we often see threads with the title "fired for no reason," or "new grad harassed and fired" or something to that effect. and i always feel at least a little sympathy for the individual involved, if only because i can clearly see by reading between the lines of their self-justifying post that there was a reason for their termination, even if they just don't get it. (there are always a few posts every year from a new grad who is convinced that the reason she's not getting along with her co-workers is that she's just so beautiful they're all jealous, that crowds of mean people are following her around, that she's so wonderful she's going to rock the er or icu or nicu or or and no one sees her wonderfulness clearly, or that some mean, tired, old nurse who ought to retire and get out of the way is targeting her for no good reason.)
i worked with a new grad who was recently terminated for, as she puts it, totally bogus reasons. evidently seeing mine as a sympathetic ear, she went on and on and on about how unfair it was that management expected her to get her act together and actually understand what was going on with her patients. "i've got the time management thing down pat," she said. "i don't know what else they want. they're just picking on me for no good reason." i liked sal, i really did. she was interesting and entertaining and really, really nice. she was also smart, hard-working (when she was at work) and well-educated. but she didn't study outside of work, and really didn't understand what was going on with her patients. i participated in several meetings with her in which it was pointed out that it's not enough to do the tasks, you have to understand why you're doing them. it's not enough to draw the labs. you have to understand what the results mean and then address them. for instance, if the inr is 9, it might explain the nosebleed, the cherry red urine and the fact that the hemoglobin is now 6. giving the coumadin at 6pm as scheduled is not a good thing, even if you gave it right on time and were able to explain to the patient that "it's a blood thinner." i could go on and on.
i got a call from sal today, complaining that she knows she's blackballed for no good reason because she just can't get another job. she wanted me to give her a reference. did she just not get it?
all you new grads out there who are convinced that you're being picked on for no reason, that your more experienced colleagues are just out to get you, and that you're being unfairly targeting, harassed, or picked on, hear this: it may be something you're doing (or not doing) and all those "mean people" are trying to explain it to you so you catch on, learn your job and succeed. we all tried over and over with sal, and she still doesn't get it. are you guilty of the same thing? if your preceptor says you lack critical thinking skills, do you take it to heart, think about it and learn from it? or are you convinced that the entire issue is that she's jealous of your extreme good looks? if your charge nurse charges you with a deficit in your time management skills do you spend time figuring out where you could speed things up a bit? or do you dismiss her as a tired old dog who can't learn a new trick and ought to retire anyway? are you taking to heart and benefitting from any negative feedback you're getting, however poorly given it is? or are you obsessing about how "mean" that nurse was to you and totally overlooking the message?
i wish sal would have "gotten it." she would have been delightful to work with if she had. but right now she's focused on badmouthing her preceptors and the charge nurse, and she still doesn't understand what she did wrong. don't make the same mistakes.
I never saw any nurse that was that bad. Some were unable to think outside the box, some were uncaring and selfish, but none were incompetent or deserved to be fired.
I am in agreement with most of the responses here and have learned tons just from this forum. I had a difficult time during one clinical rotation, which was at a very poorly run site. However, I must say that the mistakes I made were my fault solely. It took me a while to fully accept resonsibility for my errors. I think I am now far more open to all feedback, good or bad. I only wish I had learned this sooner.
We need to be more careful, caring, balanced, and diligent in our evaluation processes, so that we can have a true understanding as to what is consistently "weed performance" versus what is not.
We have to be willing to analyze and treat the cause. And that means working to seriously limit all the bias that goes into current "precepting" and evaluation processes in many institutions. Until places seriously start to look at this, I find it difficult to give their "Magnet Status" much credence.
We have to get real as to what is in general a negative and detrimental function of our profession.
Nursing in general tends to be capricious and build up only those that are "likeable" within the group. It doesn't seek to support and mentor those that are dedicated to nursing that may be somewhat different in thinking for the dominant group. Medicine does a much better job at mentoring those in medicine--regardless of differences in thinking.
