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

RochesterRN-BSN, BSN, RN · Feb 27, 2009

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--

xariel · Feb 27, 2009

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.

caliotter3 · Feb 27, 2009

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.

caliotter3 · Feb 27, 2009

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 · Feb 27, 2009

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 · Mar 2, 2009

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.

caringchic · Mar 5, 2009

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.

caringchic · Mar 5, 2009

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...

xariel · Mar 5, 2009

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 · Mar 5, 2009

"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 · Mar 10, 2009

@ 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..