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made a mistake, might get fired- thoughts/advice?

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xariel xariel (New) New

I think I might be getting fired. Again.

I started on a med/surg floor right when I graduated a little more than a year ago. After six weeks of orientation, I was fired without warning (they can do that at this hospital). When I asked why, my manager listed several things my preceptor told her: giving a patient xanax when they didn't need it so that I would have an easier shift, not telling anyone when my patient had PE symptoms, etc etc. I hadn't done ANY of that and I was devastated about being fired. To this day I don't know why my preceptor lied about me.

I got re-hired to a different floor of the same hospital within a few weeks. I've worked there for two weeks shy of a year without getting in trouble... I did get a note once saying I'd forgotten to clock in with my badge too many times (we have a book where you sign in when you forget so they still have a record). I'm not sure if that counts as a "written warning" or not. I have been way better about that since then and, other than that, things have been good.

Well..... Last week I was having an ultra busy shift and I did something really stupid. I was giving two liquid meds per feeding tube. One came in a little syringe (wrong size to attach to feeding tube) and one in a cup. Well, I drew up the one in the cup into the right size syringe, and then I set the cup on the garbage can. I say "on" and not "in" because it was overflowing. The whole top layer was "clean" type trash- papers and stuff, and I put the cup right-side-up on top of that. Then I remembered I needed a cup to put the other med in before I could draw it into the right syringe, so- you can probably guess where this is going- I grabbed the cup back from on top the garbage. I used the cup to draw up the other med, gave the meds to the patient, and threw the cup away (again). I'm pretty sure the patient didn't see any of the stuff with the garbage can since I was doing it with my back to him. A CNA was in the room at the time, and he pulled me aside an hour or so later and totally chewed me out for using a cup that had been in the trash. He also said that the end of the feeding machine tubing touched the floor while I had it disconnected to administer the meds. I didn't think it did, but maybe he saw something I didn't. Anyway, he told the charge, who told the manager. I didn't get a chance to tell the charge or the manager my side of the story, and I'm pretty sure the CNA exaggerated, because he's never liked me and he's that kind of guy. My manager called me at the start of the week to put me on suspension until she has time to meet with me (tomorrow), and she said she is discussing disciplinary action with HR (she'll tell me what they decide tomorrow, so I don't get a chance to state my case to her at all). What really worries me is that when she called me, she had her boss's boss in the room, and had us all on speaker phone.

I totally admit that I did something wrong and stupid, but I don't think I deserve to get fired for it. I hope I get a written warning or something... but if her boss's boss is involved? That seriously doesn't look good. And I'm not sure if my clocking in thing "used up" my warning, which they don't even have to give me anyway. After getting fired from my first job, I'm really terrified that I'm going to get fired again. I doubt anyone would hire an RN who has been canned twice in the one year she's been a nurse... What do you guys think? One of my friends suggested I just quit before they can fire me. I really want to work for this hospital.... what would you do? Do you think I'm going to get fired?

RochesterRN-BSN, BSN, RN

Specializes in Psych, ER, Resp/Med, LTC, Education. Has 6 years experience.

I would think that your punching in woudl be separate from actual clinical discipline-- usually they have to give you verbal warning, then written then they can fire you...thats AFTER your probation of 90 days--within the first 90 days I think it can be without any warnings-- So I would think it would be a warning......it's a bit harsh and the mistake you made was not life threatening to the patient. For god sakes a peg tube is going into the stomach....not exactly sterile. That is why you can use tap water! It's not like an IV.

For future reference-- do you not ever let your med go in with gravity through the large plunger.....I do the flush first....then take out the plunger from the syringe--use like a 60cc syringe--and attach just syringe and pour in the meds a little at a time with some water in between if I need to --you can hold it up to make it go in quicker and have less gargleing--and the patient gets less air pumped into them this way.......if I have crushed pills, powders I mix them up with some warm water in a specamin cup so I can put on the lid and shake them up really good, and with the warm water and shaking they disolve well......just some pointers. I have been in Psych ED since april now so not a lot of tube feedings there....or code browns!! lol don't miss it!!

Good luck and hope all works out--

I really hope that you're right and the punching in counts as different than clinical performance. Is the probationary period 90 days everywhere? I couldn't find any information about that on the HR website.

We use the 60cc syringes as well... My preceptor on this floor suggested that we push the meds rather than doing it by gravity because it's faster that way. I'll try it your way... that is, if I'm ever allowed back at work.

