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let go during orientation, needs advice?

by sheepingarden sheepingarden (New) New

Hi there,

I started at a large prestigious hospital ICU unit 4 months ago. Previously I have worked at a small community hospital ICU for about a year. I had no issue at my prior job and I made the change because I was young and wanted the "big hospital, high acuity" experience. For the first two months, there had been no concern about me, everyone on the unit was saying how fast I would adopt to this environment. Then an incident occurred where there were questions about my critical thinking ability. I won't go into details due to patient privacy but I have fully taken responsibility for it and there were no harm done to the patient. I met with the educators, debriefed over the incident and discussed what had went wrong.

The orientation since then had been quite rocky since I felt like I was being watched over all the time and i was not too sure if my preceptor had ever really trusted my ability since then. Fast forward to this week, I was called into a meeting with my manager regarding my progress, apparently my preceptor had significant concerns about me and this was documented in a very detailed journal. I was not aware of a lot of concerns she had and i felt like even things that I have said (unrelated to patient care) was documented. I was surprised but maintained myself during the meeting. The manager said they would extend my orientation and if it doesn't work out then she will ask me to resign. My question is that I still work per diem at my old place, and there will be a temp full time position opening, I havent technically been let go yet at this new place. However I felt like thats the direction we are gonna go into. I am wondering if I should call it quit now or give it a try? My coworkers at the old place are aware the orientation aren't working at this new job and they are quite supportive of me returning. My family and friends said I should not quit this new job and this is a prestigious hospital and I wont be able to be re-hired. They told me its practically a career suicide. Any suggestions? I would appreciate any help!

P.S this new job had been a 1.5 hr commute each way plus I get very minimal break at work so I am constantly tired, having trouble sleeping. My old job is a 5 mins commute and my work life balance then was much better.

dream'n, BSN, RN

Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych. Has 28 years experience.

Unfortunately it can be hard to change early impressions, and in your case it sounds as if your preceptor is not in your corner. TBH though, the commute would be the real reason I'd leave.

As for this being a "prestigious hospital", unless you are in a unit doing cutting edge research or treatment, it really doesn't matter. I worked many years at a "world renowned" medical institution and in most every way it wasn't much different than any other hospital I ever worked at.

Thanks dream'n! Yes, I was planning to leave after a year since the commute is so hard. I just don't think 1 month is going to change a lot. Like you said, the impression is already made. The unit do have a lot of leading treatment and research, so it is a prestigious unit. However, the unit culture was quite different for me to adjust to. My prior job was very supportive, typical small community hospital where it felt like a family. The new unit is very big and people talks behind people's back all the time. I could give my extra efforts to make it work, but at this point I am really questioning if its worth it. I know 1 year is the ideal time before u can start looking again, however would 6 months of job experience a red flag for my future career?

Sounds to me as if you have made up your mind already. And so you should. Sometimes things just don't work out. What difference is it if it is a "large prestigious hospital" or a small community hospital to your family? Would you want to get re-hired by them anyways? One could argue that in a small community hospital there's room for advancement, for floating, for lots of things that one doesn't get if they are a number as opposed to a nurse.

I always say don't burn bridges, but in this case there's a couple of things going on--in your initial meeting where you were "debriefed" there should have been an improvement plan put into place. That was specific, goal oriented and time lined. That you would continue to meet with your manager to check progress on.

This "journal" is an issue. This is not meant as legal advice, per AN TOS, just a thought or 2-- Exactly what will be done with this subjectively opinioned, potentially slandering, privacy violating act of literary "genius"???? That book needs to be destroyed, and not taken into consideration. This is not precepting input on a formal plan for improvement, in my opinion. You can not expect a personal subjective documentation of "nurse did not suction correctly, claims she is hungry" type of foolishness to be any part of a professional nursing/precepting plan. And any manager who condones such garbage is incorrect in my opinion. So if you have malpractice insurance, now would be the time to contact them for advice.

It astounds me that an experienced nurse, who is a preceptor, who works in ICU, in a large prestigious hospital (and perhaps even the magnetizing variety, no?) has the time to write a journal regarding your every move--from your practice (which should be done, just not in subjective journal form) to your personal musings? What, is your preceptor writing a book? Perhaps you can have the journal and publish it? Seriously, that is an issue, because it does nothing to enhance your practice. And if she is writing down her feelings, she is not actively precepting.....

I wish you nothing but the best. Run far, far away but make sure you protect yourself.

Oh, and PS......you have a year experience already--in your small hospital ICU. You are still employed by them. Even if it is per diem. So future career red flags wouldn't be an issue I would not think.

Not sure what your ultimate goal is, but there is not one think wrong with being in a place where you thrive.

Lev, BSN, RN

Specializes in Emergency - CEN. Has 7 years experience.

Definitely go back to your old job. That journal speaks volumes (literally and figuratively) about your preceptor. Resign and if asked about it in the future say that the commute was too much for you.

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

I could not stomach the thought of continuing to work in a unit where a coworker or preceptor was covertly journaling my every move with the intention of 'collecting evidence.' I would be disgusted by a person like that.

A preceptor who really wanted to help you would bring concerns up to you as they occur, not secretly jot stuff down so she can produce her findings to the manager at a later date. The bad first impression had been made and it cannot be overcome. Leave ASAP.


