I Have to Find Another Job ......

Nurses LPN/LVN

Published

Thank you all for listening to my plight. I was called into the office at lunch time and told I had to be let go. I worked in Asst. Living. The residents are very much oriented x 3. I know we have rules that must be followed and I had no problem with that. When I first went there I was told I could be hired as a med tech. When I appeared for the interview two months ago the facility administrator hired me on the spot as an LPN at $21.00/hr. I had orientation for a couple of weeks with 8 different people. Instead of one to mentor me and had no consistency. Everyone had their own way and their own rules and told me this is what they did. So, I took a little from each one and then went on my way to be on my own as a new graduate. I had to apologize to a resident last week for an aide telling a dear woman that she was disgusting when she went in to clean her colostomy bag. Just today I had to apologize to another resident who is on hospice for waking up the aide during night shift at 1:00 AM wanting prune juice from her fridge and tylenol. Resident was brought the tylenol and not asked what the pain was, the scale of pain or where the pain was located. An EMT was on and told her to be quiet and get back to bed it was 1:00 AM. I had found out after being hired that there were 2 med techs there in their early 20s. Since I was hired they had zero hours. Also, the one was reinstated after she had been relieve of duties due to disciplinary measures.

I had a resident who has a yo yo blood sugar. She had a b/s of 80 at 5:00 PM and refused 5 units of insulin. After dinner I took b/s again and it was 87 she refused insulin. The MAR stated at 8:30 hs to give 2 units. At that time her b/s was 250. Since she had no coverage at all at dinner I gave her 2 units plus 2 units for coverage. The other patients in asst. living are sliding scale. I had to leave and there was NO nursing coverage overnight. I wrote this up in the notes what I had done and why. The next day I was told it was a VERY serious med error and that the family had to be called. There were no side effects at all and it was 2 extra units on a nursing judgement that I made. Why then was I allowed the next day to work and give out all the medications on the 2nd floor then called down and told to sign a form and they had to let me go. Was this a serious med error in Asst living to give 2 extra units for a 250 blood sugar? I am so crushed.

I loved these people and had grown fond of them. I truly care about my profession and made a bad call. The DON said I should have called her at home or call the doctor. Well ok so now I have lost my job that I was just settling into. Was this really grounds for letting me go? Just like that?

The people really liked me and I cared about them.

Oh, the DON told me as she walked me out the door that she liked me as a person and would

write me a good letter of recommendation for another job if I needed it. She told me she would

not report me to the state regarding my licensure. ??? Am I the only newly graduated nurse to make

a bad decision like this. Is this what happens when you are on the job and new??

Thank you for you expert nursing advice.......

The decision to let the nurse go has very little to do with patient safety, and more to do with the politics of covering the facility's butt. You'll understand more about healthcare facility politics when you start working as a nurse.

Excellent point. Sad but true.

Specializes in geriatrics and psychiatric.

Yes, resident was receiving humalog - fast acting - 5 units pre breakfast, 6 lunch, 5 dinner and 2 hs. 8:30/9:30 PM

The DON on call at this ALF is an LPN. No RN here and I should have called the dr for clarification.

My wrong decision. How easy it is for a new nurse to get herself in a wrong call.

Thank you all so much for your feedback. The resident is just fine. She had no side effects as I had talked to her the next day. I was brought to the DON office three days later, on a friday when the new schedule was due to come out. Would a Med Tech not make an error ever as I did? The facility is staffed with Med Tech's and the one med tech that had her status taken away was given her status back when her disciplinary measures were lifted from no show/no calls. These are young girls that are given two med passes take a test and then give out the meds and do the treatments. I did make a med error but I worked on the hospital floor for 2 yrs doing my clinical rotation and worked with sliding scales and wrongly assumed. Yes, I did wrong and I sure now know that I can not assume with the sliding scale and insulin. I should have called the dr. The resident refused her insulin at evening meal as it was 80. She can drop rapidly to 40s and 50s. Her b/s is brittle and goes up too into the 400s . So, I did not want to leave her with zero coverage as I was going home and there is no nurse on overnight. I had no right to make that decision and I now know that. Never Ever will I decide on my own over a physician's order. The other residents all have s/s and this one woman whom I love dearly was reading b/s 250 at 9 PM. The DON said I should have given just the 2 units and checked an hr later the b/s then call the dr if it went higher. It was a learning curve for me for sure. She was to receive 2 u and I gave 2 plus 2 u extra and then I truthfully documented exactly what I had done. It was clearly a learning mistake for me and not done out of arrogance. I am green and feeling my way with the resident's safety first in my mind. The DON had talked to me a few wks ago stating she had no hrs to give me and this was as good as ever to let me go with this incident. I do miss my residents and had gotten to care about them very much.... I guess this is what makes a caring and compassionate nurse.

