I got fired today...

Nurses New Nurse

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I'm officially fired from my first RN job today. My manager suspended me starting from last Thursday due to my medication error, which happened on Sunday, 25th. I made two errors during my orientation period, and those two errors are something that didn't teach in nursing school.

The first incident happened around 4 weeks ago. This patient was admitted due to SOB and was getting better. When I was providing medication to the patient, the doctor walked in and assess the patient for a bit. I stayed and listed to what the doctor said to the patient. Doctor said that patient is getting better and told me to walk the patient around the unit. So I agreed and walked the patient. On the half way, patient started showing SOB and wanted to sit down. I called help and many nurses helped me to sit the patient and escort the patient back to the room using a rolling chair. One of the nurses pointed out that I should grab a portable oxygen tank with me when walking this type of patient.

Specializes in cardiac CVRU/ICU/cardiac rehab/case management.

Thank you so much funkmarv , I really appreciate it. I was feeling kind of drained today and your comment felt like an instant tonic,Thanks!

I agree but I also think some of the fault lies with the preceptor who was not paying attention when the original poster asked if they should give the solumedrol with the med change/new orders. I can't completely faoult the new nurse for this one. The preceptor is there to help mold these critical thinking skills and should have given this as a learning opportunity- discussing the order change, and what the new nurse would do and why it was wrong or right- that would have been a more meaningful interaction. But I think the preceptor had something else on their mind and blew this new nurse off and when push came to shove in the manager's office, didn't even remeber the new nurse asking what they should do. Unless I'm reading the transpiring of events wrong.

It just seems like no one is willing to take the time with any new employees anymore. Whether they be new nurse or old experienced nurses new to the facility. It just seems these money wasting facilites could save alot of money in recruiting and the laughable brief orienting they do, if they would just invest alittle time into keeping the new person they have infront of them. But NO- hurry through the shotty orientation with the shotty preceptor, don't pass the new orientee, new orientee just made a screw up,, out you go and on to the next- that's not saving any money, That is spending it faster than anyone can catch on to. Isn't that called"the big hussle" Spend the money once, and do it right. If it's done that way, they just might find out it's not the nursing staff that's over budget but the HR staff and all those worthless talks about fire regulations, electrical safety and the trays of danish and cookies. it's busiy work to keep these people on the payroll by having them do lesson plans for " general orientation" each month or every 2 weeks. Have the HR director lady come to give their benefit speel before the general orientation group while the other 3 dozen HR flunkies are in the office throwing resumes in the trash, shredding paper and blowing their snotty noses. I say cut the desk worker positions and use their salaries to put nurses back on these floors and then they can stop spending all that money they are allocating/wasting for visitor drinks, extra"tool box" junk/bribes, and movie tickets. That ought to pay a few more staff nursing salaries. Maybe it's time to build a new multi billion dollar new hospital- it must be the old building's fault- not contemporary enough looking!!!

Prayers for you, this is extremely harsh. Welcome to nursing, sad but true. I know several new nurses this has happened too, what a rough way to start. Believe when I say you will find something else better, could be tough to find another position for awhile. Look in LTC, psych. Best wishes and prayers for you. Rough profession it really is, there are places that are kind and truly teach. Again I am sorry for this incident.

Specializes in Pediatrics.
I agree but I also think some of the fault lies with the preceptor who was not paying attention when the original poster asked if they should give the solumedrol with the med change/new orders. I can't completely faoult the new nurse for this one. The preceptor is there to help mold these critical thinking skills and should have given this as a learning opportunity- discussing the order change, and what the new nurse would do and why it was wrong or right- that would have been a more meaningful interaction. But I think the preceptor had something else on their mind and blew this new nurse off and when push came to shove in the manager's office, didn't even remeber the new nurse asking what they should do. Unless I'm reading the transpiring of events wrong.

I have to respectfully disagree here. While the preceptor is there to guide the oriented, there comes a point where there needs to be some ownness on the part of the new nurse... That RN (we are not talking about a student here). Yes, continued ,old ing of critical thinking should be happening here, but this seems like more of a common sense thing. The patient went from TID to BID. Common sense should dictate that the patient will get the med less frequently, not more. Going from every 8 to every 12, then gives it 2 hours after the last dose? This is a concept that we encounter frequently in clinical (2nd semester). In Peds, almost every asthmatic kid on nebulizers get 'advanced', from Q2 to Q3, or q3 to q4. It is not at all a foreign concept.

It just seems like no one is willing to take the time with any new employees anymore. Whether they be new nurse or old experienced nurses new to the facility. It just seems these money wasting facilites could save alot of money in recruiting and the laughable brief orienting they do, if they would just invest alittle time into keeping the new person they have infront of them.

