Published Aug 12, 2009
BullyLoveRN
12 Posts
just want to warn you: this is long! but i hope to counsel other young nurses about what i have gone through one day and would appreciated your feedback!
i can't even think of how to begin the story of how my nursing career has came about...
here's the back ground: i graduated from nursing school august of 2007 and starting working at a premier teaching hospital in my area! in september of 2007. i started in pediatrics, which is ironic because i hated peds in nursing school. but on a whim, and after much pestering by one of my friends who worked on the floor, i decided to interview. i had already been offered two jobs, one in cardiac surgery, one in the mother/infant unit. i went on the interview just to practice my interview skills. i ended up shadowing one of the nurses on the floor and absolutely, irrevocably fell in complete love with pediatrics! i can never imagine doing anything else.
the first year of nursing was hard, adjusting to the schedule and the new “grown-up” responsibilities. but at the end of each day, i loved my job and knew i made the right choice when i chose pediatric nursing. as i progressed at work i became chemotherapy certified, became a resource nurse, joined the nursing student education committee and the schedule committee (the hardest committee ever.. is was hard to please 90 people at once!). i was flourishing. i had heard horror stories from my old classmates of how much they hated their job, the coworkers, and their patients. i felt blessed to truly love my job each and every day. then some rainy days came….............
the most challenging aspect of nursing i have encountered is learning how to separate and leave it behind when i come home. i love cancer patients, and after a year of not losing any patients, i lost four in 3 months. on my unit, we had team nursing, so we grew really close to our patients. i had taken care of two who died on my watch within two weeks (both were palliative). i know this may not seem like a lot, but children do not usually die on our unit, the docs and nurses were really good at realizing when a patient was circling the drain, and was quickly moved to the picu. the second patient that died on my watch died while i was in her room. then a month later we unexpectantly lost a 16 year old cystic fibrosis patient that had been coming to our floor for all her life (i was on her nursing team). not even a month after that, my first primary died. he was a great kid and his death (on top of the other 3) effected me very hard! i was a new nurse, and i was grieving unsuccessfully.
one night, after a particularly rough shift, i came home and posted a poem he had written (that his mom put on his funeral bulletin) with a picture of him and i on a social networking site. for some reason, at the time, i thought since i did not use his name it would be okay. i was hurting, and i wanted to honor his memory in a innocent way. the next day, my friend called me and talked some sense into me and i to take the picture down realizing i could get into trouble. ten days later, my nm calls me to her office and tells me she has to report me to the compliance committee and that i faced termination.
needless to say, i was horrified and shocked! i wrote a proposal to my nm and the complience committee asking them to allow me to continue working based on my previous exemplary yearly evaluation and on the promise to do a type of “community service” to my profession. my proposal was to put together an educational teaching of “breaching confidentiality in the new technological world”. i wanted to teach my co-workers to learn from my mistake. i wanted to spread the message that breaking confidentiality is easier that you think, and holds a very serious punishment. i knew i messed up, but to me, immediate termination felt like a harsh sentence for my crime. i had no idea, that my grief-stricken ode to a former patient would carry the same weight as coming to work intoxicated, diverting drugs, forging medical records, or assaulting a patient!
i am positive that no one on that unit (myself included) expected me to be fired for the mistake i made. my mentor (a nurse that has worked on the unit for over 20 years) as well as a couple of the np’s from the clinics were even surprised and outraged. sometimes i feel like me being fired was not fair, because the usual support systems for nurses who had lost patients were not in place due to budget cuts. do not get me wrong, i do know what i did was a mistake and a violation. but my motives were not malicious. i was not gossiping or providing any information that was incriminating. i am almost positive if that patients mother knew i got fired, she would be livid, she would be knocking down doors trying to right this! i know this because she wrote two letter to the vp of nursing about the excellent care her son received while a patient at *hospital name witheld*, and i was specifically named in both. i think it should be said that i do not think what i did should go unpunished. i know i messed up, and i think i should have been punished, i just do not think firing me was exact fair... but i have come to terms with it and accept it. the part i find the hardest to deal with is that in my termination papers i am deemed "ineligible for rehire".
what is your take on this situation? i have since been reported to the board and hired a lawyer. i also got a new job, but it just sucks being "ineligible" for rehire at my old employer. (like i said it is the premiere hospital in the area). my lawyer seems to think we have a good case, since the parents of this patient have each spoken out about this both to my old employer and the board of nursing.
llg, PhD, RN
13,469 Posts
I think you can "be OK" in the long run. You made a big mistake and are having to pay a big penalty for it. You don't like paying the penalty, but that's the way it usually is with penalties.
