I was fired for refusing to give injections incorrectly!

Nurses Safety

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Hello, my name is Katherine. I have been an LPN for 10 years. I am an experienced clinition and have won awards for my excellence in clinical practice. I worked in an office for 10 years which gave me a vast amount of experience, from family practice,internal medicine,pre-op teaching,pediatric nursing to urgent care. I take pride in my skills and am dedicated to doing it right for the benefit of my patient. I loved my job but felt it was time for a change so I took a new job in a pediatric office, this office served patients from birth to 18 years old. When I discovered the nurses in this office were giving IM injections with a 5/8" needle I requested that they order some 1" needles, which they did. When the nurse who was orienting me told me that she "tapes syringes together" to give immunizations I almost fell over! I told her that was not clinically appropriate and I would not be doing that. I worked there for two weeks and was brought into the office managers office after work one evening and told that it wasn't working out and they would have to let me go. When I asked why she told me it was because I was too set in my ways and obviously was not willing to do things their way. As difficult as this has been for me, I feel proud that I stood my ground and refused to do it wrong to just keep my job. From what I understand the department of health got word of this and has since gone in to correct the situation. Unfortunately it was at the expence of my job but at least I know the children are being properly immunized because of my sacrifice. Now I'm off to the trenches again to find a job that appreciates a skilled and dedicated nurse!

but if you think about it, is it really harmful to a pt?..

Well yes it is harmful to the patient - what if one of the needles hits a vein? when you draw back - how do you do so. Localising two needles within half an inch of each other has got to intensify the feeling for the patient. If the patient has a reaction (rare but it happens) - which syringe was the cause of the reaction? & finally taping doesn't really allow for a decent grip on the barrel - if the syringes enter at different angles there will be potential tearing friction against the skin.

If you are working in a area so short staffed that two staff arn't available it may be just possible that you need to give two injections (scary for peads I know) but mum or dad are there to comfort (usually). Its not the best situation but a few more tears is better then a double whammy into one arm....

you did good by sticking to your code of morals ! i'd look for another position first...of course...then go after that practice for wrongful dismissal! you should have no problems with winning & they would have eat your legal expenses too.

good luck ~ cheers!

moe

in my parents' unfortunate experience, even a "sure thing" isn't so sure. my parents were convinced by a lawyer to go after my dad's former partner who had absconded with money from the partnership account after he had been told not to. what my parents got was two years of sheer misery, a judgment which was basically non-commital--and a huge lawyer bill. there's a reason mental health professionals ask if you are in litigation as a possible cause of (di)stress...

nursefirst

Specializes in Med Surg, Peds, OB, L/D, Ortho.

I have never heard of such a practice! OMG! Good luck in your next position!:uhoh3:

When she gives immunizations such as DTaP and say Hep B....she tapes the syringes together to give two injections at the same time. This makes it so two injections are given less than a 1/2 inch apart...clearly inappropriate landmarks.
I told her that was not clinically appropriate and I would not be doing that. I worked there for two weeks and was brought into the office managers office after work one evening and told that it wasn't working out and they would have to let me go. When I asked why she told me it was because I was too set in my ways and obviously was not willing to do things their way. !

I think there's another way to look at this situation, another perspective. Many of us have been in clinical situations where the practice ranged from "not supported by research" to "unsafe". I wonder if the time had been taken to build rapport and trust with your new coworkers if you couldn't have made a tremendous positive impact on their practice? Could you have closely watched and listened to your preceptors instructions and then done it the way you knew was correct anyway? Show rather than tell? No one likes being TOLD they're doing something wrong, especially from a new employee who they don't know or trust. At the same time, I have never met a nurse who purposefully wanted to harm a patient (although I've heard about them on TV!).

I have a fundamental philosophy that I strive to use in every situation, it's simply to "believe the best" about people. No matter how I want to question motives, etc. I try to remember that most people WANT to do a good job. This is how I would apply this to your situation: First, I would believe that my new place of employment wanted to provide great patient care to their pediatric patients. I would approach each day with a "what can I learn from my new coworkers" attitude and how can I provide the best patient care possible. I would seek to ASK QUESTIONS rather than to TELL. I would not compromise what I know to be safe patient care while at the same time being respectful of others. For instance, instead of TELLING your preceptor her practice is "clinically inappropriate" and you would "not be doing that". What might have happened had you ASKED her questions like "I've never seen that done like that. What's the benefit to the patient?" and look like you're INTERESTED in the answer. She may have been told to do it that way by an LPN with 20 years of experience or she may not even know why she does it. But you created an opening. Then you can start a dialog and you never know you both might learn something. Regardless, you've not created an enemy, you've shown that you ARE willing to do things differently and you begin building trust with your coworkers so that you can ultimately impact the care given to the patients.

