Fired for giving Med late

[Beaubou]

I am a new nurse, graduated May 2010. My first job was in home health, I was then offered a job at the local hospital 3 months later and I snagged it. I work on the cardiovascular/telemetry unit for 4 months before my husband received orders to move.

I started my new job on the PCU in December. I just got off orientation 2 weeks ago.

The day of the incident: The day was going great, I had four Pt's I had the day before so I was fairly familiar with them. I was actually caught up with all of my documentation (for once!) by midday. I was then told 2 of my Pt's would be transferred. As I was finishing giving report, the ED was beeping in to give me report. Anyways, one Pt came in at 1700, the other at 1800, this is where it all went to chaos.

I should have prepared early and gave my 5 o'clock meds at 4, but I didn't. So after admitting the Pt's and doing their assessments, answering family member's questions (you know the drill) it was 1830, the night shift was starting to come in and I haven't filled out the report sheet yet. After I do that, I give report and it's now 1925. I have completely forgotten about the 5 o'clock meds, and I start working on my admission paperwork. I then see that I didn't give my meds. The night nurse asks me about it and I tell her I haven't given them yet, it is unclear whether she says she will give them or not. So I wrap up my paperwork (Which I shouldn't have done...putting paperwork ahead of care). I notice on the MAR that the night nurse didn't give the meds and she is very busy with the Pt's I gave her. I head to the pyxis, double check to see if she has taken out the 5 o'clock meds and she hasen't. So I take them out and give them to the Pt (klor con, long acting insulin). I then head home, making sure my cell is by me all night in case the night nurse has any questions, assume everything is ok when I went to bed that night.

The next afternoon I receive a call that there was a "medication situation" and my floor manager wants to talk tomorrow morning. She says she is concerned about my errors, lack of time management and critical thinking, and suggests the possibility of putting me on orientation again. The nursing supervisor then comes in and says that I would be better off on a med/surg floor. I asked if I was getting fired and she said not yet. They will meet with the HR and the VP and let me know tomorrow.

I am quite sure I am getting fired though because the nursing supervisor was set on it. I have never even received a warning. I know I ended up giving the meds 4 hours late, but it was long acting insulin (note: his sugar was 409 that AM, and he's a diabetic that just had limbs amputated b/c of his DM) and PO klor con. THe big issue was the night nurse gave short acting insulin a half hour later.

By no means do I not feel completely accountable for my actions! But I think half the reason I was fired is because I am too passive, I didn't put up a big enough fight for them to keep me. Quite frankly, I wasn't expecting to have to fight to keep my job, I thought I would get written up. I am so confused, hurt and disappointed and I don't know what to do next. Should I put this job on my resume? Have any of you been fired before?

[MN-Nurse, ASN, RN]

It is ridiculous that you get fired for something like this.

The OP didn't get fired, she resigned.

I don't think the problem here was that the OP fell behind, it is how she reacted to falling behind. Further, she didn't appear to react appropriately to management's investigation or discussion of remediation.

[Beaubou]

Did you read my above post MN_Nurse?

Can you please elaborate, how should have I reacted in my manager's office? What exactly was my "reaction" when I fell behind?

[Meriwhen, ASN, BSN, MSN, RN]

I'm sorry this went south on you. At least the patient wasn't harmed in the end. Learn from this experience.

I've always followed the policy that my current patients trump potential patients (admits). That is, I will get the new patient settled but make sure everything is taken care of for my current patients before tackling their admission. Of course, this is subject to tweaking based on patient acuity.

As far as whether to list it...you're probably better off listing it, because if you omitted it, it could bite you in the rear--if not right away, then down the road. There's a thread somewhere on AN about someone who got fired because their DON had found out via word of mouth that the nurse was let go from another facility (can't remember if she was fired or resigned from the first facility), but never listed it on the application. And the nurse was several months into this new job before the DON found out.

Best of luck.

[MN-Nurse, ASN, RN]

Did you read my above post MN_Nurse?

Can you please elaborate, how should have I reacted in my manager's office? What exactly was my "reaction" when I fell behind?

Your reaction when you fell behind should have been to notify your charge nurse, fellow nurses, MDs, or ANYONE that "I am way behind on this patient's time sensitive meds, how should we proceed?"

Instead, you just gave the meds (4 hours late per your report), crossed your fingers, and went home. These weren't vitamins, they were insulin and potassium.

As I stated earlier, I don't think you should have been fired for this, mostly because I thought you sure as heck learned a lesson and would never do the same thing again. (I hope.)

Even with the house supervisor's gloom and doom, you could have explored your options with management rather than preemptively resigning. They really don't want to fire people they have invested in - unless the worker is simply dangerous and unable to learn from mistakes. If there were other issues or incidents you aren't including in the discussion, firing could have been inevitable.

As far as your resume goes: be honest.

