Fired from my first nursing job, before one year

[mightynurse1]

I am a lost for words, I never thought this could actually happen to me. This was my first job, on the telemetry floor of a major hospital, with an outstanding reputation, one that consistently ranks among the best. During preceptorship, I was learning so much, I got to the point where I really felt confident.

I was quickly handling a full patient load and developing my efficiency. I was building my intuition, patient outcome prediction skills, and patient and family rapport skills. I was 6 months into the job (5 or so on the floor by myself after preceptorship) and I was already floated to the ICU step down unit, and given an excellent 6 month review for my performance. And through it all, I never had a patient code on me, this was by design, not default. My intuition allowed me to closely monitor patients that "didnt look right", and intervened before it got worse.

However, I could not help but notice how an average of 1-2 nurses would leave to get work in another hospital! I would always ask myself: why? this is supposed to be one of the best hospitals?

Anyways, leading up to my 6 mo review, I would find myself at work every single shift 15 mins ahead of time 6:45- 6:50am (which has always been the case) and leaving right on time because of how well I managed my patient load. I even put together a powerpoint presentation to educate the nurses on the floor about a pain management team I was planning to head, as was asked of me by my asst. director. I was not feeling very challenged anymore though. Im sorry if my being frank can be interpreted as arrogance but it is just the truth. I wasn't feeling challenged. I was getting bored.

So I enrolled in an EMT course to challenge the paramedic exam and have those extra credentials. Working 12 days a month, and not going home with baggage or "worries" put me in a position to feel the need to reach out for professional development opportunities to increase my chances of getting into the ER.

WOW WHAT A MISTAKE! After I told my other asst. director about enrolling, and asking for certain days on my schedule to accomodate the classes, EVERYTHING CHANGED!!!

My director then got fired, and i'm assuming it was because of the very low patient satisfaction scores (HCAPP), and high nurse turnover rates.

Just a couple of weeks later, I was written up for using a pair of sciossors to cut a pill instead of using a pill cutter. WRITTEN UP! a written counseling for this? Really? Oral medication administration is not an aseptic technique, so it stands to reason that if your in a pinch (which I was at the time) a sciossor could do the trick. Isn't that what nursing is all about anyways? A constant, moment to moment evaluation of your priorities based on the acuity of your patients needs? BELIEVE ME, there where more important things going on at that time.

I let it slide, I simply refused to let it bring me down. I figured "hey, maybe they are big on that stuff".

However, it didn't stop there. A couple of weeks after that, I get called into my managers office to be placed on a "performance improvement plan" I could not believe it!! They were taking (I put 2 and 2 together based on the conversation) this one nurse's advice about my performance. This nasty, miserable, with a history of getting other nurses in trouble, nurse's account of my performance, and it was enough to place me on a performance improvement plan. Unbelievable!!! I felt sooooo betrayed!!!

I couldn't help but approach her and ask her why she would do such a thing without having spoken to me about any heart felt concerns (if they were so sincere) in order to work with me to correct any legitimate problems with my performance? About a minute into the conversation she not only admitted to having "reported me to administration", but also cut off the conversation and insisted on resuming discussion in our managers office.

Needless to say the conversation got pretty nasty in there, she accused me of retaliating against her, and I ended up getting suspended.

I returned approximately 2 weeks later and was given a heavy patient load. It was complete with a patient that had been discharged 3 times (during the same hospitalization) before the head M.D. of internal medicine asked me to call security to have her escorted out of the room, three discharges, two admissions, and a training on insulin pumps. They even tried to give me a direct admit (which is much more involved than a regular one or a transfer). Talk about a nice homecoming huh?

The next day I report to work and halfway through the day Im called into my managers office, again. They said I left an IV port on one of the patients I discharged the day before. They said the patient returned to have it removed. As such, my employment ended that day.

How sad, I gave this place my every last ounce of heart, soul, and passion. I promise you that I have never dedicated sooo much to something in my life, and now it is over, done. There are no words that can describe how frikin painful this feels.

I just want to know where I go from here? What should I do now? Will I ever get hired by another good hospital, let alone a major one? Does this mean that Im basically black balled from nursing? being that I was fired during my first year? (because that one year mark seems to be such an important milestone) Is there some unwritten code that states that if a nurse doesnt get past the first year they are basically not one of the "good nurses" or am just being upset and paranoid.

