New Grad, disciplinary woes

[furelite]

I am a new grad on a busy M/S floor on day 16 of my floor orientation. I have two more weeks under a preceptor, though I have been caring for my patients independently for the past several shifts with supervision over my charting. I work in a hospital that has no formal residency or training program, you essentially get paired with a preceptor and are expected to take on 4-5 patients independently by the end of 6 weeks on the floor if not sooner. People are very helpful, but of course it is very scary as a new nurse on this type of floor especially, as every patient is a different set of problems never encountered before as an inexperienced nurse. I worked last night, and everything seemed to go just great with my patients overall. I did my hourly rounding and made frequent checks. I got called in this afternoon to meet with my manager. I was terrified I had made a medical error...but instead, I received a verbal warning based on a complaint regarding my interpersonal interaction with a parent and the care of their child last night. I am not going to go into specifics, but there was no indication through the night of dissatisfaction, and the patient was sleeping most of the time except during an episode of acute pain, which I attended to promptly. However, the parent's perception of my service was very negative (no med errors or unsafe practices...essentially a negative interpersonal impression). Of course, with all the emphasis on the patient experience and ratings, they take this complaint very seriously. My preceptor was never notified of any issues through the night. Now I have a verbal warning that I have to sign, and am feeling like a failure. How do I regroup? Maybe this sounds silly to everyone else, but I feel I have a target on my back, though my clinical skills are not in question and up until now, I have gotten really good feedback. The thing is, I get along with almost everyone really well, and my patients...up until this one, have always loved me. The patient's parent complained loudly, and took it up the administrative chain. Now I have to sign a verbal warning because this complaint will take our patient satisfaction ratings down significantly. Of course I can reflect back and understand misperceptions and miscommunications and will learn from it. I just feel like this will have a very negative impact on my success and am doubting myself and my career. I guess I am looking for support. Being disciplined is not something I am used to. I am a third career new nurse and now am questioning everything.

[Kyrshamarks, BSN, RN]

you know how many people have complained about me to management? After all these years I can't even count how many. Just take it as it is. Nobody get a along with everybody.

Think of it this way...now you will never have to care for them again, I see that as a winning situation.

[Coffee Nurse, BSN, RN]

It's a shame it sounds like your management doesn't have your back terribly well. Did they at least give you a chance to tell your side of the story or address the parent's complaint before giving you the warning?

[Been there,done that, ASN, RN]

You do NOT have to sign a verbal warning. What exactly is the administrative complaint against you? I would file a grievance first and foremost.

Pediatric nursing is a tough gig. There are hyper-vigilant parents that develop the wrong impression. My guess is you were so focused on administering the proper care , you did not pat little Johnny's butt / head enough.

You do not deserve a write up, do not need to take 20 lashes for the almighty satisfaction scores.

[artisticmind]

My previous job in another field made employees sign "verbal" warnings essentially so they could cover their behinds in case it advanced far enough for them to terminate you. That way if they were giving you a 1st written warning you couldn't come back and say "but I never even received a verbal warning over xyz!" Do I think that this situation from what we are told necessitates a verbal warning? No- if it does any nurse that has ever been "fired" by a patient should be "verbally" warned for bring down their respective facilities satisfaction scores. It sounds like they are looking for a scape goat and you happen to be it

[Karou]

I honestly feel like your manager is overreacting.

Not everyone will like you, often for reasons you have no control over. This family member sounds petty to make such a fuss over a personality issue when you provided competent care clinically.

It's difficult to not let it hurt your feelings at first. Eventually you will feel blessed when these problem families/patients "fire" you. Then they become someone else's lovely assignment.

I am sorry this happened. I am sorry you manager took the complaint to this level.

[FolksBtrippin, BSN, RN]

You probably do not have a target on your back. It is common for people who are new to feel that way because they haven't had time to feel secure and confident.

To resolve the feelings you are having about this, I think you need to take a close objective look at your behavior in the situation. It's going to be hard to be objective, but you can do it.

You didn't state the facts here, and you don't have to. I don't know if I would; sometimes people are extremely judgmental in this forum. It's kind of random and you never know what you're going to get.

Look at the facts. What were the precipitating factors to the event mom complained about? What did you say/do? Was there body language?

Now a little analysis. What factors do you think contributed toward moms perception of a bad dynamic? Some possibilities include: mom's stress, patient's stress, your stress, miscommunication.

In interpersonal situations, both people are responsible for the dynamic. It sounds like mom isn't taking responsibility, but you still can. Learn what you can from the situation. Figure out if there is some way you could improve the dynamic in case you have a patient/ family member exactly like mom again. Usually there is something you can do, even with very unreasonable people. Even when someone is just trying to use you as a punching bag, there are things you can do to change the dynamic. Not "punching" back or cowering is key for those situations.

Once you figure out what happened and why and what you can do about it if it happens again, let it go. You have taken the lesson out of the situation, and you don't need to think about it anymore.

[furelite]

Thanks y'all. I do understand where the miscommunications took place and see where I need to improve. I guess I am also feeling a little thrown out to the wolves, since apparently my preceptor never even went into the room to double check on my work or the patient/family. I know when I am on my own there won't be anyone doing that, but I am still on orientation (started on the floor first of October). Also, I have not been trained in pediatric care, and they won't let any nurse take a pediatric patient who hasn't been. My preceptor is pediatric trained and a very experienced nurse, but this didn't help me last night. I am dreading going in tonight. I am sure they were all talking about me all day.

[Been there,done that, ASN, RN]

Did not realize you were still in orientation!!

Your ( useless) preceptor is responsible for this fiasco, not you.

Cannot fathom an administration that would write up an orientee, while working with a preceptor.

Does NOT compute.

[~PedsRN~, BSN, RN]

I would be so disappointed in my management if I was in your shoes. Honestly, you will always have patients/parents who do not like you - and there will be no pleasing them. If you provided safe care, competent care, and this patients needs were met - why are you getting a warning? I find that truly ridiculous.

If I got a warning for every time I have been fired by a patient for some reason or another - I wouldn't have a job right now. Pediatrics is a fickle nursing specialty.

I'd love to know what the specific complaint against you was.

[LPNtoRNin2016OH, LPN]

First off, a freaking thousand KUDOS to you having your first job in peds. Honestly, I can't imagine how you deal with all the parents. I know because when my then 4 month old was hospitalized for RSV last spring, I was a freaking hot mess of anxiety but my nurses did a great job of keeping me from flipping off the broom handle (which isn't really their job so I really appreciated it). But we were paired in with another RSV infant and their family who were TURDS. Complained about everything and wanted the staff to change the baby's diaper... uhhh that's why we room in with them. I felt so bad for the nurses and staff.

I have been complained about before and it really wrecked me at the time because I am pretty patient and pleasant with my patients. Looking back, I honestly did not do anything wrong, the patient was frustrated with the whole business and took it out on me. But my turf boss didn't back me up so I eventually resigned because if you are otherwise a good nurse and on patient complaint is going to put a spot on your record with them, you do not want to work there anyways. BUT I realize your a new grad and its essential you stick out your first year. My hospital system I used to work for was BIG on patient satisfaction to the point they wanted you to let patients essentially verbally abuse you. It's the new trend, patient is ALWAYS right, even if they are terribly wrong.

Have you thought of have your preceptors talk to management that they saw nothing amiss?

[LPNtoRNin2016OH, LPN]

Oh and WTH would you had to sign a verbal? If you are signing it, then it's a written warning. I have received verbal "talking to" 's that never required a signature.