But NO- hurry through the shotty orientation with the shotty preceptor, don't pass the new orientee, new orientee just made a screw up,, out you go and on to the next- that's not saving any money, That is spending it faster than anyone can catch on to. Isn't that called"the big hussle" Spend the money once, and do it right. If it's done that way, they just might find out it's not the nursing staff that's over budget but the HR staff and all those worthless talks about fire regulations, electrical safety and the trays of danish and cookies. it's busiy work to keep these people on the payroll by having them do lesson plans for " general orientation" each month or every 2 weeks. Have the HR director lady come to give their benefit speel before the general orientation group while the other 3 dozen HR flunkies are in the office throwing resumes in the trash, shredding paper and blowing their snotty noses. I say cut the desk worker positions and use their salaries to put nurses back on these floors and then they can stop spending all that money they are allocating/wasting for visitor drinks, extra"tool box" junk/bribes, and movie tickets. That ought to pay a few more staff nursing salaries. Maybe it's time to build a new multi billion dollar new hospital- it must be the old building's fault- not contemporary enough looking!!!

This point, I do agree with. There needs to be a better transition from student to graduate nurse. Not all preceptorship are shoddy. And they are not necessarily educators either.

Specializes in being a Credible Source.
Oxygen is considered a medication. In fact, it's the most common medication administered in hospitals.
It's off-topic but parenthetically, I'd venture to say that NS is administered more frequently than is oxygen...

ProfRN4- I respectfully disagree with you. The title of this thread is "I got fired from my first RN job today". The poster stated in their second post, they asked their preceptor if it was alright to give the next dose of solumedrol( the first dose of the new orders at 12 ) after giving the first dose at 0900 and th preceptor "said it was ok" per the poster. The original poster goes on to say that in the nurse manager's office the precptor "didn't remember" that the poster asked if it was ok. This says to me that this is a new RN with no critical thinking skills other than that of a student was left unattended by their preceptor and that the preceptor was not paying attention to this new RN giving out meds. precepting a new RN is a big job and should be done by someone who relly wants to put the time forth into doing it. Not some one who want a pay increase and a brag point on their resume.

That's the problem with lot of these facilities, they dont have the experienced RN's/ the talent pool they used to years ago. Now a days it is the inexperienced teaching the no experienced, close your eyes and hope for the best or no one get's killed. i have seen these preceptors in action- they sit at the desk and let the newbie out on their own to hang and do the team assignment alone. It's don't call me, I'll call you. I have also seen many a new RN quit over this also. No direction.

PorfRN4- with rspect to the robot comment and all students and new nurses think all nurses do is "tasks" I think that they do that because that is where they are i their professional role developement- "From Novice to Expert" Pat Benner. the novice nurse IS focused on tasks, it isn't until they get a few years of experience under their belts that they "let go" of that task oriented thinking and start intergrating the other factors in patient care. That preceptor is more responsible for what happend than that new RN. That Nurse manager is also responsible- the deignation of a preceptor who can't pay attention to their appointed newbie's.

I am so sorry you were fired. I was "there" a few months ago and almost quit nursing for good. You questioned that solumedrol order continuously and still didn't administer it perfectly. Honestly? I think that is a mistake that every nurse can/could make. And you were smart enough to question it. I think a lot of nurses are better than you or I at ducking under the radar by not speaking up. Ask yourself, which nurse is more dangerous to the patient?

I was fired for much less :) Well, technically I handed my joke of a manager my resignation faster than she could flip through the termination papers.

- Taking a b/p while pt was lying on side

- charting b/p on wrong patient (uncharted within seconds, made sure no inapporpriate orders were made, etc.)

- charting b/p on wrong patient a week later (uncharted within seconds, and told my boss).

- refusing to falsify documentation (!!!) (Yes, I chose to have my license over that job)/

Biggest mistake of my first job was being honest with my manager.

BUT.... after almost leaving nursing over a hellish first job, I found a new great one that I love, and even got a pay raise for experience!

I wish you the best -- hope that leaving this job leads to better opportunities.

1 Votes
Specializes in Pediatrics.

PorfRN4- with rspect to the robot comment and all students and new nurses think all nurses do is "tasks" I think that they do that because that is where they are i their professional role developement- "From Novice to Expert" Pat Benner. the novice nurse IS focused on tasks, it isn't until they get a few years of experience under their belts that they "let go" of that task oriented thinking and start intergrating the other factors in patient care. That preceptor is more responsible for what happend than that new RN. That Nurse manager is also responsible- the deignation of a preceptor who can't pay attention to their appointed newbie's.

I'm not disagreeing with the role development comment. However, students are (repetitively) given critical thinking questions, scenarios, and simulations (the Sims we do in our school are often more about thinking and problem solving than physical tasks, yet they all are dying to 'give' something.

