Fired. How To Get Over It.

Nurses Career Support Nursing Q/A

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I've been an RN for over 30 years. I was terminated for the first time in my nursing career for starting an IV on a patient without having completed the IV competency. Patient was not injured and they even kept my IV site and infusion going after I had left.

I have over 30 years of infusion and hi-tech IV experience. The organization posted a complaint to the Nursing State Board that I had maliciously and incompetently performed these actions. I think this should have been a written disciplinary action.

There was an investigation and the Nursing Board found I did nothing outside the scope of my practice, or dangerous enough to warrant my license being suspended or disciplinary action. I did break policy and it was an error in judgement I admit. 

I have secured another job. There was never anything asked on the employment app about previous terminations. But, I worry that the employer learns of my firing and terminates me. Could they?

How do I get rid of this scared/apprehensive feeling? 

How to I respond if in the future I am asked by an employer?

Any and all assistance is appreciated.

The first thing I would want to know is was reporting you to the board an act of malice because if it was, you may have grounds for a law suit. You should consider that. A lawyer will only take your case if they think they can win. You're right in believing a reprimand was all that was necessary. Consider yourself lucky you're no longer in their employ.

I know what it's like to be reported to the board and having to defend your license. I prevailed because the BON was caught in numerous lies and I had outside help. People don't understand what a cascade of events this creates for the nurse and believe me, the large majority do not have a good outcome. Always remember that the BON is not your friend.

I wouldn't worry about your concern until it happens. If it doesn't all the better for you.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
mrphil79 said:

Aside from my very first job out of school when I had 3 months of orientation, I've never one single time had to prove to anyone I could start an IV - at 12 different facilities. 

Don't know what to tell you. It's a Joint Commission requirement that all nurses/clinical staff have a personnel file that shows completed competencies. The fact that you never have had to do that I guess is a good illustration about why a lot of hospitals have "findings" when TJC comes a knockin. Which skills require a competency and which ones do not is up to the individual organization. Perhaps you have just been lucky that none of the organizations you've ever worked for has required IV starts as one of the required competencies, but certainly a lot do (most organizations will require it for those skills that are considered "invasive" and have higher risks associated with them).

https://www.jointcommission.org/en/standards/standard-faqs/office-based-surgery/human-resources-hr/000002152

I retired from nursing this past October and things like this happening are partly why. I've been getting phone messages about various positions open but I'm not really interested. I will keep my nursing license current though, and the necessary certs current, once a nurse always a nurse, I say. Who knows, I might be able to do private one-on-one care or something like that. Not really working anywhere right now and actually beginning to get used to it! For the record, the last two years of my nursing career were hell, dealing with this COVID-19 stuff.

Specializes in ED, Critical Care.

I had a quit or be fired deal few years back. Been a peds ICU and ED RN in a regional trauma and peds faculty for about 10 years. At this point I had been a paramedic for 25 years as well. I took a job at a critical access hospital for the slower pace and to pad my state retirement as EMS and this place both paid into the same state system.

Job was in their "ICU' which for this place was the most ICU thing was hanging blood. Everything was sent out to the big city about an hour up the road literally. I had been there a few months and asked to move to the ED. That was when my troubles started. I was brought in and received a scathing review and then was told I was going to be "retrained".

I was put with a particular nurse and knew my days were numbered. Long story short the manager called me and started with "well according to nurse so and so your not cutting it. We have to let you go. I knew from day one of "retraining" I was done. So I asked the manager, "listen could you just let me resign? I've never been fired." 

She said, yes she could to that. So we blah blahed for a few and she said I could go home. I submitted a resignation. Yeah it bothered me. I am nobody special, I'm not super nurse or medic. I can be slow. My work gets done and knock on wood, I've never had a med error. I was the one they called to try the hard IV's.  My GF said put in for travel nursing so I did and this particular manager gave me a favorable review. I ended up at another big city hospital ED instead. I'm now doing prison nursing and its the easiest job I've had. 

Keep your head up, the state said you did nothing wrong. some places just have miserable management and miserable staff.

rninformatics said:

I have over 30 years of infusion and hi-tech IV experience. The organization posted a complaint to the Nursing State Board that I had maliciously and incompetently performed these actions. I think this should have been a written disciplinary action.

There was an investigation and the Nursing Board found I did nothing outside the scope of my practice, or dangerous enough to warrant my license being suspended or disciplinary action. I did break policy and it was an error in judgement I admit. 

My God this is scary.  One wrong thing and they reported you to the highest of the high.  I'm sad for us.  This is why so many nurses feel anxiety and depression.

