What do I tell her?

[HisHands]

Today my girlfriend confided in me regarding a situation she recently went through. I just don't know what to tell her.

We are both relatively new nurses (2 years on the job). We work together at a fantastic rehab facility. To supplement her income, she started a position at another facility on her off days. She told me that her first day of orientation at the new facility, her preceptor had another orientee with her. One preceptor and two orientees. The other orientee was on her last shift of orientation, so the facility justified to her that she would still get most of the preceptors attention. Well, apparently it wasn't so, and my friend felt like she didn't get any orientation at all. Ok, so 3:00 rolls around and my girlfriend is fed up. They gave her an admission to do basically by herself since her preceptor was no where to be found. She told me that she wrote out the patients meds and faxed them to the pharmacy, did as much of the paperwork as she could figure out on her own, and then told her preceptor she was going on lunch break (they got off at 7:30pm). Well, she never went back after lunch. Now the DON is threatening to call the state because they say she abandoned her assignment. My friend feels like she didn't have an assigment to abandon. She did not receive report, and did not count the narcotics. Her only responsibility that entire shift was to do the admission.

I have a hard time believing they can revoke her license for job abandonment, since she hadn't taken report on any patients and had no real responsibilities other than to do as much of the admission as she could. But, I haven't been a nurse all that long either and haven't known anyone to be in this situation.

We are in Michigan. I sure could use some guidance. My friend is torn up over this. She's afraid that she could lose the job that she currently has and loves.

Any feedback?

Thanks a bunch,

HisHands

[BittyBabyGrower, MSN, RN]

Sorry, that was totally irresponsible and foolish. Is this girl going to walk out everytime she comes up against something that ticks her off instead of opening her mouth as she should have? My guess would be yes. She is lucky something didn't happen to that patient since no one knew she had left. You can't even try to justify what she did.

[gr8rnpjt, RN]

I hope the OP sincerely had read all of the replies, because we're all telling him the same thing. If he really cares about his GF he will tell her about this thread and the replies, and hopefully she will learn from it.

OP is a female, I think by "girlfriend" she meant more like BFF, Best Bud, that type of girlfriend.

Many people are questioning how she found out the preceptor had left. That does not seem as important to me as the fact that this preceptor was assigned 2 orientees and she was allowed to leave early to visit her sick husband! That sounds like a disaster waiting to happen, but still does not excuse the abandonment issue.

I have one more thing to say. I was a new nurse one time as well. I was in my first pregnancy and had been off for about 6 weeks with severe moring sickness that lasted all day long. My first day back, I worked 3-11. I had half a unit (16 pt's) with one LPN and one aid for the entire floor. The other nurse ended up leaving after a couple of hours becase she was not feeling well. They were frantically looking for a replacement, but it seemed that I was it. I was not really feeling well myself, beside the fact that my LPN and aide were the type that hid places and went to smoke every couple of hours. I felt like I was there by myself, and had 32 pts to pass meds, I had about 7 complete care pts that needed turning q2h. There was no one to help because the LPN and aide kept playing hide n seek with me, and I was plugging along with my queasy stomach and after having been off 6 weeks. I went into a room and the pt's daughter complained that mom had waited 45 minutes for her hycodan which she had requested for her cough. I explained that we were short staffed and I was pretty much alone on the floor and if she had any complaints she could discuss with my supervisor. I though my supervisor would have my back, but an hour later she had chased me down and admonished me for saying we were short staffed. she said we were not shoft staffed because I had an LPN and an aide. . I could not believe my ears. I told her you know what they are like, they hide all shift, and I am left doing all the work. I looked her dead in the eye, I said, "have you had any luck replacing the other nurse that left, because you are in for a bad night because I quit!"

She looked at me blankly and said she had not found anyone. So I told her she better keep looking, and I walked away.

She sat at my nursing station calling nurses, and about 15 minutes later I came back and told her I would stay to the end of my shift, but I truly was quitting and not coming back.

My point, is that although I was having a really bad day, and pregnant with morning sickness all day long to boot, and getting yelled at for saying something that I felt was completely appropriate, I stayed to the end of my shift, then I did quit.

My age at the time? 23.

[TazziRN, RN]

My point, is that although I was having a really bad day, and pregnant with morning sickness all day long to boot, and getting yelled at for saying something that I felt was completely appropriate, I stayed to the end of my shift, then I did quit.

My age at the time? 23.

And therein lies the difference between the OP's GF and the rest of us......she would have been well within her rights and would have been applauded for quitting without notice at the end of the shift, but to just walk off the job without saying anything in the middle of the shift.........

[HisHands, ASN, RN]

Sorry for not replying sooner... I've been super busy.

First off, I am not trying to justify my gf's actions. But, I see her every day. I know what kind of an employee she is. I know what kind of a nurse she is. So, I feel like I need to make her out to be the great person she is even though she had this serious lapse in judgement.

