RN75

Agreed, with a capital "B" no doubt. The patient only had a supposedly dose of 75 mg of which the manager claims the doctor never ordered. Would a single, random dose, harm this patient in terms of postop complications - or even death a week later? The recent news is the patient died several days postop. Of course they never told me this when I was terminated. They said he was doing fine, out of the unit and back on the floor about to be discharged. What a bunch of liars. What a night mare this so-called nurse manager is. Really a paid coward willing to stab people in the back to protect her job and these higher ups in my straight forward opinion. Ironically, I don't live far from Atlanta... just a hop and a skip really. However....this latest event has really done me in with nursing in a hospital setting. Im burned out after 12 years and have sworn never to work for a hospital again...though I AM a very good nurse. You work your butt off for what? For all the political crap like this? Hospital Nurses work harder than most people realize. I've had enough. There are not enough rewards to keep me in this setting. Its time for me to move on. BTW....thanks and to everyone who have posted. I really value your thoughts on this. Somehow, it gives me comfort reading all the opinions and knowledge about this sad situation. Never in all my years of nursing have I ever been so badly treated, nor ever conceived someone in administration would stoop so low as this. Better said, never thought it would happen to me. It can happen to anyone.

Initially....worked there 16 months, but then resigned with eligibility for rehire. Worked most of my career at another hospital then resigned and went back to the first one only to be fired after a 2 week orientation. Kinda figured most employers only require a five year work history. Just wanted to hear from others who know for sure and what they've done if ever fired.

Worked at Hospital "X" in 1997 (11 years ago) for 16 months. Resigned then worked for Hospital "Y" for seven years then resigned. Worked agency a few years then went back to first Hospital (Hospital "X") but was fired after 2 week orientation!!! (politics - being fired was political reason I feel). Should I disclose working for Hospital "X" on my resume? The problem is I worked for them over a year back in 1997 and resigned with eligible for rehire. After going back for only 2 weeks, I am fired with a no rehire status. It wasn't fair, but life isn't fair in the sick world of nursing. My question is would you even mention them as an employer on your resume? What would you do? Never been in this predicament. I just don't know what to do. Thanks :uhoh21:

I did hand the manager my letter of resignation. She said she would put it my file but that their decision was to "let me go" with a no rehire status. The first time we discussed this (before they decided) her demeanor was not as harsh informing me that if they did decide to terminate me it wouldn't affect my job reference. But when I went in to meet with her and another ICU Nurse Director, I think it was more of a power trip they were on. I told them both it was punitive and harsh to fire me for something like this. Usually an incident report is filed and likely some disciplinary action; but not getting fired over ONE isolated med error! I have never been fired in my life over 12 years in my nursing career so sitting there in that office resisting shame and intimidation was very difficult. I listened carefully to their rationale and finally spoke up telling her "I am good nurse. Just because I made a mistake doesn't make me a bad nurse. The PCM angrily replied, "Well WE think you are!" To that I looked her straight in the eye and calmly answered, "That's your opinion... but it's not mine, all the patients I've cared for over 12 years, or all the previous managers I worked with." I think me standing up for myself made her even more angry because that's when she said, "Well, it doesn't matter because you will never work for this facility or any affiliated facility in this area again because we are not recommending you for rehire!" I just let it go and told her that there are many other nurses working there that should be sitting in this chair than me, namely one who was verbally and physically abusing an Alzheimer's patient by screaming at him and manhandling him because he didn't understand what was going on and had soiled the bed and was being noncompliant. And I asked her what is she going to do about the Pharmacist who made the mistake of putting the Plavix on the Mar, or the nurses who preopp'd this patient before surgery, or the nurse that gave him a dose the day before me? She said that was none of my business. The point to me is I gave them my letter of resignation and had it ready to give to them before this meeting. Even if they would have decided not to terminate me, I would have resigned. After a week of orienting there, I got bad vibes that one wrong move and I will be out of there. I have never felt this way about a place. When I left, I went straight to the hospital I use to work and ran into an old nurse friend who had no idea I had just went through this being told I wasn't a good nurse. She asked how I was and where I was working but I didn't tell her what had just happened 30 minutes ago. She said I should come back to work there, because I was such a good nurse and was good at what I did. I am back working where I belong with nurses and people in charge who treat people the way they want to be treated. BTW: Plavix acts in that it inhibits platelets causing them not to work like they are supposed to. It doesn't decrease the number, it only makes them act stupid over the life of the platelet which is approximately 7-10 days. This is why we should stop Plavix 5-7 days before a scheduled surgical procedure. According to the nurse manager, they claimed I was the only one who gave Plavix 75 mg the day before surgery because the pharmacist made the mistake. I clearly saw it given on the MAR the day before and the computerized med cart! They are lying. Thanks everyone for your help. Its wonderful knowing we can come here and get the help and knowledge of our peers when we need it.

