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 :/
Don't pigeonhole yourself to one job because you think you wont be able to handle a job you want. While you're out of work, continue to work on your nursing knowledge for a few hours a day- don't get rusty. This is not a vacation!
Your issues may deal with The Policy. My experience has revealed that sometimes even resource or senior personnel on the unit don't know what the true written policy states. I don't think they teach the new guys about these enough. Next job these are a must read. Often they spell out solutions to problems word for word.
If it were me I'd still go with the grievance, time and guarantee notwithstanding. You presumably payed your union dues so might as well take advantage of their help. Or at least some closure and maybe help the next guy to come along.
Specializes in ICU/community health/school nursing.
Make sure you are considered rehireable by the institution. That's your main concern. If HR tells you you aren't, fight that tooth and nail.
Otherwise, yes...your training sounds inadequate; if those red flags weren't raised all along the path then your nurse manager isn't doing his/her job; and yes, this happens all the time. Time management is something with which we all struggle at the beginning. I think as an experienced nurse I forget how difficult it is moving from task-oriented behavior into the critical thinking role that's important for all of us. Hang in there. Don't get discouraged. In a year this probably won't matter.
As far as the surgery prep without orders.... If I was told at report that surgery is in the AM, the patient tells me they are having surgery in the AM, and the note says there is going to be surgery in the AM, I would have gone ahead and done the prep too even if there weren't orders for surgery prep.
Yes, a million times. Depending on the way things are done on a particular unit, doing a CHG bath and making someone NPO overnight is no big deal, even if surgery is decided against or delayed. NOT doing it with all that information at your disposal would have put you in a heap of trouble.
I work with surgical patients all the time, if the patient is having surgery, there needs to be clear written orders from the physician regarding prep work. I would never prep a patient for surgery without orders. Sometimes the patients surgeries are delayed because the physicians did not put in prep orders for the surgery, the night before.
So physician notes, patient understanding of the plan, and off-going nurse confirmation of surgery isn't enough to implement simple prep, which leads to a delay of patient care? And the surgeons are cool with that? Really?
So physician notes, patient understanding of the plan, and off-going nurse confirmation of surgery isn't enough to implement simple prep, which leads to a delay of patient care? And the surgeons are cool with that? Really?
If not, they should learn to put the orders in.
We all have our part to play - theirs includes writing orders.
Don't pigeonhole yourself to one job because you think you wont be able to handle a job you want. While you're out of work, continue to work on your nursing knowledge for a few hours a day- don't get rusty. This is not a vacation!
Your issues may deal with The Policy. My experience has revealed that sometimes even resource or senior personnel on the unit don't know what the true written policy states. I don't think they teach the new guys about these enough. Next job these are a must read. Often they spell out solutions to problems word for word.
If it were me I'd still go with the grievance, time and guarantee notwithstanding. You presumably payed your union dues so might as well take advantage of their help. Or at least some closure and maybe help the next guy to come along.
Accolay is giving great advice about the policies. We have an online resource to look up all of the policies for my facility. Wherever you land for your next job, I would suggest you find out where and how you can look up the policies for that facility. As Accolay said, sometimes senior staff do not always know the answer and going by the policy of the facility should never get you in trouble. I am not saying that senior staff are not helpful or trustworthy, just that policies change and sometimes staff is not properly notified of those changes in a timely fashion. Good luck at your next job! I am sorry this has happened to you.
I'm truly stumped about the job search and feel like resigning myself to a SNF.
First of all, SNF is not where failed nurses go to die, so get that idea out of your head. If you DO end up working in an SNF, you can gain a lot of skill, knowledge, and experience if you choose to...or you can just get by (this is true no matter where you work).
Second, your are not "doomed" to never work in an acute care hospital again. Apply for jobs. What's the worst that can happen?
Third, don't give yourself the label of "failed nurse". You aren't that. Give yourself some grace and allow yourself to learn and move on with your career.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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?
Your first post is long, wordy and confusing. It is difficult to follow and it isn't clear exactly what the problems were that contributed to your termination. I am concerned -- as some of the other posters, too, it seems -- that you might have difficulty in understanding or making yourself understood verbally and in writing. The fact that YOU don't think you have any issues with communication isn't a reliable indicator of whether or not others think you do. It might be a factor. Please consider the possibility thoughtfully before you dismiss it out of hand.
Communication problems might also explain why you thought you were doing well but your manager thought differently enough to terminate your employment. I've had several orientees who thought they were doing great, despite several meetings to discuss their mistakes or shortcomings and performance improvement plans which were discussed and then signed by both parties. I'm not saying that's what happened in your case, but it is also a possibility worth considering thoughtfully. Have there been discussions with charge nurses or management when they discussed an error or something that you could have handled differently?
As far as interviews in the future, if you resigned rather than were terminated, you can use the standard "It wasn't a good fit," followed immediately by some sort of explanation why the current employer would be a better fit. Or, since you're moving back to California to be with your family, you can say that you left your first job due to relocation.
Specializes in ED, Cardiac-step down, tele, med surg.
I would be glad to get out of there and would examine if there were any red flags that came up that you can look out for in your next job. You did make some mistakes and someone should have also coached you on them and it's also a good idea to review your policy and procedures so you know what the expectations are. Always report abnormal findings to the MD, make sure you check about upcoming procedures and don't trust everything you hear in shift report, ask the MD or OR or go to the primary source when in doubt. Try to learn about different medications, different disease processes you see where you work and what to look out for.
By the end of the orientation period, a nurse should know what to do first and why and who to ask if they are not sure. They should know about the meds they give, side effects, adverse reactions and how to reverse these. They should know emergency procedures, have working suction in the room and know how to operate the crash cart. They should know where to locate policy and procedures. They should know how to talk to the MDs, not let fear or uncertainty hinder them from speaking up. It's okay to be nervous, but as a nurse, you've got to speak up and talk to the MD if you are ever in doubt or if your intuition is telling you to.
I have never worked at a place that would have let someone go for the reasons you describe. I would try to speak with the manager and ask if there were anything else. You could fight it, speak to an attorney or go through the union, but if I were in your place I wouldn't want to work there anymore. I would want to work in a place that would help me out if there were something I didn't know and help guide me in the right direction so that I could be a valuable team member. You'll find something better, use this experience to make you stronger and better
Accolay
345 Posts
Don't pigeonhole yourself to one job because you think you wont be able to handle a job you want. While you're out of work, continue to work on your nursing knowledge for a few hours a day- don't get rusty. This is not a vacation!
Your issues may deal with The Policy. My experience has revealed that sometimes even resource or senior personnel on the unit don't know what the true written policy states. I don't think they teach the new guys about these enough. Next job these are a must read. Often they spell out solutions to problems word for word.
If it were me I'd still go with the grievance, time and guarantee notwithstanding. You presumably payed your union dues so might as well take advantage of their help. Or at least some closure and maybe help the next guy to come along.