I believe you should follow your attorney's advice to the letter when you go to the board. But I suspect that they will "go easy on you" if you show true remorse, take full responsibility, don't make excuses, etc.
I'm glad to hear you have gotten another job. If you can "stay clean" for a while, you will probably be able to switch jobs to something that you like better -- though it may be quite a while before you will be able to get a job in which you regularly work with critically ill and/or dying children. Apparently, you weren't ready to handle the emotional distress of that environment and that stress clouded your judgment. You have to realize that employers will be quite hesitant to put you in that type of environment again -- at least not for a while.
Be prepared to discuss what you have learned from the situation -- and I don't just mean that you shouldn't post things to social networking sites. I mean, "What have you learned about yourself and your ability to handle certain situations?" "How would you handle such stress differently in the future?" "What insights about yourself and about nursing have you gained from this experience and how will you use those insights?" Those are the types of questions I would be asking you if you were to apply for a job I had to offer.
Accept your punishment, learn from it, and move on. That's what I would recommend. That's what I would look for in someone who came to me as a job applicant in the future.
Good luck to you. I hope the board is understanding and kind to you and that you fully recover from this stressful situation and from the mistake that you made.
Thanks for your input! I agree that I was not ready to handle the situation of kids dying.... (really, who is ready for that???) I just wish I had KNOWN that!
Trust me, if I had the chance to relive this whole situation, I would not have posted the "note" on the social networking site. Not because I am concerned with harming a patient or breaching confidentiality (that was never my intention) but because I learned to recognize in myself, when I need additional support and that it is okay to ask for it. I had never heard the term "Compassion Fatigue" before, but I am sure it was manifesting in me at the time. I have learned that to be able to take care of my patients most effectively, I need to take care of myself.
During this incident, and the termination that occurred, I have learned first hand that it is essential to actively seek out bereavement support when needed. I also understand fully, how much more difficult dealing with loss is when it comes to the death of a child. I have never experienced loss as frequently as I have as a nurse. I am hoping to take from this experience the lessons I have learned and use them to recognize, in myself and in others, work-related emotional distress and compassion fatigue. It is my goal to help other nurses avoid the potential negative side effects, such as lapses in judgment... that although they seem benevolent at the time, can have substantial effects on you career.
That's a good long-term goal ... but right now, you need to focus on helping yourself. You'll be in a far better position to help others after you have taken care of your own needs and gotten your career back on track. That will take some time. If you rush it, you are likely to find yourself back in a similar situation again -- focusing on trying to help others when you should be focusing on your own development as a nurse.
Good luck to you.
vanlo001
91 Posts
Wow. I'm sorry this happened to you. You are doing a great service increasing the awareness of the issue of confidentiality a d social networking sites. We had a huge to do about this reminding us not to be "friends" wjth patients or their families because it breaches confidentiality and the bounds of professionalism.
HouTx, BSN, MSN, EdD
9,051 Posts
Many thanks to the OP for sharing her story. That took a lot of courage.
I have responded to previous AN posts urging everyone to be more cautious about the nature of the clinical details that they are sharing. Basically, if anyone could possibly figure out who the patient might be - it's a HIPAA violation.
I also agree that it just doesn't seem fair to equate the OP's actions to those of other, far more serious behaviors that would justify immediate termination. However, HIPAA is a Federal mandate and the rules are very clear. Facilities place themselves in jeopardy if they do not respond decisively to known violations. As the current law is written, they have no choice. Maybe we need to be working to change the law??