Fired from my first travel gig after 4 days

[Birdsofprey, BSN]

Hi All,

I was hired as a travel nurse with 1 year of experience in Tele/then Covid stepdown(when the first wave hit NYC). I know that usually you need at least 2 years, but due to the Covid crisis, I was able to snag a travel nursing contract from a large agency.

I oriented for 1 day(I understand that is the norm). I trained with the senior nurse on a med-surg floor.

After that, I was floated 2 days in a row to PCCU, and Covid stepdown ICU for "me to help out". I did admissions, discharges, transfers, administered some meds, glucose, etc.

The 3rd day they assigned me to the same floor where I previously trained with a senior nurse for that 1 day. This is a med-surg floor. I was stressed only because it is different pumps, med dispensing system and glucometers than I am used to. I was running behind on meds but other nurses said "that always happens and they (management) do not care about that very much. 

Anyway, the next afternoon my travel agency calls me and tells me that the hospital decided not to move forward with my contract "because I am too inexperienced", and they cited a bunch of reasons which were absurd. Some were sort of valid but still miniscule according to other travel nurses I know. For example, they claimed I gave a patient a glucose tab they did not need, which is not true at all. They also claimed they had to give other nurses on the floor more patients because I could not handle the assignment- that is also not true- I was assigned those patients from the start of the shift. They also claimed I gave lantus 2 hours late and also did not give lunch aspart- both meals were hours late that day and the lantus was late because the FS was low enough that I had to confirm if it was OK from the doctor first, which took forever. The aspart was not needed due to the FS value (rolling scale). They also said I did not chart any assessments on my patients until hours into my shift (which from what I gather is typical at this facility also). I explained all this to the Clinical Director of my travel agency. 

I explained this to the Clinical RN Director of the Staffing Agency. They said the facility's Clinical Director "adored me" personally and would even hire me as staff to give me more training which makes ZERO SENSE if they think I am so horrible.

Because of this, my agency needs to make a decision among their clinical team to decide if I can move on to travel gigs after this. I will find out within a few business days.

I sounds like they were watching me moreso than others. I think this might be because of something that happened that 1 day that I trained with that senior nurse- she asked me how long I had been a nurse and I said "a year", without thinking anything of it. She made a face and glared at another nurse. She seemed to grow to like me over the course of the day, but now that this all happened I am starting to think I should not have disclosed that I have been an RN for a year and should have said "A few years" or something.

Would an experience like this keep me from getting travel contracts after this from this agency? 

I am just looking from feedback from people who are travel nurses. I am replaying how I did yesterday on the med-surg floor and I honestly keep feeling that I did OK for being new to a floor with a new med system and pumps than I am used to... I feel stupid now because I left a job to be a travel nurse and now I have no idea what is going to happen with this path.

Thanks.

[Damion Jenkins, MSN, RN]

Don't be hard on yourself. From the sounds of it, you were in the wrong place at the wrong time and even someone who had several more years of experience than you did - even I was "fired" from a travel contract because of something that was not my fault. 

You see, I was contracted to come up to NYC to help them open a brand new IMCU. I had several years experience. All my travel agency paperwork was correct and all my skills and abilities were up to date. On my first day (out of the two day orientation) I was assigned four patients, where two of them were on mechanical ventilators. I immediately informed the charge nurse and unit manager that I did not have vent experience, and that I cannot take those patients. My travel agency had that on file and it was easily retrievable online. 

The charge nurse and unit manager convinced me to do all of the basic care for the patients, but anything vent related, the charge nurse and the respiratory therapist would manage. I insisted that I was not comfortable, but went along with it because they had no one else to take the patients and the charge nurse needed to remain out of the numbers (minus the vent related tasks/assessments/meds, etc.)

Other than that awkward start to the shift, the day went smoothly and everything seemed to be just fine. 

Later that evening, I got a call from my recruiter and he said that they were terminating my contract because I was demonstrating "unsafe" nursing practice. 

I explained my side of the story to the recruiter, and he said "This facility has been guilty of this before. Don't feel bad, I know you're a great nurse and I will find you another contract ASAP." The next morning he had me in a sister facility on a similar unit, which actually worked better for me in regards to commute and I made several friends from working there. 

