask questions. I would suggest you be really cautious in the future about reporting a charge nurse to the manager, especially when you have worked on the unit for such a short period of time. The outcome is not very surprising given multiple errors in a short period of time and also getting on the bad side of the charge nurse.

[13grad71]

Reporting the charge nurse to the manager ensures that you will have enemies. Your new to the unit, not a good idea to piss people off.

[anewsns]

I'm stuck on why there was no co-sign on the insulin-..

When a group of people know each other and are doing a tough job they get bonded. It's not always cliqueyness”. They don't know you from Adam. People take a while to warm up. Im not sure if that's true there but usually that's how I interpret tight knit groups when I'm new and when they see your integrity and communication they usually are willing to help a lot more. Also it's good to try and be a team player when you're new and that doesn't necessarily mean being buddies with everyone it just means being grateful for any help and trying to give back a little if you can. Getting managers involved with floor politics is annoying for everyone all around.

I don't normally see charge nurses sitting around but if i did and needed help First step is ask politely for help.

[klone, MSN, RN]

What is BCMA ?

Barcode med administration. Scanning the patient's arm band and the barcode on the medication, with an electronic MAR. It helps to prevent/catch med errors before they reach the patient.

[AnnieOaklyRN, BSN, RN, EMT-P]

Accept accountability for one thing, and you are NOT a safe nurse, you made MULTIPLE medication errors!!!! Take these seriously because med errors kill people, you just got lucky yours didn't!

Annie

[Nurse SMS, MSN, RN]

This is hard for you and I am sorry it happened. The med errors are serious, but there is also no denying that a hostile work environment contributes to events that compromise patient safety. Do take ownership of your part, but allow yourself to grieve. Whether this hospital system takes ownership of their part is no longer your concern. The only part of this you can control is yourself and therefore your own role in this debacle is a far greater priority than that of your work environment when it comes to moving forward.

You will recover from this. When you land your next interview be sure you do take complete ownership of what happened, without mentioning your impression of your work environment. Bashing a past employer looks bad on you, no matter how justified it may be.

Recognize that hurrying is a major cause of an error. Utilize the STAR method...Stop...Thing...Act...Reflect.....especially when things seem urgent, because you know this urgency can cause errors to happen. Double check your charting on things, particularly something like a blood sugar and insulin dosage. Does your hospital use dual sign-off for insulin? If so, this error got past two people, not just one.

Never trust the Pyxis to be the best indicator of your order accuracy and check your dosages.

You will learn from this and it is going to be okay. Right now it stinks and it will always probably sting when you look back on it. However, it will not always loom this large in your mind. Most people get fired from a job at least once in their lives. It hurts. I am sorry. Grieve. Take care of yourself. Get back on the horse sooner rather than later.

[ProperlySeasoned]

Are you sure that the dreaded "ineligible to rehire" box was checked? Maybe check with HR?

[marace]

I hear you and I empathize. I always made myself available to new nurses on teh floor due to my first experiences. Sad state of affairs. It will haunt you and to ban you... there are places in teh US that do this but I h ear that after a year they will rehire. Try to get a job part time at least to fill in teh void. Take some classes on medication administration. I understand completely. Those preprinted MARS are deceiving as they sometimes post the full amt in a vial (like insulin 100 u) on them which is totally confusing. Take your time is all I can say.

[TheMB, ASN]

You are an unsafe nurse and until you realize that the errors you made were your fault and your fault only then you will continue to make errors, take accountability!

[Ruby Vee, BSN]

Young nurse recently fired from big name hospital for med errors. extra unit of insulin for a patient, gabapentin dose was changed for a patient but higher dose still active in computer and Pyxis but scanned, 25mg instead of 12.5mg of phenergan. All errors self reported. Doctor reassured me that these were learning experiences and that I was doing a good job otherwise.

I want to say my floor was super catty and cliquey. Mixture of very kind nurses and mixture of women who won't even acknowledge me (and several charge nurses not willing to help a newbie out). I expressed my concerns to my managers about a couple of charge nurses. Then suddenly was fired for phenergan error.

I understand med administration is serious business but these were all minor and I emailed my manager about all of them. People make tons of mistakes on my floor daily but are too dishonest to report them.

I have my most recent preceptor telling my manager I've improved and she's proud of me but it makes no difference. I feel like it has been a witch hunt from day 1 because I don't engage in friendships with these petty women. my reputation is tarnished now and I am deemed incompetent by those nurses I reported to my manager.

I am knowledgeable and I am safe. I've just had a few hiccups. I had a year LPN experience passing meds before this with no issue.

now I am ineligible for rehire in this hospital system that dominates the state and I feel hopeless. How can a new nurse learn from her mistakes and get back on her feet into a hospital again ?

You made three errors (that you know of) in a very short period of time. It's great that you self-reported, but you made three errors.

I hesitate to even point this out because it should be so obvious, but the doctor is not in your chain of command. Doctors don't really have a clue what "doing a good job" as a nurse is all about. Your manager, your former preceptor, those "catty, cliquey, dishonest and petty" colleagues and the charge nurses you've "expressed concerns about" are the ones who know whether or not you're doing a good job. Evidently they don't think you were doing a good job.

You don't seem to understand the potential ramifications of your medication errors, nor do you seem to be taking full responsibility. The fact that you made med errors has NOTHING to do with whether your colleagues are catty, cliquey or petty and nothing to do with what the charge nurse was doing at the time. YOU made the med errors, YOU are accountable.

Workplace relationships are worth your time -- and you say you "don't engage in friendships with those petty women." Big mistake on your part. It sounds as though you have nothing good to say about your colleagues, and I'm sure that's coming across. They don't like you, and so they didn't do anything to bail you out when you got yourself into trouble. I hope you've learned from your (YOUR) mistakes and you can find a new position where you'll devote the time and energy to workplace relationships, patient safety and developing your knowledge base that you've neglected in this job.

[ruby_jane, BSN, RN]

I had a flashback to my very first chaotic job where we had to check three places in the paper chart for new orders and we were responsible for getting those into the system...

You can check the hospital's policy regarding the number of medication errors and corrective action taken. You can also review any contract you signed - I think 5 months puts you out of probation and into regular status. If you were still on probation they can do anything they want. If you were in a regular contract in a right to work state...they can still do whatever they want.

I am still unclear about how you found out you were a no-rehire. Unless you're on probation, they have to follow certain rules and document that they've attempted to help you with your practice but that you are still not succeeding. If you're really concerned, have a discussion with HR or consider an employment attorney.

A previous poster suggested taking a medication refresher course and that is a good idea. Moving forward, you can say you identified an issue in your practice and fixed it. If you make a mistake in public, it's always best to report that mistake yourself.

Good luck.