PLEASE HELP! fired/demoted RN still on orientation

Jory, MSN, APRN, CNM · May 22, 2015

For what it's worth, in NY, you can't work as a tech with the RN license as it's considered working "below your scope". Once most places find out you have an RN license, they won't let you tech or sit. Sounds like someone spoke out of turn to you and now the CNO might be trying to fix it.

I wouldn't necessarily agree with that. Many nursing assistants around here are still working as assistants at their current jobs until they find something that they really want as an RN. Some are more picky than others.

There is no facility rule on not allowing an RN to work as a tech. They just don't pay you as an RN and there isn't any law that says they can't hire an RN as a tech. However, if something goes wrong, you'll be held to the same standard as an RN. For example, if the patient has a fall. An RN is going to know how to better prevent a fall than a tech. It's not increased liability...it's increased protection. Some techs have a patient that is in trouble but they don't know enough to report it.

The OP doesn't have anything to worry about anyway. You can be reported to the BON for anything, just like you can be sued for anything. However, a complaint is going to go into the circular file. I think they are just blowing smoke up her rear to get her to take a job she may not really want.

Kooky Korky, BSN, RN · May 22, 2015

Just agonizing and very disheartening. I worked so hard to get through school- to pass my boards- etc. even to get the job at this particular hospital, and I feel like a complete failure. Being fired/unfired/ unsure within the first 3 months of practice. On the positive, I was offered another FT job working with the Developmentally Disabled today (interview was yesterday). I have 2 developmentally disabled children, so maybe this is the right place for me....

I hope you stood up for yourself and explained that Nurse Susie actually was the one who didn't rehook the G tube, etc. Or did you just let yourself be blamed?

Stop crying over how hard you've had it and still have it. Not saying this isn't the case, but letting it scare you and make you angry/bitter/whatever isn't helping at all. I'm sorry for the woes you've had, but we all have plenty of heartaches and obstacles to deal with. The more we look to God, yes I said God, and away from the problems, the better we can receive His wisdom and know what path to take.

Here people have diagnosed you as having enemies at work and, alternatively, to just making new nurse type blunders, like feeding a crabapple doctor too much info. Big Freaking Deal. Prissy prima dona doctors.

Only you can figure out what is true and what to do.

I applaud you for getting back up out of bed and for having the pluck to keep putting one foot in front of the other. Keep on steppin', girl, you will be alright.

Do you think working with DD all shift and then going home to your own DD children will be a good thing?

I wish you clarity of mind, good decision-making, and all the best. Someday you can write your memoirs and include this ridiculous bullying (to report you to the BON).There will likely be many more colorful characters in your work life to come.

Jory, MSN, APRN, CNM · May 22, 2015

I am very surprised the Board of Nursing in your state would give you any reassurances without knowing the particulars of your case. Not to scare you, but the hospital in which you are currently working for could have a list of mistakes they are keeping track of. These mistakes could constitute violations of the nurse practice act in your state. In my opinion, I would lay low and get into better standing with your hospital and then resign in good standing. That way you don't have to worry about the board of nursing, because trust me you don't want to go that route.
I just want to add another quick piece of advice....In some states (Virginia being one) it is a violation of the nurse practice act to leave an employer off of an application. It is also a violation to misrepresent why you were terminated. This violation will institute disciplinary action that may then become part of your permanent record. Not good. An application for a job is a legal document. It is best to write that you were terminated and then write "willing to discuss at interview" for reason. Just some thoughts....

Could you cite that specifically? I pulled it up and there was nothing referencing what you are claiming in Virginia.

What an employer tells you they terminated you for may or may not be the same thing as what is in your HR file. They are not even required to give you a reason. They can simply tell you that today is your last day in at-will states. I know tons of people that leave off employers for good reason. Never once have I never seen anyone be sanctioned by the BON for it.

I think you are confusing it with misrepresentation of licensure. The OP is fully licensed and is still under probation.

SookieBSN · May 22, 2015

So I had to dig a little bit (I couldn't remember exactly where I read it), but if you go the Virginia Board of Nursing website and look up Case Decisions you will find examples of nurses who have been disciplined for failing to disclose that they had been terminated from a former employer on a job application.

These nurses have been disciplined for violating "The Commonwealth of Virginia - Regulations Governing the Practice of Nursing" - specifically regulation 18 VAC 90-20-300(A)(2)(e) which states:

"The board has the authority to deny, revoke or suspend a license or multistate licensure privilege issued, or to otherwise discipline a licensee or holder of a multistate licensure privilege upon proof that the licensee or holder of a multistate licensure privilege has violated any of the provisions of 54.1-3007 of the Code of Virginia. For the purpose of establishing allegations to be included in the notice of hearing, the board has adopted the following definitions: (e) Falsifying or otherwise altering patient, employer, student, or educational program records, including falsely representing facts on a job application or other employment-related documents,"

They are also violating the 54.1-3007 (2), (5), & (8) of the Code of Virginia.

I hope this helps. Obviously this is usually not the primary reason a nurse is disciplined, but it is usually an add on.

TriciaJ, RN · May 22, 2015

If they're paying you the RN wage, take the job as a sitter. You're going to be doing a lot less work and getting paid the same. You can look for another RN job while you're working as a sitter. This way you still have connections and a job.
Being unionized is not an open invitation to being able to get away with underperforming. If you can't handle the job then management has every right to tell you about it, give you a chance to improve and then terminate when there is no sign of improvement.

Not only that, if you're still on probation, you're likely in a work-at-will situation. In most places you are not protected until you complete probation.