[Horseshoe, BSN, RN]

At the beginning of the meeting, it was only me and my floor manager going over the events of the day in question. She and I were discussing what would be best for me like going back on orientation again, but with a different preceptor. It's when the house supervisor came in and started talking about working on another floor or another facility that might be better suited for where I am at right now, that I realized she was telling me I was going to be let go. That's when I asked if I was being fired and she said "no, not yet." That they have to meet with HR and the VP and call me tomorrow afternoon to let me know.

I still think you jumped the gun. Your immediate supervisors would have likely had input into your situation; the House Supervisor doesn't usually run around firing people at my hospital.

You assumed you were going to be fired, but it's very possible you would have been offered remediation. I agree with someone upstream-it's expensive to train new nurses. I can't imagine that it would have made financial sense to fire a newly oriented new grad for one bad shift which did not even result in harm to the patient.

[Beaubou]

I still think you jumped the gun. Your immediate supervisors would have likely had input into your situation; the House Supervisor doesn't usually run around firing people at my hospital.

You assumed you were going to be fired, but it's very possible you would have been offered remediation. I agree with someone upstream-it's expensive to train new nurses. I can't imagine that it would have made financial sense to fire a newly oriented new grad for one bad shift which did not even result in harm to the patient.

I felt the house supervisor was shifting that way when she starting saying that she didn't think another week or two of orientation would do anything for me. (I very much disagree, since I feel that my biggest problem is time management, unfortunately I was in a state of shock that I couldn't think to say anything like this). Then she started talking about me working in another facility, a less acute area. That's when I started to get the notion they didn't want me to work with them.

That's when I said... wait a minute, am I being fired. and I swear she said exactly "no, not yet. It's a lot harder to fire someone than you think, the manager and I have to discuss this further, then we will meet with HR and the VP of the company and that's when we'll decide."

I said: how long is this going to take? My floor manager looked at the house sup and said "tomorrow afternoon? Yeah, we'll call you tomorrow afternoon and let you know."

I then called my nurse friends and asked for their advice, and after hours of debating, I came to the conclusion that I didn't want to work for a facility that doesn't nurture their new nurses and is willing to think about firing them, even when the nurse has never had a written or verbal warning regarding any wrongdoing.

That's when I put in my resignation.

By the way, this is a magnet hospital.

[Beaubou]

your reaction when you fell behind should have been to notify your charge nurse, fellow nurses, mds, or anyone that "i am way behind on this patient's time sensitive meds, how should we proceed?"

instead, you just gave the meds (4 hours late per your report), crossed your fingers, and went home. these weren't vitamins, they were insulin and potassium.

as i stated earlier, i don't think you should have been fired for this, mostly because i thought you sure as heck learned a lesson and would never do the same thing again. (i hope.)

even with the house supervisor's gloom and doom, you could have explored your options with management rather than preemptively resigning. they really don't want to fire people they have invested in - unless the worker is simply dangerous and unable to learn from mistakes. if there were other issues or incidents you aren't including in the discussion, firing could have been inevitable.

as far as your resume goes: be honest.

you can say that again!

you can bet your bottom dollar that i will have a one track mind when it comes to giving meds and not only asking, but demanding for help!! being nice, and not wanting to make to make waves, will no longer be my concern!!

lesson learned.

[Meriwhen, ASN, BSN, MSN, RN]

You can say that again!

You can bet your bottom dollar that I will have a one track mind when it comes to giving meds and not only asking, but demanding for help!! Being nice, and not wanting to make to make waves, will no longer be my concern!!

Lesson Learned.

Sometimes learning to ask for help is the hardest thing we have to do, especially when we're a new grad trying to prove ourselves.

[NoviceRN10]

My advice to you is to not do admissions in the middle of your med pass. I would never put off giving my meds on time to do that. When we get admits the nurse aides usually help get the pt in bed and do vitals, and there is not usually a reason to run right in there and do the admission (on computer), although I would give pain meds if needed. I can't believe you would have been fired for what happened, nurses at my place of work give meds late or never even give them at all quite often (I know this by looking at are eMAR and all the red boxes before my shift), and nobody is losing a job over it. I work with a nurse that is always giving her 10p meds hours late (and I mean at 2,3, or 4 am!) and nobody seems to notice or care. You must have gave them a bad impression of you for some other reason.

[Vespertinas]

You don't have to answer this but I'm going to go out on a limb and guess it's NYU and not Mount Sinai if we're talking about NYC

[Beaubou]

Have you had, or heard of, bad experiences with NYU?

[NurseCard, ADN]

I personally wouldn't mention exactly where you work, or worked,

on here. Just a bad idea IMO.

Anyhoo, count me as one who thinks that you really

should not have just resigned. Should have discussed

openly and honestly, the situation with your bosses...

offered to go back on orientation or transfer to a less

acute unit. Heck, if you are a fairly new nurse, working

on an intensive care or step-down unit... you should have

still been on orientation, IMO!

But, hindsiight is 20/20 right? I would go ahead and put

it on your resume; maybe explain that the unit that you

were on just did not turn out to be a good fit for you.

Think hard before you accept the next position.... based

on what you have learned about yourself, WILL this job be a

good fit? Because it would behoove you to stay at your next

job for a good while. Good luck!