TomCCRN1991

Wilbur, I am going through the same thing you are now. They were able to do a constructive discharge with one of my co-workers and it worked because she quit, but it nearly destroyed her. When they tried it with me I fought them so they fabricated some excuses to have me fired. My attorney served them with our demands last week concerning a lawsuit for unlawful discharge. I am suing them based on age and gender discrimination. (I'm a 45 y/o male.) If you are over 40 y/o you are in a protected category and as a male in a female dominated profession, you are also in a protected category. I was replaced by two 26 year old female nurses with less experience than me combined. The excuses they used are also patently false. Also we are showing that by refusing my requests for transfer and to resign in lieu of discharge, they showed malice and vindictiveness. The excuses they used also indicated I was singled out for differential treatment. The brand new manager who fired me was much younger than me also. To make a long story short, I think I have a pretty good case, but we will probably reach a settlement for the sake of expediancy and cost. Were you treated differently with regard to younger, female co-workers? I dont know what the details of your situation are, but I wanted to let you know that there may be some hope. If it has hurt you as much as you say, you really should see an attorney. Unfortunately, being A-holes is not illegal and they dont need reasons to let you go. However, making your work environment so hostile that you have no choice but to quit, I believe, is illegal. I would be happy to answer any questions you may have about my situation. I'll let you know how my case works out.

BTW, I think Texas Rocks!!!

You could do a lot worse. That's better than I make after 18 years in ICU in Wisconsin. You have to compare it to the cost of living though. Wisconsin's ecomnomy sucks, with high cost of living and low wages.

Remember, sexy is an attitude, and not a look. I think scrubs are sexy anyway! I do think you should go with the sexy underwear idea though.

Screw 'em! Thats why they make the big bucks. If they didn't want to get woken up at night they should not have gone to medical school. You just do your job, and let them yell if it makes them feel better.

Thank all of you for your input. I am working very hard to find another job using some inside connections I've acqired over the years and trying to move on as quickly as I can. I'm waiting to hear from lawyers about my case, and if I can have a good case , that would just be a bonus. I'm actually not cheaper, if you are talking salary, but with benefits and pension, I could be. The worst thing she did though was weaken a unit as other experienced nurses will be quitting, leaving the unit with few experienced nurses. The new manager, hersef, doesn't know any of the computer charting, the Docs, protocols, etc. In wisconsin, the law says that you dont have to prove that age was the sole factor in a termination, just a factor. When you are over 40 though, and have child support to pay, you worry about it alot.

