Is this a VALID reason to terminate someone?

[lllenjolll]

I NEED OPINIONS. THIS REALLY MADE ME SO DEPRESSED FOR DAYS NOW.

Recently I got terminated on my 5th month for an incident that did not happened of my shift. I'm a new nurse. Barely on my 5 months on the facility I worked for(so im still on probation being an orientee).

DURING MY 5 MONTHS

For the first few months I was working hard. I got very good feedbacks from other staff member, from patients to families for being attentive to their needs and whatnot. All in all, I was doing really well. Even my manager and director commend me because they've been hearing good stuff from peers. Not to brag but I'm really the kind of person who likes to balance things out. I worked for a rehab/LTC and since it has gloom atmosphere, I try to put in a cheery attitude. So that really keeps my job a breeze. Despite all this efforts, I don't fit in to my working environment. Most of them have 5-10 years of experience. Mostly, they are beyond my age range. As I'm only on my 1 year. Some of my coworkers warned me about others being a snitch but I brushed it off. I'm just there to do my job. But then again, I kept this 1 or 2 time subtle informal counseling from my unit manager about this and that. But being new, I just signed away it not knowing it will go on my records. Again, it did not bother me because I consistently getting smiles and good feedback from them. It gave me this illusion that it's a team and everyone got each other's back.

ON MY 4th MONTH

Anway, a month before this incident, I got a nursing job under the new grad program from an affiliated hospital. Being a new nurse, I couldn't be happier. But all my coworker had been telling me that that I have to be a 6 months employee to get a hospital transfer. The human resource manager from the hospital said that they requested my director if they could make an exception for me. The director agreed on one condition; they have to find a replacement for me before I leave. After a month of waiting, they finally found a replacement for me. But on my final week of working in this rehab, this incident happened:

Last week, I was so in distraught I got terminated for 1 time mistake I'm not even aware of! An IV line that was found clogged last week of February. They found out that IV dressing wasn't change since from the patients admission to the facility (which was early feb). They said it was supposed to be change every week.

I was the nurse on duty during those shifts that it needed to be change. They saw on the treatment records my initials, indicating that I have done it.

Mainly, they blame the unchanged needle connector for getting clogged.

In my defense, and in all honesty, I took it as a PRN because a PRN was added in the instruction. So on those both shifts I only did an assessment,; the IV line was patent, clean and intact. I really thought it appears every day so I did not worry. Also, the change needle connector wasn't stated on the instruction. So even though the IV dressing was changed, it will still be clotted since it's not stated there. I also asked them how come other nurses didn't notice that the IV dressing wasn't change (I'm only part time and I'm not there all the time). Regardless of my explanations, they kept emphasizing how I did not do my job on those days. AND it really make me so nervous because my director is lawyering me.

For confidentiality, the incident happened like:

Day 7 of week 1, I was nurse on duty.

Day 7 of week 2, I was nurse on duty.

Day 7 of week 3, Other nurse was on duty. (No one initialed on this day)

Day 7 of week 4, IV line was found clogged. Dressing was found not changed.

Week 5, they did an investigation based on grievance. The next day they find I'm at fault and fired me.

Day 7 of week 5. Supposed to be my LAST day.

On week 5, they summoned me at the office. They told me that I am terminated for falsifying a documentation. (DESPITE MY EXPLANATIONS!!) I never been so devastated. What's more crushing was that they said I won't also be getting my hospital transfer. What's really aggravating about my situation was that they terminated me 1 day before my last day.

I am also confused with the number of compliments I am getting, they fire me over this kind of incident. When I told this to my friends, they told me it sounds like there's discrimination because normally, incidents like this has a process. Start of from a verbal warning, to written warning and to a suspension.

I did not get any counselling, nor warning... and I will gladly accept if it's suspension, but I feel like termination is an extreme consequence.