Specializes in ICU, LTACH, Internal Medicine. Has 8 years experience.

OP, you are in my former ICU, I guess. I had exactly the same thing done, with one lady having nothing else to do except to follow me and write down the words I, by her opinion, mispronounced.

Just get outta there, and the quicker, the better

CrunchRN, ADN, RN

Specializes in Clinical Research, Outpt Women's Health. Has 25 years experience.

Do what makes you happiest. there are always jobs out there. That said give proper notice. They may opt to have you leave immediately, but do the professional thing and maybe the bridge won't be permanently burned.

Been there,done that, ASN, RN

Has 33 years experience.

Are the people in your family nurses? If not , they have no real insight on the issues you are up against at "prestigious' hospital.Sounds like your preceptor is documenting anything and everything to get your out. It WOULD be career suicide to get canned from there.

Run, don't walk back to your old position. When the dust settles, you can figure out how to become more challenged there.

Good luck.

iluvivt, BSN, RN

Specializes in Infusion Nursing, Home Health Infusion. Has 32 years experience.

Sheepingarden, You need to get out of there as fast as possible. They ARE on a path to get rid of you and I am certain your preceptor was not told to stop writing this journal as should have been done. That nurse is on a mission to get rid of you and even if you stay she would be on you! Did the manger give you a detailed plan for improvement with measurable goals, if not they are not serious about nurturing you and keeping you!

It is not career suicide to give this job up at all. As far as your family goes, I am sorry they are not the ones that must do the hard work of nursing the critically ill and being unhappy because of a toxic work environment or one where you are not wanted! I think your heart is telling you your next move and I believe that you need to listen to it! This place it not where you belong because they do not value what you have to offer. I think they made their minds up at the time the incident occurred!


Specializes in ICU.

Get out. Who cares about the prestige of the hospital name when the staff are not supportive of their own? Leave on your own terms and trust your instincts.


Specializes in public health, women's health, reproductive health.

I would be gone, gone, gone. There is no way I'd stay in such an environment when I had another, closer, (and better for my quality of life) job available. Wouldn't give it a second thought and wouldn't care about what others were saying. You are the one who has to go to work each shift under those circumstances. Not them. I do not believe leaving will be career suicide for you. It looks like they are gunning to get rid of you. Go with your head held high and move on with your life.

JerseyTomatoMDCrab, BSN

Specializes in med-surg, IMC, school nursing, NICU. Has 9 years experience.

As for this being a "prestigious hospital"' date=' unless you are in a unit doing cutting edge research or treatment, it really doesn't matter. I worked many years at a "world renowned" medical institution and in most every way it wasn't much different than any other hospital I ever worked at.[/quote']

THIS. So many people I have spoken to (mostly very young/new grads) have this idea that a big name medical center is going to be better work experience. I, like dream'n left a VERY large and prestigious hospital for my current job. The day-to-day wasn't any different than the smaller hospital where I worked previously. Some of the patients were a bit more complex since they were transferred to us from smaller community hospitals but really, the differences stopped there.

Work where you think you will be happy. Work where you can still have a life. Don't worry about what your family and friends say. They aren't living your reality.

It sounds like you know what you want to do. You want to resign and take the FT position at your per diem place, and it sounds like you are wanting validation.

Anyway, on to my opinion....run from this place, professionally, of course. Put your notice in NOW. I cannot imagine from what you have told us, them NOT firing you. I have no idea why. Clearly you've established yourself as a good employee in the other ICU. This to me is a "take your extra orientation and shove it," kind if situation. They want you out. Their loss.

hawaiicarl, BSN, RN

Specializes in Critical care. Has 28 years experience.

My very first job was in pediatric open hearts at a big teaching hospital. Looking back, I am amazed I never harmed a patient (that I am aware of). About 6 months in I was called in to the manager's office, who I had only met once, and a list of complaints was presented to me. This included things like pt was prescribed 21 cal/ounce formula, and the nurse following me thinks I must have given 23 cal/ounce formula because the patient had runny bowel movements, even though I specifically documented 120ml of 21 cal/ounce formula in my feeding note. I simply asked her "If all of these things were a concern, why weren't they brought up to me at the time, instead of collecting them and presenting them 6 months later?" The manager agreed, and back to work I went, never trusting them day ******* again (credit Laura Gasparus for the term). In the end I think your old job sounds WAYYYYYY better, prestigious teaching hospitals are overrated anyway.



Specializes in ED RN, PEDS RN, IV NURSE. Has 3 years experience.

I'm sorry it's been so rough! A new place is tough enough without an increased acuity in patients!

However to be brief and simple, your last paragraph-the P.s portion is a clear indicator of what you want to do. You basically did a "should I go here or there? Oh btw there I am happy, here I am not".....

Follow your gut. I personally wouldn't quit (assuming the facility is tolerable). It's the nature of the field, sometimes the going gets really rough but you have to keep going. You can't be scared of what you do not know and use it as a stepping stone to be a better nurse. I wouldn't let it destroy me I would let it cultivate me. But that's just me and speaking as someone NOT In your shoes, I can only speak minimally. Best of luck.