Any time a supervisor takes the word of a CNA over a licensed nurse and starts adverse action against the nurse without even listening to the nurse, that spells trouble. If you don't get fired, think very hard about where you will be six months from now. Perhaps it is time to consider other employment opportunities.

And you know what? If only the CNA and you were in the room, and you don't think any patient saw or really heard what was going on, I would probably insist that the CNA was lying through his teeth. He said, she said. What makes them believe what he says and not you? Who is to say that he didn't just make all of this up? It wouldn't be the first time something like this happened.

BabyLady, BSN, RN

Specializes in NICU, Post-partum.

What concerns me most about your post, is that you don't seem to take the job seriously.

For example, you actually, within a very, very short amount of time, forgot to clock in and out so many times that they actually had to send you a note about it. Your response in your post was, "I'm getting way better at it"....tells me that you don't seem to really care or take seriously warnings from management.

In that case, I would have been FREAKING OUT if I had just been fired from the same hospital system...and they actually had to send me a note to tell me something that most McDonald's employee's would do without fail. You are a PROFESSIONAL...if I had to set an alarm on my cell phone to go off every 5 minutes on vibrate in my pocket to remind me to clock out....I would do it.

In fact, the fear of getting in trouble at all would have been enough to keep me from forgetting.

I also cannot believe that you set ANYTHING in the trash to use on a patient. It's not about not thinking, it's about what "your standard of clean" is. It's the fact that you never gave it a second thought and seem to be more disturbed that you got stone-cold busted by the CNA (who had EVERY right to report it to management) than the fact that you were doing something for YOUR convenience and putting patient safety first.

You have no idea of what is in that trash or what has been put in it. There is no such thing as "clean" trash.

Don't go through your career looking for shortcuts or what is convenient. That will come with time (I'm a student...and I'm slow as Christmas because I am working on establishing GOOD habits so that they will become routine).

I would be mortified if I went to a restaurant and found out that they served me food using the 3 second rule.

I would be equally infuriated if I found out one of my family members had a nurse that was not being as sanitary as you could have, especially something that was administered.

You really, really need to take a good, hard, OBJECTIVE look at your work performance.

RoyalNurse

Specializes in CVICU, ER.

I hope you get a warning, but seriously, learn from that mistake, it may have been nothing now, but shortcuts can lead down a Wrong path quickly. I can understand you forgot you needed the cup, but on the trash? and then you used it: shortcut. It does sound like you're more worried about the CNA "telling" on you, than about your nursing practice.

It takes 5 minutes to run out and get a new cup. Not swabbing IV ports with alcohol before you use them, not double checking a med in the room b/c you forgot the MAG in the med room, not checking compatibility of IV medications before you hang them: big trouble.

I only have a little over a year in, but I realized that when I saw some nurses taking risky shortcuts, then I started doing the same, and made med errors.

to babybug,

when you are a licensed RN then feel free to write a post beratting another nurse about their nursing practice. Until then why dont you learn from someone else's mistakes b/c lord knows you dont have time to make them all yourself.

to the original poster,

in the start of your career there will always be times when pressure is great, patients to many or to demanding and the shortcuts seems like the best way. I think every nurse takes shortcuts at times, the ones who say they dont may not be completely honest. It has been my experience to ask myself some questions in that pressured moment: #1 is this short cut capable of harming the pt, in the short term or the long term? #2 is this something my management would like me to do but bears no potential danger? and #3, is this action something that can has a narrow margin of error or is there several ways to accomplish the same goal?

Nursing is sometimes so very frustrating b/c much of our prioritazation and approach is very individualized. If you can ask 20 nurses the same question and get 20 different responses you are probably ok. However if it is someting critical you will usually get the same response from all 20.

Nurses are way to back biting, and not near enough mentoring of one another. Has anyone asked you what you learned from this experience? What you would do differently the next time? How would you could change the outcome given the opportunity? We all know when we have screwed up, what we need to know is how to do it better the next time! Good Lord nothing in your post is worth the cruifiction you have gotten. Was it best practice ....um.... I think you know that ! :) Take a deep breath, and move forward hindsight is always 20/20, move confidently forward b/c of your mistakes that is how we learn! From someone who has been there...

