Let go/resign from new grad 6 months in

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Seeking advice and understanding. Started a new grad program/ in desired field cardiac, had 6 weeks orientation but felt nervous to be to be on my own so had my orientation extended another week. Once I was on my own I was perfectly fine there were moments I wasn't sure about a situation but I asked co workers and it was fine. I felt my time management and prioritization was good. I had one time I had a patient with uncontrolled hyperglycemia, it was night shift and his cbg was in the 300s, I scanned his insulin and no pop up came up signifying half dose; I questioned why no pop up but thought I remembered it was Q4 checks, which would explain no pop up, so I gave him his full dose. Once I did I went back to the computer and realized it was 4x a day. My blood ran cold I rechecked his cbg 20 min later and it was around 365, it was like the insulin had no effect. I still felt I made a mistake and filed it in the system for management. It was never brought up again and I figured it was because there was no adverse reaction. I go the rest of my 6 months feeling good and fairly confident. Then the last week before my 6 months is up I Change out an iv bag and tubing for the on coming RN and forget to put a date sticker and curos cap on the tubing, that morning management compiled a list, I didn't finish my admit intake(bcs Pt went to dialysis for most of the night), didn't change out an Iv, was due that morning, had to talk to my cna multiple times that night for not completing task, and he told the manger things I didn't say (no past issues w/ other CNAs), lastly I prepped a pt for surgery despite no orders; based on shift change report and pt statement and advice from charge nurse...this was the list presented to me upon being let go 1day after my 6 months...help! Is this justified and do I now forget ever working in cardiac or a hospital again? How do I move forward in interviews, I didn't feel over my head and I loved my job?! My union rep said I could file a grievance but it's yr long process so I agreed to resign. Ugh I'm moving back to California with family and it is difficult to findx work there! Thanx for any advice :/

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Specializes in ICU and Dialysis.

Were any problems with your work brought to your attention prior to being fired?

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No, only during the orientation time, usual stuff like time management, and scanning insulin before I knew about the 1/2 dose but it was not given.

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So, I find your post is slightly hard to decipher. What I think happened is you had a few small bumps in the road during your first six months as a nurse and you were let go by management without any warning? Is this right?

I'm not sure what the deal with the insulin was...

If you prepped a pt for surgery, what did that entail?

What came of the they said/you said thing with the CNA?

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Seeking advice and understanding. Started a new grad program/ in desired field cardiac, had 6 weeks orientation but felt nervous to be to be on my own so had my orientation extended another week. Once I was on my own I was perfectly fine there were moments I wasn't sure about a situation but I asked co workers and it was fine. I felt my time management and prioritization was good. I had one time I had a patient with uncontrolled hyperglycemia, it was night shift and his cbg was in the 300s, I scanned his insulin and no pop up came up signifying half dose; I questioned why no pop up but thought I remembered it was Q4 checks, which would explain no pop up, so I gave him his full dose. Once I did I went back to the computer and realized it was 4x a day. My blood ran cold I rechecked his cbg 20 min later and it was around 365, it was like the insulin had no effect. I still felt I made a mistake and filed it in the system for management. It was never brought up again and I figured it was because there was no adverse reaction. I go the rest of my 6 months feeling good and fairly confident. Then the last week before my 6 months is up I Change out an iv bag and tubing for the on coming RN and forget to put a date sticker and curos cap on the tubing, that morning management compiled a list, I didn't finish my admit intake(bcs Pt went to dialysis for most of the night), didn't change out an Iv, was due that morning, had to talk to my cna multiple times that night for not completing task, and he told the manger things I didn't say (no past issues w/ other CNAs), lastly I prepped a pt for surgery despite no orders; based on shift change report and pt statement and advice from charge nurse...this was the list presented to me upon being let go 1day after my 6 months...help! Is this justified and do I now forget ever working in cardiac or a hospital again? How do I move forward in interviews, I didn't feel over my head and I loved my job?! My union rep said I could file a grievance but it's yr long process so I agreed to resign. Ugh I'm moving back to California with family and it is difficult to findx work there! Thanx for any advice :/

This is really difficult to follow and makes me wonder if communication might be an issue for you? Beyond that, a seven week orientation in acute care seems inadequate. I'm not surprised that you had difficulties. I had a lot of difficulties after an orientation twice that long.

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Specializes in ICU.

Those really sound like bogus reasons to let you go. (Not changing out an iv that was due that morning? We don't change ours at all, we only re-start one when it goes bad). You are probably lucky to be let go, because it doesn't sound like they would help you out if something ever did go wrong. Oh, and how do you prep a patient for surgery? We used to do this many years ago, but now all we do is remove dentures and place them in a hospital gown.

