i am a fairly new grad. i got my first job working in a very high acuity icu step-down type hospital (ventilator and trach patients were most common) and worked there for nine months. i loved my job but had a really hard time getting along with the new cco. this may take a minute to tell you all of it but here goes......
i was supposed to be given up to 12 weeks of training. i got 5-6 and was gradually introduced to my normal 8 patient workload. from 5-6 i struggled a bit and asked for 5 the next shift and was told they didn't want to go backwards and given a sixth patient anyway. our hospital has a very old computerized charting system. our patients were very high acuity with many prn pain medications, usually 2-3 hour dilaudid. at our hospital you will sign your narcotics out of the narc cabinet, then chart the time given in the computer system. we do not have patient id band scanning. as a new grad i had a hectic time with my charting and had to play catch up at the end of the shift many times. we were 3 months without a nurse manager after i was let loose on my own. i was called to the cco (new) office and told about 2 medication variances from 3 months prior, (signed out but not charted in computer) i was written up for each. a week later i was called for another one, from 2 months prior, written up. i talked to my head nurse and told her i was concerned because i felt that i should not be written up again for things that occurred prior to our first conversation. for all i knew i could have another from a month ago and lose my job over it! she said not to worry, i would be okay. for some reason this new cco seemed to have it out for me. to make things worse i had a med error!!! my med error was that i gave a woman 2 mg of morphine instead of 2 mg of dilaudid ivp. i still want to cry over this! i cried myself to sleep that night even though i knew it was a lesser strength dose i was ashamed that i had not caught it. so my cco tells me that i needed to be placed under a performance review and asked me to research current best practice for safe medication administration and demonstrate to them what i had learned. i was to take 6-7 patients during this time and no lpn's ivs. i was then told that i would have to present this to my coworkers as a presentation!
i told her i was not comfortable with this and had no problem with making up a board to place in the report room with handouts to demonstrate to them what i learned but did not feel it was appropriate to involve all my coworkers in my business! she said it is what i had to do. i worked, was given 8 patients and lpn's iv's because they were short staffed... worked on my board, got it done, told her i still did not like the idea. i felt that my peers were either going to look at me like "who does she think she is to teach us something" or "what the hell did she do wrong". besides this, no one else had ever been asked to so something like this. well come to find out the day it was due was not a day i worked (like she thought it was) and she was out of town the whole week! my (new) nurse manager called me and when i told her what i was doing she said, "what, that is ridiculous! i have never heard of anything like that. put it on hold till i have a chance to talk to her on monday when she gets back." monday i get a call from the cco, i try to return it, cannot get a hold of her. she calls me tuesday and says i failed to meet our agreement. i explained what the nurse manager said, she said i am aware of what she told you but we had an agreement. she says i could have turned my board in and did the presentation at another time. i said, you are telling me this now? i didn't know that.... she says she will accept my resignation. i resigned about 4 days later and stated on the letter that i resigned as requested by her. i know how hard it is to find a job and felt that was better then having to put i was fired. now i am going to have to fight them for unemployment. soooooo after this long long tale, was i in the wrong? what are your thoughts?
i also worked with some very crabby people...lol i told her the people she sees are totally different then the ones i work with. when they come to her they are on their best behavior and not the same snippy ones i work with..lol
Speaking of which... I just got a phone call for a job interview at a local hospital!!!! It is for Wednesday morning at 8:30 AM. Any other suggestions on what to say about why I left the other position. I know better then to bad mouth the company but would it be fair to say that I felt uncomfortable with some of the practices there? I know my previous nurse manager (at the place I quit) now works for this hospital (the one I'm interviewing with) and was told by a fellow nursing student that she told them the reason she quit her job (she is now a float nurse) was because they asked and expected too much out of the nurses and she feared for her license each time she worked...
Wish me luck on the job interview! I am so excited!!!
