Fired during orientation/7 weeks in

[beachlover]

I worked at a hospital for 2 1/2 years as an NA with no issues/writeups/problems. Once I received my RN, I was hired on a floor. On the last day with one of my preceptors, I was told to do things that were unethical and illegal. (giving meds without scanning them or the patient, giving insulin coverage when the trays were not on the floor and pt was being downgraded/transported soon). I stated each time that I was not comfortable doing this since I was on probation, but was told "we all do it and its no big deal" and yelled at for questioning her. I went along with it, hoping to speak to someone the next work day about this (it was a weekend with no admin/nurse educators/management in, of course). First thing the following day I was let go due to my being"disrespectful" to my preceptor and telling her what to do, not asking. I am still stunned. I have no union recourse, as I was on probation. Any suggestions?

[CBlover, BSN, RN]

But I am concerned about (1) using them as a reference and what is says in my HR file and (2) this happening to other new nurses.

The last thing you need to worry about is "other new nurses." You have enough to worry about besides strangers! As far as using them as a reference, all you could tell the prospecting employer is what happened if you were interviewed. That's just my opinion. I've not been in your shoes, but nurses get fired and the same nurses get hired somewhere else before you know it. I've seen it myself.

[Been there,done that, ASN, RN]

This not about following policy. This is about your relationship with your preceptor.

A decent facility would have weekly reviews with you, your preceptor and management.. in order to identify issues like this and your progress.

I know it's tough now.. you will find another job and be grateful you got out of there.

In the future, don't tune out your preceptor, even when they are wrong. Get through orientation , then you can practice as you see fit.

Good luck, let us know how you are doing.

[Big Blondie, ASN, BSN, MSN, APRN]

A preceptor can make or break a good preceptee. Just move on, learn from it. Next time if you are having such a hard time with a preceptor you might need to address it as it is occurring. Might not have gotten to this point.

[PapaBearRN, BSN]

Was this a new grad program? A hospital spends a decent penny orienting new grads and usually won't let you go on an isolated incident, that would cost them a ton of money. I feel like your preceptor felt that you are set in your own ways and are unwilling to be flexible and learn, making you a bad fit for the unit. I believe "tuning out" your preceptor is the ultimate reason for your release. I'm sorry this happened to you. But as new nurses we are not experienced enough to determine what knowledge is insignificant, specially if a 20 year veteran nurse is calling you out of a room to tell you. The information may actually correlate with your med pass or whatever you're currently doing and you just didn't see it at the time. Once again I'm sorry this happened.

[Ruby Vee, BSN]

I agree both that you probably don't want to work at a place like that anyway and that there is likely more to the story. It hard to imagine a hospital firing a good new nurse they invested in to orient based on one day and one preceptor's report. My guess is there were other complaints. Like others said give it some consideration, learn from it and turn the page.

FWIW I think this is way kinder than the ones they know are incompetent and extend orientation in what seems possibly a plan to gather more information to fire them.

I agree it's way kinder to fire someone early on rather than extend orientation again and again when everyone (possibly even the orientee) can see that it's not working out. I remember an orientee who just didn't get it -- we kept trying to remediate. We changed her preceptor a few times, but every single preceptor had the exact same concerns. After six months of this, we were ready to let her go. But then she had a mental health issue and went on leave. When she came back months later, she was even worse. We couldn't get her to pay attention to ANY negative feedback. That was really scary. All told, she dragged it on for over a year.

Take some time, think about what you contributed to the situation. And once you figure it out, come up with a plan to take forward so this doesn't happen again. Good luck.

[Ruby Vee, BSN]

That is what is so bizarre and weird about the whole thing. This one preceptor made my life a living hell from day one. I would be drawing up meds for a patient, and she would want me to put everything down (needle and all) and come out to the hallway to her WOW so she could show me something that was insignificant. I tried my best to keep giving the meds, but she would interrupt me constantly. I never said anything bad - just that I was in the middle of giving meds, needed to focus on that and that I would be with her in a minute. She would continue to hound me until I couldn't focus - so I had to "tune her out". I never said anything, just did my job and then would go to her and say nicely - what did you want to show me? As for both instances I listed (not scanning the meds and giving the insulin) she took my WOW and completed them under my name, and gave the insulin, while berating me. Both of these issues are cause for firing in my hospital.

As many of you have said, I am Ok with not working on that unit. I have thought A LOT about what happened, and I honestly would not change a thing because I felt I had my patients best interest in mind. I didn't argue, I just stated that i didn't feel comfortable doing certain things. If she had explained to me that it was acceptable to do these things because of X circumstance, I would have been fine with it.

