How would I address a firing?

Published

I graduated in May and I began working at a LTC in July. I was suspended today because of a mistake I made yesterday when the state surveyors were there. The ADON told me to call her on Monday to make an appointment to meet with her after they finish their investigation.

If I do get fired, how would I address this when looking for a new job? What do I say when hiring managers ask why I left?

I'm sure everyone wants to know what happened. A surveyor came to me and asked what I would do if a CNA told me a resident had a pulse ox of 78%. I said I would put her on O2, check vitals, assess, and try to titrate her back up to 90%. Then the surveyor said she saw the CNA take the pulse ox of the resident and it was 78% and asked if the CNA told me this. I told her the CNA did not tell me, and I looked at the vitals sheet from the CNA and saw that she put down the resident had a pulse ox of 92%. I made an unsafe assumption that the CNA had retaken the pulse ox after it was 78% and it was 92%, so I did not follow up on it and assess the resident.

I accept full responsibility for what happened. It was my responsibility to check vitals and assess the resident myself given the information about the 78%, and I didn't do it. I do feel it was an honest mistake, especially for a new nurse, although I didn't fully think through what was going on and what I was told. But it was a mistake nonetheless, and I accept the consequences of it.

Up Vote Up Vote ×
Specializes in Psych ICU, addictions.

Unless you left something out of this, I'm not getting where you made the mistake. If the CNA did not tell you the patient had a 78% pulse ox, then how were you to know you had to follow up on it?

Now, when the surveyor told you that she saw the pulse ox had read 78%, you should have high-tailed it in there and assessed the patient no matter what the chart said. Is that where you went wrong, by not doing that?

Of course, the nurse is always the first one thrown under the bus. I'm sorry you're going through this.

Up Vote Up Vote ×
Now, when the surveyor told you that she saw the pulse ox had read 78%, you should have high-tailed it in there and assessed the patient no matter what the chart said. Is that where you went wrong, by not doing that?

Yes, this is what the mistake was.

Up Vote Up Vote ×
Specializes in Psych.

Wait, I'm confused. Why did the CNA put 92%? If they saw 78 and she put 92, and the only number you knew atm was 92, how are you in trouble?

Up Vote Up Vote ×
Specializes in Psych ICU, addictions.
Wait, I'm confused. Why did the CNA put 92%? If they saw 78 and she put 92, and the only number you knew atm was 92, how are you in trouble?

I was too until the OP clarified it in a follow-up post.

The surveyor told the OP that she saw the CNA take the reading and it was 78%. The surveyor told the OP about the 78%. The OP didn't go to assess the patient when she learned about the 78%; instead she looked in the chart, saw that the CNA put 92% and let the matter go. Whether the CNA rechecked the pulse ox and put the updated number or (God forbid!) false charted doesn't matter, at least for the purpose of the OP's problem anyway.

I think the point the surveyor and the OP's superiors were trying to make was that the OP should have immediately went to assess the patient once she learned from the surveyor the patient had had a reading of 78% at one point, even if the pulse ox had been rechecked by the CNA.

That's my understanding from the OP's post and clarification anyway--I'm sure the OP can fill in any more gaps.

Up Vote Up Vote ×

Yes, that is correct. Again, I know it was my mistake and I accept responsibility for it.

My question is if I do get fired for this, how do I address it with potential employers going forward?

Up Vote Up Vote ×

I did get fired.

Up Vote Up Vote ×
Specializes in Psych ICU, addictions.

I'm sorry. It sounds like they made an example of you because the surveyor was there. While you did make a mistake in not going to reassess, at the same time I think being fired for this incident is harsh, especially since a. the CNA or even the surveyor never told you about the 78% right away when you should have been told, and b. the patient came through without incident.

Up Vote Up Vote ×
Specializes in Psych.

I agree, it seems like an overreaction to fire you for that. Sorry to hear about it. :-(

Up Vote Up Vote ×

Thanks.

What should I say when it comes up with applying for jobs? I asked the ADON what she would suggest (I really think the decision came from above her and she wanted to help me), and she just said to say "it wasn't a good fit". But then the follow up is going to be "why?" and I don't know what to say to that. Or should I just tell the whole story and hope they are understanding?

Up Vote Up Vote ×

I would go with the good fit explanation and not go into detail, but try to go around the question, or say another generic comment like, "A surveyor was present and there was a question about how I handled a situation involving the surveyor. I became frazzled by the surveyor. I learned from this that I should slow down and take time to think before I speak or act." That may be all you need to say. If they want more detail, then try to invoke HIPAA. If it were me I would not want to be caught talking about a specific incident where anything remotely connected to a HIPAA violation could be pinned on me. Good luck.

Up Vote Up Vote ×
Specializes in Hospice, Case Mgt., RN Consultant, ICU.
I would go with the good fit explanation and not go into detail, but try to go around the question, or say another generic comment like, "A surveyor was present and there was a question about how I handled a situation involving the surveyor. I became frazzled by the surveyor. I learned from this that I should slow down and take time to think before I speak or act." That may be all you need to say. If they want more detail, then try to invoke HIPAA. If it were me I would not want to be caught talking about a specific incident where anything remotely connected to a HIPAA violation could be pinned on me. Good luck.

I think the part about being frazzled by the surveyor is very believable. Nurses are human and do make mistakes. You are so new to the profession and I am wondering if your employer had given you any feedback before this? I would stress the positive and get on to some thing else. I do think being fired was rather harsh if they had been pleased with your work so far. They could have used it as a learning experience. :)

Up Vote Up Vote ×
+ Join the Discussion