Is late or lack of Documentation a reason for fireability?

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So, i work in an ICU. It is always busy and were always tripled. The only time we actually have one to one is when theres a balloon pump or impella. The rest doesnt really count.

Recently, i have been notfied of my lateness in charting and sometimes there are some parts for 6oclock documentation that I miss. Its not everytime, but i could say its like once or twice a month.

1 week ago, the director called me while i was working and he was mad. He was calling me out for not documenting on time. In my defense, it was a very busy day.

Fast forward to yesterday, another busy shift. Apparently i missed one area of my 6oclock assessment. The management called me in to put in late entry. Of course, they werent happy.

Will they fire me one day?

Im only 7-8 months in...

Will it be hard to find a job if you were fired from your previous job?

I kind of want to leave and or want them to fire me. The place just sucks to work at. Super understaffed, unfair assignments, and it is very stressful.

Specializes in Pedi.

To answer your general question of is late or lack of documentation a fireable offense? The answer is a resounding YES. I don't think what you describe is really that level though. When I worked in home health, we had nurses who would turn in their notes WEEKS late. In that field, visits can't be billed without the documentation so it was a huge issue. When I was a liaison in home infusion, I know there were a few nurses who never turned in the teach sheets we were supposed to fill out which led to issues in the pharmacy- they didn't have a confirmed address or phone number or written confirmation that the patient was taught to self-administer or what method of administration they were taught.

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Do you always do real time charting? It's not possible for you to change the time? I may chart my 9am assessment at 10am but I change the time to 0900.

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Specializes in Critical Care.

You actually can't always be fired for failing to document, in the case of states with no mandatory overtime laws you can't be required to stay late or to come in extra to finish charting. We appropriately prioritize charting and providing care until our the end of our scheduled shift and then leave. In states with no mandatory overtime laws then yes, they are free to terminate you as this would fall under insubordination.

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They are putting together a "file" on you for the purpose of termination.

Get out as soon as humanly possible.

There was a time in nursing when you could be canned and still find work, as long as you had a license.

That time is in the past.

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They are putting together a "file" on you for the purpose of termination.

Get out as soon as humanly possible.

Does seem like that is what management is doing :(

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Specializes in Varied.

Documentation timelines exist for patient safety. It isn't uncommon to miss documentation as a new nurse. It may be that the ICU isn't for you. Documentation is a fireable offense because Medicade/Medicare guidelines direct us.

Quitting is ALWAYS preferable to being fired.

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Specializes in ER Technician.

It is well known that most healthcare workers have been fired at least once. Most employers will look past it if you take accountability and tell them what you learned from the experience in your interview.

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Specializes in Geriatrics, Dialysis.

Yes, sadly missing documentation might be a reason to fire you. If you are not a union hospital they can fire you for any reason or no reason at all. You are not being unreasonable in your dislike for this job though. I don't work ICU and even I know that a ratio like that is not compatible with good nursing care if these are patients that truly belong in an ICU. The heck with the magic one year mark, start looking for another job now and quit as soon as you find one. It's easier to find another job while you are still employed for some reason so stay employed if you can long enough to get one.

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I disagree with this! I have been a nurse for 25 years, in that time i have only known 7 nurses who were fired.

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My first job as a nurse was in a CICU, and I was overwhelmed every single day! Of course, this was in the day of Paper Charting.

As a new nurse, you need to find an organization system that works for you. "Brain Sheets".

Before you leave, check and recheck that you have documented the requirements.

They are obviously auditing your charts.

In terms of care, if you did NOT document something it wasn't done. And many charges are generated through certain charting.

The above advice is for your NEXT job. You are in a toxic environment. Get out now. And consider this a lesson so you will perform better in your next job!

All the best,

Lisa

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Was it related to restraints? If so, documentation rules are very stringent. I've seen nurses be called into the office for that as well. They did not get fired. It was just something the managers watched very closely.

But I agree with the others that if it feels unsafe, better to quit.

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Specializes in Case manager, float pool, and more.

Quit on your own terms is always better than getting fired. Totally agree with all the above suggestions.

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