So I'm asking you guys if you think it is justifiable to terminate me over an incident that didn't happen on my shift? (

For weeks since I got the hospital job, I kept following up with them because I feel like they were stalling me and I don't want to miss out the program. I also never get a return call from HR after at least 3 calls per week. But then again, my director reassure me she's communicating with them and that they extended the position for me. Being a motivated new nurse, I was hoping I'm not being a bugger. I can't help but to think it was all a set up because this all happens right after they found a replacement for me.

Do you guys think I irritated them for asking when my hospital transfer would be. I really feel like I pissed of my director and kept getting my hopes high so I won't leave until she find a replacement for me. Then decided to screw things up for me. What do you think?

I don't know what to think anymore.

*sorry for typos and grammatical errors

[Libby1987]

The other nurses didn't take proper action.

You didn't take proper action and lied about it.

You even said on the other thread that you were fired without warning for not changing a dressing but left out the previous warnings and the fact that you lied in the medical record. Your written word is absolutely not trustworthy. Dishonesty is neither safe nor teachable. Managers tend to not want to take the chance or time to build an employee's integrity.

[SierraBravo]

It sounds like the patient had a central line, and the dressing and cap wasn't changed for 4 weeks. You were the nurse for day 7 of weeks 1 and 2, and another nurse was on for day 7 of week 3. The only nurse who noticed it was the one on day 7 of week 4. In my opinion, all nurses who took care of this patient for three solid weeks (day 7 onward) should be written up.

Whenever I have a central line patient, I note date of insertion and date of last dressing change during report or in chart review. SOP for me. The nurses where you worked have very bad habits.

ETA: your inexperience with central line care is also evident. Changing dressings q7 days and cap changes is a standard of care. Was this not covered during orientation?

This is exactly what I was thinking, likely a mediport. Which begs the question, would the OP have known to do a sterile dressing change, let alone a needle change? I'm going to go out on a limb and say no.

OP - it sounds as if you are partially getting it, and that's good. But as others have said you need to fully understand and accept the gravity of what you did without offering up any excuses such as short staffing, being tired, etc... At that point, you can begin to grow and move on from this experience.

[KelRN215, BSN, RN]

It's a common misconception that a "valid" reason is needed to terminate someone's employment. You can be terminated for any reason or no reason at all, save for a few specific reasons (race, gender, disability, veteran's status) prohibited by law.

That said, falsifying documentation is a pretty valid reason for termination. Not performing the required dressing and cap changes on a central line is a huge safety issue. You initialed that you did it, leading the nurses following you to believe that it had been done on schedule. If the dressing was dated and no one noticed that it hadn't actually been changed, they dropped the ball as well, but you made the bigger mistake by falsifying documentation.

[Angeljho, MSN, NP]

I kept this 1 or 2 time subtle informal counseling from my unit manager about this and that. But being new, I just signed away it not knowing it will go on my records.

I think you may have thought this was an informal counseling but you were really getting a verbal warning followed by a written counseling - or what you might call a "write up". You were new, so you didn't know better. Always clarify whenever a supervisor asks you to sign any form of counseling so you know exactly what it is.

When I told this to my friends, they told me it sounds like there's discrimination because normally, incidents like this has a process. Start of from a verbal warning, to written warning and to a suspension. I did not get any counselling, nor warning... and I will gladly accept if it's suspension, but I feel like termination is an extreme consequence.

While it's true that verbal is usually first, followed by written, and so on - the severity of the incident is also a factor. If a nurse gives a patient the wrong medication and the patient happens to be allergic to that medication, a verbal warning will not be considered; that's grounds for termination. I understand that you are new, but the incident is not minor. Also, signing for anything, means you've done it; so thinking the dressing was a PRN order only served to work against you because you still signed off.

[poppycat, ADN, BSN]

You said they saw your initials on the treatment record indicating you had done it (changed the dressing). If you did, in fact, initial that you had done it when you really hadn't, that IS falsification of documentation which is the reason you were given for termination.

