Forced to resign after 7 weeks

Nurses New Nurse

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I desperately need advice. I was forced to resign my first new grad RN position after 7 weeks, and it's been almost Impossible getting another position. I've used sources on now to articulating my failed experience in a positive light. How I have grown from it, and why I am a better candidate because of it. I used the whole the whole positive, negative, positive formula.

I've even been told by recruiters that I interviewed so well, but the manager probably won't hire me because of it... and I've not gotten a call back yet.

Do I actually NEED to disclose this at all?!

But here is why I was forced to resign:

I was hired as a new grad RN to a med/surg unit. Orientation was 4 weeks in class, and 4 weeks bedside. Week 5, my first week bedside I was not precepted on the unit I was hired for. When I got to my unit I had a different preceptor every day, and it became evident that I did not fit in with the culture of the unit.

How I learn, is by asking (appropriate) questions. I always understood that it was good to ask questions (appropriate), it shows you are interested and actively engaged. Unfortunately on this unit, my inquisitive learning style was constantly misinterpreted as a potential error/mistake and NOT a method learning.

Some examples of my "potential errors" are:

A) Bringing an order for 75 units of lantus to my preceptors attention, (THAT'S A LOT!) questioning the order, and asking her what 75 units of lantus looked like.

-I have never seen 75 units of insulin, and an insulin syringe only holds 30 units of humalog. I couldn't fathom what 75 units of lantus looked like.

**viewed as potential medication error

B) I was in the process hanging Zosyn when my patient told me he was in pain. He had an order for prn dilaudid he could get now.

I know Zosyn runs for 4 hours. I also know give the dilaudid I needed to document a pain assessment, go to the Pyxis, get a vitals machine, document vitals, flush, push over 2-3mins,and flush. All that could take me 15mins.

I know some meds can't be given close together, So I asked my preceptor if I should stop hanging the zosyn and get the dilaudid. She didn't answer me, so I just finished hanging the zosyn then took care of the dilaudid. I did not want to make a medication error by stopping the zosyn in 15 mins to give the dilaudid, but since she didn't answer me I just finished what I was already doing.

******My preceptor told my manager I WAS NOT ASSESSING MY PATIENTS PAIN!!! I NEVER intended on holding the dilaudid for 4 hours, and that is NOT what I DID. I just wanted to know if the zosyn drip could be stopped to give the dilaudid.

When being forced to resign, what the had documented as "ISSUES" were my situation appropriate learning questions. I never DID anything wrong or made ANY errors!! I was beyond floored while being confronted with LEARNING as reason for me being forced to resign.

So- once again, here are my question.. any anyone could answer them:

A) do I need to disclose this 7 week employment on my best job interview(s)?

B) will this job show up on a background check?

We've all heard the phrase, "The only stupid question is the one that isn't asked." We say this to encourage people to ask rather than pretend to know.

Nonetheless, there is such a thing as a poorly thought-out question. For instance, a question with an answer that can be located with a few minutes of research should be answered by researching it first. Googling "Lantus 75 units" would have revealed that this dosage is definitely not outside the realm of possibilities. Asking what 75 units of Lantus looks like is a redundant question.

Also, a smart question could seem utterly stupid due to the manner in you ask. Asking if Zosyn could be paused to administer Dilaudid was a great question. Thus, it could have been asked differently to elicit a better response: "When a patient complains of pain, what's the hospital's policy on the length of time we have to address the request? My patient is in pain, but his Zosyn drip is running."

There are several questions you should silently ask yourself in an on-the-job training experience before you start questioning coworkers:

1. Has the question been asked/answered multiple times?

2. Are you presenting the question poorly? (read: do you seem bumbling?)

3. Is your question one that could have been answered through a couple of minutes of quick research?

If the answer to any of the aforementioned questions is "yes," think twice before asking your coworkers. Good luck to you!

I was thinking along these lines too. Sometimes a preceptor/employer wants to see you use the resources at hand and know that you can find answers to your questions yourself rather than just ask someone. A couple of reasons comes to mind: other nurses may be busy and not have time for answering questions that you could find answers to another way; also, sometimes the answers that you get from other nurses may be wrong and you will have followed the wrong advice causing YOU to have made an error, and following someone else's wrong advice does not necessarily absolve you of your own accountability in that situation, particularly when it comes to medication administration. Make sure you know your facility's policies. Facilities will have these available somewhere, usually on their intranet these days, so you can look them up when in doubt. You can also look up how to administer some medications in a med book or ask the pharmacist.

