Got fire because manager said I need some critical thinking

[HNursing]

Hi everyone,

I came to work today and felt something was wrong already. Nurses were looking at me like they wonder why I was still there. My manager came in to work and then he told me we need to go to HR. I follow him and wonder what is going on. He did not told me that he is going to fired me. He told me that we are going to HR and talk to them about my orientation. He started telling the lady in HR that I did many mistake and they had been going over my mistake many times ever since last months. My mistake was miss pronouncing the name of the diagnosis and can not critically think. I defense myself that I tried to learn it and tried my best to pronounce those diagnosis especially the long words. I also told him that when I had a hard time. I spell for the nurses, but he said I can not do that. It just take too much of the time and people will complaint on you. Then he complaint about that I did not catch one of the doctor mistake for writing the same medication. In my mine in that time, I did not know should i argued with him or not because if someone wanted to fired you they do not need you to explain or if they willing to let you explain they won't fired now. I still go ahead and explain to him and HR lady about it because I was not the one who signed the order off and I was not one who saw that order. I saw it in the computer, but then we have many medication for people with HTN. How should I know that those two medications are the same medications where they have different names. I was upset by it because I was new and I am still learning. I learned from it and the second time I saw it. I told my preceptor and call the pharmacy. But my nurse preceptor did not tell my manager about it. She only told him what I done wrong. Then he told me that the doctor hang up the phone on me once and I had to asked doctor to spell medication order for me. I was felt so sad that my manager had done this to me because I asked doctor to spell the medication out for me because I am the one who going to write the order in behave of the doctor and I do not want to write the wrong order or wrong medication. I was just making sure I am given the right things to my patients. The doctor who hang up on me. It is not my fault that the doctor hang up on me because he was busy. I was so sad because he is against me with these things.

I am new in the floor with many nurses who have so many years of hospital experiences. They compared me with them. I felt so awful. Now I had to look for another job. He said fired me I can not look for job in their system anymore. I was so sad because I did not did a mistake that kill someone. I did not hurt anyone. I know I had limited experience because I did not have much of nursing experience. He told me to find a job in nursing home and get more experience before coming back to the hospital or take some classes about how to pronounce some of the terminology. I was so stock by it. I came home and told my family exactly what happen. They said they believe it because that how he can over his position.

I really do not feel it is fair for him to do that. I never have a patients who complaints on me. I did some mistake, but i learn from it. I had patients who buy me gift and things like that. Felt so unfair that my preceptor did not tell them things I done right and they have to wait for my preceptor not there to fired me. I had no one who can back me up or anything.

Now I got fire and can never apply for any job under that system as well as I don't know how to find another job with this economy and how to tell people that I got fired or I leave the job.

[HNursing]

This is how I write my progress note: Patient VSWNL, BS clear, soft and symmetry. LS is clear bilaterally. Skin WNL and no sign of edema. Maintained patient safety.

[Aaron86]

That does seem clear and concise. As far as "maintained patient safety" though, that is a bit vague, perhaps in the future explicitly mention what interventions you did that provided safety?

Keep in mind a patient's chart is a legal document and should something happen to that patient, while under your care or not, the chart could be presented in court. Anything vague is liable to be attacked by a lawyer.

Its sad to say, but hospitals probably pay more attention to things like that when determining if a new nurse is a potential liability. Thats my two cents anyway. I try to stay clear of the "boiler plate" charting phrases and make sure to include info on the specific patient and something I did for the patient if it was even slightly out of the ordinary.

I have seen too many nurses type (or write) in a a little blurb on the patients chart to the effect of everything being WNL and they havn't even been in to see the patient yet! They do this in front of a student too.... for shame

[TuTonka]

I'm sorry you've had a bad experience and lost your job. Start thinking now (and practicing) about how you will talk about this in job interviews. It's important that you be honest and open about it -- don't try to hide from people that you were let go from this position -- and be able to talk about what you've done to improve your skills and avoid similar errors in the future, without sounding defensive or blaming your previous employers.

Lots of nurses get fired and continue on with their careers -- this is not the end of the world (although I'm sure it feels like it to you right now! :)) Best wishes for your job-hunting!

That was the sweetest response to a post I have read in a situation such as this. Thank-you. If I ever need to talk to someone to be uplifted I would definately look for you. May blessing be rained down upon you.

TuTonka

[BrnEyedGirl, BSN, MSN, RN, APRN]

First of all I'm very impressed with you're ability to speak 4 languages! That in and of itself proves you are a very smart person. I agree with the others, you're communication skills are going to have to improve if you're going to continue to work in an English speaking environment. Have you ever thought of working as an interpreter? In my area of the country they get paid way more than the nurses! It would also be a way for you to sharpen your English skills. Best of luck to you,..keep trying,....you are obviously up to the task!

