A Cautionary Tale (Feedback and advice would be appreciated....):
Just wanted to say I was recently terminated after a 12 week orientation. The reason given was that I was not able to handle the level of acuity and pace of the unit. The managers did not believe I would be able to succeed, based on their experience with "hundreds" of new nurses. They suggested I apply for less acute units in the hospital or in the associated clinics, but did not offer any referrals. I was told to clean out my locker. This was after receiving no formal written performance appraisals and having passed all my orientation classes. My preceptor had told me I was not picking up things as quickly as I should at about the 10th week, but never mentioned the possibility of termination. She verbally suggested I work on "focusing to prevent distraction and organizing my workload". She wanted me to try the night shifts to see if I would do better with less distraction. She did say that 10 weeks was the new length of orientation and I was already at the end of that period. (My orientation book said it was 12 weeks -- apparently old information.) No one mentioned the possibility of termination -- not the preceptor, the manager, the supervisor, or the nurse educator.
Termination after orientation can happen. This was my first job after graduation and a very difficult transition for a new grad, an older-age one at that. It has been extremely demoralizing to be fired. I wonder if I should quit the profession and give up, but I have invested too much in time and finances, and have staked too much of my future on becoming a nurse.
It is disheartening to hear the comments (on a different topic thread) that it is very rare for a nurse to fail orientation. I do feel like a failure. Looking back I see that I could have done some things differently. I did not come home and study or study on my days off, which now I believe I should have done. My excuse is that I was too tired and stressed from the exhausting and overwhelming hours at work. Often it was 13+ hours straight, with 6 to 8 hours before a break or chance to eat. (When really busy, nurses worked 9 to 13 hours straight through, counting extra time for report and charting, with no breaks at all). And there was the constant bombardment of new information to digest. It was just full-tilt boogie for the whole shift. It would take me all of the available hours before the next shift just to recover my energy and clear my head.
My advice: If you truly want to keep your job, you must push through the exhaustion and stress and study. Ask for written evaluations early on and if you are not at the expected performance level, ask for a remediation plan and regular reviews of progress. If you sense something ominous in the wind, speak up and ask what's going on. These things I did not do, since I expected a chance to review my performance with the supervisor and manager and to remediate if necessary. (Part of me did have a growing fear that I might be terminated... This is when I should have point-blank asked!)
There were many things in the way my termination was handled that I could complain about, but I don't wish to dwell on that here. I need to learn the lessons and move on, whether it is to continue in nursing or not. It has been a little over a month since my firing and I am still trying to get over the emotional trauma.
Good luck to you! (I don't know how old this post is. I hope you've succeeded and gone on to become a great nurse.)
Wow! what a timely post. I am an older nurse; this is my second career, and I just started with my preceptor this week (I worked 2 days with her). And I love the patients, the pace, the feeling of being able to help a patient, but my preceptor is from Hades. She spent the first day telling how horrified that she was that I hadn't done XYZ during clinicals, and then the next day telling me that I was slowing her down. Well, yes, i am slowing her down, because I don't know what to do; I've never cathed someone (although, I've done it a million times in lab), and I've seen a lot of things, but only once.
So, OP, I'm so sorry you are going through this, but thank you so much for this post--I refuse to give up, and so I will study, study, study...and study some more. I might not make it, but by golly, I'm not going down without a fight! (Another nurse told me that my preceptor was horrible to her also, so she asked for another preceptor--don't know if that would be a good ideal or not--don't want to rock the boat-). I hate feeling like this.
Wow! what a timely post. I am an older nurse; this is my second career, and I just started with my preceptor this week (I worked 2 days with her). And I love the patients, the pace, the feeling of being able to help a patient, but my preceptor is from Hades. She spent the first day telling how horrified that she was that I hadn't done XYZ during clinicals, and then the next day telling me that I was slowing her down. Well, yes, i am slowing her down, because I don't know what to do; I've never cathed someone (although, I've done it a million times in lab), and I've seen a lot of things, but only once.