If someone has had little to no experience with insulin I can see how you would question the amount of an order for 75 units of Lantus, and it is your responsibility to question orders that you are unsure of. But it would never occur to me to question or state that I don't know what 75 units of insluin LOOKS like, so I can see that as a bit odd. Not a fireable offense, but odd, so taking a minute to think through your questions before verbalizing them is definitely a good idea.

One other thing...even if you push dilaudid for an entire 2 minutes, there is no reason to stop the zosyn for anywhere close to 15 minutes. You would do whatever you needed to do to prepare for giving the dilaudid and only stop it when actually ready to push the dilaudid.

The way I would give the dilaudid is to draw it up in a 10cc syringe and dilute it with NS if the patient also had NS infusing, or I would draw up the dilaudid in a 10cc syringe that was pre-filled with NS. Then I would simply pinch off the line infusing the zosyn above the port, flush the below the port, push the dilaudid, flush below the port again, then allow the zosyn to continue to infuse. All this is assuming that the patient has only one PIV. If he has more than one PIV, problem solved.

Edited to add: Sometimes I forget that we do things a bit differently in the ER and we regularly hang antibiotics without using a pump. On a M/S floor you would be using a pump so you would only need to pause it to push the dilaudid...after first flushing the line of course.

Specializes in Neuro, Telemetry.

I have about a year experience and still ask questions. But only after doing some research myself when I can't find the answer or if it's an emergency and I think I need a quick answer.

I have found that other nurses are more apt to answer your questions and help you when you ask in a way that seems you want to be able to find these answers yourself. I usually say "I have looked here and here but can't find what I'm looking for. Can you show me I find (insert needed info here)." Or "I tried researching this, but it still doesn't make sense. This is what I know. What am I not getting?"

Phrasing your questions like that shows whoever you are asking that you are trying to be independent but just couldn't find what you are looking for. I have found that most experienced nurses don't seem to mind helping me when I've truly tried to figure it out myself. If it's a patient safety issue then I will sometimes even double check what I found with a nurse by saying "I haven't done this before and this is what policy says, this is what I will do. Is this correct?" To make sure I don't hurt anyone. I don't have to ask questions very often anymore because I've learned where to find my answers. You will too, if you ask the right questions.

Unfortunately I feel you sorta made your bed and now you have to lay in it. Never ever speak on every single feeling you are experiencing when you are training as a new nurse. As you work and gain experience, your confidence shall improve. What was your orientation like, once a week? No one expects you to know it all realistically. You spoke way to much however I feel that the preceptor was not exactly giving you a fair shot if he or she didn't probe further into what you were talking about. Assess the patient, ask them if they want pain medication right away or can it wait for a few minutes while you finish something. Not all insulin looks the same, we all know that, however do you know how to administer it safely? If you don't figure it out before you give it. If you can give it safely give it. If your try to figure it out with help and you still don't know, then I would be concerned. If you do or can, be quiet and administer the darn medication. I have seen nurses in stressful situations with a lot on their plate know what they are doing overall but ask very quickly does this or that make sense. Was this a teaching hospital you were trained at? I am just curious?

Specializes in Hospice, Palliative Care.
stupid questions

Maybe I need to wait longer for it, but in 53 years of life, I've only heard one question that was silly. Are you stating nursing is so harsh a field for new grads (of which I'm one) that we have to do homework on what's not a stupid question?

Specializes in CVICU CCRN.
Maybe I need to wait longer for it, but in 53 years of life, I've only heard one question that was silly. Are you stating nursing is so harsh a field for new grads (of which I'm one) that we have to do homework on what's not a stupid question?

Sorry, but there were some excellent posts up the thread about how to phrase things and present inquiry in a way that shows you are prepared and thinking critically vs just throwing out a stream of inquisitive consciousness.

It's not homework on which questions are stupid, it is professional presentation skills that we should all continue to develop. The people orienting you need to have confidence that you are a safe, thoughtful, and thorough novice nurse. Whether we like it or not, a huge piece of others' perception of us comes from how we present ourselves verbally and our overall bearing. You can be all smarts on the inside, but if your outside shows an indecisive or scattered persona who is not thinking things through before speaking... you're not going to like some of the feedback you receive.

Sadly there is no way to put a positive spin on being asked to resign after 7 weeks, your recent interviews have proven this point. It's time to try a new approach. Leave the job off your resume and don't mention it at your interviews. If asked what you have been doing have a more palatable answer ready, maybe something to do with family.

I understand this is dishonest but it's time to ask yourself if that might just be an acceptable price to get a second chance. In all honestly I have never left a job off a resume before but I did work with someone once who openly admitted (to us nurses, not management) to being fired from a previous job. She left it off, said she was caring for children and had no trouble being employed. Good Luck.