-A patient comes in to ER for passing out -has a heart cath - admitted to cardiac floor and scheduled for CABG all within 3 days. MAR says give Plavix 75 mg. Patient says "I never took that before." I say, "you don't have to, let me find out more about it." I take unopened pill with me to verify. I go to get the chart to find order. (earlier I reviewed preop order and notice Plavix is not checked to stop by CV Surgeon). Can't find the chart now, so look in the computer med cart to see when last dose was given. Last dose verified in computer med cart documented as taken out and given to patient the day before. I go back to patients room and tell him he took Plavix yesterday and instruct medication rationale, also informing he does NOT have to take it. He agrees to take it. Problem: Nurse Manager says MD never ordered Plavix! Says I am the first one to give it. No one else did. Says Pharmacist made error. She denies previous dose given though I tell her I saw it pulled from computer med cart with my own eyes. I also see it on the previous MAR. She also says the night nurse failed to reconcile the MAR with the orders the night before and insists I am the only one who gave it. Now, Nurse Manager says I am not a prudent, good nurse because a prudent nurse would have checked the order to see if MD wrote the order. Says because I didn't do that I am being terminated and not eligible for rehire. Says I could have killed this patient by giving him Plavix 75 mg. Question: Don't heart patients scheduled for CABG get Plavix? Would Plavix 75 mg kill or harm this patient? Somehow, it seems reasonable to me based on the fact Plavix is an anti-coagulant, clot buster, which inhibits platelets so they do not form clots, would help this patient. Somehow, I get the feeling the MD DID order this med and forgot to stop it preoperatively. So in order to cover his azz, they claim he never ordered it in the first place! Come on folks, was terminating me for this justified? I am new and orienting in this hospital and the first med error made. I have been a RN 12 years and have NEVER been treated so punitively for one med error! There's gotta be someone here whose a manager, an expert in cardiology, that can help me out here. I told her Im a good nurse and refuse to let her decision make me feel bad. Ironically, the surgeon had to go back in and reopen this patient finding other occlusions that were not picked up earlier. Something sounds fishy to me. Just seems a bit HARSH to fire me over something like this. She says "I dont get it," yeah, she's right! I don't get her way of thinking! Needless to say, I already had my letter of resignation with me and told her, I am a good nurse! That's just your opinion! And the only opinion that matters is mine, Gods who called and gifted me into nursing, my patients over 12 years, and previous managers Ive never had problems with!