I agree that everybody is saying the same thing here... she messed up BIG time. I agree. I do not agree that she should find a different career. She went to school for 6 years and could never find a career that fit her until she found nursing. It's in her blood. It's who she is. I appreciate the people that related with her story. I have to feel sympathetic to her situation, even though I do not support her actions. What's that old phrase... hate the sin, love the sinner. She's a good nurse.... unfortunately with a bad judgement call.

"Many people are questioning how she found out the preceptor had left. That does not seem as important to me as the fact that this preceptor was assigned 2 orientees and she was allowed to leave early to visit her sick husband! That sounds like a disaster waiting to happen, but still does not excuse the abandonment issue."

THANK YOU!!!

To clear up some issues:

My gf was assigned tasks like 'go give so and so their insulin', so my friend would and return to the med cart and the preceptor would be MIA. So my friend would look for her and find her on another unit blabbing. She attempted to follow the preceptor who then would assign her to 'go put calmoseptine on so and so's sacrum'. So my friend would do it and return to finding the preceptor MIA. And so the cycle continued. She spent so much time looking for the preceptor that she couldn't really learn anything. And if it wasn't that, the preceptor would be sitting doing paperwork and instead of involving my gf to help her learn, she would sit their completely silent. My gf told me she even asked the preceptor to teach her some of the paperwork or policies. The preceptor told her that she would learn it eventually. :stone So she would either do busy work, or sit quietly and do nothing. Not much of an orientation if you ask me. Anyway, I stray from my original point. So, the orientator gives my friend the task of doing as much of the admission paperwork as she could figure out. (The preceptor did the admission assessment, contacted RT, etc while my friend was out on a "busy work" run) So my friend did careplans, etc. The preceptor was gone for over 45 minutes. My gf saw the other orientee and asked where the preceptor was and she said she didn't know... maybe on lunch. That is when my friend reported off for lunch and yadda yadda yadda.

When she talked to the DON the following business day, she asked the DON where the orientator had disappeared to and the DON told my friend she had pre-arranged to go see her husband at the hospital. The orientator never mentioned that to my friend the whole day. Apparently an MDS nurse was going to take over her set for the last 5 hours of the shift. Either way, I have to think that either the original orientator or the MDS nurse should have followed up with my gf in those 45 minutes.

Maybe I'm blinded because I work in a great facility that gave me a super orientation... I don't know. Hopefully that fills in some of the missing pieces of the story... anymore questions, let me know.

Thanks again for all of your opinions. I have read every single entry here, and have passed along all of your wisdom to my gf.

And by the way, yes I'm a lady... and yes I was referring to my girlfriend in one of those "girl" "friend"... bff sort of ways.

Blessings

[HisHands, ASN, RN]

"The best thing your girlfriend could do is to see an attorney and plan a good offense...like why was a brand new orientee that was not being surpervised properly allowed to take on a new admission, is this their policy. I am sure they don't want their door open for inspection either."

I know I'm her friend and maybe a little defensive about this whole thing... but EXACTLY! Why was a brand new ORIENTEE who was unsupervised given the task of a new admission?!?! SOMEONE should have been there to help her. She was abandoned too.

[Mags4711, RN]

Absolutely your GF was abandoned, and now that you have filled in some other parts of what happened to her that day, I can see how she'd be VERY frustrated. But as you and we have said, that is still no excuse for walking away from a job, any job.

The fact is that not everyone is a good preceptor. Many people are tapped to teach orientees that should never have that responsibility. Unfortunately there's little you can do as an orientee except try your hardest to get the preceptor to teach you something (and it does sound like your GF did try). Sometimes in life you just have to grin and bear it until the end of the day and then decide what to do.

It sounds like that may not have been the place she wanted to work, anyway. Throughout my career when I have been considering a new job, I have requested (and been allowed) to come and shadow a nurse for at least an 8hr shift (I've offered to sign HIPPA/confidentiality statements and never had a problem). Though that isn't perfect, at least you get some idea of how the workflow goes and whether or not you thin it would be a good fit for you. You also get the chance to meet other staff and can sort of feel folks out.

Hopefully she has learned from this experience and will not do anything like that again. I feel many folks nowadays have no idea what a work ethic is and it's sad.

You are doing your friend a really great service by starting this thread and by listening to all of our responses, be they thoughtful ones or rants

[ShayRN]

Yes, her walking off the job was wrong. It probably was patient abandonment, BUT! She was treated horribly. I see the DON didn't turn her into the board. I can assure you it wasn't out of the goodness of her heart. It was because they didn't want THEIR actions examed too closely...Giving someone a new admission without teaching her the paperwork? A preceptor who leaves early without a new one being assigned? COME ON!!!! When I have new nurses with me, the whole first day is them following me around just to get them adjusted to the routine of the place. This woman wanted a brand new nurse to the facility to do her job. She was lazy and inconsiderate. I would not have walked off the job, I would have placed a called to the state board that oversees nursing home accrediation.