Long story short - it's not always about what others think. What matters is that you ALWAYS do your best, and you'll get the jobs you want. 

They NEED us. You'll have many more opprotunities. 

Good luck!

-Damion

[Birdsofprey, BSN]

2 hours ago, Damion Jenkins said:

Don't be hard on yourself. From the sounds of it, you were in the wrong place at the wrong time and even someone who had several more years of experience than you did - even I was "fired" from a travel contract because of something that was not my fault. 

You see, I was contracted to come up to NYC to help them open a brand new IMCU. I had several years experience. All my travel agency paperwork was correct and all my skills and abilities were up to date. On my first day (out of the two day orientation) I was assigned four patients, where two of them were on mechanical ventilators. I immediately informed the charge nurse and unit manager that I did not have vent experience, and that I cannot take those patients. My travel agency had that on file and it was easily retrievable online. 

The charge nurse and unit manager convinced me to do all of the basic care for the patients, but anything vent related, the charge nurse and the respiratory therapist would manage. I insisted that I was not comfortable, but went along with it because they had no one else to take the patients and the charge nurse needed to remain out of the numbers (minus the vent related tasks/assessments/meds, etc.)

Other than that awkward start to the shift, the day went smoothly and everything seemed to be just fine. 

Later that evening, I got a call from my recruiter and he said that they were terminating my contract because I was demonstrating "unsafe" nursing practice. 

I explained my side of the story to the recruiter, and he said "This facility has been guilty of this before. Don't feel bad, I know you're a great nurse and I will find you another contract ASAP." The next morning he had me in a sister facility on a similar unit, which actually worked better for me in regards to commute and I made several friends from working there. 

Long story short - it's not always about what others think. What matters is that you ALWAYS do your best, and you'll get the jobs you want. 

They NEED us. You'll have many more opprotunities. 

Good luck!

-Damion

Thanks Damion. Sorry that happened to you as well - from what I am reading, this is just part of the downside of Travel Assignments. My confidence is a little shaken since I am a relatively new RN and also new to travel nursing, I did not do perfectly yesterday but as you said- I did my best. I hope this does not happen at my next assignment (hopefully I will get one). I will definitely be mindful of some of the things they used against me though so I am more careful or inquisitive next time. I guess sometimes one must learn the hard way.

[NedRN]

Sorry this happened to you. I don't want to blame the victim, but you didn't have enough experience. Just because a hospital and an agency is willing to take a chance on you doesn't mean you are ready. I think the hospital made an error in judgement and perhaps out of desperation decided to see if you could keep up. They may have done this cynically recognizing a substantial chance that you would fail. There is no contradiction between your potential and value as a permanent employee, and your lack of value as a green traveler unable to hit the ground running.

Even such a (so called) entry level position doesn't mean you can handle a completely new environment, patient flow, charting software, culture - I could go on but it is clear that this happened to you. That can be a lot for experienced travelers too, but they have had practice adapting quickly and a better clinical experience base.

From your description, it sounds like this hospital just decided you would take too long to become fully functional (extra expense), and the risk of a mistake was too high. More often termination happens as the result of personal interaction which could just be a couple of wrong words to the wrong person once. Not sure it will make you feel any better, but the industry "fall off rate", which is the failure of an assignment to finish from any cause is about 10%, or about 1 in 10 assignments. No doubt in my mind the risk is higher than that for a new traveler. 

Hard to know the risks of travel before you start, but there are a number of ways to minimize the risk, including sufficient clinical experience, and careful query by a new traveler about whether the unit is "traveler friendly" for a first ever assignment. That is much more important that taking a first assignment for the money.

It is quite a shock to be terminated no matter the reason. It will fade, but never be forgotten. Try to settle back in to a career. Consider going back to staff for at least one more year. Do leave this incident off your work history, not unethical in any way to not mention 4 days of work. Do not bring it up in interviews. You can say that you were investigating travel if the interviewer is questioning why you are seeking new employment, but simply say potential travel assignments fell through.

[Damion Jenkins, MSN, RN]

8 hours ago, Birdsofprey said:

Thanks Damion. Sorry that happened to you as well - from what I am reading, this is just part of the downside of Travel Assignments. My confidence is a little shaken since I am a relatively new RN and also new to travel nursing, I did not do perfectly yesterday but as you said- I did my best. I hope this does not happen at my next assignment (hopefully I will get one). I will definitely be mindful of some of the things they used against me though so I am more careful or inquisitive next time. I guess sometimes one must learn the hard way.

