Just got fired from my first real job as an lpn and need some advice

[Crystal-Wings, LVN]

Hey all. I've always lurked on this board but never made an account. Anyway I desperately need some advice! Just as a bit of background info, I suffer from anxiety, depression, and ADHD for which I am seeing a doctor and have been for years and am taking meds. Anyway, I just got fired from my first real job as an LVN doing pediatric home health care. It took me 2 years to find this job, and I relocated to take it. When I was hired, I was told by the owner of the company (who is an NP) that it didn't matter that I had no experience as a nurse or in pediatrics because I would get on the job training. I thought this sounded ok, and I stupidily thought it would be similar to my old job as a home health aide working with elderly clients (I loved that job and the people I took care of dearly, and I also had really good working relationships with my supervisors; the only reason I left was because the pay was low and I was pressured by family members to find a job as a "real" lvn).

The on the job training consisted of another nurse who worked with the same client to orient me for a couple of hours at the clients home. All the nurses I worked with were people who although very nice, had only been working as nurses for a 3-6 months and were expected to know how to orient a new grad for a client. After that, I was on my own for night shifts) Things were going ok for a month, and I felt like I was getting used to the job and felt more comfortable. Then during one of my shifts, the kid I was working with's j port came out and it surprised me. The child was fine, and the mom said it was ok that it had happened before with other nurses but I still felt extremely bad and apologized profusely. Something like that had never happened to me before, and although I was taught before I started working there how to insert a temporary g port until the j port could be replaced in case it ever fell out, it was only on a doll. I finished my shift without incident and thought things would be ok. The next day however, my nurse manager called me and told me that I couldn't work on that case anymore because the mom had told her she didn't feel comfortable with me working alone with her kid because she travels a lot and I'd be alone with the kid and I didn't appear to have any confidence in my job or would know what to do if an emergency occured. I don't blame her, because I'd feel the same way if it was my kid. So my manager made me sign a document that said I was aware of the reason I was being removed from the case.

At this point, all the confidence I had been building up was gone. However, I didn't want to give up and was willing to try again. I asked for more training and they said they would put me with another client and another nurse to orient me. The next patient I received was a kid with both a g port and a j port and suction and had seizures. I knew I was in over my head but i needed this job and was willing to stick it out and try harder. The nurse that oriented me had never oriented anyone before, and although she seemed to know a lot and was good at her job, I don't think she was the best teacher. I tried my absolute hardest to try and learn everything in the 2 days I was with her but I was still nervous and unsure of myself because I didn't want to make a mistake and risk the child's safety. I asked if it was possible to have more training so I could get more comfortable, and my manager said that would be fine and not to worry. However, she called me yesterday and said I needed to come to the office again because there was another problem. So I went in today and I was told me I would be taken off the case because the parent felt I didn't have enough training or confidence, and that I was fired because I didn't seem to be a good fit for the job. I worked with a new client yesterday that was an autistic kid and it went great, so I was pretty shocked.

I don't know what to do! I moved away from home for the first time to take this job because I couldn't find anything else where I was living except the elder care job that I already had. I can't go back home, and I'm so ashamed with myself for failing. I'm afraid to work in LTC because of a bad experience I had as a CNA and couldn't keep up with the work load. Nursing school was horrible and I hated clinicals, but I worked my ass off to get through it. I feel so lost and alone right now and I have nobody to talk to, as I haven't lived where I've been living long enough to get to know anyone. I don't even know where to begin looking for work. I already know now pediatrics is not for me, and I do much better working with older people. In a way I'm relieved I got fired because I didn't want to put the kids or my license at risk, but at the same time I'm panicking because I don't have a job! Does anyone on here have any advice to give that would help me???

[FlyingScot, RN]

Can you please edit your post to add paragraphs? That huge block of text is impossible to read. Especially on an iPad.

[Crystal-Wings, LVN]

Sorry! I'm using my phone to post. I tried to break it into smaller paragraphs (hope that's better!)

[Crystal-Wings, LVN]

Can you please edit your post to add paragraphs? That huge block of text is impossible to read. Especially on an iPad.

Can you read my post now?

[caliotter3]

If you aren't going to go home, or even if you do, you need another job, or to step back and take a breather. Go to another home health company and start again. However nervous and inexperienced you have been to date, your employer did not take the time to work with you. This is the first I have ever heard of a home health agency firing a new nurse with so little to go on. I have seen nurses who were a physical threat (because of incompetence, not violence-prone!) go on, and on, without getting fired. You just need to get with a nursing supervisor who is willing to give you the support that you need. And you need to work on yourself too. At night you have plenty of time to go over emergency procedures, look up disease processes, procedures, etc. Mentally go over the steps to replace the GT, mentally go over the 911 procedure, etc. Think of every possible situation, and write out the steps on a paper, put those steps in a document protector and place these in a small binder to keep in your bag. At night, go over these. This will help with your confidence. Also suggest that you look into the immunization clinic jobs coming up to branch out a bit and add to your resume. Good luck.