All new RNs are deemed (minimally) competent. Questions are so situational these days, requiring much more than memorization. While I don't dispute Benners theory per se, the current healthcare culture demands much more of new grads, do they need to be forced out of that task-oriented mentality.

Regarding how competent the preceptor is: we'll never really know. We also cannot assume that this preceptor does not enjoy her job. perhaps she was given a full and/or heavy caseload, on top of precepting. the $value in many hospitals in inconsequential. I still maintain that the time change is something that is out of the realm of the recent graduate RN.

Specializes in Oncology.

I'm so sorry this happened to you. You sound like someone whose heart is in the right place, judging by your level of humble introspection - very mature, and not often the case when someone is fired (people always want to blame the manager or someone else instead of taking responsibility for their own actions).

These are all qualities that will serve you well in your next job. I also have to wonder if it was more than just these few incidents. You admit to a lack of critical thinking in these circumstances, are there any other occurrences that demonstrated a persistent lack of critical thinking throughout orientation? If so, this would be another area on which to reflect before you start a new job. Some of the new grads we had to let go where I work were really sweet people who were fastidious and so afraid of doing the wrong thing. We were all heartbroken about it because we so wanted it to work and were really rooting for them. Gave them extra time, etc. Managers do want their employees to succeed, believe it or not. Unfortunately, repeated patterns of behavior despite remedial training still did not yield the results we needed for these new nurses to practice competently or independently. Sad for everyone involved, but not all settings of nursing are appropriate for everyone. I firmly believe that anyone can find their niche in nursing, it may not be the one you initially want or expect, and that's OK.

Chin up, reflect on your strengths and weaknesses, and keep searching for your nursing "home". I do hope you find it soon.

Specializes in Oncology.

Quote from Samadams8:

The whole thing sounds screwy. Betcha somehow you weren't liked or they found someone they liked better for some reason, or there is some kind of game going on. Your mistakes were not Fire-worthy in the bigger scheme of things, especially for being a new nurse.There's a game afoot. I've seen this at other places.This sounds like a potentially toxic environment. Seriously. The whole thing is asinine, and I wouldn't want to work there....and I'm a very good nurse. Something is wrong there.Considered yourself blessed. Write a strong letter to admin and appropriate people w/i this place, and then don't look back.I'm not saying you were right, but I have seen much worse mistakes, and nurses and doctors that have made them grew to be great in their roles. This is a bad environment. The way it sounds, they would have just continued to make your life there miserable. You can do much better..seriously...I'm not talking sour grapes, sweet lemons.

I'm a little disturbed by this line of thinking. It sounds, I don't know, paranoid maybe? I don't mean to pick on you in particular, but I've noticed this type of general theme a lot on Allnurses, and I feel the need to say something, because it is potentially damaging.

I know a lot of people come on here to vent, and we want to to give them our support and lift them up. I get that. However, acting like the people who are venting are 110% A-OK/perfect/blameless while big, fat, evil, maniacal administrators/managers/higher-ups/bigwigs/"the powers that be" are setting them up to fail, is frankly, not realistic. It perpetuates the attitude of "us vs. them" instead of holding people accountable for their actions and truly helping them. That is, helping them emotionally (through understanding, support, and encouragement) and professionally (by helping them to acknowledge their own short comings and make a genuine effort to improve). Blaming others, especially when we only hear one side of the story, does nothing to help an individual improve or reach their full potential. All it does is perpetuate the concept of victimization and create a form of classism within nursing that is not helpful.

I am not naive enough to think that management are all angels, nor am I cynical enough to think they are devils either. We all need to start looking at situations from the other person's perspective (yes, even managers/administrators) or we will simply keep perpetuating all these negative stereotypes about one another.

That's all for now. This post has been a long time coming, so I appreciate any who read it. Thanks for the vent.

Specializes in ED staff.

Sounds to me like you should have had a better orientation. When you hear the words "nurses eat their young" consider this an example. The solumedrol... that extra dose probably helped your patient! I'm not saying that you weren't wrong in giving the double dose but its not something that you would have gotten into major trouble for. If the patient is on oxygen just sitting in the bed then they need oxygen even more when they are up walking around. Hindsight is always 20/20. I know here in Birmingham, AL at UAB they have nurse internships for new grads. Maybe someone has something like that in your area?

Oxygen is considered a medication. In fact, it's the most common medication administered in hospitals.

Eventhough you want to blame the school for not teaching you this...I have no doubt you learned the concept of oxygenation throughout your nursing program (medsurg, peds, fundamentals, you name it). What you didn't develop was the ability to critically think and apply your base-line knowledge learned in theory to practical applications such as this one.

There's no one to blame in this scenario except yourself.

Damn Delaware... You don't have to be a **** about it...

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