I took a per diem job about 2 months ago in a residential eating disorder facility. I have been an RN for two years. I spent the first year in L&D, and did well there, but when I was told they would be moving me to nights I had to resign. I was also scheduled to have a hysterectomy, and had not been on the job long enough to qualify for FMLA. I then took a job as a school nurse working with medically fragile children, and have been doing well with that. At both of those jobs I have received excellent reviews, and have been told that I am a good nurse. The per diem job I mentioned above sounded fine, but I began having doubts on the first day. I was so informally trained that I began doing research on my own to supplement my training. After 2 partial days of job shadowing, I was told that I was "trained", and that I was on the schedule as the RN. Since it was a per diem job I was only scheduled for 2 Saturdays per month. Everything was going well, and I was starting to feel comfortable that I could meet the demands of the job. I was on break from the school nursing job, so I asked the DON if I could work a partial night shift in order to learn the routine in the event that I was ever called to work nights. She refused, saying that as I was only scheduled for Saturdays, that it would be unnecessary for me to learn the night routine. Sure enough, last Saturday, the DON called me up frantically asking me to cover a partial night shift for that night as the agency nurse had called in. I reminded her that I had not been on a night shift before, but she assured me there wouldn't be anything I wasn't familiar with involved, and that the day nurse would be there at change of shift to answer any questions. I reluctantly said yes (wanting to be a team player), and showed up to work midnight to 6am. The day nurse informed me that of the 3 patients in the house at that time, the 2 diabetics were in the same bedroom. She told me which bed each one was in, and that they needed fingersticks at midnight and 4am. I was told not to turn on the bedroom lights, but instead to use a flashlight so as not to interrupt their sleep more than necessary. Furthermore, they each have their own glucometers, which we keep locked up in the med room, and they are identical. They each have a piece of masking tape on the outside with their names on them. So here is the incident that took place:
I took both kits into the room at 12:15am. I had the flashlight on and went to the bed where I was told patient A was sleeping. I called her by patient A's name and she woke up and sort of sat up and I told her it was time to check her blood sugar. She took the kit from me and did the fingerstick herself (which is company policy). When she handed me the kit back she looked at the kit and told me it was not hers. This shocked me, as I had been told that Patient A was in that bed, and I had called her by patient A's name and she responded. The problem is that the facility does not have a policy for making sure the patient's who do their own fingersticks change the lancet each time. No one knew whether the lancet was new or not. The rest of the shift was uneventful. When the day nurse came back at 6am, I told her what had happened, and she said she was unsure if the lancet was new or not. I filled out an incident report, discussed it with the day nurse, discussed it with the safety director (who just happened to be filling in for someone else), and then called the DON that day to report it. They all assured me I had done what was possible to be be safe in the circumstances. The DON told me she didn't think she would have done anything different given the situation. The doctor was notified, and the two patients had bloodwork done. The bloodwork came back clear. I had suggested to the DON that there should be some sort of label to show the name of each patient on their beds, and she agreed with me. She told me to chalk up this experience as a "learning curve". I just got a phone call from the facility manager today, informing me that risk management directed the facility to fire me due to the incident. I was very frustrated! I feel like I did all I could to deliver safe patient care, and that the incident was due more to the facility's lack of organization than my negligence. I am still within my 90 day probation period there, so they will not show it on my record as an involuntary termination, but I am still upset. The facility manager said he would send me a letter stating that the decision for me to leave the job was a mutual decision based on a scheduling conflict. I just don't know how to react to all of this. Any input would be welcomed. Thank you!