Some of the best lessons are through the journey and the struggle. I do think you should gain another year or so of experience - because travel assignments can be brutal. The facility DOES NOT CARE about you. They want you to be productive, safe and not cause any problems for them. Since you are shaken at the moment, I'd focus on learning from this experience and get your ducks in a row so that you can have a meaningful travel nurse career! 

Good luck - and you'll do fine! Sometimes it just takes a little longer to position ourselves for success.

Best,

Damion

[Birdsofprey, BSN]

6 hours ago, NedRN said:

Sorry this happened to you. I don't want to blame the victim, but you didn't have enough experience. Just because a hospital and an agency is willing to take a chance on you doesn't mean you are ready. I think the hospital made an error in judgement and perhaps out of desperation decided to see if you could keep up. They may have done this cynically recognizing a substantial chance that you would fail. There is no contradiction between your potential and value as a permanent employee, and your lack of value as a green traveler unable to hit the ground running.

Even such a (so called) entry level position doesn't mean you can handle a completely new environment, patient flow, charting software, culture - I could go on but it is clear that this happened to you. That can be a lot for experienced travelers too, but they have had practice adapting quickly and a better clinical experience base.

From your description, it sounds like this hospital just decided you would take too long to become fully functional (extra expense), and the risk of a mistake was too high. More often termination happens as the result of personal interaction which could just be a couple of wrong words to the wrong person once. Not sure it will make you feel any better, but the industry "fall off rate", which is the failure of an assignment to finish from any cause is about 10%, or about 1 in 10 assignments. No doubt in my mind the risk is higher than that for a new traveler. 

Hard to know the risks of travel before you start, but there are a number of ways to minimize the risk, including sufficient clinical experience, and careful query by a new traveler about whether the unit is "traveler friendly" for a first ever assignment. That is much more important that taking a first assignment for the money.

It is quite a shock to be terminated no matter the reason. It will fade, but never be forgotten. Try to settle back in to a career. Consider going back to staff for at least one more year. Do leave this incident off your work history, not unethical in any way to not mention 4 days of work. Do not bring it up in interviews. You can say that you were investigating travel if the interviewer is questioning why you are seeking new employment, but simply say potential travel assignments fell through.

Thanks NedRN, it seems that I have learned some of the reality of travel nursing the hard way. Just because I am marketable for having experience in a dysfunctional city hospital where I had 12 patients at a time and went through the first wave of Covid in NYC does not mean I can be placed in a new hospital without needing adjustment. I am not saying that to toot my own horn, but that there is a big difference between surviving as a nurse in a hospital where policies aren't really enforced and then being able to cross your t's and dot your I's in an easier, private setting. In fact, this travel assignment showed how me how things should be done in a hospital. I think I did a good job that day - but they were going to use my inexperience against me. As you mentioned, I figured that because they were willing to hire me, it meant I was ready- I guess it slipped my mind how cold and high-pressure hospitals can be.

I am going to mull over what to do next. Many are urging me not to give up on travel just yet, but depending on how I feel I may get an additional year of experience before trying travel again, especially since I get my BSN  in December and will be marketable to private hospitals after that.

[NedRN]

Now that you have learned your limitations, I'm sure you will make the right choice going forward. If you choose travel, work hard to find a recruiter that has your best interests in mind and helps you get an "easy" assignment well within your clinical skills so you can focus on many other new ways you will have to adapt to at new facilities. If staff, do the opposite and pick the hardest and most varied job you can find, preferably at a teaching hospital where you will be exposed to the widest variety of patients.

I had a fabulous orientation at a teaching hospital for my first job (spent 3 years there). However, I really didn't know how my skills would translate to other hospitals as a traveler. So I went out of my way to do some per diem shifts at other hospitals. Things were easier back then with paper charting and I did fine and have been traveling for 25 years now.

But typically with nurses I see with one year experience, many do not even know how what they don't know. They may feel like stars at their sheltered first jobs, but haven't really understood how varied patient populations can be at other facilities or how different the work flow can be. Very different support systems at different hospitals should change the workload, but in fact in my experience it just shifts to other tasks and I stay very busy. While my work environment is very different to yours (I work in surgery), I know the same thing happens in other specialties.