Let me start with some facts. I am 45 years old and have been an RN for over 18 years. The last 9 years I have worked in critical care at one particular hospital. (2000-2009) I received my CCRN certification in 2006. I have had an excellent record for the 1st 8.5 years, only disciplined once in 2001 for excessive abscences. We are allowed 3, and I was sick 4 times that year. In September of 2008, we hired a new Manager for the ICU. Within one month, I was called into her office and disciplined for "not washing my hands enough." I disagreed with her assessment as it was only subjective and filled with conjecture as there was no documentation, but I signed the paper any way, thinking that woul be the end of it. But I was wrong. On Feb. 19th, 2009, I was called in to the office again and summarily fired for very weak reasons as I will enumerate. The first reason for my termination was the fact that while serving on the infection control team, I "failed to turn in enough handwashing audits". Handwashing audits consisted of spying on fellow employees and watching to see if they washed their hands before entering and exiting patient's rooms. This was not part of my regular duties as I had 2-3 patients to care for and did not always have time to sit and watch people. Besides, in the ICU, if you are thinking about handwashing audits you're not thinking about your patients as you should be. The number of audits they expected was merely arbitrary as no set amount was given to turn in each month. I missed October's, but turned in my audits for November, December, and January, plus I attended every meeting of the team. Yet, on my termination sheet it was listed that I was not "an active member of the team". During the time period of September through the day I was let go, they continued to have me precept a total of 3 new hires to the unit. In January, while precepting , I made some unprofessional remarks at the desk after a family told our manager that they didn't want me caring for their father any more as they alledged that I was unresponsive to his needs. I admitted this as I was upset because I had busted my butt for this patient all day. The reason the were upset was that he put his call light on at 1510 (Shift report is 1500-1530) and told me his colostomy bag was full. I took extra care to empty the bag and to retrieve a syringe so I could irrigate the bag so it would be extra clean. It took to 1530 to complete and I left to give report. As I was walking out of the room, the patient said that he had some mucus drainage from his rectum and needed to be changed. As he was a large man I needed help anyway, so I asked the 2nd shift aide to get help and see if they cant get him cleaned up as soon as possible, because I was already late for report and didn't want them to start out the shift already behind. I assumed that he was cleaned up and didn't hear about anything until the next day. The next day I was precepting another male nurse and was told of the family wishes at 1430 (my orientee was caring for him)and was somewhat upset and made some remarks which I regret in front of my colleagues, but no one else. The third reason I was terminated was that I "allowed a unit of blood to expire and blame it on someone else." While it is true that the blood was allowed to expire, it was not my doing as the surgeon for my orientee's patient came in at 1510 and wrote an order to transfuse one unit of blood "today". It was not an emergency as his crit was just starting to drift down. My orientee did not tell me about the order and ordered the blood from the blood bank without my knowledge and without setting up for the blood or waiting so we could go over the hospital blood tranfusion policy before giving it. It was a busy day and in addition to precepting him, I also had my own patient to care for. At 1535, he set a unit of blood in front of me as I was charting on my patient and said, "here you go." I had no idea who this was for and after he explained it to me I told him he should have waited for me and asked him to check with the PM nurse who had already assumed the patient's care, to ask about giving the blood. The PM nurse threw a fit and started arguing and by the time things were figured out, the blood had sat out too long. A mistake, yes, but not one belonging to just one person and certainly not a reason to terminate a longstanding employee. Given the fact that I had a great record up until the new manager came in and I was let go for such petty reasons in such a hurried manner suggests that she had intentions of getting rid of me and was looking for any justification. After I was let go, I realized I had been training my replacement as there was no reason to hire a new day shift nurse if I was still going to be there. Plus the fact that all 3 of the new nurses hired to replace me were in their mid 20's with less experience combined than I had. I would be interested in what other people think. Please feel free to ask questions.

Thanks. I agree that a swan would be very helpful. I'm glad you agree with me that an inotrope would be helpful. You are correct though that Primacor would be a better choice. The swan would tell us his SVR and if he needed a balloon pump. I thought that with red frothy sputum he might have all the fluid he could handle, but the swan could prove me wrong. Too bad one wasn't available.

Iwasn't women,but a woman, my manager. My co workers like me very well. We just got a new manager, and the old manager, before leaving, left me a big F-Uon my final eval so bad that I wouldn't get any raise at all. The new manager refused to believe it, since what she has observed of my work and what my coworker have said, has been very good. She asked HR for special permission to reevaluate me in January and base my raise off of that. For that I was very appreciative. I don't know what to make of 8 years of good, not perfect, but good evals, to suddenly getting a very poor eval. The new manager said since she kept my salary so low for these years, I should have a lot of money coming to me. I hope so. I think there was discrimination, but I'm not sure I can prove it. I'll see what happens in January. Thanks for the response.

No, due to family issues (children), I never went back to get my BSN. Someday I will. Yes, that is THE MATC. Although some will use it for Madison area tech college. Can't help you with the UW system since I never went to one, but I hear they are pretty good.

Mike, I graduated from Milwaukee Area Technical College.

I once saw an order that said: O2@4L/Foley cath. I think he meant it to be 2 separate orders.

A big question is how you handle stress or behave in stressful situations.

In sepsis, with a patient on a vent, you should shoot for a CVP of 12-15. This is because the high positive intrathoracic pressure decreases venous return to the heart, thus significantly decreasing preload and cardiac output. A higher CVP offset that with higher right heart pressures. I agree that the renal failure is prerenal. Our sepsis protocol kicks in with a lactate of 2.2, but with severe hypotension and MSOF, who cares if its low. You have to treat the shock first, and assume he's septic and treat with ABT. At our hospital we use Levo as a first line pressor in shock then add Dopamine and Vasopressin. I don't think I've seen any of the intesivists order Neo. I'm not sure why. This patient also needs alot more fluid, like 2000ml over an hour. Thats my opinion, but I realize there is more than one right way to do things too.

Hi! New to the forum. Glad to be here. Went to nusing school after 4 years active duty USMC. Grauated 1991. 18 years as an RN, the last 9 in ICU.