So, OP, I'm so sorry you are going through this, but thank you so much for this post--I refuse to give up, and so I will study, study, study...and study some more. I might not make it, but by golly, I'm not going down without a fight! (Another nurse told me that my preceptor was horrible to her also, so she asked for another preceptor--don't know if that would be a good ideal or not--don't want to rock the boat-). I hate feeling like this.
thanks, gonzo1.... I like that first suggestion, since it's pretty much my case, too. I started out on a cardiac telemetry unit, my first job as a nurse. Our patients were mostly elderly with many comorbidities, tubes, lines, wounds, etc. You were pretty much on your own with figuring out how to organize the information and workload. My preceptor, as sweet as she was, couldn't give me the help I needed. Either she didn't know how, was too busy herself, or what. She demonstrated how she did things with me watching most of the time. When it was my turn to hang the IV or give the injection, she would guide me step by step. But still, when it came to doing it on my own without her there, I'd forget everything she had shown me. At one point I asked for extra help with the IV's and her response was "you know how to do it, you just lack confidence." But that wasn't true. I needed to practice it a couple times with her there, me doing it, and no live patient attached.
The manager and supervisor (who IMHO should have been monitoring my progress and making sure I was on track) were distant and unavailable. Neither ever spoke to me about any problems I was having. They would walk by me and smile and say "how are you doing?" And that was it. They were on another loftier plane, apparently. At least until the day they fired me! My preceptor was unaware I was going to be terminated and only found out the following week when she returned to the unit. The managers were getting their input from somewhere, I guess...
My problem is I'm slow! Slow to pick up on things and slow to get things done. Almost every clinical instructor and employer has told me this. I know I am smart enough. I think I need behavioral rehearsal like athletes do, by mentally going through the steps over and over until I don't have to think about it anymore. I had trouble with the workload because I didn't have a clear picture of where to start. I'm not sure this is making sense. I'm reading a time management book that is really helpful in explaining me to myself. It talks about the need for thinking about what needs to be done upfront in "knowledge" jobs. This is what I wasn't allowed time for. I would go into a patient's room not knowing clearly where to start and what to do. I'd get anxious and feel like I was floundering. I was unfocused and inefficient. I felt the need to get my thoughts organized, make sure I wasn't leaving anything out, and that I was clear on the next steps to take. But if I tried to take a minute to breathe -- and I mean that literally -- I'd be told, "now it's time to do such and such..."
I wasn't allowed the autonomy to decide what to do next. I was being directed at every moment, as in "do this, now do that, no don't do that, do this, and do it faster, faster, faster." The constant pressure to go faster than I was ready for led to mistakes. My confidence level began to drop dangerously. I could not function that way. I needed to think things through, find my own system of organizing, and my own rhythm. I couldn't do that with someone hovering over me and directing my every move. It felt almost abusive. I began to feel angry and frustrated with the people who were trying to "help" me.
I feel if I can just find the key to organize myself, stay relaxed and focused, and work on getting familiar with all the physiology I will be okay. I really, really want to succeed at this!!!! I've always gotten good grades, I can understand highly complex things, I can be an ace at critical thinking and problem solving, it just takes me longer to get there sometimes!!! I can get side-tracked by unimportant things and lose sight of what needs to get done. I know I can be good at this if someone can allow me the time and be patient with me until I find my "sea legs." The time management book is helping me get a system that will keep me focused and on-task.
I have an interview scheduled for med/surg this week and also one for psych with a different hospital. I'm leaning strongly toward the med/surg because I want that basic nursing experience. I don't see myself in a psych nurse career now at all and am wondering if I should just cancel that interview. Anyway--- I'm going on and on here. Any suggestions about how to prepare for the med/surg interview? Anyone? I'm supposed to meet with the HR person first, then with the hiring managers. Interviews feel so phony! Me trying to sell myself and not reveal the problems that got me canned. Trying to put the positive spin on everything. It seems so insincere and almost like lying. Help! :) I think the suggestion from gonzo to keep it simple is key here, too. As you can see from the above, if you've stuck with me thus far, I do complicate the heck out of things! I have to analyze and pick it apart to truly grasp it and internalize it, whatever the "it" might be. My strength as well as my weakness!
Hi, nursemaddie... I can't read the saying on your photo...the print is too small. What does it say?
Sorry your'e feeling bad about your preceptor. Mine was nice, but she seemed to demonstrate things way too fast. And expected me to have it down after seeing it once, as you said. Others have suggested jotting a note each time there's a skill, a med, a lab, anything you need to look up. I should have been doing this daily after each shift. I think it would have helped. I could have reviewed my skills in my texts, all of which I saved, thankfully.
