Is My Job at Risk or Not?

Nurse Beth, MSN · Jan 30, 2018

Dear Nurse Beth,

I've been a nurse for almost 4 years and always worked for the same hospital system. I worked on a med-surg floor for 1 3/4 years before transferring to NICU.

I was given 8 weeks of orientation and turned loose on my own. I was given almost exclusively level 2 patients until I had been there 10 months. Suddenly, the charge nurse wants me to admit a critical baby. I voiced my concerns and she acted like I was being lazy. Things didn't go well in that admission (fortunately the baby was not harmed); I was called into the manager's office to discuss what happened and to create a remediation plan. I was put back on orientation for 2 weeks but had a different preceptor every night for the second week.

After 2 weeks, our manager decided that I would benefit from working on the women & newborn floor for a year. I'm 8 months in. In October I was a clinical ladder participant and received a card from my manager thanking me for my "continued efforts at professional improvement".

Then last month, I was written up out of the blue for "poor practice". It involved a list of complaints from opposite shift nurses that I forgot to complete tasks that could be done on either shift. Said list stretched back over at least 4 months, and none of it had been brought up to me until now. If I realize I forgot something at shift-change, I always offer to stay over and set it right; I pointed this out to the managers and they dismissed it because "the other nurse probably felt that you had the entire shift to do it and she might as well do it herself at this point."

I was told that I currently do not qualify to go back to NICU right now and could lose my job "if my performance does not improve". Now anytime I make a mistake or forget something, I feel like I'm going to be fired from my job. I even looked into jobs at other hospitals in case the worst should happen, and I found the other hospital in town is hiring for NICU.

I absolutely loved NICU and want to get back to it, but I'm torn. Do I try to stick it out where I'm at with the hope of getting back to NICU or do I leave this hospital and go to the one across town? Would it look bad to leave now that I've been written up? What do I tell a potential employer if I do decide to leave?

Dear Could Lose My Job,

I'm sorry you are going through this, and you mustn't underestimate how serious it is.

To recap:

After 10 months in NICU you were remediated and put back on orientation for 2 weeks.

Then you were transferred out to mother & baby.

Then you were given a warning that your job is at risk for "poor practice"

They are preparing to let you go, and you are better off to leave before you are terminated. It's easier to land another job when you are employed than when you are unemployed. The hospital you are currently at will most likely not reveal that you are in disciplinary proceedings- they will probably just provide dates of employment and title if asked for a reference.

I would actively seek another job. At the same time, you do not want history to repeat itself, and until you identify your responsibility in this, it could happen again. Before you go to another job, ask yourself what you will do differently.

It's difficult to succeed unless you are given helpful constructive feedback. In the future, you may want to ask for more regular feedback and request specific performance goals. For example, when a manager says your performance must improve, you can ask for a measurable goal. "What can I do this week to meet the performance expectations?"

and "How would my performance look different if I was to improve?" You may be told that you must not have any overtime as evidence of time management. Once you meet that goal, meet again with your manager to validate your performance. Read "When you Receive a Warning at Work"

You may be asked in an interview why you left NICU for mother & baby. Spend some time thinking of an answer other than "it was performance related". It may be difficult to answer, but you could say that you wanted to experience a broader experience of maternal child healthcare, but now realize your heart is in the NICU.

As far as being prepared to care for critically ill infants, that doesn't seem to have been resolved. Do you have your Neonatal Advanced Life Support provider card? If you do, get out your book and refresh yourself so you are practice- ready.

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!