Fired over neglect

[monkey2012]

Hello my fellow nurses,

I am a young nurse and have been working for almost two years. I was a clinic nurse at a community clinic for 8 mos. It is a messy big clinic where staff likes to play the blame game and full of office politics. With the change of a Health Care Manager in Feb 2013, a total of 9 medical support staff left the clinic since June 2013, 4 fired, 1 quit suddenly, and 4 left. It's like every month we had someone leaving.

The incident that precipitated my termination was this:

Pt saw family doc and I was ordered to send patient to ER to r/o appendicitis. The usual routine at the clinic for nurse is this: Doc comes and give report about pt. Nurse calls hospital ER, give report, give map if doc asks, nurse document and fax over any pertinent information to ER if asked. I gave the patient the map, explained that this is the address, and husband said "thank you." Spanish couple but doc said they speak English. I closed the door to give them privacy. About an hour later, I stood up to clock out and saw the husband open the door. I then asked "How come you and your wife have not left yet?" The doc overheard me and gave me an accusing look, "You let the patient waited for two hours?" I responded to her, "I gave them the map, and they said thank you, I don't know why they stayed in the room for two hrs." I knew she was upset and explained the same thing to her several minutes later. At the time I didn't know it was only 1 hr 10 mins, not 2 hr, as exaggerated by the doc. Every doc has a MA who is responsible for checking the rooms.

On that night, she wrote a risk report and I was terminated the next morning. They did the risk investigation and made up their mind without me.

I have to tell you my other mistakes that led up to this firing. I made one omission on charting and did not properly triage a patient asked by front desk because front desk always freak out and calls the nurse for every little thing. I was called to triage but quickly assessed the patient and said she could wait a couple days to see the doc. I did not document either. The lady later called and complained why she couldn't be seen that day. I had to tell the truth of what happened to my health center manager. I quickly called the patient like she asked and took care of the patient's problem. The health center manager seemed ok with that. I admit and own up to those mistakes.

When I got fired, they told me that I'm not a good fit for this company, I put the patient at risk, and because there were problems with my documentation and triage. I was never properly trained/ disciplined for my mistakes by my superior. When I was first hired, the health center manager and I were having a conversation and she said the company gives 3mos to see improvement, blah blah blah, but never gave me one. She was smiling to me in the beginning, and said she would mentor me, and it turned out, she was the one to fire me!

They let an MA trained for 3 days for her mistakes verses me, a nurse, fired after several mistakes. 2 nurses were let go before me.

Anyway, I have been crying and depressed since the firing, fixing my resume/ cover letter and hoping to start over. My nursing journey so far has been a rocky one and I wonder what I should do next.

I wrote a complaint letter, explained what happened, and asked to step down verses termination. The top guy has responded for a meeting (he's been with the company for 7mos), and I'm planning to see him tomorrow. Any advise on how I should talk to him? I think with my personality, I may end up saying how screwed up the company is.

[imintrouble, BSN, RN]

I don't have any real advice. Nothing hurts like being fired. Lots of us here have experienced it. Hopefully you'll be able to resign vs being fired.

Let us know what happens.

[klone, MSN, RN]

How is it that the room the patient and her husband were in were never checked in over an hour after you thought they had left? As someone who works in a clinic setting, it's hard for me to understand how you could not know the patient hadn't left to go to the hospital for over an hour.

[nurse2033, MSN, RN]

If you can frame the problems from a safety point of view, or relate them to nursing standards, or the policies of the institution it will make you look responsible and articulate. I think I would also have assumed that the patient left. You talk to them, they say they understand, what else can you do? Perhaps it was as simple as closing the communication loop by asking them to explain back to you what they need to do. Good luck.

[nursel56]

I think that if you want to convince the top guy to let you step down you will have to avoid the impulse to talk about how terrible the company is, how many other people were fired and why, etc. Find a way to communicate the systemic barriers that led to these decisions in a matter-of-fact way without personalizing it.

It's hard for me to understand your reason for not taking the triage call because the office staff "refers every little thing" and how you failed to ascertain the disposition of your ER referral family and presumably would have left them in the building had the man not stuck his head out the door.

I'm not trying to pile on, I just hope you have really internalized and understood those incidents and determined how you would do things differently no matter how disorganized and full of politics your former clinic was.

I was really fortunate to work for a great company in ny clinic years and sorry yours was not that way. Wishing you all the best!

[monkey2012]

The doc has an MA who checks pt in and out, and nurses work in a different area than the docs.

[monkey2012]

I actually saw the triage pt. I admitted I made this mistake. As for the ER disposition, the doc has a MA, I did the routine as to what nurses would do at the clinic. Thanks for your advice.

[TriciaJ, RN]

Hope your meeting went well. Sounds like: 1. It's a poorly-run workplace. 2. You received minimal orientation. When you get over the crappy feeling of losing a crappy job, you will come to see this as a gift from the Universe. When you interview for your next job, just emphasize that you're a fast and willing learner, but as a fairly new nurse you really benefit from some mentoring. Hopefully they get the picture without you having to spell out what a poor previous employer you had. This time next year, you'll be enjoying a job you've gotten good at and this whole experience will be a thing of the past. Good luck.

[klone, MSN, RN]

The doc has an MA who checks pt in and out and nurses work in a different area than the docs.[/quote']

I don't care who does it, I still don't see how it could have been missed. Who turns over the rooms? Why did not someone check on that room to turn it over for the next patient for over an hour?

[kungpoopanda]

If you are looking for new positions, I would leave this clinic off the resume altogether. You were only there briefly and it won't help you to have to explain why you were fired so soon. Just make a fresh start and as another poster mentioned, emphasise you willingness to learn under the guidance of a mentor. Good luck with finding a position that is a good fit for you.

[nurseprnRN, BSN, RN]

And do pay better attention to your documentation and follow-through. Never, never make those mistakes again.

[monkey2012]

I went and spoke to the top guy, he is supportive of my resignation but he will go and talk to human resource and we will see. I will let everyone know when I find out.