Complaints are common among new travelers about lower levels of support than they are used to, from aides to housekeeping to secretaries to unresponsive physicians. Generally a balance is struck between patient load, time, and support (pharmacy and blood bank are often pain points) but it is up to the traveler to make that unfamiliar balance work.

[marienm, RN, CCRN]

I've never traveled and I'm sorry you had this experience. Most of the TNs I see are pretty diligent about covering their butts, and now you know why!  *Maybe* some judicious notes would have helped you here..."Lunch tray delivered at 1300, BG checked and mealtime insulin given based on sliding-scale order, see Med Rec for administration time."  Or make a note in the Med admin window about why it was late. Short-acting insulin is considered "high-risk" at my hospital and if we don't give it within the right timeframe we are expected to explain why.

This is just my perspective, but I personally would worry about your *experience* if you didn't seem like you knew what to do *clinically* vs, um, administratively. So if the Lantus pt's BG was 75 and you came to me as the charge nurse and said "hey, how do I reach the doc for this pt, I need to see if they want me to hold this lantus or adjust the dose?" that's an administrative question (how to reach the provider) that I realize you probably won't know after being here for 3 days. But if you seemed clinically uncertain (do I give a snack? Give dextrose? Hold the dose without asking? Re-check in an hour? etc...) I'd be more likely to think that experience was the issue.  I'm not saying that you did this, but maybe something to keep in mind? 

(For reference, the only TN I've participated in firing turned off all of her pressors to draw from a central line when the pt had an A-line, made weirdly racist comments about a patient, and disappeared "to get something from her car" for, like, hours at a time!  Asking legitimate questions doesn't even raise my eyebrows. And even if you are asking clinical questions that I think you should be able to answer, I'd prefer that you asked if you weren't sure!) 

[NedRN]

Unfortunately, there are some really bad travelers out there. They are rare, but sometimes travel is the only way some nurses can work at all. I doubt the one you describe could last long anywhere but there are scary stories out there about all kinds of providers, including those working without licenses.

I was at a very small hospital - Mammoth Lakes CA 15 beds - and commonly such rural hospitals have locum docs (travelers). Locum GYN doc does something bizarre I had never seen before after over 10 years (at the time) experience in the OR, she cut a raytec in half and stuffed it in the lady parts (don't remember the procedure). I told her she couldn't do that, and reported her. She had some other reports of bad care by OB nurses, but they couldn't fire her. They did so only after she was arrested for shoplifting!

At another rural hospital in Western Mass that I had worked at a couple times, a traveler RN comes through and the techs are begging me not to leave them in a room alone with her. One story that other OR nurses will relate to: on closing, the tech asks for a pack of dressing sponges. Which this traveler put on the back table unopened. While all OR nurses suffer breaks in technique occasionally, this is one no competent OR nurse would make.

Different hospitals deal with these issues very differently, and many respect the contract while others are fast to bump. This traveler also wasn't fired for clinical competence (oddly for all of us), but searching her work history discovered something falsified and was terminated for that. Best guess is this traveler had worked in a doctor's office that did minor procedures so she had picked up just enough experience to be dangerous.

The OP doesn't really fit this kind of profile other than not sufficient experience for travel. Sounds like he has the basics and lots of potential. I wish him well.

[londonflo]

On 9/11/2020 at 10:20 PM, Birdsofprey said:

After that, I was floated 2 days in a row to PCCU, and Covid stepdown ICU for "me to help out". 

I just wonder if they realized they did not need your FTE position and made up a story to cut your contract.

[jobellestarr]

I’m so sorry that this happened to you. And that you may not ever understand the why. Maybe you were too inexperienced or maybe just that they overbooked. It sounds to me like you need to consider it a blessing. Sometimes, things work out for better in the long run than what we were pursuing or thought we wanted at the time. I’d say the angels were on your side. ❤️

[rockchickrn, ADN]

I could never be a traveler. They give you no orientation and throw you to the wolves. Heck, I've been a nurse 25 years and would feel overwhelmed. If you want to travel get in a couple of years of med surg first.