peaceluvandnursing

I have only been in psych nursing for 8 months although I have been a nurse for 15 years and recently completed my MSN-Nurse Practitioner requirements. I was recently terminated for the above reason and also denied unemployment. I was pulled to a residential adolescent unit to work as a Mental Health Tech due to DHS ratio requirements. We have very strict rules regarding patients and contraband. These patients are there because they either attempted suicide or made statements of wanting to harm themselves or others. Their safety is our main concern. A patient I was not familiar with approached me at the staff table and asked me for another paper cup at the evening meal. I asked her where the cup I gave her with her dinner was. She replied that she threw it away. I was suspicious as there was not a trash bag out yet and besides they must ask permission to throw away so we are sure they don't hide anything on their person. I have seen it all and patients often eat things like paper cups, antiseptic wipes, crayons, even pencils. I felt it was my responsibility to be direct with her to be sure she was safe. She started to get defensive. I then noticed that her chest area was all lumpy with hard edges, like she might have hidden things in her bra. I explained to her why I was asking and reminded her of the policy. She continued to be insulted about me asking. I had a pen in my right hand, (I am left handed) and was moving my hands as we talked. I very casually, and without any drama, pointed to the right center of her chest area and asked "What is that??" like I was perplexed, (which I was!). My pen accidently touched her shirt and I heard a "pop", just like Styrofoam. I reported it to the other tech and the nurse assigned to the unit. His comment was "Don't worry about it, she is going home soon anyway". Next day the patient reported it and I was fired, confirmed, they said, on video tape. ( no audio). Reason: She was a male transitioning to female and I violated the therapeutic boundaries of a transgender patient by touching her chest with my pen.with her chest area. The policy they used was "professional standards of conduct" therefore considered misconduct. I have been bullied by this nurse manager since I arrived. I am appealing the unemployment. I cannot find an actual definition of therapeutic boundaries in their manual. What is my defense, do I have a chance of convincing Unemployment this was not misconduct? Professional conduct is defined as "any sexual, emotional, or physical abuse to a patient..."

I was recently offered a job as a Geri-Psych nurse, full time for a wage that I think is below market. But the real stinker is I was offered a dollar less an hour than a friend of mine who will be doing med-surg. I have a BSN and a MSN, she has a ADN. We have both been nurses for 15 years. I thought it was pretty standard that a BSN was paid more than a ADN. Recruier stated that they didn't pay more based on education. I almost dropped the phone. I know they are shooting for Magnet status in the future so..... I need this job but how do I negotiate what I am worth without having the offer pulled? Fair is fair and I have wroked hard for these degrees and my level of knowledge is greater than that of a 2 year degree. And I am not dissing 2 yer degrees as I would not be here with first getting my ADN.

That is NOT true! If you look on the ANCC website and AANP and other places, the litigation rate for NP's has NOT increased and stays around 2%. I did read, even though veryow incidence, that most litigations are about "failure to refer when needed".

Chin up Buttercup! You sound like a very good nurse to me....you just have to keep swimming. I think we can all relate to how difficult bedside nursing is...whether as a new grad or learning a new specialty. Your biggest asset is you are AWARE of your weak areas and want to improve. I think the 16 month accelerated program didn't adequately prepare you for real life at the bedside. NOT your fault. My own NP program, even though a private, expensive school, had "a weekend" of skills practice before sending us out into doctors offices and clinics. OK, student NP, perform this pelvic exam. Uh...say what? So back up and regroup. Look high and low for a place that has a true New Grad internship or residency program. Not just an orientation or on-boarding period. They are paid positions and can last from 1-2 years and are centered around teaching you the skills to succeed, not weeding out "bad nurses" . They are often listed on career boards as HR assigns them a position number just like any other job. I don't know your story is as far as portability, but any medical center associated with a College of Nursing or Medical School is a good place to start. Don't waste your time with a company who helps you locate a program and charges a fee for this service...watch out for these bad boys! Two more words: Critical Thinking. If at the end of the day you can't identify where you used critical thinking that day, it could be hard to be a bedside nurse. Trust me, Nursing 101 I was clueless! But I quickly learned that I use critical thinking every time I come in contact with a patient and with experience this only grows. I guess that is why I stay. Good Luck, You can do this.

Thank you both. No, I specifically asked about reporting at the time. The Head of HR assured me i was not a DHS reportable offense nor a nursing board issue. It was the DON who made the decision to deny the unemployment.