Keep your head held high and try to find a place where it is not so stressful.  This would have gut punched me as well.  You certainly are not alone.  Manage the stress, put it behind you and keep your focus forward.  You'll be alright.

Specializes in BSN, RN, CVRN-BC.
mrphil79 said:

Aside from my very first job out of school when I had 3 months of orientation, I've never one single time had to prove to anyone I could start an IV - at 12 different facilities. 

After initial competencies in orientation they just get pencil whipped each year.  Maybe not completely pencil whipped,but most of the competencies are things that we at least once or twice a week if not daily.  No one has every actually come to look over my shoulder prior to signing off beyond the initial competency.  Some of competency items that are rare and we sign off that I have the theoretical knowledge to do them and the team-lead or manager signs off.  Competencies that are critical but are seldom to do tasks we have in an annual skill fair where we get a brief refresher training and a check-off.  If we get a new product for central line dressing changes we get an inservice and maybe someone watches us do one.  

I'm shocked that a facility would fire a nurse for successfully starting an IV on a patient who was a hard stick and then report it to the board to add insult to injury.  Someone was looking for a reason to fire and decided to throw in a side dish of malice.  

My manager lost the confidence of the director.  Within 3 months they found a reason to fire her.  It was a petty reason similarly to this situation.

I wish I knew which facility it was so that I can make sure that I avoid them.

Specializes in geriatric, home health.

It's so sad that there are so many people in management who do such immature things to just find a petty reason to fire someone just because they don't like them or have a personality conflict. That facility should have checked you off on the competency before turning you loose on the floor. With 30 years of experience and so much IV experience I know that you had a lot of expertise that you could have taught many of the new nurses the skills and techniques to successfully start IVs on hard to stick patients. Their loss. Your new facility gain in hiring you.

I have read similar post like this so many times, which brings to light over and over how nurses are not supported no matter how many years of experience.  I believe whether intentional or not you were set-up to fail.  When I graduated I received no training at all as an LPN.  All RN's hired received a minimum of 2 months of orientation and LPN's a big 0.  I had the same responsibilities as the other nurses.  I worked with an RN associate that I asked for help.  She unfortunately did not have much more knowledge than I had.  Inadvertently she handed me (yes I know, but I was a new grad) a syringe of Morphine that I thought she had wasted 7mg of the 15mg and then added another medication as ordered.  It was not until I came back for her to co-sign that I realized she never wasted the morphine.  So I had to contact the physician, the surgeon (going to surgery) the family and the DON.  I was so freaked out I fought back tears all day in a 12 hour shift.  This happened in 1991 and I remember it like yesterday.  I ended up using EAP and getting counseling.  I was so overwhelmed and could not get out of my head, my instructors voice about nurses making a mistake was the worst (and it is bad and could be life threatening) but offered no forgiveness, no way to recover.  The good news is that with a nursing degree you have many options.  I have worked in county jails, clinics, assisted living, as an agency nurse, behavioral, drug and alcohol recovery, and medical sales.  You have options, many options.  Also consider taking classes, you can find hands on refresher courses as well.  You may consider an Long Term Acute Care hospital as well.  Good luck to you, we have all been there and feel your pain.

Specializes in Informatics, Education, and Oncology.

Davey Do, I can't thank you enough.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
sideshowstarlet said:

I've heard of LVN's having to take a specific IV certification course before the facility lets them start IV's, but I never heard of RN's having to do this. 

The OP didn't need to take a certification course, but just complete a check-off showing she's competent. Almost all hospitals require that you complete a competency check-off on many skills before you're allowed to complete the skills independently. The check-off is usually performed by someone from nursing education, the new nurse's preceptor, or nurse leader. It's a Joint Commission requirement.

OP, every place I've worked, if a new (to the organization) nurse does a skill and doesn't have the associated completed competency for it, it's the fault of that nurse's manager, not the nurse itself. It's MY responsibility, nobody else's, to make sure the nurses who work in my unit have demonstrated and documented competency in the various skills that they perform. The fact that they fired YOU for this is ***.

Without knowing more details, I'm suspicious that this all about ageism -  you're expensive, and could possibly be replaced with a couple of (part time) new grads.  
Call me a cynic, but it happens 

It was a BS move on their part. 

klone said:

 Almost all hospitals require that you complete a competency check-off on many skills before you're allowed to complete the skills independently

Aside from my very first job out of school when I had 3 months of orientation, I've never one single time had to prove to anyone I could start an IV - at 12 different facilities. 

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