Got fired... again. Should I not be a nurse?

[Sarah K, RN]

Yesterday I was termed from my job at a LTC facility (technically I "resigned"). I had only worked there a couple of months. I understood their reasoning for letting me go. Due to low census they sent home the nurse who was working the other end of my hall and so I then had 70+ residents to take care of (something I'd never done). On top of that I had an admit (never had done that either). I got confused b/c I thought one of the nurses from a different hall (there are 2 on that hall) would be coming up to cover the other half of mine, which turned out not to be the case. Anywho, so when it was all over and done with some people ended up getting their meds too late and some didn't get them at all. The nurse that had been sent home had already signed out the meds but hadn't given them. Apparently they were in little cups somewhere in the cart but I don't remember her showing me where. I tried to get some help from the other nurses but they were busy with their own stuff and I wasn't sure whether one of them was coming to help. I called my ADON, got her voicemail, and got a call back 1.5 hrs later telling me to do my best. I was quite overwhelmed by the end of the shift and may not have been thinking clearly.

I also got termed from an L&D floor at the end of my orientation b/c they said I wasn't learning the ropes fast enough and they could no longer make an investment in me. I was also in grad-school full-time while working there.

I also got asked to leave a nurse-midwifery program I went into right after nursing school b/c of professional issues. They said I should work as an L&D nurse for a while and try again (really easy in this economy, right?)

I originally went to nursing school b/c I wanted to go to midwifery school and I found I like being an RN and am proud to be a nurse. I'm very passionate about women's health and helping women have the births they want safely. I did quite well in midwifery school in terms of my clinical skills.

After dumping all my dirty laundry on you guys I'd like some feedback. Is it possible to be so passionate about something and just be bad at it? Are there any recommendations for me? I have started applying for jobs and am willing to move anywhere. My dad asked me last night whether I should think about something other than nursing since that doesn't seem to be my forte.

I am very confused and my self-esteem is pretty low so any advice would be greatly appreciated.

[classicdame, MSN, EdD]

consider nursing in another area - like Home Health, Health dept., industry - at least till you find your niche. Also, if you want midwifery consider area women's clinics and MD offices. Good luck

[trixie]

What I see lacking in your experience is Med/Surg from an acute care facility. Many feel (and may post) that it is not needed. However, with a great mentor and med/surg experience - I would bet you would see your skill set improve. It seems you jumped into L&D/midwifery without this. I have seen others do it - but wouldn't advise it. Even a few years in med/surg will teach you much about organization, prioritizing, etc.

What goes on in LTC facilities boggles my mind and I can't imagine that ever being my cup of tea.

Best wishes to you. Don't ever give up on your dream - just tackle it a different way.

[subee, MSN, CRNA]

The LTC thing - sounds like it has nothing to do with you - more like it was a very dangerous place..for staff and patients. Two judgement issues that I would call "bad" - orienting on a new job while going to grad school full time; and, attempting to even START midwifery school without any experience. However, I fault the school more than you because they shouldn't have accepted you or taken your money! The med-surg advice is good advice. You may like it, you may not , BUT it will provide you will a foundation for whatever else you do. I thought the public health idea had it merits - one patient at a time - but without med-surg under your belt, I'm not sure how useful you'd be to the patients you see post acute-care discharge.

[yalienne]

I have not read all the reply so I might repeat what has already been said. I really think you can still be a nurse. Have you thought about getting a job at a private home where you will have just one patient to take care of? That might be more feasible for you and allow you to go to school and work at the same time. or you may want to work at a hospital where the ratio of nurses to patient is low. I remember when I shadow a physician for a day in the OR, the nurses just prepared the skin to get applied to the wound. These burn unit nurses where not running around like the floor nurses who have to deal with patients, families etc... I think while you go to school, you might want to look for something like that. You just need to find out what you are good at as a nurse and stick to it. I think taking care of 70 patients will drive anybody crazy. There are so many branches in nursing and there are so many things you can do as a nurse such a case manager, DON, consultant, educator etcc... You just have to find what suits you the individual. You can even work as a travel nurse that makes house call. I know this nurse that works for this agency for the intellectually or physically disabled. She spend an hour or more at each clients house to make sure the home providers are on top of things. She also give the new home providers or Direct support employees test so they can become med certified for the agency etc... Pretty relaxing. She does not have to deal with 70 clients in one day, family members, etc....

Good luck!!!

[Vito Andolini]

:nurse:First, do not EVER give meds that someone else has set up. The nurse who opened them and signed them out should have stayed to give them, despite having been told to go home. I can't believe you were actually going to give them. Didn't your school drum it into you to never do that? Be glad, Girl, that you never found them in their itty bitty little med cups in their itty bitty little individual drawers. And just when were you told you had to take over the entire floor? And were you told you had to pass meds someone else had signed out and opened? Do you know how long it would take you to ID each pill? About 5 days, Girl. Now do you hear me? ARe you ever again going to even consider passing meds you have not personally prepared? If you are, I'm comin' to getchoo and tan your hide! Seriously, OP, you have to speak up when you are given unreasonable or unsafe assignments, like caring for 70 patients and passing meds that someone else poured. Geez, now my BP is sky high, thinking about how you might have given someone the wrong meds and been blamed for terrible side effects.