I understand what it's like being nervous going through orientation. But that does not excuse a nurse from making medication errors. Why didn't she make check the patient's wristband to the MAR before giving meds? I find it inexcusable. I've given meds to the wrong patient once and I was scared silly when I realized what I had done. I was busy and didn't check the MAR to the patient's wristband. I owned up to my mistake, called the doc, and filled out an incident report. But giving meds to the wrong patient three times?? Three times?
These posts all speak clearly so I've nothing to add, but just wanted to say that, like you, I have made a med error, and like you, I called the doc, etc., etc... I was a young nurse and scared out of my mind (too inexperienced to know that the mistake would not, thank God, harm the patient) and mind you, I did not WANT to call the doc myself, but my charge nurse insisted. Best thing she could've done- I think I was sniffling on the phone talking to the doc, and he was kind about it, but boy THAT'S a good way to learn a lesson that sticks!
We have to get real as to what is in general a negative and detrimental function of our profession.
Nursing in general tends to be capricious and build up only those that are "likeable" within the group. It doesn't seek to support and mentor those that are dedicated to nursing that may be somewhat different in thinking for the dominant group. Medicine does a much better job at mentoring those in medicine--regardless of differences in thinking.
You know, I have to honestly say that I've not ever seen this...the only times that we've had someone in our group who we all didn't get along with it was b/c their incompetence was a hazard to all the patients on the floor. Their patients, just b/c they were the most likely to have a poorer outcome by having a total nincompoop take care of them, and our patients, b/c of the time we had to spend away from them fixing problems with their patients. And I have to qualify that and say that even those who were incompetent, if they were willing to expend the energy to try and improve themselves and not spend all their energy in rationalizing why nothing was their fault, we do get along with in general...and are more than willing to try and help along. It does take some people a little longer to warm up to them, which can be a shame, but there's usually enough of us there to say "lighten up and give them a chance, they're trying, for gosh's sake!" that it works out well in the end.
The two we had most recently, one of them I really liked on a personal level but she just couldn't get it together. The other thought that she was God's gift to nursing even though she couldn't adequately assess for cardiac issues despite working on a tele floor for over a year...and yes, management was aware of how bad she was, and put her into a temporary charge position. This person, for just one example, failed to recognize when a patient went into a third degree heart block and then refused to call the doctor for FIVE HOURS while the patient sat with a HR in the 30's...and also failed to assess them any more often than every four hours, her rationale being "he's on the monitor, if he codes I'll see it". Both ended up leaving and the one who was God's gift told our manager that we were "too cliquey" despite the fact that she was the only person, out of over thirty people, who wasn't gelling with our group...obviously there was nothing wrong with her attitude, it was the rest of us who had a problem.
One of my problems is that in general, I try to get along with everyone...even the ones who are incompetent and show no signs of changing, and those who just need a few more months (or even years) of guidance to get up to speed...which can lead to me being in uncomfortable positions sometimes. Have you ever had someone that you get along with really well, but always leaves a disaster for the next shift, ask you flat out how bad they are to follow? That stretches my diplomatic skills to the limit, b/c I won't lie to them. But I figure that if they're asking, they already recognize that there is a problem and are willing to listen to honest advice from someone that they have a rapport with (otherwise they wouldn't be asking) to try and get better.
Sorry so wordy, I'm a little on the tired side right now...it brings out the verbosity :)
Wow, you are very fortunate. Perhaps it is more of a critical care environment thing. Can be very cut throat--very dog-eat-dog--either too your face or beyond your back or both. It's very sad, b/c it is a good area to work and learn it. It's just that some nurses play control games--then others go along with it out of fear. Makes the environment inbalanced and tough to work in.