OH! This is why nurses are treated so poorly. WE allow it to happen. I am NOT condoning walking off a job, but maybe if we stuck up more for ourselves in poor working conditions we could make some REAL changes in the profession.

[RunnerRN, BSN, RN]

The person being precepted is not responsible, the nurse precepting is responsible for the orientee and the patients. This is why it is such a responsible job to precept new employees. Orientees are often pulled off the floor for classes and photo ID's and such, that is why someone else is always in a position to carry through with the patients.

I would disagree with this statement. When precepting nursing students - or anyone without a license - I agree that the preceptor is ultimately responsible for the patients and the preceptee's actions. But if the preceptee is licensed, then any actions he takes are his responsibility. Licensed people are expected to know that if an action is not right (even if a preceptor says "that's how we do it here") then you don't do it. Yes, the preceptor would probably get in trouble if their orientee blatantly did something wrong ("why weren't you supervising?") but the ultimate responsibility for the patient and the actions that a licensed person carries out is that person's alone. Therefore this RN had accepted care of this new admit, and abandoned him/her. I would assume she won't make this mistake again!

[lever5]

An orientee on the first day of the job is not responsible for the patients, I am a travel nurse with a typical 2 day orientation, in two days I can learn what I need to know, in less than 1 day I could not function. I would get out of that situation. We experienced nurses can function with miminal orientation, but not with less than 1 day. She has nothing to worry about. Would any of you be able to function at a new facility with less than 1 day orientation? This is a real failure on the facility's part, who gave permission for the staff nurse to leave? If you want to keep your new staff, you do not leave them on the floor alone. Yes, she should have notified someone up the chain of her situation, but, I can see her frustration. When we are orientating new staff, we are responsible for thier actions and mistakes. Orientation is how new staff are evaluated, this is how we decide if the new staff is a good match for the job. A lot of problems here, don't get fixated on the nurse's behavior, let's give equal credit to a bad facility.

[TrudyRN]

OP is a female, I think by "girlfriend" she meant more like BFF, Best Bud, that type of girlfriend.

Many people are questioning how she found out the preceptor had left. That does not seem as important to me as the fact that this preceptor was assigned 2 orientees and she was allowed to leave early to visit her sick husband! That sounds like a disaster waiting to happen, but still does not excuse the abandonment issue.

I have one more thing to say. I was a new nurse one time as well. I was in my first pregnancy and had been off for about 6 weeks with severe moring sickness that lasted all day long. My first day back, I worked 3-11. I had half a unit (16 pt's) with one LPN and one aid for the entire floor. The other nurse ended up leaving after a couple of hours becase she was not feeling well. They were frantically looking for a replacement, but it seemed that I was it. I was not really feeling well myself, beside the fact that my LPN and aide were the type that hid places and went to smoke every couple of hours. I felt like I was there by myself, and had 32 pts to pass meds, I had about 7 complete care pts that needed turning q2h. There was no one to help because the LPN and aide kept playing hide n seek with me, and I was plugging along with my queasy stomach and after having been off 6 weeks. I went into a room and the pt's daughter complained that mom had waited 45 minutes for her hycodan which she had requested for her cough. I explained that we were short staffed and I was pretty much alone on the floor and if she had any complaints she could discuss with my supervisor. I though my supervisor would have my back, but an hour later she had chased me down and admonished me for saying we were short staffed. she said we were not shoft staffed because I had an LPN and an aide. . I could not believe my ears. I told her you know what they are like, they hide all shift, and I am left doing all the work. I looked her dead in the eye, I said, "have you had any luck replacing the other nurse that left, because you are in for a bad night because I quit!"

She looked at me blankly and said she had not found anyone. So I told her she better keep looking, and I walked away.

She sat at my nursing station calling nurses, and about 15 minutes later I came back and told her I would stay to the end of my shift, but I truly was quitting and not coming back.

My point, is that although I was having a really bad day, and pregnant with morning sickness all day long to boot, and getting yelled at for saying something that I felt was completely appropriate, I stayed to the end of my shift, then I did quit.

My age at the time? 23.

Interesting that she found time to come chew you out for telling the truth (which, BTW, you should not have said to the pt, IMHO, even if true) but she did not have time to lift a finger to help you, or even to tell the 2 slugs you were "working" with that they needed to keep their shiney hinies indoors and their noses to the grindstones. She sounds like a poor supervisor. I see you had a lovely baby. That's a great picture of her with Mary.

[TrudyRN]

The person being precepted is not responsible, the nurse precepting is responsible for the orientee and the patients. This is why it is such a responsible job to precept new employees. Orientees are often pulled off the floor for classes and photo ID's and such, that is why someone else is always in a position to carry through with the patients.

The preceptee IS responsible, too. Even students can be sued. Do you think students and preceptees are totally without responsibility or that the preceptor and facility are responsible for everything the learners do or don't do?

[RN4NICU, LPN, LVN]

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