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

[lllenjolll]

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!

No. Sorry if you perceived it differently. I'm not trying to blame anyone or the short staffing, heavy workload, limited orientation, coworkers. I am simply telling these factors could have a subtle effect of how you perform in a workplace. Like what @Iamintrouble had previously explained, there's really that pressure at LTC to fill those holes for state visits whether you did it or not. Most of the time, managers doesn't care. Though with my experience I really felt so stupid for giving in. That I missed out that 1 IV dressing and filling in holes. I know on a 3rd POV it's really stupid that I did it. But at the end of the day, I am to take responsible for my own actions.

@maxthecath Please don't jump to conclusion I did not have IV education. It's not rocket science for nurses that anything that has to do with IV is sterile. I wasn't there all the time though. I only work 2x a week in my previous employer. And for those shifts. I work at nights. My patient was there for two weeks when I am supposed to be in charge of IV dressing. But it was found out after a month. All of us fail to check it. My mistake is the TAR was only initialed by me.

@buckybadger Lol. I'm not fighting based on discrimination. It's just 1 of my friend said I should. He overly sympathized on my situation and tries to compare his bad history with racism when he worked long time ago. He thinks I'm getting discriminated because I worked in an environment heavily populated with black and Hispanic people. The management are all black. But giving a hard thought about what happened, I really don't think it has to do with race so I try to discourage my friend from getting a case based on racial discrimination. It's not just.. right.

@Libby1987 I don't consider it lying. It was a stupid mistake and assumptions. The one you read on the other thread pertains to this situation I wrote here. I was wondering why not warning but they had to be termination. but @rubyvee gave a whole explanation of why I get fired regardless of the severity as long as it's NOT right.

Thanks for all the response. I'm certainly getting back on my feet. Told myself I not gon' screw my license again.

[klone, MSN, 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?

The OP's healthcare experience was likely in something other than RN - a tech, extern, CNA, etc.

My profile lists "10 years" of experience, yet I've only been an RN for 9 years - I was a nurse extern for 1 year before becoming an RN.

[JustBeachyNurse, LPN]

No. Sorry if you perceived it differently. I'm not trying to blame anyone or the short staffing, heavy workload, limited orientation, coworkers. I am simply telling these factors could have a subtle effect of how you perform in a workplace. Like what @Iamintrouble had previously explained, there's really that pressure at LTC to fill those holes for state visits whether you did it or not. Most of the time, managers doesn't care. Though with my experience I really felt so stupid for giving in. That I missed out that 1 IV dressing and filling in holes. I know on a 3rd POV it's really stupid that I did it. But at the end of the day, I am to take responsible for my own actions.

@maxthecath Please don't jump to conclusion I did not have IV education. It's not rocket science for nurses that anything that has to do with IV is sterile. I wasn't there all the time though. I only work 2x a week in my previous employer. And for those shifts. I work at nights. My patient was there for two weeks when I am supposed to be in charge of IV dressing. But it was found out after a month. All of us fail to check it. My mistake is the TAR was only initialed by me.

@buckybadger Lol. I'm not fighting based on discrimination. It's just 1 of my friend said I should. He overly sympathized on my situation and tries to compare his bad history with racism when he worked long time ago. He thinks I'm getting discriminated because I worked in an environment heavily populated with black and Hispanic people. The management are all black. But giving a hard thought about what happened, I really don't think it has to do with race so I try to discourage my friend from getting a case based on racial discrimination. It's not just.. right.

@Libby1987 I don't consider it lying. It was a stupid mistake and assumptions. The one you read on the other thread pertains to this situation I wrote here. I was wondering why not warning but they had to be termination. but @rubyvee gave a whole explanation of why I get fired regardless of the severity as long as it's NOT right.

Thanks for all the response. I'm certainly getting back on my feet. Told myself I not gon' screw my license again.

Your previous written warnings you mentioned in your original post WERE your warnings whether or not you understand that. However falsification of records and failure to perform safe and competent care resulting in patient injury/illness/adverse event is grounds for immediate termination and potential to be brought to the BoN. If caught by a state auditor falsification of patient records would result in fines to the facility, your license in jeopardy AND your name placed on the OIG exclusion list. OIG exclusion list bars you from working for any facility or company that accepts Medicare or Medicaid for payment. In other words you can't work in hospitals, LTC or many outpatient facilities while on the list.

If you were only terminated, (regardless what others do or have done YOU were caught, you admit that you falsified a TAR entry) consider yourself lucky, learn from the experience and move forward.

[Libby1987]

I am not without sympathy for nurses who are stuck working in a LTC with 50 patients. I've said multiple times I would clean houses before I would be worked like that in unsafe conditions. Or PDN. Or food service.

However if I were to take that job because I didn't want to spend my degree/license on cleaning houses, then I would bring my integrity to work and stand up to anyone and everyone before I purposefully endangered a patient (and that's exactly what falsifying (lying) a weekly dressing change for 2 weeks in a bacteria filled facility is, patient endangerment).

Once you clock in and take responsibility, for 8-12 hrs those patients are more important than your financially security. You don't put them on the line to keep a job. It's one thing to run your butt off and do the best you can and say you couldn't get to it, it's entirely another to lie to save your ass from being fired.

And maybe worse, you all caving and filling in all of the boxes when you haven't performed the work? You're showing the state that it can be done, further perpetuating the problem.

[lllenjolll]

And maybe worse, you all caving and filling in all of the boxes when you haven't performed the work? You're showing the state that it can be done, further perpetuating the problem.

Nope, not me. (yeah, accuse me of lying about this too tho it's cool).

Though I've witness nurses who do this like it's a norm. LTCs predominantly.