[agldragonRN]

nursing home work is extremely fast-paced and hectic.

thank you very much for this comment valerie. i certainly hope those people who suggested to work in a nursing home have actually worked in one because i would like to know where is this "slow-paced" nursing home they are talking about, so i can get an application

to the original poster, i'm so sorry this has happened to you. english is not my first language as well so i understand where you are coming from. i also have an accent so every time i call doctors, i speak slowly so they would understand me better. maybe you can try doing that? a lot of doctors have accents as well so sometimes i ask them to repeat their orders and i always repeat it back to them. some get mad but i don't care because i am doing what i am supposed to do.

i admire you for speaking several languages. you must be smart! however, i agree with the previous posts about enrolling in some kind of esl class/writing class. this does not mean in any way that you are stupid or anything. it just means you are trying to work on one of your weaknesses. also, try to read a lot of books, in english of course, and bring a dictionary with you and look up words you do not understand. i used to do this when i was a new immigrant in this country.

well, good luck with the job hunt and as suggested by someone, try applying at a place or have a position where they can utilize your multi-language skills.

angel

[Virgo_RN, BSN, RN]

I agree with the others. Being multi lingual is an asset. I'll bet you can find some place where that skill would be valued.

[Lucky0220]

You said that you have a BSN in your bio. Did you go to college in the US? I'm just wondering if you don't mind telling us.

[DA314]

Aaron- I never said that mispronouncing words was unprofessional. However, as a safety issue, it is important for nurses to learn the correct way to pronounce things. There are many drugs that sound similar and could cause a medication error if not pronounced correctly. As far as the medical terminology classes, I'm shocked you didnt have to take one. I had to take one as a pre-req, and then a condensed course as part of the nursing program, and I'm only in LPN school. I would assume that RN's have more requirements than that.

I see from other posts that the OP is in Michigan. How long have you been in the states. Like I said earlier, I know English is a very difficult language to learn, especailly if you are foriegn, but if you're going to work in an english speaking country, then it is vital to grasp the language. I'm not trying to be mean, but I feel it is a safety issue.

Good luck to OP. We all have parts of nursing that give us trouble and I'm sure with a little work you'll be ableto overcome this and be the great nurse that is inside you.

[TexasPediRN]

This is how I write my progress note: Patient VSWNL, BS clear, soft and symmetry. LS is clear bilaterally. Skin WNL and no sign of edema. Maintained patient safety.

OP:

I just read this entire thread, and I am sorry you were fired, but I commend you on being able to speak 4 languages. With that being said, you do need to take a course to brush up your english, so that you can be more understood.

For your assessment above..heres what I am reading and what I feel should be changed..

Patients vitals Within normal limits (this is ok, as long as the vital signs are charted somewhere else)

Breath sounds clear (again, this works, until you keep reading..)

something is soft and symmetry(is this the abdomen? If so, Bowel sounds present x4quadrants, abdomen soft, symmetric, or nondistended.).

Lung sounds (or left side), clear bilaterally?? If its just the left side, it cannot be clear bilaterally (which means both sides). And, we already charted lung sounds above with breath sounds..so this is a repeat and not very clear..

Skin WNL ( this works, but would be better to chart skin with no signs of redness or breakdown. )

Maintained patient safety (how did you maintain patient safety. How about, side rails up, call bell within reach, encouraged to call nurse with any questions or concerns?)

Does that make sense to you? It would be a better way of charting what you were charting, so that you have covered the information you were hoping to chart, but in a clear and concise way.

I wish you luck with your english! Just keep practicing and soon you will understand the words much better :)

[NC Girl BSN]

This is how I write my progress note: Patient VSWNL, BS clear, soft and symmetry. LS is clear bilaterally. Skin WNL and no sign of edema. Maintained patient safety.

At my hospital, this would not be an acceptable note.

I would say:

Pt. vitals signs, BP=120/70, R=18, P=88,T=98.6. Bowel sounds active in all four quadrants, abdomen soft and symmetric. Lung Sounds are clear in upper and lower quadrants bilaterally. Skin is warm, dry, intact and no edema. Siderail up, bed low and call bell in reach.

This gives the reader alot more information. My hospital doesn't like WNL. What does that really tell you? Good Luck to you. I know with time, you will overcome all your obstacles with your language barriers. I am almost jealous of what you know. I wish I could speak spanish half as good.Again Good Luck and keep practicing.

[sjt9721, BSN, RN]

This is how I write my progress note: Patient VSWNL, BS clear, soft and symmetry. LS is clear bilaterally. Skin WNL and no sign of edema. Maintained patient safety.

Too many abbreviations.

"VSWNL"......I know what you're trying to say, but is this an approved abbreviation? Would any provider read this & know what you mean?

"BS clear".....Breath or bowel sounds? If bowel, then what do you mean by clear? If breath, what do you mean by soft?

"LS clear".....I'm assuming lung sounds. If so, then the above must be bowel.

Hate to sound like management, but The Joint Commission would have a field day with this entry.

[LesMonsterRN, ADN, RN]

I am sorry about your job, but consider it an opportunity to learn from experience, learn what you can do to improve your performance and go forward with joy!