Apedro

Ruby Vee, I was concerned because I am a new nurse, period. I felt really bad and was scared. I did nothing criminal and I didn't put my patients in danger. One of the reasons given for my dismissal was that I take too long to document - my shift was 7p - 7a. I usually left 1-2 hrs after. The patient-staff ratio was 7:1 and we did paper documentation. I wasn't always the last nurse to go home. Now that I've had time to process, I see my faults but I don't feel like I should have lost my job. I was fired by the new CNO; she was there for one week when she let me know I was not doing well. Two weeks later she fired me. She said it was based on performance. The old CNO who hired me has agreed to be my point of contact and has offered to help me any way she can. I hope those reading this post don't share Ruby Vee's opinion...I'm biased but I don't think everyone fired, is fired for a good reason.

Thanks Esme12...I really needed those hugs

Carrie RN, I did not check with my unemployment office, I just assumed since I was fired, I don't qualify. I don't believe I violated the nurse practice act. I was told I was being fired based on my performance. I asked HR how this would affect my license; she said it would not affect my license. I was given an HR hotline number to call but I don't know if I should call it; seems like every time I say something the situation gets worse.

I graduated in May, started at an LTAC on August 25th and was fired yesterday November 14th. My license is intact but I can't get unemployment since I was fired...I need another job quick. This was my first nursing job however and I don't know what to do now. I know I have to list this job in my employment history but I think it will make getting another job impossible. Are my fears real...if I put down my CNO's name and phone number will she bad mouth me and keep me from getting another job? Am I allowed to call the CNO? I was escorted off the floor by HR..am I forbidden from stepping foot on the floor again? Not that I want to go back. When I was hired, I gave references and provided reference letters with names and contact information, but the DON did not call any of my references...I know because she told me she wasn't going to but that she had to document that she had, she filled that form out in front of me reading as she wrote "supervisor's name" called on "date" at "time". Any hiring managers out there, would you please answer the question...if you received my resume, how would you proceed or am I automatically out of the running? Also I read a couple of posts form other nurses in similar situations and they were adviced to seek employment in LTC and at flu shot clinics...any other suggestions? Is a dialysis clinic an option? Thanks in advance...to those nurses out there that eat their young...please don't bite at me..there is very little left.

I am kind of disappointed so far with my LTAC. I've been working for coming on 3 months next week and I had a very informal orientation with absolutely no guidelines for the orientation. It was basically up to the nurse (who was told when he/she arrived on shift) who was orienting me to decide what she/he would teach me. Only now that a nurse who I don't get along with complained about me not documenting a med order correctly (mind you she didn't bring the error to my attention or correct it herself) that I was given an orientation checklist (it took them four days to find this checklist). I went searching for protocols myself and came across a huge "nursing orientation" binder...I showed it to four nurses (two of them charge nurses) and all said they didn't know that binder existed. I've been very bitter lately. Since I started I noticed that most nurses I work with make mistakes on a daily bases and everyone takes shortcuts where they see fit. It bothered me that I was not oriented the way I thought was correct when I began, but I just thought - I will learn as I go, like everyone else has; but since I've been written up I am really angry. Even my writeup was BS...it was completely vague and when I asked for it to be specific as to my mistake, the CNO said that she had written it up in a hurry and that it was based on what I had said to her during our sit down...the sit down she called me in for to discuss my "mistake". I was a Staff Sergeant in the Army (as a Network Manager) and I am a good leader/supervisor so I know what they did with me is complete BS. Sorry, I don't want to scare new nurses but I do want to warn you that as a new nurse you have to be above reproach because you are vulnerable (you have no friends or seniority to protect you).

Altra, yes the patient was a an insulin gtt when she was first diagnosed at the hospital, by the time she was admitted to the specialty hospital where I work she was no longer on the gtt. Thank you for the topic suggestions, I will look them up. :) thank you GoBlueGirl15 :)

As always, thank you HouTx, and yes VANurse we do not have a RR team.