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the patient is prepped the night before surgery with chlorhexidine wipes, basically like a bed bath. There were no orders for surgery which happens, then the doc comes in the morning of and puts the orders in. I informed the pt there were no orders but he said he had talked to the dr....this was one of the reasons my manager gave for my termination, that I falsely told him he was going to surgery...I'm angry and am not sure what to say in my cover letters, interviews, or resume... i don't know how to move forward

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I had no issues with communication with anyone except that one night with a really inexperienced and flustered CNA. I saw the manager when I first started on the floor and gave her paperwork, the next time I saw her was the day she let me go. I wasn't struggling on the floor, I mean I've had some challenging nights but that's normal. you would think if I had issues all along I would have had more warnings or discussions with her along the way, or maybe let go of sooner, right?

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the patient is prepped the night before surgery with chlorhexidine wipes, basically like a bed bath. There were no orders for surgery which happens, then the doc comes in the morning of and puts the orders in. I informed the pt there were no orders but he said he had talked to the dr....this was one of the reasons my manager gave for my termination, that I falsely told him he was going to surgery...I'm angry and am not sure what to say in my cover letters, interviews, or resume... i don't know how to move forward

Did the MD mention the possible surgery in his/her note? At my facility we have made patients NPO the night before, without an order, for possible surgery in the morning, once the surgeon sees them. This usually happens when the patient comes in on nightshift and the hospitalist believes an intervention is urgent, so that we prepare the patient as if they will be going to surgery.

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Specializes in Pediatric Critical Care.
Did the MD mention the possible surgery in his/her note? At my facility we have made patients NPO the night before, without an order, for possible surgery in the morning, once the surgeon sees them. This usually happens when the patient comes in on nightshift and the hospitalist believes an intervention is urgent, so that we prepare the patient as if they will be going to surgery.

I think even in a case like that, the provider should be putting in their NPO orders, etc. in anticipation of possible surgery. To cover myself, I would ask them to put orders in.

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Did you notify the doc of giving the wrong insulin? I know with a BS of 300s, that may seem unnecessary, but that's protocol.

Did the doc say surgery tomorrow? Or just the patient? If it was just the patient, I would've clarified with the surgeon or have the PA on call to place orders if unsure. Patients often confuse things... and if you have family involved in a surgery they weren't aware of, things could blow up kind of quickly. And if the doctor told me him/herself, I would get orders for npo, surgical prep, etc.

Although I am not sure it is a fireable offense, it does sound like you may have dropped the ball on communication. None of us are perfect... thats ok. Elicit feedback and reflect with your next job.

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Specializes in Surgical, Home Infusions, HVU, PCU, Neuro.

Ok so the insulin was a med error, and you owned up to that. Is the filing in the system for management the same thing as an incident report? My only concern here is whether or not you informed the doctor and charge nurse when this incident took place.

I work on a surgical floor and we prep the patients with a chlorhexidine as well, and do not let them have anything to eat or drink after midnight. We do this whether the surgeon has seen the patient and placed orders or not. I would rather err on the side of caution and have the patient ready on our end vs delaying the surgery due to eating or drinking. The patient informed you what the doctor said and you used your change nurse's advise to be proactive in the care of the patient. Was the patient harmed in this prep? If not I do not agree this is an issue warranting termination.

We change our tubings every Monday, Wed, and Friday, and would probably not have much staff left if not placing a sticker on the tubing. The IV and tubing is charted on every 4 hours which includes the day the tubing needs to be changed out. Curos caps are only used on central lines where I work. Are you expected to relocate the IV site when the time is on the upcoming shift? I would possibly change the site if I had the time needed for it, otherwise, I would pass it on in report. I don't understand why this was even an issue.

The dialysis patient's admission did need to be completed, but being of the unit for an extended amount of time can certainly pose a hindrance in the completion of that task. Some options that may help in the future with this is to see if the patient has been admitted before and use the data from that or ask the patient's permission to discuss with family to complete the admission. You do need to ensure that the medications are current and any other changes the patient has had. If none of this is available and the patient is not in the unit, did they expect you to stay and complete the admission when the patient got back? Did you pass in report that there was missing information for the admission to be completed?

You mention the CNA tiff when the manager confronted you on this did you tell your side of the story? Were the tasks you were asking the CNA to do outside of their scope? What tasks did you have to bring to the CNA's attention? Did you include your charge nurse when this was taking place?

When they talked to you and decided to give you the option to resigning or being terminated, did you stand up for yourself? Did you put your recollection of events on the paperwork before signing it? IMO, these are some pretty petty things to be terminated/ forced resignation on. And unfortunately, the majority of states are an at-will employment so you can be terminated for just about anything.

This should not deter you from seeking employment at another facility and getting back on a cardiac floor. If this is your first job I would just put on the applications that you left for personal reasons. During upcoming interviews do not bash the hospital, unit, co-workers or management, but rather say it was a personal decision to leave.

Side note- paragraphs are your friend and make reading easier to follow. Using the quote button allows us to know who you are responding to.

This is such an unfortunate event that has taken place and I still don't see how these things could lead to termination. Apply for other positions, and I would look into filing for unemployment for the time being. I sincerely hope everything works out for you.

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