Made Mistakes, Fired and Jobless, any advice?

[dreydog19]

I'm from MI. We have lots of schools that put out nursing students here and it was difficult to find a job after graduating in 2006 with a BSN. I found a job in chronic outpatient dialysis, which I felt didn't use all of my abilities. I found a job at a hospital ICU by walking on to the floor with my resume, I have never gotten very far with online applications. Well I maintained this job for 5 months and loved it. Until...

For 2-3 days the state came through so everyone was being careful. Well the state found some problems w/ in my charting. I had made a med error. I gave Lantus 30 units at 8pm. When given report the reporting nurse said the patient "was to get the Lantus at 8" and that would help since his BS was in the 300s, so I gave it to him at 8 trusting the reporting nurse. I know the 5 rights, and should have looked in the chart for correct time to give the med. The med was supposed to be given at 8am. There was no record that it had been given that morning! Anyway I called the nurse at home and she said she had given it to him (his BS was in the 300s all day). I watched him closely and tried to find the sheet to write down the incident report, but the secretary couldn't find it and I got caught up with all the other work I had to do as an ICU RN. I watched the pt closely (he had no ill affects) and his BS remained in the 170s during the night. I told the oncoming nurse what had happened.

Second thing I did wrong. My patient was post cardiac sheath, the sheath was out (about 2 days). I had forgotten he had had that sheath in. We were doing dopplers on his legs, which I had thought was due to his bad perfusion. I couldn't find the pulse, but pt didn't complain of pain and foot was still warm. Meanwhile, shortly after 8pm assessment my other pt had a BP of 52/19 and needed immediate attention. I called the DO and started a saline bolus. They wanted a bunch of tests done on him and I was busy w/ him for awhile, his BP didn't come up to 70s/x for 2-3 hrs. I peaked in on my other guy to do turns etc, but still couldn't get a pulse w/ the doppler. I asked an LPN to check the doppler reading while I was busy w/ my other pt but she didn't have time to do it either. My night manager was gone for staffing during some of the time and didn't ask if I needed help when she got back (she knew that I was busy the DOs were up to help and such). The night manager even allowed the phlebotomist to take blood out of the doppler guy's affected leg...since his perfusion was so bad and she couldn't get blood any other way.

There is no union at this hospital. I was called in to comment on the mistakes and was very upset. They called the HR department and suspended me pending discharge for "deliberate behavior resulting in danger, discomfort or harm to a pt." I was given a hearing which consisted of meeting w/ the same immediate supervisor and the HR guy, both of whom were biased. The hospital let go of 26 people a month previous and has had major budget cuts.

I'm trying to get unemployment but was denied initially. Any ideas on were to go from here? I have my BSN...but jobs are scarce here. Also how do I address this in an interview, should I emphasize overall budget cuts? Any help would be greatly appreciated. I feel terrible and am considering any ideas:cry:

[TheCommuter, BSN, RN]

Is there any possibility you can move out of Michigan, which is clearly one of the most economically depressed states in the union? While I'm aware that some people cannot simply pack up and relocate, you'd probably be able to find work fairly rapidly in another region that is still faring better economically.

[caliotter3]

Just be prepared for your job search to be harder and to take longer. You should strongly consider being flexible about moving out of the area as The Commuter suggested. Also, don't be surprised to find that hospital jobs will be harder to land. Don't put off applying to long term care facilities, because that may be the first place that proves willing to take a chance with you. Unfortunately you got caught up with a state inspection. But you might have been caught up with these mistakes even without state being around. You will need to think about your mistakes and be prepared to talk about how you intend to avoid making the same mistakes. Good luck to you.

[HouTx, BSN, MSN, EdD]

dreydog19,

Did your former employer take any further actions with your BON? In Texas, whenever a nurse is terminated for clinically-related cause we have to report this & there may be further actions which may affect licensure. Make sure you follow up to see if anything further is happening in this area. If there is, you may need to contact an attorney.

From what you wrote, your actions were not in line with appropriate standards of ICU nursing care. In an ICU setting, we can't 'forget' important details about patient care such as the fact that they had a femoral sheath... ongoing detailed and thorough physical assessments are just part of the job. We have a higher level of accountability for patient safety than some other clinical areas - that's one of the major justifications for our lower patient ratios. Giving meds without confirming the order is not acceptable either, although it seems as though you attribute your mistake to a problem with charting, not your actions.