I don't know about asking for another preceptor either, but I do believe there should be a way to give feedback to the preceptor if their style is not a good fit for you. In hindsight I could have done that more. When I met resistance from her to my requests for more help, I just shrank back and gave up. Like you, I was afraid of rocking the boat. Little did I know, the boat was already rocking and about to pitch me out!
I think people learn in different ways. I'm trying to find out now what I need from a preceptor to be successful. I'm reading about time management in a book called Getting Things Done, by David Allen. It is excellent! It's hitting the nail on the head about how to get a handle on complex, overwhelming workloads. (Can you relate?) I recommend it highly. It talks about how trying to hold everything we need to do in our heads is a recipe for disaster. Our short-term memory just crashes from the overload. That is exactly what I felt was happening to me, when I couldn't take two minutes between patients to clear my head and plan my next actions for the next patients. I felt like I had someone over me cracking the whip! It was awful! I'd get so stressed I couldn't even think straight, much less remember everything I needed to do.
I'm not giving up either, nursemaddie! I've worked too hard to get to where I am. Turning back is not my style! :)
Flatlander-I'm sorry this happened to you, but you seem to have reflected upon it and aren't letting the experience bring you down! I myself am a career switcher on week 5 of a 16 week "accelerated" orientation. We have a "check in" every 2 weeks with an Educator to make sure we are on par with where we are supposed to be and so the Educator can give us pointers or goals for the next 2 weeks. Even with all of this structure, I still have the "what if" in the back of my head simply because I'm a "baby nurse" and there are so many experienced nurses trying to get hired into the same unit.
As for studying, I have been picking the brains of the various primary nurses I've worked with over these past few weeks and I intend on picking up some materials that were recommended.
Good luck in finding your niche and a department that will love you back!
That every two week check-in makes alot of sense. I can't understand why this was not done, or something similar, at my facility. There was a lot of "mystery," I felt. Things not above board, maybe discussions going on behind the scenes to which I was not privy. Very uncomfortable situation. I got little feedback unless I asked and then it was like "How do YOU think you're doing?" (Not helpful.) I never had any feedback from the educator, nor any one-to-one with her, the manager, or the supervisor, and yet, I believe they were the ones who decided to let me go. My preceptor said she "had no clue" that was going to happen. (She was a sweet and kind person, through and through...maybe she just didn't want to hurt my feelings:!)Bad business....
The wonderful feedback on this forum lets me know that this is just how it's done in some places. I think it's cruel, but it gives another dimension to "nurses eat their young."
It has left me with a very negative feeling about the profession and those in charge. Yes, finding my niche and a place where I can be appreciated and respected is what I wish for. But how can one ever know before taking the job? Is it just luck? I guess in my interviews this week I will ask alot of questions about the orientation process, the involvement of the supervisor and the educator, about frequency of formal feedback and performance reviews. I'll try to be upfront about what I think I need.
Well, good luck to you. It sounds like you are doing well. And if you can learn from my experience, that makes me happy! I love that we can learn from each other on this forum. It's invaluable! :)
I was fired after working 3 1/2 weeks. I posted a thread here if you noticed. I was pretty upset but not devastated. I got a job at nursing home last friday, a week after I got fired. It was nice and I cant complain anymore. Good luck on finding another job! I wish you the best!!
I too got fired during orientation. I only managed to make it thru 6 weeks. I worked the night shift at a Magnet hospital. Most of them were scheduled three days in a row. I felt exhausted all the time. My biggest problem was keeping pace with my workflow including charting. At first my preceptor appeared to be supportive but in reality she was reporting all my missteps and failings to management (including the exact number of minutes it took me to hang TPN). Many times she humiliated me in front of the other nurses. Of course, all of this did not matter. But now, I ask myself if I really have a future in nursing especially since few facilities are willing to train new grads. I worked so hard to get this job and am not feeling hopeful about finding another one anytime soon. The RN job market in the Southeast is horrible! Hardly any places are hiring newbies (inclduing nursing homes, home health and prisons). For those who were terminated, how long did it take to get another job? I am older and for me, this is a second career. I wonder if I should just go back to my former field. I went into nursing out of a strong desire to help others. So far, my experiences have been a rude awakening. I no longer wonder why so many rns never stay. It is simply a hostile environment and Magnet status is no better. I think hospitals just use it as a promo tool to make themselves look good in ads.