Yes, my manager is a RN and she said I could have killed this patient by giving him the Plavix the day before his surgery. He also got Plavix the day before which another nurse gave since it was ordered daily. I took care of the patient during orientation. He was waiting to have surgery the next morning at 0830. I did not preop him because that would have been done by the night nurse around 6 am the next day. I am a staff nurse caring for patients who come in on tele awaiting surgery, heart caths, stents, whatever the case may be. The doctor signed the preop order but failed to check holding the Plavix. Maybe I should have known to call and question giving Plavix since he was going to surgery the next day, at least thats what my manager would say as I did not use good critical thinking in this case. In my mind, I am protecting the patient by giving the Plavix as to prevent him from throwing a clot before surgery. Its my understanding the heart-lung machine is heparized, but I have no knowledge of what goes on during a CABG except they stop the heart and the patient is put on the heart-lung machine. She's pinning the patients negative outcome on me and I don't appreciate it. I may not be a seasoned cardiac nurse, but I am a conscientious one who cares deeply for my patients. I take pride in my work. Now here she comes along and handles this situation like this saying shes going to think it over this weekend whether to fire me or not. I fully expect her to fire me on Monday. I have never been fired in my life, especially for something like this, nor had disciplinary problems whatsoever in 12 years of Med-Surg Nursing. I seriously think this is the straw that broke the camels back for me in nursing. I think the prudent thing for me to do if she decides she wants to keep me employed is to decline that and tell her why, then move on. I can see yet another incident like this happening where the nurse gets blamed for the negative outcome of the patients surgery or hospital stay. If I am responsible then okay....but after studying CABG and Plavix, as well as talking to other peers who would tell me like it is, I think I am being scapegoated for the doctor. I have lost all respect for this hospital who claims all this integrity, blah, blah, blah. The bottom line is they need the surgeon cause he brings in the money so lets protect him at all cost. Me? I'm the new kid on the block having been oriented for 2 weeks; so lets fire this imcompetent RN in order to mitigate possible litigation if something goes wrong even more; which I understand the patient isn't doing well after they went back in discovering even more problems that had nothing to do with bleeding. I've had enough of nursing. I think Im gonna sell Mary Kay. Anyone up for some personal pampering? Seriously, I was really depressed yesterday and didn't sleep very well at all last night because of this. I've got an attitude adjustment cause I know what's really going on here. As long as the cause for this patients problems were not because of me, I feel a lot better. I just don't appreciate my manager doing this to me knowing full well what really happened. If someone comes on here and tells me the Plavix did it, then okay I'm open for correction.

Does this mean you think the Plavix did cause or just contribute to the problem?? Since Plavix has to do with anti-platelet coagulation, shouldn't the doctor check the platelet count before surgery? If the platelet count was okay, then how could Plavix caused the problem? That's a very good point I will point out when the manager calls me on Monday with her decision to keep me or not. This is good advice, however, after pondering this all day and half the night, I don't think I want to work for this hospital. I think the manager is using me as a scapegoat and I don't want to work for people like that. I am disappointed in her but it hasn't been the first time I've been the sacrificial lamb. They took this patient back to surgery to find out why he was bleeding and in the process found other blocked arteries they did not catch the first time around. How do I know the surgeon didn't tie off a vessel correctly or left a foreign body in his chest? Who knows why the patient was oozing? Maybe it was the heart- lung machine which are heparinized and someone put too much heparin in? I just think its harsh and over-reacting to fire me because I should have known better not to give Plavix. Its like you and others here already said, I'm not the doctor and can't make that call to discontinue a med or not! The patient just had stents put in and I told him he was getting plavix to keep his blood flowing and not throwing a clot. When to stop these meds is not my call yet Nursing Administration says I am to blame and they would fire me today if they had to, but will think about it over the weekend. Whatever her decision, I have made mine. I don't want to work for someone who will fire me like that for this reason. I think she is over-reacting to cover their own butts. That way they can tell the patient and his family they fired an incompetent nurse and hope to avoid potential litigation. Thats just my gut feeling. Thanks for helping me out with this. The ironic thing about this, is the last nurse I worked with told me I was a good nurse and will definitely be an asset at this hospital. She's worked there 17 years.