[LadyFree28, BSN, LPN, RN]

I'm not trying to be mean, but I still hear you making excuses and blaming others. I hope that you will take a clear-eyed look at the situation and realize that this was your mistake, not anyone else's responsibility. You are a licensed professional and responsible for the care you provide and professional and legal standards to which you're obligated. None of the things you mention, low staffing, heavy workload, limited orientation, coworkers setting a poor example, being tired, doing other nurses' treatments at other times, etc., etc., etc., relieves you of that responsibility. I hope that the other nurses involved were also disciplined, but it's not "unfair" that you were fired, and it's not "a shame" that you failed to provide safe, necessary nursing care and, essentially, lied about it in the client's chart, it's a serious and dangerous error on your part. Falsifying documentation is one of the most serious offenses a nurse can commit. Given that it did result, in this case, in harm to a client, I wouldn't be terribly surprised to learn that your previous employer is reporting this to the BON, in addition to firing you (if only to cover the facility's collective butt).

I hope that, before you start another job, you do consider this experience a "wake-up call," truly recognize how serious a matter this was, and think seriously about what you need to do differently going forward to make sure you don't find yourself in a similar situation in the future. Best wishes!

THIS.

Do you have malpractice insurance? I ask this because your previous employer, especially in LTC, may report you to the BON for this; it happened to a former co worker of mine; be prepared to have to explain to the BON your actions, of that happens.

Best wishes.

[rnmaybe]

Whether it was PRN or scheduled doesn't matter when you signed the record stating you had done the dressing change but did not actually do it.

[maxthecat]

What I can't understand is how you could get through nursing school with no education about IV care. Why would you ever think it would be OK to leave the assembly and dressing unchanged for a month??? I would have thought plain old common sense would have told you that that is an infection waiting to happen. Something about this just doesn't make sense to me.

And if you didn't learn about this in nursing school (which I still find incomprehensible), why didn't you check with another nurse to make sure you knew how to take care of this correctly?

I am sorry that you are feeling depressed; I guess this post is to remind you that when you're a little less emotional, you really need to analyze what went wrong and what you are going to do to prevent this type of mistake in the future. Analysis and planning, not excuses, are what will make you a great nurse.

[BuckyBadgerRN, ASN, RN]

I'm still waiting to learn what in the heck OP thinks her discrimination claim would be based on?!

[TriciaJ, RN]

I'm confused about another thing: OP, it states in your profile that you joined AN in 2011 and have 1 year of experience. In this current thread, you identify yourself as a new grad. Am I misreading something?

[imintrouble, BSN, RN]

I'm not excusing the falsification, but there is such pressure on nurses in LTC to sign what they don't do.

One place where I worked expected all the holes to be filled on the treatment record and MAR whether you did it or not.

They didn't care.

Documentation had to be intact for the state. Nurses would admit they hadn't done it, therefore hadn't signed it.

Management would still expect it to be signed. Most nurses caved.

I have only sympathy for nurses who find themselves in these positions. There are tough choices to be made.

[TriciaJ, RN]

I'm not excusing the falsification, but there is such pressure on nurses in LTC to sign what they don't do.

One place where I worked expected all the holes to be filled on the treatment record and MAR whether you did it or not.

They didn't care.

Documentation had to be intact for the state. Nurses would admit they hadn't done it, therefore hadn't signed it.

Management would still expect it to be signed. Most nurses caved.

I have only sympathy for nurses who find themselves in these positions. There are tough choices to be made.

Oh, I think you're talking about a place where I did 5 agency shifts, before I told the agency I would no longer work there. Yes, if you do nothing else, make sure all the spaces are initialed for the state auditors. One shift when I was frantically trying to get my 5,000 meds and treatments done, an administrative person approached me with a smile. Did she ask if I needed help or if I'd managed to get a break? (Yes I did and no I hadn't.) She said cheerfully "Make sure you initial all the squares." And then walked off.

If OP got fired from that kind of place, she should consider it a blessing. Dust off and move on.