We all make mistakes - we're human. But an important part of this experience should be some honest self-examination & reflection about what we did wrong and how we can learn from it. The incidents you mentioned were very serious and could have caused patient death or loss of limb. You failed to complete a report on your medication error because it slipped your mind. And yet you believe that the HR representative and your immediate supervisor were biased. How did you expect them to react? Do you think you would have been treated differently in a union environment? Do you really think that your termination was due to budget cuts?

[dreydog19]

No what I did was wrong truly. I don't deny that. I want to get a new position in a little less stressful position. I don't deny that what I did was wrong and I've even contemplated not being a nurse anymore, trust me this has ruined my life...that I made these mistakes. I was just trying to decide what to do for my future. Geez rbezemek thanks for the negative remarks. They aren't doing anything w/ my license.

[dreydog19]

should i just forget nursing? according to rbezemek it sounds like I should.

[SuesquatchRN, BSN, RN]

dreydog, you didn't deliberately do anything, and you haven't done anything much in the course of five months.

would fight for unemployment until you can find another spot. You're not a new grad anymore, and frankly, never belonged in the ICU.

{{{dreydog}}}

[dreydog19]

Yeah I'm fighting for unemployment and looking for a less stressful job. I did well in chronic outpatient dialysis, but am looking into other avenues too.

[blondnursey]

every new grad makes mistakes, as long as you learn from them you shouldnt beat yourself up forever.

have you looked into private duty home care? nursing homes?

[elkpark]

You mentioned interviews and whether to emphasize the budget cuts/layoffs. Since you were fired for cause (whether justified or not, and I'm not implying any judgment about that), it's important that you not sound, in interviews, like you're denying or minimizing the concerns leading to your termination -- that will be a red flag for potential employers. It's important that you be honest about the previous situation, be able to talk about it without sounding defensive, and be prepared to talk about what reflection you have done and steps you have taken to ensure that you will be able to avoid similar problems in the future.

Plenty of people get fired from positions and "live to nurse another day." This is not a career-ender. The important thing is what you can learn from this experience and whether you can maintain a positive attitude about learning from it and moving on.

As others have noted here, there are probably better places to be looking for a job right now than MI. You might want to think seriously about moving to one of the areas in the country that does have a significant nursing shortage and is hiring.

I'm sorry you've ended up in this position. Best wishes!

[Multicollinearity, BSN, RN]

dreydog, you didn't deliberately do anything, and you haven't done anything much in the course of five months.

would fight for unemployment until you can find another spot. You're not a new grad anymore, and frankly, never belonged in the ICU.

{{{dreydog}}}

I wonder, though, if she fights for unemployment, if the hospital's HR department would push back and amplify their justifications about the firing being due to "cause." An easy way for the hospital to demonstrate evidence that the firing was the employee's fault would be to provide evidence that the hospital reported dreydog to the BON.

Personally, I'd be afraid to fight for unemployment when I was fired due to cause. I'd be afraid of the BON finding out. I wonder if this is a situation where it's better to "let sleeping dogs lie."

A few years ago a friend appealed being denied unemployment when he was fired. He had to attend an administrative hearing with an administrative law judge, and so did his former employer. His former employer's HR manager showed up with written evidence to justify that he was fired due to his own conduct. I'd hate for the hospital in the OP's case to have to look for written evidence and build a case to show to an administrative law judge at an official unemployment hearing.

Of course I'm still a nursing student, so I don't know. I'd love to hear from the more experienced if my above concern has merit.

[elkpark]

I wonder, though, if she fights for unemployment, if the hospital's HR department would push back and amplify their justifications about the firing being due to "cause." An easy way for the hospital to demonstrate evidence that the firing was the employee's fault would be to provide evidence that the hospital reported dreydog to the BON.

Personally, I'd be afraid to fight for unemployment when I was fired due to cause. I'd be afraid of the BON finding out. I wonder if this is a situation where it's better to "let sleeping dogs lie."

A few years ago a friend appealed being denied unemployment when he was fired. He had to attend an administrative hearing with an administrative law judge, and so did his former employer. His former employer's HR manager showed up with written evidence to justify that he was fired due to his own conduct. I'd hate for the hospital in the OP's case to have to look for written evidence and build a case to show to an administrative law judge at an official unemployment hearing.

Of course I'm still a nursing student, so I don't know. I'd love to hear from the more experienced if my above concern has merit.

While I have no personal experience in this area, what you say makes a lot of sense to me. If it were me, I would not be putting the hospital in the situation of having to defend firing me, because you can bet the farm that they have the documentation and evidence to do so, and it could only make my situation worse.