Fired for following orders

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I was recently fired from my job as a PCT. A nurse asked me if I could perform a particular task. I told her I wasn't sure, I called the supervisor and asked if I am permitted to do this. She asked if I had been taught it in nursing school. I indicated that I was. She said that the nurse can, then, delegate that task to me. I did it and was fired about a month after. This occurred in the state of Ohio, where the law is clear that the RN is responsible for accurate delegation and is to be who is held accountable for improper delegation. The task was inserting an NG tube. The procedure went smoothly and no harm was done. I have never been written up before, never even been late. The RN I was working for and the supervisor both said to do it. I rely on their knowledge to know how to do my job. I feel like I am a patsy.

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Specializes in Pain, critical care, administration, med.

As a PCT you need to know the scope of your practice with your training specific to the job you perform. I cannot imagine a nurse delegating that job and the nurse should be disciplined. But cannot imagine being in your spot accepting that duty to perform. That is definitely not in the role of a PCT to perform. I do think you need to be disciplined but not fired. A tough lesson to learn.

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Specializes in Neuro, Telemetry.

Agreed that while it is the nurses job to responsibly delegate, it is also your job to understand your scope of practice. Blaming the nurse for delegating the task does not relieve you of being responsible for practicing outside of your scope. Because of the risk involved in dropping NG tubes and the assessment required after doing so, this is a nursing task. You should have known this and declined the task. And since you didnt know, you should have declined. When unsure about something, do not do it unless you verify it is ok for you to do so. I imagine that when you have done this is nursing school, it was with am RN present and not by yourself. Hopefully you have learned from this experience and will make better decisions next time.

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Specializes in Clinical Research, Outpt Women's Health.

All parties were wrong and should all be counseled on scope of practice and delegation.

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Agreed that while it is the nurses job to responsibly delegate, it is also your job to understand your scope of practice.

PCTs don't have a firm "scope of practice". Some things are obvious though, we aren't going to be pushing IV meds, and any tech that does that knows they are going outside their scope. Still theres lots of gray area. Some techs start foleys, some don't, some start IVs and draw blood, some can suction or clean trachs, it all depends on where you work. Heck in the ER Ive seen techs do stuff that RNs on the floors cant do, so it varies a lot depending on the unit.

Generally if there is any doubt, then don't do it

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Specializes in Critical Care, Emergency Medicine, C-NPT, FP-C.
As a PCT you need to know the scope of your practice with your training specific to the job you perform. I cannot imagine a nurse delegating that job and the nurse should be disciplined. But cannot imagine being in your spot accepting that duty to perform. That is definitely not in the role of a PCT to perform. I do think you need to be disciplined but not fired. A tough lesson to learn.

A PCT can't place an NG? I know in the ED I worked in, both the ER Techs and the ER Paramedics would do that skill on a regular basis. But then again, the PCTs were trained in it and had to pass proficiency with it.

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Your supervisor and the nurse would of known this was not in PCT scope of duties. Did you have any issues with either of them before this event? If you are going for your RN degree do you think they intentionally tried to ruin your future career in nursing? I agree you should of known this wasn't a PCT duty, if this happened to me I would accept the decision to fire me but I would make sure the higher authorities at the hospital knew that your supervisor and nurse delegated a task to you when per their own education knew that they couldn't delegate.

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Specializes in Emergency, Telemetry, Transplant.
She asked if I had been taught it in nursing school. I indicated that I was. She said that the nurse can, then, delegate that task to me.

False.

I have never worked anywhere what allows techs to place NG tubes, in nursing school or not. Of course I have not worked everywhere, and it seems like in some places techs can drop NGs--however, my guess is that they cannot in the majority of places.

The RN who delegated this task and the supervisor who approved of it, should face some disciplinary action too, and I would go up the chain of command on that.

In the future, as a tech, never perform any task you have not be specifically trained to do by your place of employment. Even though you learned that skill in school, and maybe even performed it successfully in nursing school, you are not necessarily able to perform that skill at work.

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I missed the part where you said it was passing an NG tube, yeah while a PCTs scope might vary depending on the unit, THAT one should have been a no brainer. Its totally irrelevant if you were taught to do it in Nursing school. RN students are taught lots of things they totally suck at, and this is something that is airway related.

I don't want some unsupervised nursing student passing an NG tube on me, would you? I don't understand why some techs have this desire to do extra things not requiredof them just to win some brownie points or feel special. Its harsh that you got fired IF you were given the OK by your supervisor to do this specific task(and not some vague if you learned it in Nursing school it can be delegated), but when I floated as a tech I was occasionally asked by an RN to do something I didn't feel comfortable doing and I ALWAYS refused to do it, even if it was something a tech on that unit did but I wasn't properly trained in or had regular practice doing.

RNs make the big bucks, let them do this stuff. RN STUDENT means nothing outside of your clinicals and classroom. Ive seen RN students that were some of the worst ******* techs ive ever encountered.

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Specializes in Emergency, Telemetry, Transplant.
RNs make the big bucks

Now let's not get carried away. ;)

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Shame on everyone involved. You need to know your scope as a PCT and as an RN in the future. You can be fired for following orders. If a doctor told you to remove sutures, would you, just because you saw if performed once or twice? When in doubt, question it. If you're uncomfortable with something, even something IN your scope, ask for assistance. You will not get fired for questioning an order or for not performing a task you're uncomfortable with.

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i understand the logic as to why this task is beyond the scope of practice, however, my former employer never once provided me a copy of a job description. We routinely are expected to perform tasks for which we never formerly were evaluated on our level of preparedness (foley insertion, dressing changes, etc). Based on the fact that the patient was A and O and able to follow instructions well, I was confident that the procedure would go smoothly, which it did. Nonetheless, I checked with the supervisor. What more could I have done? I checked with someone in authority. And, I remind you, in our state, legally, the RN who delegates is to be held accountable, not the unlicensed person. To answer other questions, this was reported to management by a nurse who was working on a different part of the floor. Never had a problem with him, he is just one of those people that loves to tattle. He has gotten many people in trouble. Sadly, he is a good nurse, he just likes to create drama for others. Neither the supervisor, nor the RN I was working for, had an issue with my work. They were as surprised as I was that it was being taken up by management.

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