[caliotter3]

If I were you, I would look at getting a caregiver job (caregiver, HHA, CNA, sitter) to keep the wolf from the door before I would try LTC at this point. You need to build some confidence and bravery with baby steps. There is nothing wrong with working as a caregiver if you can't find, or aren't ready for, an LVN job.

[Crystal-Wings, LVN]

I've never been able to find another home health job as an LVN because they all want a year of experience. That would be awesome to have a manager that was understanding. Where would I find a job in immunization clinics? That sounds awesome and like I could handle it, but everything I've seen listed wants 1 year of experience! I would love to come back to an aid job, but I don't think I'd earn enough money to survive. My family is pushing me to work in LTC because that's "the only way to get experience" they say, yet none of them are in the industry. I feel like my hands are tied and I'm on the Titanic and have struck the iceberg and the ship is sinking. Thank you for responding though! It's nice to have someone to talk to about what's going on.

[enuf_already]

I worked in pedi home care for years as an experienced critical care nurse and I will tell you that the job is not easy! There were days some of these kids scared me and I don't scare easily.

Two days of orientation for a new grad set you up to fail. I commend you for recognizing the situation was not a good fit for either you or your employer. Did you ever wonder why your employer had so many new employees?

Have you considered a doctor's office, a group home for people with developmental disabilities, or considered adult home care? Look in your local paper for ads for personal care attendants. It's summer and right now, to make ends meet, you could likely get a job as a nanny or sitter.

If you are willing to work with children with autism, especially teens, parents are always looking for help (but you'll have to work on the confidence part). It might require that you get some additional training/certification, but in my area, a good care provider is hard to find.

Good luck to you. Take a deep breath. Brush yourself off, stop listening to your family, and do what you want to do!

[caliotter3]

Look on the employment web sites for the immunization clinic jobs. One of the nationwide companies that do these clinics is Maxim, so find their nearest office and go there. They can offer you the clinic type job or extended care home health. Also try the local hospital systems to see if they offer the immunization clinics and go to the local pharmacies to see who they contract with (although most of them have their own pharmacists do the immunizations now).

[Gooselady, BSN, RN]

I too think you were set up for failure, through no fault of your own. Caring for peds in home care may sound low key but kids don't mess around when they go 'bad' between one moment and the next!

I've been a nurse (in a variety of settings) for 24 years and after blowing my right knee out (and wanting a change) I went from the hospital to home care with kids and adults. So far, I've just worked with kids. I had ZERO peds experience except with my own adult children and grandchildren lol. Kids aren't miniature adults, and my experience may have kept me somewhat calm, it also served the opposite because my imagination for what could go wrong is quite strong.

I agree that nurses working outside a hospital or LTC environment need at least a year of experience, primarily to GET that sense of self-confidence. Even if it is fake . Parents/family really depend on their perception of YOUR confidence, which goes without saying.

With your anxiety/depression/ADHD, your have some additional obstacles to overcome to get to that confidence, but you CAN and once you do, you'll find that your symptoms are diminished overall, in other areas of your life.

I suggest you get direct, specific help for your symptoms as they relate to work. You may have to do this yourself, by learning and applying cognitive/behavioral techniques to your thought processes, become aware of them and work with them (or around them!) until it becomes a HABIT to not just go off at the first feeling of anxiety.

Just to make it as a nurse with these conditions, you'll need to work hard on yourself with your symptoms. It will be totally worth it in the long run. One of the things that comes up with depression and anxiety is 'helplessness', where it doesn't occur to you to grab yourself by your bootstraps and get into 'conquer the anxiety' mode. It's hard to see that things are NOT as terrifying as your anxiety/depression make them appear. In fact, nursing itself is actually a good 'treatment' for these conditions. As you learn to manage your symptoms, and get nursing experience under your belt, you will begin to have 'success experiences' where you 'did it right' and then your confidence will improve. It's a bit like being thrown in the water to learn to swim, but that's where YOUR personal efforts to manage your symptoms comes in. Depression and anxiety are one of the rare mental illnesses that can be 'cured' or at least diminished greatly, with or without medication.

There are a lot of people 'just like you' and you are far from alone. Nursing tends to draw anxious, sensitive types of persons anyway, so some of your symptoms may actually become strengths once you get a grip on them.

You will never find a job, as a nurse, that 'takes care of you', and manages to avoid all the triggers and scary things that set you off. You have that job :) and regardless of what you believe about yourself, you can and will rise above them with some good old fashioned self development work.

[Adele_Michal7, ASN, RN]

Caliotter gave you great advice, take it. Don't give up. Apply even if a job says you need a year. Exceptions are made all the time. You're going to be ok.

[CrunchRN, ADN, RN]

You need to keep trying to find a job in home health as that is where your confidence lies. Do anything to pay the rent and keep trying.