I have read all the pages in this thread throughout the course of the day today (some I've skimmed, I'll admit...it's a long thread). I think, unless you've seen the type of nurse the OP describes, you can't fathom it. Simple as that. As soon as I read it, I knew EXACTLY what she was talking about. Common sense and book smarts are two totally different things, for one...getting through school and passing your boards will NOT make you a good nurse. That is part of it, IMO. Passing the buck and not owning up to the fact that it's just plain YOUR fault that you're not good enough is another. "They're all just jealous of me because I'm smarter/prettier/younger/thinner" is not why you were let go, sweetheart. Sorry. Wake up and smell it.
I worked with this type of nurse. One that couldn't connect the dots from point A to point B, no matter what. She was going to kill somebody if she stayed in her positon (luckily for us, she didn't, they let her go). She had a post op patient one night, who throughout their frequent VS had an increasing HR and a decreasing BP. Any nurse can watch that trend and know what it means. One of them by itself can be benign. The two together are classic. This nurse was off orientation and working by herself, so no one else was aware of the situation. She didn't pass on the info of the trend in report, either, so when the night nurse went in to do her first assessment, the patient was unresponsive and they couldn't get a BP on her. They called a code and took her back to surgery, where they found a liter of blood in her abdomen. After a LAP CHOLE. She'd had a clip come loose. This wasn't in an ICU, this was a med/surg floor (so, you don't only find this lack of critical thinking a problem in an ICU). She made many mistakes since the time she started, but none apparently were "big" enough to warrant firing her. Guess they had to wait for the "big" one to be able to act. Well, that was it. No matter how many times she was corrected, redirected, however you want to word it, she JUST DIDN'T GET IT. You can't justify or excuse not realizing what was going on with that patient.
I have read all the pages in this thread throughout the course of the day today (some I've skimmed, I'll admit...it's a long thread). I think, unless you've seen the type of nurse the OP describes, you can't fathom it. Simple as that. As soon as I read it, I knew EXACTLY what she was talking about. Common sense and book smarts are two totally different things, for one...getting through school and passing your boards will NOT make you a good nurse. That is part of it, IMO. Passing the buck and not owning up to the fact that it's just plain YOUR fault that you're not good enough is another. "They're all just jealous of me because I'm smarter/prettier/younger/thinner" is not why you were let go, sweetheart. Sorry. Wake up and smell it.
I worked with this type of nurse. One that couldn't connect the dots from point A to point B, no matter what. She was going to kill somebody if she stayed in her positon (luckily for us, she didn't, they let her go). She had a post op patient one night, who throughout their frequent VS had an increasing HR and a decreasing BP. Any nurse can watch that trend and know what it means. One of them by itself can be benign. The two together are classic. This nurse was off orientation and working by herself, so no one else was aware of the situation. She didn't pass on the info of the trend in report, either, so when the night nurse went in to do her first assessment, the patient was unresponsive and they couldn't get a BP on her. They called a code and took her back to surgery, where they found a liter of blood in her abdomen. After a LAP CHOLE. She'd had a clip come loose. This wasn't in an ICU, this was a med/surg floor (so, you don't only find this lack of critical thinking a problem in an ICU). She made many mistakes since the time she started, but none apparently were "big" enough to warrant firing her. Guess they had to wait for the "big" one to be able to act. Well, that was it. No matter how many times she was corrected, redirected, however you want to word it, she JUST DIDN'T GET IT. You can't justify or excuse not realizing what was going on with that patient.
Nah. Not talking about someone that is truly incompetent on a regular basis. Every situation and person needs to be considered on her/his own and its own merit. It's hard to tell what the whole picture is by way of one's person's biased representation. That's why you need to strive for the most consistent, well-documented, and objective measures possible. In my experience, often that is bypassed.
Many a nurse has been let go for reasons that have absolutely nothing to do with incompetence and safety issues.
BTW, the patient could have well been hypotensive and tachycardic b/c he or she was intravascularly dry. Worked a lot of surgery, and have seen it many, many times. Nonetheless, the nurse was negligent for not making other nurses and the physician and surgeon aware, period. You know, I've worked in many critical care areas; but I believe people underestimate how sick the patients are that come to the floor and how closely they need monitoring. I remember working Med-surg and Tele. Those patients could crash quickly, and back in those days, we would have WAY TOO many patients. It was unreal. Frankly I am amazed that many of us worked the area as long as we did. We'd often joke about have little mini-ICUs with all our other needy med-surg patients.