My main concern is that I worked at this hospital for 2 1/2 years - with 2 of them in the ER. I got a long with everyone, all the nurses loved me and said what a great nurse I would be. And then this happens. I am not necessarily looking to fight for my job back, as I don't need to work with nurses who aren't on the up and up? But I am concerned about (1) using them as a reference and what is says in my HR file and (2) this happening to other new nurses. I am certainly not looking to get a 20 year veteran at this hospital in trouble, as it would be her word against mine - and I know it would get no where.

Thanks everyone for your posts. This does kind of haunt me, and I am trying to "get over it".

THIS! This is why you were fired. Not that you didn't "bond with" your preceptor but that you wouldn't LISTEN to her. I'd have a real big issue with an orientee who wouldn't listen to me. As far as the insulin and the scanning -- there may have been good reasons why the preceptor wanted you to do what she wanted you to do, and they may have been perfectly safe things to do as illustrated by previous posters. But you wouldn't listen to her. So you don't know why she thought it was OK.

I don't think you need to worry about this happening to other new nurses. In my experience, MOST new nurses listen to the preceptor and take her advice to heart.

[LobotRN, BSN, RN]

Agree with above....and I know that there are times when I am precepting that instead of saying, "stop! you're going to make a mistake that way" I have instead opted to say, "oh, hey, come out here with me for a second, I needed to show you something." This is for the PATIENT's benefit e.g. not getting concerned about a new grad/new nurse making a mistake on him/her. And when done casually, saves a bit of face for the new grad/new nurse. Golden rule, praise in public, counsel in private. Perhaps that is what your preceptor was trying as a technique to catch and correct practice before bad habits form or before mistakes occur.

I am curious exactly what she/he showed you after you tuned back in that is deemed "insignificant".....

[Julius Seizure]

If you want to, you could always ask for an exit interview. Perhaps they would be willing to sit down with you and discuss what made your orientation unsuccessful and what you could do to improve. Plus, on your next interview, it will show that you try to learn from your failures if you are able to say that a previous preceptorship didnt work out, but that you requested an exit interview and learned that ______ is something that you will do better in the future.

[NocturneRN]

That is what is so bizarre and weird about the whole thing. This one preceptor made my life a living hell from day one. I would be drawing up meds for a patient and she would want me to put everything down (needle and all) and come out to the hallway to her WOW so she could show me something that was insignificant. I tried my best to keep giving the meds, but she would interrupt me constantly[/b']. I never said anything bad - just that I was in the middle of giving meds, needed to focus on that and that I would be with her in a minute. She would continue to hound me until I couldn't focus - so I had to "tune her out". I never said anything, just did my job and then would go to her and say nicely - what did you want to show me?

Bold and underlined are by me. That right there shows me why the preceptor didn't 'bond' with you. If my preceptee tuned me out, I would not be happy.

*********************

I'm afraid I've got to disagree in this instance. In my workplace, the rule is that you don't interrupt a nurse who's pulling or preparing medications.

The preceptor was wrong to interrupt in this, unless she was interrupting to point out an error in the way the medication was being prepared.

[Been there,done that, ASN, RN]

*********************

I'm afraid I've got to disagree in this instance. In my workplace, the rule is that you don't interrupt a nurse who's pulling or preparing medications.

The preceptor was wrong to interrupt in this, unless she was interrupting to point out an error in the way the medication was being prepared.

Unless you are the nurses's preceptor and RESPONSIBLE for the meds they administer.

[Meriwhen, ASN, BSN, MSN, RN]

I think there is more to this story.

Did you actually give the insulin prior to the meal? Because I would have not given it and explained to my preceptor that I wasn't comfortable doing so, because it was against policy.

Not scanning meds is a big no-no at my hospital and is grounds for termination. Again, I would have refused and given the same explanation as above.

This was a very hard lesson to learn, but never, never,never go against policy because "Everybody does it".

Not scanning meds at my workplace is also frowned upon, though we can skip scanning if the patient's acuity is severe enough that we need to get meds in them ASAP. We are expected to make a note about why we didn't scan in the MAR.

Whether insulin should have been given depends on the patient's specific situation and your hospital's P&P. For example, for a NPO patient, you might hold his regular insulin but still administer lantus since that's long-acting. At my current job, we're expected to give insulin no more than 30 minutes PRIOR to the meal if we expect them to eat at least half of it--if we're not sure, we can wait until after they eat.

I'm sorry you got fired. Unfortunately, orientation is a trial period and unless you were fired for a blatantly illegal reason (e.g. your gender), there's nothing you can really do about it.

[beachlover]

I understand what you are saying by my tuning her out, but would you ask your new preceptee to stop in the middle of drawing up heparin to come out of the room to show her something insignificant? (i.e., where to find discharge instructions just in case you have a discharge today?) How would you suggest I had handled it? All opinions are welcome since I hope to learn from this. :)