New Grad Troubles

[NewGrad70]

I have a problem that I have never seen addressed on here before. I recently graduated and happily accepted a job at my local hospital. Anyhow, a physician on staff decided to do a favor for his patient as the patient had an emergency and had to go out of town. The MD took out a drain in the hospital in a room that was not being occupied with other patients. Upon completion he told the nurses to put a gauze on it. All of us nurses were busy, but as I was the new grad, I was asked by the charge nurse to put the dressing on the patient. I asked if that was o.k. for me to do and I was told yes. I did no irrigation I just placed a gauze with one piece of tape over it (bad move) didn't think there would be a problem since I had no idea about the area.

Here is the problem, the doctor literally did the patient a favor by pulling the drain and asked the patient to come to the room to do this procedure. The patient had not registered and no auth had been recieved. The doctor could have done it in his office, but was tied up at the hospital all day. I was called by the CNO and asked about the situation today, I told them what had happened and then I was told that I was going to be in trouble for the situation and given a warning and that the list of protocals that I broke would be listed on the warning. I am by far not trying to pass the buck, but I have been at this job for 11 days and I was orientating. I am crushed, confused and feel like I was thrown under a bus. I understand that there are protocals, but I am new, did not know and was told by my superiors to do it? I have never worked in this area before in my life. I am sure I will never make that mistake again, but I just feel that me getting in trouble to the extent that it is seems rather harsh, I am scared confused and feel that the charge nurse will not have my back in any situation. I have caught her on more than one occasion blaming me for mistakes and when confronted by me , she told me they were her errors.

I was told that the physician will be in trouble, the charge nurse will be written up but I will have the most reported on me. I have worked so hard for this and I am just reeling with confusion, anxiety and fear...what should I do?

I was told that the MD had called the patient while he was trying to admit and the admitting clerk went and told...and the rest is a nightmare!

[~Mi Vida Loca~RN, ASN, RN]

I can't speak as a nurse, because I am still a student so I don't know the way things work in regards to something like this, and I am all about personal responsibility, but I think it's absurd you got the brunt of this 11 days on the job AS A NEW GRAD and doing what you were told to do by the charge nurse, I mean some things should seem more obvious even though they are hard, (like favors with meds or something). Who knows, had you NOT done it, you might have got written up or had a mark put on you during your orientation for some played off reason. Sorry you got put through this, very sucky situation

Like I said, I have no idea the way things work for new grads, but this just screams wrong!

[GilaRRT]

No good deed goes unpunished.

[NewGrad70]

Thank you for your replies. No deed goes unpunished is so true. A doctor I worked with consistantly stated this. I think back and I would not have changed anything because I was directed to do these things. It happened on the 10th day of orientation and even less days in that unit. I have been so grateful to have a job and whistle going to work daily, the unit itself is not happy as a team and I have seen alot of griping and bad attitude. But again, I am elated to be working , especially after nursing school!!!! I am told by the staff that I bring positive to the unit and they need someone like me there (which is nice). This was just so unexpected, I guess the way the world has become, it is more about money and possible law suits vs. Nursing. I mean I am getting in trouble for putting essentailly a band aid on a pt. And I do see the point that they are making but, oh so harsh since I am new and orienting.This is a tiny hospital and I am told this is the norm and I was just unlucky, since the doctors and nurses do for the good of the patient and not anything else, I just happened to be put in a bad place....I don't know just so irritated and confused. No good deed goes unpunished is shouting from my mountain tops!

[Ms.RN]

I dont understand. Doc took the drain out and you put a dry gauze on it. So whats the big deal about this?

[~Mi Vida Loca~RN, ASN, RN]

I dont understand. Doc took the drain out and you put a dry gauze on it. So whats the big deal about this?

I am guessing because the patient wasn't technically a Pt. of the hospital. Sounds like Doc was busy had pt, meet him at the hospital, snuck into an empty room and did the procedure, but how we document everything, nothing to be documented because it is like the patient wasn't ever a patient. Had something gone wrong their would have been a lot of explaining to do.

That is what I took from it.

To the OP, that is great a lot of people think highly of you, try to chalk it up as a lesson learned, seems way harsh to me, I can even more so see if you were giving the patient meds before the procedure without any orders and charts and stuff. But for this, seems the punishment didn't fit the crime. I wouldn't see the HUGE deal if it was a more seasoned nurse, but the fact you were brand new, freshly orienting and told by the charge to do it, just even more so seems like, WHAT?

Hang in there.

[mauxtav8r]

Yes, you are being thrown under the bus.

If it was really no big deal, the charge would have handled it. She knew not to touch this patient.

If she asked you to do it, it's your word against hers. You will lose.

Plead your inexperience and trust of your superiors, but in the meanwhile, read the hospital's policy. Familiarize yourself with how the policies are kept, so you can look one up fast if you need to. Ours are on the hospital's inhouse website, but it takes a while to get proficient in finding the exact thing that addresses the situation you need.