I am new to cardiac unit and orienting. Had a patient scheduled for CABG the next morning at 0830. Stents were placed a few days earlier and Plavix was ordered by MD. Plavix was a new med for this patient. A dose was given 48 hours prior to CABG by one nurse and I gave a dose at 1000 am the morning BEFORE (the day before) his surgery. The preop order was not checked off to stop Plavix. Today, I was called into my managers office asking me about giving the Plavix because the patient had to be taken back to be reopened due to postoperative bleeding and oozing. He also had other arteries that were blocked which required additional surgery. I've done research online and read differing opinions about giving Plavix before surgery. Some say to stop this med 5 days preop, some say 48 hours preop, due to risk of hemorrhage. Other studies conclude Plavix is not a serious reason for postoperative bleeding as there are multiple reasons a patient could bleed out. I was interviewed by my manager today and am told she is considering firing me because I gave the Plavix and should have known better considering I am a seasoned nurse. To a point I agree with her, but in other ways I do not because its been a few years since Ive worked in a hospital setting and she knew that before hiring me and also because I think its harsh to fire me by pinpointing the reason the patient had postoperative bleeding is because I gave Plavix that should have been held. To say I am completely the reason enough to warrant termination makes me feel like walking on pins and needles with absolutely no wiggle room taking the full brunt of this patients postoperative complication. I am not a heart nurse, though I have floated many times to the cardiac floors and was being oriented. Believe it or not I am a very good nurse and have 12 years Med Surg under my belt, precepted student nurses, trained new employees, etc. I feel like their fall guy to make the patients family happy by telling them they fired me as to put the spotlight on me for this patients complication. If its my fault then I will take responsibility for it. So please - anyone out there experienced in Cardiac Nursing, I would seriously appreciate your honest opinion and input. Do you think this warrants being terminated or is Administration CYA's? I love nursing, but honestly, I am really depressed right now. I have been thinking of leaving this profession because of the demands of nurse/patient ratios, poor organization on floors, yet requiring nurses to be nearly infallible. Im just really discouraged right now.

Just wondering if anyone knows what the salary is for an IV infusion RN is? This job not only includes starting IV's and PICC lines, but differs in that I would also be doing a pharmacy job of mixing medications. It's salaried, off on weekends and on call every other weekend. I would be flown to another state for a two week intense training and be oriented by the current IV infusion RN as well. I was told this job is not easy to come by, and also read the same thing here on allnurses.com. I would be working independently, but under the supervision of infectious disease physicians. I have no clue what the fair salary would be considering I am a 11 year experienced Med-Surg nurse very proficient in IV's and with charge nurse experience. Can anyone give me a ball park idea how much this type of nursing earns so I don't get short changed if offered a position??? The VP of nursing who interviewed me today said to keep in mind it's a salaried position when and if I am offered the job. My final interview may be as early this week or next with the Doctor who has the final say in who gets hired. Help! Anyone know what the going rate is for this job????

I've done just about everything in a hospital setting...med-surg, ortho, neuro, cardio, PCU, oncology, antepartum, postpartum, newborn nursery and even charge nursed on a hectic med-surg unit. I'd like to transition into something new thats not so stressful and hard on the body as I am getting older, so I've considered Palliative Care at the hospital I've worked at for several years since they have an opening. However, since I do not have the CHPN why bother to apply? Though I have 10 years experience I still don't have this required certiification. So can anyone tell me the best way to get into Palliative Care??? I don't have a clue the first thing to do! HELP!!! Thanks! :uhoh21:

I've been reading through these posts and this statement caught my attention. ATLAST someone has pointed this out! The first time I heard this concept, was in my first semester in Nursing School 13 years ago, in "Fundamental's of Nursing." We had the police department speaking in our class. It was a female police officer who told us that most nurses (not all), were physically or sexually abused, (or both), so they grew up with this need to feel we can make a difference. Immediately, I understood the underlying reasons I was becoming a nurse. However, I felt ashamed and almost embarrassed that someone in class might know everything that happened to me growing up! Then, I looked around and wondered how many in this huge class went through similar experiences I did. No one said a word in that classroom. But in my heart, I knew the policewoman was right. The question is: "Why in the world do we go into a profession where we are overworked, underpaid, not appreciated, have no one on our side, and ultimately are expected to act above human standards?" I'll tell you a few possible reasons why. Maybe we are trying to prove something. Maybe we are trying to subconsciously persuade the abuser (in this case, hospital administration replaces the perpetrator in the home) that we are valuable and deserve better. Sounds like an oxymoron; however, we may be setting our life circumstances up to repeat the same cycle as an effort to convince the abuser he/she is wrong to regard us this way, in hopes they will suddenly change their minds and love us as human beings should be loved. Or maybe it's because we simply repeat the cycle of abuse because it's familiar...we're comfortable in it. Maybe because we do not have a healthy self-esteem, therefore we fear authority figures. Therefore, we utilize coping mechanisms such as passive-aggressive behaviors thereby failing to assertively speak out against abusive behaviors. These coping skills perpetuate the sad state of the Nursing Environment. I wonder how the "mean preceptor" would react if the student nurse assertively addressed her. And if this first step didn't change her behavior, then why not report it to the Nurse Manager and so forth? I assure you, I spoke up to my Nurse Manager when she publically said something inappropriate. Earlier, I told her I would work 2 extra evening shifts, but called in. She knew why I didn't come in and called me at home. I told her I didn't appreciate her show at the nurses station and I am considering transferring out of her department. She promptly apologized and asked for another chance. My point is, "We train people how to treat us" once we become adults. There is something very interesting about the question: "Why in the world do we go into a profession where we are overworked, underpaid, not appreciated, have no one on our side, and ultimately are expected to act above human standards?" This reality mimics and recreates very similar experiences and set-ups we experienced as abused children. I see it, and maybe some of you here will too. Nurses are expected to act above human standards just as a child who was used for some sick adults pleasure and rage. It's really no less in Corporate America. I have been out of nursing for a year and a half. And I have practiced in multiple venues of nursing as well, from Med-Surg, Ortho, Uro, Cardio, Oncology, PCU, antepartum, postpartum, newborn nursery, NICU, etc. I was also a Charge Nurse on a busy and stressful Med-Surg Unit. If the general public really knew how the hospital was run in my area (which is a very popular hospital and even has TV commercials) they would be shocked. The single most, and blatantly obvious reason there is a nursing shortage in hospital settings nationwide, is a result of greed. Otherwise known as the "Botton Line." Money, moolah, pay-ola. Administration, pharmaceuticals, physicians, insurance companies, are all the major players who make a huge profit off the sick and dying. Very sad, indeed, is it not? But it's a reality. There are however, some hospitals who begin their mission of healing for the right reasons, but insurance companies and pharmaceutical companies make it almost financially impossible to care for the sick in a respectable and loving way. Either way you slice it.....it all trickles down from the top. The people who make the 6 figure incomes by all the worker bee's. Solution? I have a few. I am a little person, but a very observant, astute, inquisitive, RN with some miles behind me and seen alot. I have seen the wrong people in upper, middle, and lower management and believe me, it really is a "good ole boy" policy between them. The cliche, "Birds of the feather, flock together" is very true. I even witnessed a nurse I knew years before she became a nurse, who was a very sweet person, who when became a Nurse Manager, morphed into a total witch. Talk about WHOOOA!!! Blew my mind to watch her. She was never my manager, but she knew me, and I could feel a sense of hesitation from her in speaking to me in the same way she did others. Anyway, just my two cents, in terms of this particular statement.