I realize I'm making a lot of assumptions based on one brief email (as all the other posters have done as well) but I would guess that your preceptor, even after the health department came to "straighten them out", still has her job. Ask yourself if it wasn't the fact that you refused to do things their way that you were fired what could it have been? Is it possible it could have been your attitude? Was there ANY other way to handle the situation besides TELLING or REFUSING - both of which don't invite trust but do build walls that prevent good communication.

I highly recommend two books to everyone - "Crucial Conversations" and "Crucial Confrontations" both by Kerry Patterson. Excellent books on communication.

Best of luck to you.

Hello, my name is Katherine. I have been an LPN for 10 years. I am an experienced clinition and have won awards for my excellence in clinical practice. I worked in an office for 10 years which gave me a vast amount of experience, from family practice,internal medicine,pre-op teaching,pediatric nursing to urgent care. I take pride in my skills and am dedicated to doing it right for the benefit of my patient. I loved my job but felt it was time for a change so I took a new job in a pediatric office, this office served patients from birth to 18 years old. When I discovered the nurses in this office were giving IM injections with a 5/8" needle I requested that they order some 1" needles, which they did. When the nurse who was orienting me told me that she "tapes syringes together" to give immunizations I almost fell over! I told her that was not clinically appropriate and I would not be doing that. I worked there for two weeks and was brought into the office managers office after work one evening and told that it wasn't working out and they would have to let me go. When I asked why she told me it was because I was too set in my ways and obviously was not willing to do things their way. As difficult as this has been for me, I feel proud that I stood my ground and refused to do it wrong to just keep my job. From what I understand the department of health got word of this and has since gone in to correct the situation. Unfortunately it was at the expence of my job but at least I know the children are being properly immunized because of my sacrifice. Now I'm off to the trenches again to find a job that appreciates a skilled and dedicated nurse!

It sounds as if you are lucky to be out of there! I would make lots of noise until they coprrect the sitaution and be truthful (at your next inteview) about why you were let go.

They were taping syringes together ? You mean so that they could give two shots at once?? That's really bad!

Good God! :eek: Who taught her to do that??

Get yourself a lawyer, hun. Standards and Practice are clearly on your side...and not hers! :angryfire

I believe in her post she said that they told her "it wasnt working out" or something to that effect. She was a TROUBLE MAKER , in my opinion, and they GOT RID of her. PERIOD. You can bet they have their but covered regarding firing her.Nobody wants a trouble maker around, not even management.:angryfire

(WORKED WITH TOO MANY of these kind of nurses, who, when you get to the heart of it, are just all TROUBLE MAKERS, whose "complaints" about patient care are rediculous and more about personal issues.)

I believe in her post she said that they told her "it wasnt working out" or something to that effect. She was a TROUBLE MAKER , in my opinion, and they GOT RID of her. PERIOD. You can bet they have their but covered regarding firing her.Nobody wants a trouble maker around, not even management.:angryfire

(WORKED WITH TOO MANY of these kind of nurses, who, when you get to the heart of it, are just all TROUBLE MAKERS, whose "complaints" about patient care are rediculous and more about personal issues.)[/quote

I applaud the nurse for refusing to use that improper injection technique but I do agree that maybe her approach was what got her in trouble. Maybe it was an attitude thing. She did sound confrontational.

Specializes in Rodeo Nursing (Neuro).

Yeah--what you said! (Nice post, BETSRN)

I don't see anything ridiculous about objecting to giving two injections into the same site at the same time, and from the OP it sounds like the clinic may have played fast and loose in other regards, as well. I would recommend noting this in future interviews (It wasn't a good fit...some of their practice was questionable, at best, and they didn't seem inclined to correct it...yada, yada) but without too much righteous indignation. Go home and scream to SO or get on allnurses and rant, but to employers be the voice of reason and concern.