Do not EVER accept more patients than you can handle. You could barely handle 30. How do you expect to care for 70? And you do NOT have to accept patients . You are not abandoning them if you never accepted them. Your bosses are idiots and bullies to expect you to be competent to care for so many people while you are still such a new nurse. They had never even shown you how to admit someone! They are abusive and they don't care a damn about you or your license or the welfare of the patients, for that matter. Please notify JCAHO and CMS and your state's department of licensing of such facilities of your experience so they can get after this place to improve or shut them down if need be. Their practices are very, very unsafe. How many residents are getting bedsores, missing meals, not getting proper sanitary and hygiene care, missing treatments and meds, etc.?

AS for your future: First, apply for unemployment. That will help some financially.

Secondly, figure out what you really want to do - grad school for midwifery? work L&D? forget med-surg, it is not relevant. Yeah, it's good experience but it's not what you want to do and you can learn the same skills elsewhere. Others have suggested being a mat/child Public Health Nurse or working in a doc's OB-Gyn office and I agree these might be good for you.

Do not let anyone or anything stand in the way of you reaching your goals. Never give up. Never give up. Never give up. Did I say Never give up? Well, never give up.

It's hard to be a good nurse when you're so new and when your bosses are idiots and bullies. Just keep on going and regain your confidence. Do not let them grind you up like meat for a sausage. You are a nurse, by God, and you will be an excellent nurse and an excellent midwife. Just realize that no one can survive in the kind of environment that is now, thank God, behind you.

OK, so what are you going to do, friend?

:redbeathe:nurse::heartbeat:nurse::ilyc::flwrhrts::wshgrt::thnkg:

[JomoNurse]

youre not supposed to sign off a medication if you haven't given it. why in hell did they fire you? in my opinion, this was caused by poor communication and not by your competency and potential as a nurse. you're still new. you'll learn. keep applying and working hard. also, you might want to take a few things off of your plate. i work full time and boy that takes all my energy. i can't imaging doing other things on top of that. maybe try home health? it's very low key, low stress, you get to make your own hours for the most part and all of those goodies. if you got through nursing school and passed your boards, youre able to function as a nurse.

[island40]

Please don't give up! Find a job where the staffing is adequate for you to have assistance while you learn! Not the night shift- unless the other nurses are regulars and very willing to teach/help/advise and supervise constructively. Before taking a new job talk to the other nurses that work on the unit- do they get along? do they have time to take breaks? do they leave on time? how long does it take to get someone else on the floor to help you turn someone? take them to the bathroom? get water? (you know, the tasks that can easily get overlooked and put off for 20-30 minutes) do the other nurses know what they are doing? do they know the medications they are giving or are they just taking the pack out of the medication machine and moving on to the next client because there isn't time?

I've been fired 7 times. I am a good nurse. I am not always a good employee. You will find your place in the world if you keep looking.

[trixie]

" forget med-surg, it is not relevant. Yeah, it's good experience but it's not what you want to do and you can learn the same skills elsewhere"

Told you someone would disagree. People that disagree with this statement generally don't have med/surg experience and don't know what they are missing. It IS relevant, esp if she lost a job because she wasn't catching on quickly enough.

[Hubby's girl]

I feel bad for you. First though, don't think that was a good job that you resigned from. It's good for you that you're not there. I feel sorry for the pt's at a facility like that too. Work any nursing job you can get (that isn't like the previous situation) and stay there for a while. This will tell you whether you like nursing and will give you time to perfect your nursing sklills and learn some critical thinking.

[cjcsoon2bnp, MSN, RN, NP]

I think that you need to take a little time to reevaluate what you want to do with your career. If you want to become a nurse-midwife then that should be your ultimate goal but you need to lay down the proper foundation to get to that point. I would say that at this point you probably are not ready to handle a regular Labor & Delivery floor because of all that you have had going on career wise. I would suggest that you go and find a good Med/Surg floor and get a year of experience in that setting, it will help you to sharpen your critical care skills and make you more confident as a nurse overall. I think this would be especially helpful as a midwife so that you are more well rounded as a nurse and are better able to handle situations that arise with your patients that may not be expected but are critical and require immediate treatment. Once you have the Med/Surg experience I would find a Labor & Delivery floor and put in some time there while you start looking at grad. school options, keep working part time while you go to school part time so you can add to your experience while your studying. That would be my plan but then again that may not work for you, its just an idea.

!Chris

[Sarah K, RN]

Thanks guys for all the great advice and comments. I really didn't think hard about the situation until I stopped being SO emotional about it. I'm feeling much better (thanks for the support!) and working on getting something new. I've applied several places on both L&D and med/surg. Will look into home health, etc. Like some of you said, I'm applying to all sorts of jobs. In this economy I can't be super choosy. We'll see what happens!

Thanks again and keep the advice coming! :heartbeat

-Sarah K, RN (and proud of it!)

[Txangel791]

" forget med-surg, it is not relevant. Yeah, it's good experience but it's not what you want to do and you can learn the same skills elsewhere"

Told you someone would disagree. People that disagree with this statement generally don't have med/surg experience and don't know what they are missing. It IS relevant, esp if she lost a job because she wasn't catching on quickly enough.

I agree, med/surg experience is very beneficial. When I came out of nursing school I wanted to go straight to the ICU. Many people told me to do the med/curg first, for at least a year but I didnt want to and resented them for implying that I couldnt do well in the ICU without that experience. Lucky for me, the hospital I wanted to work in didnt have an ICU position open when I gotmy license. So, I worked the med/surg floor for 18 months and learned more there than I knew I needed to know! When I finally got to ICU I could appreciate everything I learned on the floor, amd I missed med/surg so much I went back after 8 months in ICU. That time on med/surg taught me sooo much and boosted my skills and self-confidence up to where I needed to be. I encourage every new nurse/nursing student I meet to do that time on med/surg. Bet they resent it as much as I did :)