how did I get here?

[ctpicu82]

I am an RN in upstate NY. I previously worked at a local hospital with adults on a cardiac/medical unit. It was kind of like a step down from the ICU. I worked here for 7 years with no major problems and great performance reviews. I am currently at a different hospital in the PICU. Over the past 2months things for me have gone from ok to bad to worse. Last week I was once again blind sided and asked to meet with the director of Pediatric nursing and my nurse manager and nurse leader. In short, I was told that they wanted to discontinue my relationship with the PICU. I am still on orientation, with only 5-6 weeks left to go. My original Preceptor has left the hospital. He was suspended for 3 weeks and then the decision was his as to whether to return or not. After 10 years of working in the PICU he choose not to return. I am not sure why he was suspended, but I do know that he was an amazing nurse so much so that the residents, fellows and sometimes attendings would go to him with questions. There are definitely some politics at this hospital, but I am feeling quite helpless. I have had a few discussions with my nurse leader during my orientation regarding my performance and progress. There were a couple of instances where I made a mistake, none of which ever harmed a patient. All were caught long before that when I was checking or verifying with my preceptor. We discussed them and moved on. I was under the impression that this is what part of orientation is all about, learning. I am fully aware that things are very different in the pediatric world vs the adult world. However, I was told last week that my practice was unsafe and that there are questions regarding my integrity with my preceptors. The last meeting I had prior to this one was to discuss my "lack of progress". This totally caught me off guard and left me speechless. After this meeting I had decided that that was only going to happen once, and from that point on made a point of asking my preceptors after each shift of what was good, bad or indifferent. Not once was this integrity thing brought up. But it is what was told to my nurse leader. Just a thought, but if I were precepting someone and I asked them if they had done something, they responded yes and then a little later I saw them doing something that indicated they had not yet done the questioned task I would ask them about it, wouldnt you?

By the end of the meeeting last week it was decided that we would meet again this week after thinking about all that has been said by both parties. I am just so lost as to how I got here and what to do now. I feel like I am being attacked, and singled out. Basically in most instances it is my word against theirs. I plan on bringing in past performance reviews and documenting everything and handing it to HR to put in my file, but I am still left with this awful feeling of failure. I really love my job in the PICU but they dont love me. I honestly felt that pediatrics was where I should be, and it felt right to me. What do I do now? Do I stay in pediatrics and try to go to a different unit, stay at this hospital even, or do I just cut my losses and move on to somewhere for a fresh start? Any suggestions? I have been agonizing with this for days and all it is doing is making me nauseated and sleepless.

[llg, PhD, RN]

At this point, it's probably not worth a big fight. Cut your losses and move on. It doesn't sound like a good working situation. Even if you could convince them to give you another chance, would you really want to continue working for these people?

If you really want peds, I think your next job should be on a more general peds unit, may an intermediate care unit. That will give you a chance to learn pediatric care without the burden of coping with the ICU part of it at the same time. Peds ICU's are exceptionally stressful because the patients are not only ciritically ill (like in an adult ICU), they are children, which tugs on the heartstrings more.

If you really want to stay where you are, you need to get more information about the specific incidents that they are not happy with. Have they given you that information?

[GrumpyRN63, ADN, RN]

I would definitely move on, it sounds like a very negative situation all around. If you love Peds, then try for another unit , it's hard to know whether it's a unit problem or an organizational one,but if it happens again, well, move on to a new place. Is there a Peds unit at your previous hospital you could apply to? It sounds like you left on good terms so you may want to look there.In any event, I think it would be best to leave ,give whatever notice you are required to, and GET OUT, no job is worth that grief, you don't want to lose your self confidence. Even if you can't get Peds right away, move on, it sounds like they may be thinking about cutting you loose, don't give them the opportunity. GoodLuck!!

[ctpicu82]

Well thank you all for your wonderful and insightful words. I appreciate them all very much. However, I have been let go from my position in the PICU, as of Dec 11, 2 weeks exactly before Christmas, Merry freakin Xmas,huh?

I am doing ok though. I have taken the last few weeks to kind of get perspective of the whole thing and try to understand the whats and the whys. Luckily I could financially afford to take some time. But I have to say that my confidence is not what it used to be. One of the things they said to me was that this was not personal. Well I am sure that most if not all of you would agree that being a nurse is part of who you are, and when you question someone's integrity that is definitely something personal. I have come to the conclusion that my being let go was due more to the fact of who my preceptor was. The guy that was suspended, and then chose not to return after being there 10 years. It has always been my gut feeling that this had to do with him. My suspicion is that he was suspended for something, and they are afraid that I know something about this thing, that could possibly hurt them. Unfortunately, I am the one suffering the consequences. But I do plan on returning there in a few weeks and going through my file with a representative from HR, then writing a rebuttal statement, and finally setting up and exit interview with the Chief of Nursing. I have no intention of going back to work at this hospital, but who knows what is 5 or 10 years down the road, and I would really hate to regret not handling all this later on. Unfortunately, this is really the only hospital in this area that does pediatrics. So for now, unless I find an office position, pediatrics will have to go to the back burner. I havent decided where to go yet, but I am strongly considering 2 things. One is going to yet another hospital and working with cardiac patients, or the ICU, or returning to my previous hospital and going to the ICU there. It was also very difficult to really do anything about a new job because of the holidays, no one is in their offices and doing the usual stuff for the most part. Gotta love the christmas present the PICU gave me, dont ya??? Anyway, jsut wanted to give you all an update. And again thank you for your support and kind words.

[GrumpyRN63, ADN, RN]

I'm really sorry that happened to you, what a s****y thing, and right during the holidays.. it does sound like a lot of 'office politics' at work there... Is there not another unit for Peds in there, I mean, they have a PICU, have u tried other units within? It's not impossible to get hired on another floor( in the same place) after being let go ..I've seen it happen.

You are having a tough time now, but w/ 7 yrs under your belt you will bounce right back, NO DOUBT. Good Luck,

(((((((((( hugs ))))))))))), Grumpy