Thanks, caringchic. I got the opportunity to talk to my manager about it at our meeting, and I told her (without being asked) what I learned and what I should have done. I'm really, really aware that I screwed up- whoever said I obviously don't care is dead wrong. At the same time, the patient wasn't harmed, because the surfaces of the item that were used for the patient were not the same surfaces that were potentially contaminated. I'm hoping that the lack of harm allows for some mercy in this situation. I definitely want to do better, and I just hope I get that chance.

lolalolacherrycola

Specializes in Med-Surg. Has 20 years experience.

"I did get a note once saying I'd forgotten to clock in with my badge too many times (we have a book where you sign in when you forget so they still have a record). I'm not sure if that counts as a "written warning" or not. I have been way better about that since then and, other than that, things have been good."

Sad that we are professionals held to such high standards but treated as if we worked at McDonalds; anyone else out there ever feel like that???

DaretoDreamRN

Specializes in here and there.

@ Baby Bug

You seem so quick to Judge others harshly.. There is a difference between constructive criticism and just posting stuff for the fun of it. As a nursing student..I was quick to judge people till I actually became a nurse..thats where you are right now. Graduate from Nursing school, work for about 6 months... then u might choose your words carefully.

To xariel.. mistakes happen..might not have been the wisest thing to do but hey..it has happened and u move from that. It was a very unhealthy practice and i do not condone that..but the patient was not harmed ..which is the most important. U live and u learn. Every nurse I know takes short cuts....some bad..some good....

Clocking in and clocking out is not such a huge deal ( except when ur paycheck gets cut short....lol) I do it once in a while because I forget ( Im sure its the same for you), not because I just dont feel like clocking out.. Somedays..its been sooo hectic...i just want to get out of work and forget to punch out..

hm, maybe you should try working in an area less stressful or busy. Something like an outpatient surgery or something.

try being more careful and realizing what's happening around you and what your doing. don't be discouraged, as long as you know that your working hard and truly making an effort to be the best nurse, you can continue to improve. But in a career such as nursing and dealing with patients you must realize and make sure that there must be no room for error when dealing with patients. Just learn to be extra careful, and double check!

best of luck!

hm, maybe you should try working in an area less stressful or busy. Something like an outpatient surgery or something.

try being more careful and realizing what's happening around you and what your doing. don't be discouraged, as long as you know that your working hard and truly making an effort to be the best nurse, you can continue to improve. But in a career such as nursing and dealing with patients you must realize and make sure that there must be no room for error when dealing with patients. Just learn to be extra careful, and double check!

best of luck!

No offense Quel19, but in reading one of your posts from another thread, I see that you are a student trying to get into a nursing program. Maybe you should keep your advise and criticism to yourself until after you are a nurse.

best of luck!

xariel

do you have any colleagues who have witnessed you doing a good job and are willing to support you? If so, ask a couple of them if they would give you a written performance appraisal and ask for it to be added to your employment file. You need to hear what your doing right so you can get your confidence back.

dishes

BabyLady, BSN, RN

Specializes in NICU, Post-partum.

to babybug,

when you are a licensed RN then feel free to write a post beratting another nurse about their nursing practice. Until then why dont you learn from someone else's mistakes b/c lord knows you dont have time to make them all yourself.

Because if you have to have an RN license to know that you don't put things in the trash and then use them around a patient...and if you have to have an RN license to know that you are supposed to clock in and out for a job.

Then the profession is darn sure in trouble.

I hate to break it to you...but the tasks just get harder.

Thanks, caringchic. I got the opportunity to talk to my manager about it at our meeting, and I told her (without being asked) what I learned and what I should have done. I'm really, really aware that I screwed up- whoever said I obviously don't care is dead wrong. At the same time, the patient wasn't harmed, because the surfaces of the item that were used for the patient were not the same surfaces that were potentially contaminated. I'm hoping that the lack of harm allows for some mercy in this situation. I definitely want to do better, and I just hope I get that chance.

Once the cup touched the trashcan it was contaminated. You need a refresher course in basic hospital standards of what is considered clean, dirty, contaminated, and sterile. Germs and bacteria are MOBILE....if there were dirty gloves in the trashcan, then everything in that trashcan is considered dirty, including the items on the top layer. And I would not want that injected into my family member's feeding tube.

Wow...I'm surprised at how sharp folks are with students. I hope that some of the students maintain their high standards and are not discouraged. Sure, look it up. I'm a student too.

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