Again, thank you all so much......

Blessings,

Carole

Specializes in Community Health, Med-Surg, Home Health.

One of the reasons why medicine/nursing is called a practice because it is. No matter what the statistics are, everything is 50/50. We learn from our mistakes. I notice the same for the residents that come to our clinic. They are learning the same as we are. At least, the DON was not so vicious that she reported this to the state. She realized that you do care, and that placing your license in jeopardy would not be helpful, because somewhere in there, she sees that you will build confidence and will learn from this. This is a cover your butt system created, unfortunately. I sincerely hope that you get another position ASAP, because I don't believe you meant any harm. Best wishes to you, and please keep in contact with us, letting us know how you are doing.

Specializes in geriatrics and psychiatric.

I am so grateful and lucky that this forum is here to provide me with an outlet for my needed emotional support. This is so needed for us nurses for giving an unbiased opinion and some directional help.

I will keep you all informed - I have been on line looking and will pick up a sunday newspaper tomorrow for browsing.

hugss to all my on line angel mentors.....

Carole

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Would a Med Tech not make an error ever as I did?
Med techs and medication aides are making errors. However, they're not documenting them in the nurses notes for the professional world to see, which is why they do not get caught frequently.

I'm so sorry Carole. I guess we have to learn from our mistakes. I'm a new grad too at a job with minimal training and I too am learning as I go. So, I understand your frustration when you make a mistake that seems like you have your patients best interest in mind. Because of my minimal training I just always ask... better safe than sorry!

Specializes in LTC.

Oh man....Ive seen a very similar thing at my job ...we have a lady who goes out with her son every single day til almost 11 pm at night..she is ordered 70/30 before supper ( i dont know how many units as she is not on my hall)...well the time is set for 430 pm and shes never there at that time...shes either already gone when we get to work at 245 or leaving when we come in...so she doesnt usually get her insulin at that time...but what ive seen other nurses do is check her bs when she comes in at night at say...1030 and they go ahead and give her that 70/30 that she was supposed to have gotten at 430 plus....what she shouldve gotten of R sliding scale @ 430...and she doesnt even have a ss ordered for anything past 430. Me personally...according to her particular order...I would just check her bs when she came back in and leave it at that unless it was really high...but..the catch is that her son fills her slam full of junk food and fast food when he takes her home like this so its ALWAYS above 200 but under 400 and its fine throughout the day and early am when she is still in the facility. If hers was 400 ..I would call and get an order from the md. As for me..I made a really stupid med error with ativan....I had a pt who took 0.25mg at hs....had been on it for years...ok..well how about it got d/c'd and I didnt know it b/c it was still on the MAR and the med was still on the cart so ...here i go for a freakin week and kept giving it....til she ran out and when i called the pharmacy to see why they hadnt refilled it....they told me it had been dc'd ...so I was thinking...omg....what now! I looked thru the chart and found an order that was illegible to d/c that ativan and called my DON....told her what Id done....turned out the nurse who wrote the dc order never finished it out by dc'ing it on the mar so it was still given...of course no harm came from it at all and I d/c'd it on the mar right then and there....so that noone else would give one from our backup kit. I felt soooo bad when I figured out what I'd done and couldnt figure out how I could have missed it....11-7 shift is supposed to do chart checks every night ..apparently they missed that one....but I had no reason to even go check that order or else I might couldve caught it sooner.

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