A good "generic" answer to your reason for leaving: "After training and working in the position for several months I decided that it was not a good fit and gave my resignation in order to find a position more suited to my abilities." No it really doesn't say much but it's a polite answer and shows that you aren't one to badmouth your previous employer - a good thing.
You may want to call your previous manager and ask her permission to use her as a reference since she now works for this organization.
I don't know how common it is, but my hospital uses staff inservices as punishment for errors very regularly. We have regular staff meetings, and there's always a group of people who are required to do a presentation on lab/blood bank/medication safety because they made an error during the previous time period. It's a result of our "nonpunitive" incident reporting system, and mgmt wonders why we avoid filling out incident reports whenever possible. Of course, inservices aren't punishment, they're opportunities for learning. Whatever you say...
What a nightmare. Sorry you had to go through that.
8 pt's in a stepdown?? No way this is safe - no matter how much support staff there is.
It amazes me that management does not want to invest in orientation. I too had a short one, asked for more time and was given an extra day...ha/ha. The idea that they wouldn't let you go back to 5 or 6 pt (whichever it was) is ludicrous, but I see this type of thing often - unfortunately.
As for the poster / presentation. Depending on the environment this could be a beautiful thing. If you are making certain mistakes, other people probably are too and it is important to look at why and how this can be fixed - often a systems issue. Having said that your circumstance sounds punitive and intentionally hateful. Never good.
Of course there are 2 (or many more) sides to the story, but anyway you look at it this was an unsafe and unfortunate position that you were in.
Hopefully as you continue to progress in your career you will become an agent of change and help to break this cycle of nurses eating their young, instead of doing what many who are treated poorly do and make other nurses suffer as you have.
Yeah, that was the thought I kept getting stuck on. 8 stepdown patients is not normal. In and of itself. 6 is too many when you have vents, trachs, and recent transfers from the units. Let alone that short of an orientation.
Good luck with your interview. Hope it's for a better facility.
First off, 8 patients in a step down unit is ludicrous even if none of them are vented. I don't see how one nurse is supposed to take care of that number of high acuity, task intensive patients in any 12.5 hour period.
Second, the whole disciplinary process in regards to the med errors was not handled very well by management. This is just my opinion, but for the purpose of disciplinary action, I think that the two med errors the OP was originally written up for should have been taken as one occurrence, hence, just a verbal warning rather than a verbal and a written. Also, given the ridiculous amount of time it took to do chart audits and bring these occurrences to light, I don't think the third med error warrented any additional disciplinary action. Unless there were med errors being made every week, it seems reasonable to institute a "grace period" from the time the first two errors occurred up until the time the first disciplinary action was taken.
Third, it is not at all necessary to include on a resignation letter that it is being offered at the request of management. That's going to remain a part of your personnel file and can be reviewed by any hospital you apply to in the future if allow them access to your previous records as part of the application process. Generally, less is better. If you are leaving under bad terms it is fine to just write something generic thanking them for the opportunity but that you are leaving to explore other avenues of employment.
Last, I'm glad you got out. That sounds like a floor that would just chew you up, spit your out and guarantee a fast burnout. Good luck at your interview!
Specializes in Hospice, Case Mgt., RN Consultant, ICU.
I am so sorry you had this experience. Situations like this are why we are losing our new grads! I have not done hospital work in years as a result of injuries from a MNA. But I did work ICU/CCU for 10 years where the normal patient load was 1-2 patients per nurse depending on acuity. I transferred to a surgical floor where we did total patient care - meds, treatments, baths, etc. with no aids. Each nurse had 4 to 6 pts. each. The only nurse who had an aid was the charge nurse which was me. That was because the charge nurse also made rounds with all the docs and had to know what was happening with all patients. In other words, it sounds to me like you were given way too many patients!!!!!
Regarding unemployment compensation - explain there was no way you could have kept your position as you were basically forced to resign or be fired.
Good luck and again, hang in there! You were in an impossible situation in my humble opinion!!:redbeathe
luvkitties
97 Posts
Congrats on the interview...good luck!