I so hear what you are saying. There are many possible perspectives here. Again, that is precisely why we need to incorporate and maintain the most objective measures when evaluating nurse practice. I am unfortunately no longer surprised at the amount of capriciousness and subjectivity that goes into evaluation processes for both new and experienced nurses. Most of nursing could use a major overhaul in this department.
IMO if you try your best attempting to learn and have a positive attitude it will go a long way. If still problems with a preceptor, ask for a different one if possible, yet if problems with more then one it could be YOUR problem and not anyone elses. With plenty of others waiting for that particular job the manager has to decide how long before this person can be relatively self-sufficient and contribute to the team. If they decide one with more experience/energy/healthier what-ever would help more then you.. that is why people can loose their jobs. Some things we can't help i.e. the health issue..however some we can do a lot about: study, listen, learn.
great article! thanks!
i am forever wondering how people can be so unprofessional at work.
i was raised in the working world by my father. i worked for him from the time i got out of typing class until he sent me to nursing school 15 yrs later. although he was my father, he was very strict and expected HIS work ethic to be OUR work ethic as his employees. the company was small so we were very much like a family but we all knew his expectations. what he taught me was professionalism. i actually worked for and with both of my parents and shared an office with my mother. when we were at work, we worked. family business and family problems were not spoken of. you arrived to work on time. you were to be dressed professionally. every customer was to be treated like they were our only customer. you did not call in. period. i've seen him work from a wheelchair when he broke his leg and then again when he had knee surgery after a skiing accident. and he hasnt mellowed over the years either. almost 2 yrs ago he had an accident at work (he sold his business to his competition and now runs their shop) and his hand was cut off. he was in the hospital for 3 days after they were able to sew it back on and i was arguing with him2 days after that that NO he could NOT go back to work until it was healed.
i realize that we was a hard man to work for with unrelenting standards but there isnt a day that goes by that i am not grateful for the work ethic he gave me.
i am constantly amazed and dumbfounded at people i work with, especially the young people. they have NO work ethic. they have no loyalty to their company or job. well, very few do anyway. anything that happens is never their fault. there is no accountability for themselves. it's always somebody else's fault. and of course they are fired for "no reason".
i am constantly amazed and dumbfounded at people i work with, especially the young people. they have NO work ethic. they have no loyalty to their company or job. well, very few do anyway.
Employees have no loyalty to their company because companies have no loyalty to their employees. When you can be replaced at the drop of a hat for any reason, or no reason, why should you be loyal?
Employees have no loyalty to their company because companies have no loyalty to their employees. When you can be replaced at the drop of a hat for any reason, or no reason, why should you be loyal?
i dont disagree with your statement one bit. i certainly feel no loyalty to the company that owns our building. but i do feel a certain loyalty to my coworkers and to my patients.
but there is a certain professionalism that young people do NOT have these days. they just plain don't care. they don't care if they constantly call in causing their peers to work doubly hard to care for the patients, they don't care about anything but themselves that i can see. for example, what in the world would make a person think it is OK to talk on their cell phone WHILE they are performing care on a patient? it's a common form of amusement to see what these young people are wearing when they come in for an interview even. they don't even have enough respect to dress nicely! they sit and chomp and pop gum during the interview for goodness sakes!
i was raised in the working world by my father. i worked for him from the time i got out of typing class until he sent me to nursing school 15 yrs later. although he was my father, he was very strict and expected HIS work ethic to be OUR work ethic as his employees.
Ya know, I never even thought about this about myself. I also started working under my dad when I was young...about twelve or thirteen, on the weekends and later on at night as well. Wonder if that has something to do with my level of expectations as well?
truern
2,016 Posts
Then you were lucky.