Specializes in nursing education.

My answer here is based on my experiences as a clinical instructor in the last semester before graduation. So when my students finish with me, they are ready to be precepted as new grad GN/RNs.

I concur with many of the previous posts here, that the manner in which you ask questions probably is causing your preceptors to think you lack independent critical thinking skills. Here is what I tell my students: don't ask me a question that you can easily look up in a source, like what the definition of a word is, or what a medication is. When you have looked up what you can, come to me with questions about things that still don't make sense to you. I expect that they know the evidence-based resources and make use of them. They need to be developing critical thinking. Things are always changing.

Specifically regarding the insulin, I've seen doses from one unit (humalog) to more than 100 units (lantus) and since so many patients on our clinical units either have diabetes or are having blood sugar management, I feel like it's pretty basic knowledge that insulin syringes come in several sizes including 100 unit; insulin dosing is based on so many factors.

I would expect a new grad to double check the dose with the preceptor or another experienced nurse, as 70 units is somewhat unusual; but I want them to already have looked to see what the patient had been getting and what their blood sugars had been running, are they on steroids, that kind of thing that showed they had a basic idea of the relevant things about giving insulin, not just a "Wow, that's a lot!" kind of thing. It looks like insulin, in a 100 unit insulin syringe, up to the 70-unit mark.

Also, personally I would have given the pain medication, then hung the antibiotic (Press-Ganey and all that) but there are other ways to do it too as others mentioned-- have a solid rationale for all of your actions.

I would recommend to you, OP, do some role-playing, practice a more independent learning style, maybe spend some more time in your drug guide and get more familiar with the common medications. Even try videotaping yourself because that can be surprisingly eye-opening. Best wishes!

Maybe I need to wait longer for it, but in 53 years of life, I've only heard one question that was silly. Are you stating nursing is so harsh a field for new grads (of which I'm one) that we have to do homework on what's not a stupid question?

I've had repeated questions ie what color tubes do I need... After the first time, it should have been memorized, written down, use of the color legend or a call made to the lab. Or at the very least phrased as, I need lavender for the CBC and green for the CMP, correct?

Answers to questions are expected to stick and applied to relevant situations, not accumulate. Some new nurses take great notes and/or retain while others do neither. Once a bar is set there is an expectation of retention, critical thinking and problem solving.

Thank you Jules. Kinda harsh, but it's something I needed to hear. I hadn't thought of a lot of your insight, and I will reflect on this experience as well. Thank you!

Nutella- your advice really inspired me, thank you! After reading it I applied to volunteer at a community center. I think I really need to do that for me, not just because it something to tell a potential employer. Thank you!

Thank you for responding to me Johnsonmichelle! You didn't tell your new employer, at all?

no I did not tell them at all , the job market is took picky for new graduates and a few weeks of employment does not look good with employers. My previous employer had a very big turnover rate and it was not uncommon for the RN's to work only one shift and leave. I worked in a LTC/rehab facility and would not recommend it especially for someone like you. There is not a lot of support and orientation is very short ,you probably be given a large patient load as well.

Martymoose- I agree with you! I do not go out of my way to volunteer this, but when asked I haven't lied or omitted. I've had several interviews since and an explanation like "not a good fit" just hasn't been enough for the person interviewing me. They want specific examples, do I tell them about the two I mentioned, I wish they would just accept "not a good fit." Thank you, I would really like to get something soon also, this whole situation has made me really sad.

Libby- thank you, and you are right. I would love to write more of a response, but It was extremely difficult for me to read both responses from you and Jules. Thank you both for taking to bring this perspective to my attention. Definitely a bitter pill for me to swallow.

Conqueror- thank you so much! I love your unique and rational way of thinking! I really appreciate your post! Thank you! :) but to be fair, it was my first time on nights so it was my first time administering lantus. I had only ever drawn up and administered humalog. ALL syringes I had ever used/seen only held 30units.

What I didn't know was lantus came from pharmacy in pre-filled larger syringe, so I didn't actually draw it up. That's why I had never seen an insulin syringe that held they many units.

I hope you know it was said only to help you navigate these new waters.

I've had my share of bitter pills, it's growing from them that will benefit you in infinite ways.

Best to you.

Like many others have suggested, I would leave the position off your resume and not bring it up during any future interviews. You never completed orientation or even your probationary period, so there's no need to disclose. Don't sabotage yourself in the interview. Learn from your brief stint and make adjustments as needed. Sounds like you wouldn't have been happy there even if you stayed. There are plenty of RN jobs out there; keep grinding until you find one! All the best

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