Thanks all for listening...I appreciate your feedback
QuaT - I had similar experience w/similar background - 2nd career, and am wondering the same. It's a struggle to remain positive and seek work. And it is sad when the environment is so hostile. I hope you are well and all the best to you. Know you are not alone in this process. I'm still seeking after being employed in a temporary position for 12 weeks, then a permanent position for ~12 weeks. It's a struggle mentally and physically.
I've been working in a home care job for awhile now. I have one patient who is total care, quadriplegic, with trach, g- tube and suprapubic catheter, lots of meds, suctioning, feeding, etc. It's twelve hour shifts with a one hour commute each way and can get just as exhausting as the hospital job. I'm beginning to feel that 12 hour shifts are not for me. I found the hospital environment rather brutal in the attitudes toward new nurses and hours/workloads. Home health care comes with its own set of challenges, not least of which is some fuzziness in how things are done. Not the best place for an inexperienced nurse. On the plus side, there are patients who are in dire need of nurses for the reasons above (remote locations and tough care assignments.) I plan to apply for some clinic positions and see if I can get hired and have a more normal work schedule. I think I need more variety and a place where I can continue to learn and grow. How are the rest of you doing? Care to update on your experiences since firing? Thanks!
Thank you for sharing. My experience with this local hospital was fairly recent. I am still seeking employment and determining how to sell my skills and abilities despite this bad personal experience in that particular setting. Recently a perspective employer requested a reference from the institution; here is my reply:
"I do not have a reference from (this institution). My time there was short and it was not a good experience. I learned many skills and I loved my patient care and my patients were very receptive of me, however the floor was poorly managed. Six RN's resigned in a 5 week period and the floor was down 10 RNs all together. As a new grad, an older adult and a good person, this was not an encouraging place, a supportive place, nor a good fit for me. I have many other references listed. I recently applied for a position in the school district and would be happy to share the letters provided for me for that position."
Apparently, this was appeasing. A fellow RN encouraged me to remember that I am not a bad person and how much I have to offer. This first few months "out" and licensed have certainly been a journey.
I hope you are well and best luck in your search. I hope to be able to use this degree and go back to work soon.
I was fired from a clinic job after my 90 days and I was devastated but, really it was a blessing in disguise. I've always tried to do well and have always got good reviews at my jobs. The Dr I worked for was awesome but, the clinic was awful. The "trainer" was on vacation when I was hired so, I got no official training. The Dr was slow so, they wanted me to boss her around and tell her to go to the next room after 10 minutes. They wanted me to do things that were out of my scope of practice (I'm an LPN) and were irritated when I refused, they frequently wanted me to do things after my shift off of the clock. the Dr was a new speciality for the practice and none of the labs she ordered were entered into the computer, I had to call the lab and be on hold for 20 mins and fill out all kinds of extra paperwork every time I did labs which I got fussed at for. They kept telling me they'd enter them into the computer but, they never did. Basically it wasn't a great place to work and being fired was a good thing because, I probably wouldn't have quit. My next job was a much better fit for me. I've been here 10 years, I've always had good reviews and I really don't have many complaints about my company. Losing this job may be a blessing in disguise for you too! Your dream job may be out there waiting for you. 😀
nursemaddie
14 Posts
Wow! what a timely post. I am an older nurse; this is my second career, and I just started with my preceptor this week (I worked 2 days with her). And I love the patients, the pace, the feeling of being able to help a patient, but my preceptor is from Hades. She spent the first day telling how horrified that she was that I hadn't done XYZ during clinicals, and then the next day telling me that I was slowing her down. Well, yes, i am slowing her down, because I don't know what to do; I've never cathed someone (although, I've done it a million times in lab), and I've seen a lot of things, but only once.
So, OP, I'm so sorry you are going through this, but thank you so much for this post--I refuse to give up, and so I will study, study, study...and study some more. I might not make it, but by golly, I'm not going down without a fight! (Another nurse told me that my preceptor was horrible to her also, so she asked for another preceptor--don't know if that would be a good ideal or not--don't want to rock the boat-). I hate feeling like this.