TriciaJ, RN · May 22, 2015

Concrete examples include not rehooking pt returned to unit to NG tube. HOWEVER, no one (per protocol) told me he was back. Another nurse accepted him back, but never told me. She apologized later, but the only thing that was communicated was that I didn't rehook him.
Critical thinking includes things like giving Drs nore info than they need, giving IV vasotec w/out tele certified RN there, though nothing was mentioned by the RN trainjng me on it the week before and i did administer properly. Have had several preceptors throughout due to staffing. No write ups were made about these, so while I admit I should have looked it up, not sure if that counts as a med error. Putying a pt w/low BP flat instead of Trendelenberg. Also, not getting admissions done quickly enough. Worrying about the "little things" like orders for SCDs, not delegating enough. That has been the feedback.

This all sounds like typical new grad flotsam and jetsam. Part of the fresh out of school learning curve. I hope you get some action on one of your applications soon.

mimimar · May 23, 2015

Be careful when HR give a running you lucky!!!if I was on your shoes I'll make a report of it and run (resign).

Jory, MSN, APRN, CNM · May 25, 2015

So I had to dig a little bit (I couldn't remember exactly where I read it), but if you go the Virginia Board of Nursing website and look up Case Decisions you will find examples of nurses who have been disciplined for failing to disclose that they had been terminated from a former employer on a job application.
These nurses have been disciplined for violating "The Commonwealth of Virginia - Regulations Governing the Practice of Nursing" - specifically regulation 18 VAC 90-20-300(A)(2)(e) which states:
"The board has the authority to deny, revoke or suspend a license or multistate licensure privilege issued, or to otherwise discipline a licensee or holder of a multistate licensure privilege upon proof that the licensee or holder of a multistate licensure privilege has violated any of the provisions of 54.1-3007 of the Code of Virginia. For the purpose of establishing allegations to be included in the notice of hearing, the board has adopted the following definitions: (e) Falsifying or otherwise altering patient, employer, student, or educational program records, including falsely representing facts on a job application or other employment-related documents,"
They are also violating the 54.1-3007 (2), (5), & (8) of the Code of Virginia.
I hope this helps. Obviously this is usually not the primary reason a nurse is disciplined, but it is usually an add on.

I see what it says but I think a good lawyer could argue that differently and I'll give you an example.

If I was employed with General Hospital for two months and I said that I voluntarily left, that is falsifying information. If I left General Hospital off a job application, I don't consider that falsifying or altering information. Some my call it lying by omission, but here is the problem:

I don't think I have to play fair when an employer isn't playing fair, as in the case with the OP.

I would have absolutely no problem leaving this employer off my job application if an employer is actively lying to me about what the Board can and cannot do. That amounts to blackmail.

A nurse can easily make a mistake. Let's say they noticed you made multiple medication errors but you were dealing with a jerk of an employer and instead of drawing it to your attention so you could correct it they just canned you for it without given you a reason...because they don't have to give you a reason.

So, you go fill out a job application and don't list a reason for termination. I would put down "no longer needed". They didn't give you a reason.

So your future employer calls the old one and tells them about the med errors (before somebody posts that "they can't do that"...I am telling you, it's perfectly legal and yes, they can), it would be unfair to report that nurse to the Board for lying on her application.

I have a feeling that it is one of those previsions that is put in there to use only when they need it to. I seriously doubt the Board of nursing would use that against someone because they got fired because their manager didn't like them, terminated them, then the employee didn't want to disclose that to a future job.

I think they are more likely to pull the rabbit out of the hat if you lie about being fired for something serious, such as false charting, failed drug test, etc.

I have no doubt that you saw it listed in the disciplinary action you saw. However, I think the reason you saw it, like you said, they were charged with other things.

jrobbin44 · May 27, 2015

Thank you everyone for the words of encouragement. I have chosen to take a position working as the nurse for 4 day habs locally. Because of my experience with the population, they actually almost matched my current rate of pay (a big deal, because you always take a down grade in pay going from a hospital to anything else). So many people feel this will be a great fit for me, so I feel encouraged. My heart is still broken over the way I was treated at my current hospital, BUT.... the CNO apparently felt that way too and did offer me a position on another floor. I've chosen not to take that because I'm having a hard time getting over the trust issue (being told I'm a "great nurse" to being demoted), but she has offered me all of my sick/vacation time accrued, as well as my insurance through June, as well as July if needed, so clearly, she agreed that this was not the appropriate action. I AM eligible to return in the future since I am leaving as a nurse in good standing, but for now, I'm just trying to do a LOT of self talk to regain some confidence before moving on to the new job. Again, I am so grateful for the support!

jrobbin44 · May 27, 2015

greener pastures- I thought someone mentioned that when I started because I transferred in-house to another position (I AM in NY btw...), but was just so thrown by the whole thing, I didn't know what to do.

greenerpastures · May 27, 2015

Jory - are you researching everyone's answers each time we post? Let me clarify my answer then. I don't know of ANY hospitals in the North of Albany/East of Syracuse (Northern NY) region that will let you work as a tech if you have an RN license. Yes, you are held to that RN standard but it is a tech position, THEREFORE, it creates a liability for both you and the hospital. Insurance companies can reject a claim on your malpractice insurance because you weren't technically working as an RN when something happened, and the hospital insurance surely isn't going to back up an RN who should have known better when working as a tech. Therefore, most hospitals I am familiar with in that area do not hire RNs or even LPNs into a tech position. Each hospital has designated roles. If you hold a license, you have to work within that scope, not below it.

FineAgain · May 27, 2015

Also weird about not being able to give IV vasotec without a "certified RN" present.

OP probably hasn't taken a telemetry class yet. Until a new RN on our floor takes one (or ACLS whichever is required) they can't give IV cardiac meds like lopressor or vasotec; another RN who is certified has to give it. At least in our hospital...