As my foundations clinical professor said, "As a new grad you WILL make mistakes. The bigger mistake is to fail to learn from the experience."

Hang in there, gain all the experience you can, evaluate who to choose to trust, mind your license. It is YOURS to lose or to keep, regardless of what people ask you to do.

Best wishes.

[netglow, ASN, RN]

Wow.

If this were me, I'd be really struggling... what to do, what to do...

I would certainly believe you would be the least damaged. See if the threats do actually materialize, it's possible that major venting is going on.

My trust in the unit would be gone never to come back. If the worst happens, I might consider going WAY up the chain and simply stating what you said here. Inquire about transferring to another unit. This combination of things is HUGE problem on the part of that charge. If I were her management, I'd certainly have given her 2 strikes out of three for her actions. She is a danger to her patients/staff/facility and of detriment to everybody she works with. She seems quite comfortable with making poor decisions and a little too at ease and practiced in covering her ***.

[Phlavyah]

Maybe I'm just a student, but...

Am I the only one thinking "had OP known better, and refused to follow orders, she'd be in just as much trouble for not following orders"??

Why is the Doc the only getting out squeaky clean here? What exactly IS the lesson learned from the situation? All I learned from this post is "when you are new, everyone above you can p..s on your head and you just have to take it, and move on" There's something wrong here... Am I not seeing the big picture?

Like 2ndwind said, I'd be really struggling with this situation too...

[NewGrad70]

Yes, you are correct. Since the pt. was not technically a patient and the doctor snuck him in, that is where the problem lies. When he came out from behind the curtain he said motioning to us "I need for you to put a dressing on the patient" Since he was generalizing and did not care who put the gauze/bandaid on, I looked at my preceptor/charge nurse and she told me to do it. We were both busy, but since I was new I took her orders and did it. I even questioned her if I could do this, she agreed yes.

So I get a phone call from the CNO the next day informing me that an investigation would be placed on me,charge nurse and the doctor and that I would be written up for: not following Universal protocal, not charting on patient and using nursing judgement. I am beside myself, I can't sleep, my stomach is in knots and I feel betrayed. It is a lesson learned, but I feel like my whole world is crumbling. I am known for doing the right thing being a patient advocate and following protocol. The charge nurse agreed that she rcvd a phone call about pt and even ackowledged the patient entering the room, she even got a towel for the procedure. But I was told that since I put the dry gauze/piece of tape on that I will be written up with the most offenses.

I am highly worried about going back to the unit, because I caught the same nurse pawning on error off on me and when I asked what I had done she would not answer and when I continued to question her she finally admitted that it was her error and had not noted an order. This is drama that I cannot stand, after nursing school I was grateful to get a job and finally work. This was the rainbow I had been looking for, and to get in there and for this to happen I am just sick to my stomach. THe charge is known for avoiding blame, however she did admit to taking the call and the above information. Her excuse was she was just so busy and didn't really know the situation. What she failed to tell the CNO and dept mnger is that she provided the MD with the necessary supplies to do the procedure.

I was told by the CNO that it would be a verbal first warning (although it is written on triplicate)and put in my chart there. I was told that if anyhting similar ever happens it will be grounds for immediate termination. Thank you for your encouragement as I truly do not know what to do at this point. The charge nurse that this is stemming from disscouraged me to go to this dept in the first place, and another nurse in the dept. told me"How are you doing? I hope good since we are known for eating our young in this dept....The rest of the unit tells me that they need a person like me there to boost morale, but I just don't know after this. I am by far a quitter, I just dont want to be tossed under the bus again or know that I am being trained wrong.

All I can say is, What the heck? I have struggled to get here in the worst way, me and my family have gone without. My husband, children and family have been so supportive and now this? I have literally worked as a new grad 10 days on the floor. My heart is heavy and I am stressed, I just feel wronged and so confused. Thank you for your words of wisdom and encouragment....I really appreciate them:confused:

[the sparrow]

Call me crazy, but....couldn't the doc just slap a dressing on? Give me a break.

[caroladybelle, BSN, RN]

First, why did the MD not put the gauze on it? If he had the time to pull the drain, hesurely had the time to dress the room. And you do not pull a drain without having a wad of gauze to apply to the wound immediately.

Second, why did the charge nurse not do it themselves. Or object to having an unauthorized procedure done in an unoccupied room, rather than a proper exam room.

Third, how did this come to the CNO's attention and why? Were there complications that came up after the undocumented procedure that have legal implications?

Fourth, a problem with doing these things is there is no record, if there complications. And also that it sets a bad precedent. Once you start doing things " just this once", because the "MD is busy" or in a hurry, or "doing a favor" for the pt, it starts becoming a habit and frequent. Then other nurses are expected by the MD to do these things that are often not good practice.

Take my advice and try to stay away from setting such "precedents".

Yes, you are being thrown under the bus, in place of the MD and the charge and whom ever permitted the MD to use an unoccupied room to do this.