Thanks Everyone for the great answers. I thought of these myself, but needed a little reinforcement and confirmation. I've been reading up on this matter on NursingSpectrum.com Excellent website for nurses as well as here. Guess I'm just a bit paranoid and defensive and need to get past this before the interviewing process. BTW, as if all these other problematic events didn't hit me all at once, can you believe my house caught on fire several months ago too! LOL!!! Boy, my insurance company loved me I'm sure, but they did treat me well. I couldn't believe that many things could happen to one person in so short a time, even a house fire, which put us back into the hotels for 5 more months! In a two year span, my kids and I lived in our home for only 3 short months! But the fire turned out to be a blessing in disguise.....everything had to be renovated AGAIN, except this time I got a brand new kitchen, appliances, furniture, clothes, etc. And a word of advice in terms of home insurance: Get the 100% Loss of Use. It pays for everything if your home becomes uninhabitable, food, shelter, utilites, phone, laundry. Thanks for the advice. Love the comaderie here.

I resigned the first time ever suddenly with no notice. Ive been a nurse for nearly 10 years and finally had it with the hospital I worked. An old manager cheated my out of wages, position, not to mention tried to ruin my reputation as a desperate attempt to prevent my promotion. This woman was out to get me no doubt. So I transferred to another department for refuge and healing. Thats when a reported Hurricane 4-5 was predicted to hit my area AGAIN. Ironically, after a year of being out of my house for previous hurricane damage repairs, I was just moving back in that weekend the next hurricane was due to blow us away! I had made plans to sleep at the hospital with my daughter because I was scheduled to work that weekend. However, when I brought our luggage up we were told we had no room as promised, and were to sleep on the floor with a blanket and pillow there. Now come one folks, something is wrong with that picture! I dont mind sleeping on the floor as long as I have proper provisions. Leadership failed to operate with proper safety and health needs of employees by not giving us time to get a sleeping bag or air mattress at least! Well, to make a long story short, I was fed up. Between my ex manager cheating me just a few months before this, and my home being torn up for a year and having to move back the weekend ANOTHER hurricane was gonna hit, my son stranded in another state, breaking up with an ex boyfriend, my ex husband causing me grief signing insurance checks, dealing with crooked, lying, contractors, my dog staying at a kennel with a flimpsy fiberglass roof about to get blown away, and now being told me and my daughter were gonna sleep on the floor after working 12 hours on my feet with no place to shower, while they have TONS of empty beds availabe (we discharged most of the patients because of the hurricane), I HAD ENOUGH. So, I called in an hour before my shift and gave my verbal resignation. The House Supervisor was understanding and told me she didnt blame me telling me ALOT of people quit. However, when I went to collect my Paid Time Off pay, I was told that I lost it because of "Job Abandonment!" According to policy, its considered job abandonment when one fails to show up for work for 2 consecutive shifts. I didnt do that! I called in and resigned. So, I emailed HR and asked them what my "Rehire Status" was and they told me I am elligible for rehire! Now, if they consider me as job abandonment then why am I elligible for rehire? I said all this to ask.... What woud you tell the next potential employer as the reason you left your last position? Plus, I took this entire year off cause candidly I think I had an emotional stroke. I even wondered if I wanted to continue in a Nursing Career. I even wondered why I became a Nurse. As time passed and I sought healing from God and listening to wonderful, encouraging, inspiring and truthful messages at my new Church, I discovered that I am a Nurse by choice, however, God has given me a unique talent and gift to assist people to wholeness both physically and emotionally. They say "What doesn't kill you makes you stronger," and I believe that! I miss nursing so much....thankful I had the finances to stay off a year as many do not have that luxury, even though I am a single mom. I appreciate anyones advice as to the best thing to say during my next interview. I have even entertained the idea of going back to the same hospital I resigned from, to see about working on a different floor since they did say I was elligible for rehire. Also, I really, really, liked this hospital with the exception of two managers there. Somehow, I feel in my heart- the right thing to do - is to go back and make it right because its not like me to just resign without proper notice irregardless of the wrong things some of the managers did to me themselves. I just need someones help! Someone whose resigned without notice, is a PCM, or even someone familiar with HR and how open should we be about questions iike this?