Fired again

Published

That's three times in about four years.

What the hell do I do now?

Confused about you "calling in sick" but still seeing patient's. If we need to call in sick then our schedulers would find another nurse to see our patients that couldn't be moved to another day. It is part do case managing. As for the orders not being on the start of care? When we do a. SOC the first thing we ask the pt for is a copy of their d/c paperwork and our referral has what the MD wants ( PT, RN for...). If your visit was the SOC and it took you a week to get out to his house, that would be a problem in our agency. Pt's need to be seen 24-48 after d/c, joints are usually next day and again, if assigned RN unable to see, scheduler gives to another RN. Communication is key in home care! Also, no matter what the situation, never " let the see you sweat". If you seemed flustered and unsure, coupled with the patient being home a week with no visit, this is what probably prompted the wife to call the MD. Ortho docs are notoriously unforgiving ;). I am sorry this happened. Take a deep breath and do some self evaluation. Maybe an acute care setting where you have more support from seasoned RN's would be a better fit. I have been a nurse for 17 yrs and would never go to LTC. Keep us posted.

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That's a confusing story.

Was he your patient? It sounds like he was as you said you hadn't been able to see him all week, that doesn't sound like a statement a prn nurse would make. If he was your patient, he had staples so there had to be a plan for who and when they'd come out, there shouldn't have been a surprise there. When somone opens a knee patient for me, if the lab and staple orders are missing, I know we need clarification.

If you couldn't work a full day due to weather, why didn't you talk to your manager about being abLe to make it out this one that lived close?

Do they not let you carry car stock?

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I'm not trying to pick you apart, I'm trying to understand your thought process. I have an idea of the underlying issue you might be having that is causing the firings, do you feel safe enough to explain what happened in your previous jobs?

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ummmm, i don't know about you... i worked home health for 6 most while waiting to hear back from my hospital. I've made mistakes here and there but for the most part I've learned from them... if you ask me, i would challenge what they said...

for furutre reference, you should, if there is a question about orders, you should call the agency first then the doctor's office. the thing about home health that you must understand is that... the way that the home health gets new patients is by a doctor's referral. you never want to make the office look like they are hiring a bunch of newbies who don't know what they are doing. Cause if the doctor threatens to never send patients to the HH because a certain nurse called and sounded clueless, even if its the HH's fault for not giving you all the orders, you will get fired for loosing them lots of money.

furthermore, never promise a patient that you will come back later....always try to resolve the problem there... have them see you call the office. I've had many patients who were sent home with orders on their end but no orders on my end about wound care...guess what? "I'm not gonna do it!". In certain cases the wound is small enough wherei can justify doing wound care....but staple removal and lab draws? yeah...no thanks... i don't want to be sued later if anything goes wrong.

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sometimes patients will not answer their phones for the soc for days. and when they do, they still want you to come on another day... so maybe he didn't see the patient for days due to that... when this happens the office should be notified right away. i personally do not play phone tag... i have better things to be doing like spending it with my family and seeing patients that actually want to be seen. so, I tell the office i can't get ahold of the patient. they take care of locating the patient. HH is out driving and being flexible but we can't be expected to drop everything for a patient who might or might not be home. i would never visit a patient without first speaking to them and asking if its ok. If i have called every number listed to locate the patient... and nothing... well, on to the next. let the office figure it out...most of the time its because the patient still isn't discharged.

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Confused about you "calling in sick" but still seeing patient's. If we need to call in sick then our schedulers would find another nurse to see our patients that couldn't be moved to another day. It is part do case managing. As for the orders not being on the start of care? When we do a. SOC the first thing we ask the pt for is a copy of their d/c paperwork and our referral has what the MD wants ( PT, RN for...). If your visit was the SOC and it took you a week to get out to his house, that would be a problem in our agency. Pt's need to be seen 24-48 after d/c, joints are usually next day and again, if assigned RN unable to see, scheduler gives to another RN. Communication is key in home care! Also, no matter what the situation, never " let the see you sweat". If you seemed flustered and unsure, coupled with the patient being home a week with no visit, this is what probably prompted the wife to call the MD. Ortho docs are notoriously unforgiving ;). I am sorry this happened. Take a deep breath and do some self evaluation. Maybe an acute care setting where you have more support from seasoned RN's would be a better fit. I have been a nurse for 17 yrs and would never go to LTC. Keep us posted.

i agree, keeping the agency the loop is number 1... always speak to them about any concern no matter how trivial. always tell them you couldn't find patient or unable to locate.

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Specializes in HH, Peds, Rehab, Clinical.

Except OP didn't call in because she was sick. She thought it was too cold to go out....

Confused about you "calling in sick" but still seeing patient's. If we need to call in sick then our schedulers would find another nurse to see our patients that couldn't be moved to another day. It is part do case managing. As for the orders not being on the start of care? When we do a. SOC the first thing we ask the pt for is a copy of their d/c paperwork and our referral has what the MD wants ( PT, RN for...). If your visit was the SOC and it took you a week to get out to his house, that would be a problem in our agency. Pt's need to be seen 24-48 after d/c, joints are usually next day and again, if assigned RN unable to see, scheduler gives to another RN. Communication is key in home care! Also, no matter what the situation, never " let the see you sweat". If you seemed flustered and unsure, coupled with the patient being home a week with no visit, this is what probably prompted the wife to call the MD. Ortho docs are notoriously unforgiving ;). I am sorry this happened. Take a deep breath and do some self evaluation. Maybe an acute care setting where you have more support from seasoned RN's would be a better fit. I have been a nurse for 17 yrs and would never go to LTC. Keep us posted.
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You were scapegoated because the agency erred in not putting the orders out there from day one, if the orders were even available at that time. This one is on them, not you. Unfortunately, you are the one who is going to suffer for this while the individual at the agency who neglected to put the orders in place will go on to make another mistake, and to blame yet another field nurse for that mistake. But you should have informed the agency that you were seeing the patient, for liability and safety reasons. Dust yourself off.

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Sorry this isn't helpful...but all I can think of is the movie, "Friday."

Fyi, he got fired for allegedly stealing cardboard boxes.

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Specializes in OR, Nursing Professional Development.
I went to see a patient on a day that I had called in and said that I would not be coming in to the office. I called in because of the cold/wind chill and the roads. However I had a patient that I had spoke to the night before and had said that I would see in the early AM. the patient did not live far from me. He was a newer patient, I hadn't been able to see him all week, I had concerns about him.

This was a poor decision. Why would you call off but then work without notifying the office? While the missing orders and everything are an issue, I think the company was justified in terminating you for showing up at a patient's home after saying you weren't coming in. There are probably liability issues involved with the situation as well as patient privacy issues- once you called off, you were no longer authorized to be in that patient's home as a representative of the agency.

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I went to see a patient on a day that I had called in and said that I would not be coming in to the office. I called in because of the cold/wind chill and the roads. QUOTE]

:roflmao: Next time you call off because of bad weather, make sure to stay away from the facility! And away from the patient.

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Specializes in Med/Surge, Psych, LTC, Home Health.

Thanks for all of the replies, they are helpful. Home health is a challenge that is for sure. I made a big mistake. I've made a few. Dusting myself off. Looking for another job.

I have people in my office who are going to bat for me and trying to get me my job back but I'm not holding my breath.

Thanks again.

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