I've been working about 1 month and had my experienced my first code I work nights at a specialty hospital. The patient had COPD and new onset Type 2 DM. As soon as I got on shift I was told by the RT that she was desating into the 70s and that the doctor who was still present had ordered solu medrol. I gave the med and the RT had the patient on venti 40%. Throughout the night she would desat, the RT would give treatments (3 total - I'm ify about the 3rd - I checked on the patient at midnight and she was saturating at 85, I told the RT - RT said she would put her on the venti at 40, if she got up to 89 she would put her on 3L (which is what the patient was currently on) and if she didn't then she would put her on BiPap). The patient coded at 0018 - ended up in the ICU...she survived. She was found in the room with her venti mask to the side of her face and the O2 pulled from the wall. After the code, the MD was angry (of course) and wanted to know why the ABGs weren't done. My questions are: Was there something else that should have been done? Is collecting ABGs something that is protocol when any patient desats and what do we do when we get the results? I know COPDers saturate low, but how low is normal (the highest reading I got was 90%)? I don't think she should have been on 3L (I think I remember in school, they said no more than 2L) because too much O2 shuts down the respiratory response in COPDers. The MD also said he told RT to put the patient on BiPap; should the patient have been on BiPap from the start? Her sugars were also high (533 at 2000 - I gave insulin, and 437 at the time of the code - taken by the CNA right before she yelled for help, when the patient was diagnosed her sugar was over 900). Could the high sugars have something to do with the code? Is there a difference in protocol for COPDers and non-COPDers? Thank you for your responses in advance. Thank God she survived but I was scared. I want to know if there is anything I should do different in the future to prevent a code.

Thanks stitcher98, I will :)

thanks dat1nurse4u...love your pic, I used it to create a thankyou card for my preceptor :)

One more..what does "R SC Perm" mean? I think it's right subclavian but does "Perm" mean permanent and if so what does that mean? Thanks :)

Hi all :) I need some help deciphering the lingo. Referring to IV lines (types and locations), what does "R hand HL", is this a regular IV like the one placed in the ER? Does "PAC not accessed" mean peripheral access catheter not accessed or in other words what ever kind of line they have it's not working? Pretty sure "R ac" is right antecubital, correct? What does "L f/a H/L" mean? I think it's left forearm but I don't know what "H/L" means. Thank you and if you have any other acronyms you want to share I would be grateful. :)

Thanks meanmaryjean, :) You're right I don't want to be at odds with my employer. I suppose I should let them train me, and if at the end of the training I feel I need more time I should "request" it then. :)

Hi all, I've finally got a start date (Thursday) for my first job as an RN at a LTC facility. I've been told I will eventually be the only RN in the building on the night/weekend shift. I am under the impression that my training/supervisory time will be less than 1 month. I was very excited to get a job offer, it's the only I've gotten so far, but I think I remember HR saying my training would only be "a couple of days". I hope that I was so excited that I heard wrong or that HR was talking about a different position (staff nurse/LVN vs. nurse manager/RN). Any way HouTx posted this link http://www.bon.texas.gov/practice/grads.html It states guidance for employers of newly licensed LVNs/RNs. Specifically, "Once licensed, direct supervision should be continued for a period of six months, or a lesser time period if agreed upon by the newly licensed nurse and the supervising nurse. Competence to perform independently should be mutually determined by the new graduate and the supervising nurse and should be demonstrated and supported by documentation." Based on this, how much time is too little time? What if they tell me I will get 1 month of supervision? May I demand more time or do I just suck it up? Is 1 month, 2 months, or 3 months enough training/supervision for a new grad RN in LTC? Also, I think the demonstration and documentation of competence is more important. Anyone working in LTC know how this is done? The only job experience I have is military and I'm used to monthly performance counselings? What kind of "counseling" can I expect in LTC?

Thank you all, especially tokebi. I have thought about it and I think I'm ready if I get a second chance. :)