PLEASE HELP ME!! I need answers from you guys! I need answers from experienced nurses out there.

At one point I was at the top of my game, things looked great at work, I even saved the hospital Millions of dollars in what would have ended up in a medication related sentinal event. A drip that was labeled with the five rights of med adm., but attached to a Lasix vial! I caught that error, saved the hospital from certain doom!!!!

Please help me I dont know what else to do!

[kungpoopanda]

Sounds to me like you got too big for your boots too soon. You made some fundamental errors, were given the opportunity to improve but reacted defensively and outraged because you knew it all. As a new graduate, it is your position to learn and be guided by those with more experience and to abide by hospital P&P.

As for what happens next, look honestly at your part in this drama, learn from it and move on. What about pursuing the EMT course?

[DysrhythmiaRN11]

This world of nursing is a dog eat world, you have to watch your back constantly to survive. I am a 2011 graduate and I have come to realize that there are some evil people in this world and a lot of nurses are miserable. The books that I learned from in nursing school has a total different twist once in the real world. The reality of nursing will hit.

To be perfectly honest, did you mess up? Absolutely, in nursing, there cannot be an reason or excuses for shortcuts, and we have to do our best to practice to our upmost. With that said, is that always possible.... NO! We are human and sometimes cutting corners seems to help us gain time, not that this is good practice. So you being disciplined for such practice seemed to be acceptable. The problem with that is that it should have been done after you were spoken to unless something more was happening to where you did need a performance eval, but I don't see that small situation being that serious unless you continued to do it, or unless there is more to the story.

Next, sounds like that nurse is like a lot of nurses I work with. I have to constantly make sure I am doing checks and balances to ensure I am not missing anything and doing everything right because they are watching me and trying to pull me down. I do my job, and I do it right, no shortcuts.

With that said, keep your head up. Use your experience to your advantage and start filling out many applications. You may have been in a good hospital but there are many many more. You might not get into them immediately but believe me your career is not over. As long as this doesn't go on your nursing license as neglect or some sort you are ok. If you have a nursing license, you can get a job. Now you have to start from scratch as if you are a new grad. It will be hard but don't give up.

I am a 2011 graduate and if it makes you feel better I am already onto my 5th job because I wanted to find happiness and refused to be miserable in any job. Its not impossible just hard work. I am an operating room nurse due to my commitment to do what I want to do and not what people tell me I can or can't do. I am happy and love my job.

[klone, MSN, RN]

Humility is a good thing. I hear in your post a lot of talk about how great and on top of your game you are, and zero acknowledgement of the errors you made to land yourself in the situation you are in.

According to nursing theorist Patricia Benner, it takes 2-3 years in one's role to become merely competent, yet I'm reading from your post that you regard yourself an expert. After six months. You are still a new grad, and as such, still a novice in your practice. You still have a lot to learn. Keeping that in the forefront of your mind will go a long way towards helping you in your next job. Good luck.

[ArtClassRN, ADN, RN]

You should have known not to use a scissors as a pill cutter.

You know you aren't supposed to d/c people with IV access in place.

All that being said, if you worked for an organization with a union you might have had the support you needed to change your behavior.

[tyvin, BSN, RN]

Well, I can say I told you so. I mean the reaction you got from the other members on this site. You say don't take your expert self as arrogant but that's exactly how your post comes across. I'm sorry you lost you job, but my dear, nursing is a cut throat business and the almighty back must be watched at all times.

I have empathy for you because I am like you in a way that I can be proficient in anything very quickly. But, I learned way early to keep it on a low key. Even if I knew stuff I went ahead and let the other experienced nurses show me. It builds rapport and you do learn something, even if you think you know it all.

I know you are generally shocked and surprised that this happened to you; I feel your pain. As always, the person is the last one to know. I wish nurses weren't so insecure and that we could all get along but unfortunately, it's not the case at many facilities. I find from reading your post that you are a good person and you do mean well. It's unfortunate that we do need to watch our backs but it's a necessary evil. Please take a well earned lesson from all this and good luck to you.

[MadpeysRN]

how did anyone know you used scissors?

[The_Optimist]

I have empathy for you because I am like you in a way that I can be proficient in anything very quickly. But, I learned way early to keep it on a low key. Even if I knew stuff I went ahead and let the other experienced nurses show me. It builds rapport and you do learn something, even if you think you know it all.