I don't think the "trouble maker" charge is justified, though I have seen a few people who do seem to revel in the opportunity to get indignant. OP just didn't read that way, to me.

I believe in her post she said that they told her "it wasnt working out" or something to that effect. She was a TROUBLE MAKER , in my opinion, and they GOT RID of her. PERIOD. You can bet they have their but covered regarding firing her.Nobody wants a trouble maker around, not even management.:angryfire

(WORKED WITH TOO MANY of these kind of nurses, who, when you get to the heart of it, are just all TROUBLE MAKERS, whose "complaints" about patient care are rediculous and more about personal issues.)[/quote

I applaud the nurse for refusing to use that improper injection technique but I do agree that maybe her approach was what got her in trouble. Maybe it was an attitude thing. She did sound confrontational.

I appreciate your input but let me assure you I am not a trouble maker. To avoid making my thread novel length I cut to the chase with quite a bit of the details. One of the things that happened with this nurse is that I asked her where they keep the 1" needles and her reply to me was "we don't use those here" to which I asked her "do you mind telling me why" her reply was "we just don't" I told her I preferr to have them on hand and would she mind ordering them. I am a professional and I tried everything I could to fit in there, both of the nurses there gave me a hard time every chance they could. I bit my lip most of the time and figured I had to earn my wings and took it all in stride and continued to care for pt the way I was tought but never forced my beliefs on either of them. Parents began to question why their children cried less when I gave them immunizations as compared to them. It's my feeling that they were threatened by me and worked together to get me fired.

I appreciate your input but let me assure you I am not a trouble maker. To avoid making my thread novel length I cut to the chase with quite a bit of the details. One of the things that happened with this nurse is that I asked her where they keep the 1" needles and her reply to me was "we don't use those here" to which I asked her "do you mind telling me why" her reply was "we just don't" I told her I preferr to have them on hand and would she mind ordering them. I am a professional and I tried everything I could to fit in there, both of the nurses there gave me a hard time every chance they could. I bit my lip most of the time and figured I had to earn my wings and took it all in stride and continued to care for pt the way I was tought but never forced my beliefs on either of them. Parents began to question why their children cried less when I gave them immunizations as compared to them. It's my feeling that they were threatened by me and worked together to get me fired.

I totally understand what you are saying. There are times when nurses gang up against other nurses. Yes it may be due to feeling threatened. I had an unfair incident happen to me, ended up having to leave, and i know it was not my fault. The nurse had been there longer, had more power and pull w/management. She never even gave me a chance, for some reason i made her furious. She was my preceptor! I never have had that reaction again, nurses like me, complement my skills. Turned out to have a happy ending. I have a great job now and also sorts of exciting career possibilities happening. So i guess when stuff goes wrong it many times can work out for the best. But it is totally unfair to be treated badly for just trying to be professional and do your work the correct way. Again, I understand.

I have actually reported them to to board of health and they have begun an investigation. Her remark to me when I questioned her technique was " I've been doing it for years and have never had a problem." but I can tell you that I had more phone call's and kids come in with abcesses and infections at the injection site in the two weeks I was there then I did in the whole ten years I have been practicing.

I thought when you initially posted you wrote: "from what i understand, they have been reported to the board of health for this" and......now you are outright saying YOU personally did it? you were there not even a few months, right? you got those same kids from the last time the got immunized "comparing" your injection tecnique saying yours "hurt less", to the other nurse who was training you? interesting.....................................:uhoh21:

I thought when you initially posted you wrote: "from what i understand, they have been reported to the board of health for this" and......now you are outright saying YOU personally did it? you were there not even a few months, right? you got those same kids from the last time the got immunized "comparing" your injection tecnique saying yours "hurt less", to the other nurse who was training you? interesting.....................................:uhoh21:

Your right....initially they were reported by someone else but I was called by the board of health and asked to give my side of it. So no....I did not do the the actual reporting. I'm sorry if I missled you, I did not intend to. And to clear it up, I was only there two weeks. Parents can be very verbal about things and I guess some of them noticed. I have been a pediatric nurse for 10 years and the nurse who was orienting me has only been a nurse for 6 months. She didn't have to teach me how to be a nurse, just teach me about the office protocol which in my opinion has nothing to do with clinical practice. Especially when what she was telling me was incorrect.

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