on Getting Fired

Coworker recently got "fired" for advising a diabetic patient that since her BSG was high, she really should not have a treat that she requested. The nurse brought the treat after the patient insisted. I guess the patient was so offended at being told this treat would raise her blood glucose that she "fired" the nurse the next night. It was her loss though because that nurse was excellent!

Sometimes interactions with patients and/or their families spin out of control, and upon reflection a nurse can see where s/he could have directed things better.

And sometimes, there are patients/families who have refused care by just about the entire departmental staff and the entire situation has become a farce ... so yes, I have seen it "celebrated" to have Patient X removed from a nurse's assignment.

It is a sticking point with me though -- I do not characterize these situations as "getting fired" by a patient. I consider that language to be inaccurate and unnecessarily self-deprecating. Except in the case of private duty nursing - no termination of employment has occurred.

Oh yes!! I was lucky enough to get fired from a few at least- and once time I felt like I won the lottery.

In an hour drive from our house, there were 2 RN schools. School A was a lot closer and had a BSN program. School B had an AD program. I applied at both and had interviews. Got accepted at B and when I went to A's interview, the director gave me the "up down" look and said "u don't have what it takes to be a nurse". Didn't look at my packet, transcripts, letters of reference, nothing.

So I graduated from B and was working at one of our local hospitals on a diabetic medical unit and I got a transfer from ICU - an old RN that had ETOH related seizures.

She rolled up and of course it was the director that had been at school B. It took her 4 or 5 hours before she realized who I was. She asked where I had gone to nursing school and I told her. She told me she was from school A - I just said "yes ma'am I know". She asked why I went to school B and I told her the person that interviewed me said I didn't have what it took. I went back to the station and my pt called out for the charge nurse, which was me. I went in but she said she didn't need anything. :)

Her MD came on round (one of the ones that wrote me a letter of reference) and said she was requesting a new nurse. I explained the situation - I don't think I've ever seen him laugh that hard!

This is when nursing needs to be a team sport, with your manager on the same team. If there is a consistent message that MD orders need to be carried out, that the parents can expect (or the patient can expect) that it is going to cause some pain that will be medicated, it can help to educate.

Additionally, team nursing when there's a really hard patient. The primary nurse for 4 hours, the charge nurse for 4 hours, another nurse the next day. It is hard to have continuity of care when patients are in a place where they believe that they can "fire" nurses at will.

Hopefully, your manager is on board with this, and can set some limits when needed.