.

Humility is excellent and I applaud and welcome it...most of the time. But that comment above is a no-growth environment. Deliberately "dumbing" down your skills or holding back, to make your more experienced nurses appear good is not a good growing nor learning environment.

Two heads are better than one, and if even your experienced colleagues knew more, it also takes humility for them to learn from you as well.

Humility as with other good relationship behaviors should work both ways and not be one-directional.

[The_Optimist]

@MIghtynurse, how do you have two years nursing experience and this is your first year?

[Esme12, ASN, BSN, RN]

welcome to AN! The largest online nursing community!

Wow....six months out of school and you are at the top of your game. While you may feel that way....nothing is further from the truth. Mightynurse is your user ID....Okay.....

Confidence is a good thing. Arrogance will get you into trouble. Being floated was not because of your skills...it was most likely because you were low man on the totem pole. Being an EMT/paramedic will not increase your chances of getting into an ED as your are just a new grad. IN the ED we are smart and competent but humble enough to be afraid and cautious.

As a new grad out of school and deciding that you will now head the pain management team is a bold move and one that was not received well....as I am sure you already know. Using scissors (yuck what is on those scissors that is now on the pill...how were you sure they were cut in half accurately?) to cut a pill shows your inexperience as a new nurse when it is clear that you have no remorse is a warning bell to administration/manager that you might have behaviors that will make you a liability. Regardless of what is going on...there are certain short cuts that you just can't take...using scissors to cut a pill is one of them.

While you saved a patient harm by discovering the drug error....you didn't save the hospital millions of dollars. It is your JOB to prevent errors as you, the nurse, are the last line of defense. Instead of viewing yourself as savior of the facility you are the reasonable and prudent nurse who thankfully saved yourself from a med error.

Confronting someone in a hallway about a disciplinary action is not an appropriate means of communication about this situation. It can be viewed as aggressive, intimidation, and hostile.Especially if you are male and the other nurse female. Never a good thing. You were suspended. Lesson learned (?).

While it sounds like a busy day......

a heavy patient load. It was complete with a patient that had been discharged 3 times (during the same hospitalization) before the head M.D. of internal medicine asked me to call security to have her escorted out of the room, three discharges, two admissions, and a training on insulin pumps. They even tried to give me a direct admit (which is much more involved than a regular one or a transfer).

it is not an unreasonable assignment on a busy floor. A cake walk by ED standards.

Leaving an IV port in set the facility up for litigation and if that got infected and the patient suffered and amputation due to massive infection...it would be your license and not your job you wold be worrying about....hopefully you carry malpractice insurance to assist you in your defense and legal fees. If not...you need to get some.

This is about ownership.....responsibility. Caution and respect. Even after being a Critical care/ED/Trauma flight nurse for 35 years.... it is a healthy dose of caution and fear that keeps me humble and safe.

Being fired is never fun. Take this time to reflect on how to better your practice as a nurse and stop placing blame. Even after 35 years of being a nurse I never stop learning and while I consider myself extremely competent, and have those moment of "damn I'm good" I never forget that I am human and errors are the enemy.

I wish you the best.

[mightynurse1]

Thanks for all your responses, I will definitely take them in while I take this time to reflect.

What about getting something else? What do you guys think? Am I basically blackballed? Will it be harder or easier for me to find something?

Esme12, go easy on me will you? Yeah ive been pretty cocky, but believe me, im paying a really heavy price for it. One that I have been feeling at the pit of my stomach and my eyes every living second since. Dont get me wrong though, I appreciate/need your words, I just hope you can also give me some information to pick me up. I really need that right now...

[JustBeachyNurse, LPN]

You are likely ineligible for rehire for that and any affiliated facility. Yes, managers DO talk. Being marked ineligible for rehire can be just as bad as details of your termination. Self reflection and figuring out where you and your attitude went wrong (i.e. At what point did overconfidence take over and cloud your perspective of the big picture? This is what appears to have happened based upon what you posted)

Perhaps take some time to set up your own performance improvement plan. It sounds like some anger management counseling may help as you admit that your 'nasty escalation' of a confrontation with a coworker in management presence earned you a 2 week suspension. (The coworker was 100% correct in stopping your attack and seeking administrative assistance).