[Libby1987]

What soft term do you want to call charting that you did something that you did not?

[NicuGal, MSN, RN]

This is what it boils down to, and I tell my orienters: if something were to go to court, how would you justify things.

1. You clicked the box without doing the task. Falsification.

2. You say you didn't have IV teaching. The lawyer will pull up your facilities P/P for the world to see and ask you if you read it, know it, and followed it. Answer: no. Guess what, your responsibility is to know these things and be that reasonably prudent nurse who pulls P/P on things you are not sure of.

3. Lines should always be reconciled with the previous caregiver and dates in lines and dressings noted. They will ask you if you did this as it is becoming a standard of care.

It's a scary thing to even think about being on a witness stand and being asked this. Don't be that person because you have no defense. If this person had become septic and died this could have possibly gone to court, you never know.

Take something away from this.

[OCNRN63, RN]

Nope, not me. (yeah, accuse me of lying about this too tho it's cool).

Though I've witness nurses who do this like it's a norm. LTCs predominantly.

You don't seem to get that when you say you've done something you haven't, e.g. signing off on a procedure you didn't do, it's lying, plain and simple. It matters not what you've seen other nurses do; the only thing that matters is that your practice is 100% spot on.

Stop making this about you, and think about what could have happened to those patients who didn't get the appropriate care.

I take this a little personally because I have a port, and I count on the nurses taking care of it to provide appropriate care. I also cared for many people with ports and piccs; I never signed off for something I didn't do.

[psu_213, BSN, RN]

In my defense, and in all honesty, I took it as a PRN because a PRN was added in the instruction.

I'm curious how exactly the order was written. Was it written as "Change dressing q [time frame] and PRN?" Or just "PRN?" I would imagine it is not the latter, as you don't just change line dressings when they appear to need to changed.

No matter how it was written, I just can't get past the idea that you signed it off even though it wasn't done. Even in the unlikely event that it was a pure PRN order, it can't be signed off if it was not done.

[jadelpn, LPN, EMT-B]

OP, I have yet to read any of the responses, so forgive me if this is repeating. However, they don't need a reason at all to terminate you before the 6 month probation is up. None at all. What they did give you is feedback. Which they are under no obligation to do. And unfortunately, unless you got an offer letter (in writing) regarding your transfer, it is all hear-say--they could deny any of it occurred.

Going forward, if you are offered a transfer, get it in writing. It should outline what unit you will transferred to, the timeline, the shifts, the pay.

One of the reasons that a transfer doesn't usually happen in an orientation period is just for the reason you describe--they can let you go without giving a cause.

Additionally going forward--do not ever, ever, participate in assessments and sign off on them unless you have a clear understanding of what the policy is and what your orders are. And if the orders need clarification--get them clarified by the MD--"PRN" written after an IV order (besides more than likely being against the policy in place at the facility) is vague.

I have no clue what kind of IV you are speaking of, however, each and every type of access needs to have a policy regarding flushing, rotating, dressing changing--and dependent on if it is locked or in use. Do not EVER sign off on something that you are assuming from a vague order. Know that access just doesn't sit there an look pretty. It needs to be cared for (and can cause sepsis if not cared for). Know that they all require a flush, some an anti-clotting agent, to have a dressing change (which is its own protocol--for instance a PICC line is a sterile procedure) and some require site changes (and that varies per protocol).

So now you have lived and learned. You know that you have a personality that is positive and that bodes well in nursing. That is awesome and a great trait.

You just need to learn and refine your practice. Now you may not know what you need to do every time to practice well and safely, but you need to know where to find the information out in that instance--so know and use your resources. This is not a solo sport, but a team effort.

Know your orders, clarify them if needed. (ie: someone adds PRN to any existing order--RED FLAG!!)

Know the policies/procedures/protocols surrounding anything that is sticking into your patient, and anything that is coming out of your patient, and anything that the patient expels, and anything that won't expel but needs to, or any open area on your patient that should not be open, or any closed area on your patient that should not be closed. Look, listen, feel, measure, document. Know what to do with that information.

This will all come in time, and you will go forward and be a better nurse for having learned what to do going forward. Yes, this all stinks and your goals need to be re-evaluated. But you will go forward--and it more than likely will be errors to which you will not make again.

Best wishes!

[Cleake]

Anyone can be fired in healthcare for whatever reasons and you just have to be smart enough to know policies in place and able to keep track of records applicable for termination purposes. Signing off on changing the dressing and caps which is part of the dressing change to picc line is cause for termination depending on facilities policy. I've seen someone get fired for falsifying vital signs they didn't get.

[vintagemother, BSN, CNA, LVN, RN]

I'm sorry this happened to you. I may be repeating what other nurses on AN have said... But if you initialed the MAR saying you did the task but you didn't, then you did not follow appropriate nursing practice.

However, I do understand your feeling targeted because you weren't the only nurse who signed off on it as done, and, if I'm understanding correctly, other nurses also signed off but weren't terminated as you were.

I've been in situations like that. In the future, pls don't sign off on doing things you didn't do, even if other nurses do.

Many (most) facilities operate like this; there are too many tasks and every nurse takes "short cuts". But, as a new grad on probation with an at will employer, you shouldn't copy their lazy practices because you could possibly be held responsible for a problem that you weren't the only one contributing to.

I've been there done that regarding making a tiny error and being held accountable when others were making the same error, but weren't held responsible.

Facilities pick and choose which nurses to scrutinize. In the future, stick to doing what is required/listed in the mar. That's the only way to assure your license remains in tact.

I hope my post doesn't come across as harsh because that is not my intent. My intent is to tell you that you're not alone in your experience and that you can learn How to prevent this in the future if you learn from it.

Best wishes!!