"Fired for NO Reason"

[Ruby Vee]

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.

[RN1982]

I disagree. If the new grad fails despite having a supportive preceptor who reeducates the new grad on their mistakes yet the new grad continues to make the same mistakes over and over or yet makes critical mistakes then it's the new grad's fault

[Ruby Vee, BSN]

when i was a new grad in a prestigious hospital, i had a terrible preceptor. everytime when i asked him a question, he'll say: "i don't know, you tell me !" it was indeed very intimidating. when i answered the question incorrectly, he reported to the manager which made me even more nervous. i was extremely depressed at that point, thinking that i must have some problem with my critical thinking skills or maybe i have some kinds of learning disabilities. i had very low self-esteem and i even questioned myself about my ability to work as a nurse. after working there for few weeks, i quitted because of the tremendous stress that i was having.

then i started working in the step down icu in another hospital. in contrary to my previous experience, my preceptor was extremely supportive ! instead of questioning me about the labs, she showed me how to used my critical thinking skills and what to look for before i administered the medications. since then, i've learned a lot and i also received many positive feedbacks from my coworkers and patients.

the point that i'm trying to make is that being a new grad is indeed very overwhelming. what we learned from nursing school is nothing like the 'real nursing'. i seriously believe that everyone has different learning styles and everyone deserves a chance to learn and improve. before a new grad student administered coumaudin, we can give the student a hint of what lab that we should be looking for. it takes time to practice one's critical thinking skills.

i don't think it's acceptable to underestimate anyone's ability and sometimes we just need to use some creativity skills and teach the new grads using different methods. i believe that both the preceptor and new grad has the same responsibility. if the new grad fails, it also means that the preceptor has failed to do his/her job properly.

how many "second chances" should one person get? if they aren't catching on after six months, is it time to let them go? if they've had multiple second chances with multiple preceptors, perhaps we can assume that the new grad is at least partially to blame. if multiple preceptors with multiple teaching styles haven't helped, i'm thinking it's the new grad and not the preceptors, as was the case for sal.

[Ms. Nurse Assistant, LPN]

I worked in two LTC facilities, and saw with my own eyes (I experienced it myself) the workplace bullying that goes on amongst female employees. One LTC facility hired a older CNA(early 50s), and the RN/LPNs all worked together to try to get her fired because they thought she was too old to do the job.

I was bullied as well, and a few other employees saw it too, and told me. It happened again at a homecare agency, the girl did not like me for whatever reason, and she would call the nurse and make up bogus lies about me not doing my job, even though it was impossible for her to know what I was or wasn't doing because she wasn't there with me. Eventually, the RN of the company got tired of the lady complaining about me and had me pulled from that case. I eventually left that agency and worked at another one.

So I know how competitive, envious, insecure and jealous women can be when they feel threatened by another competent female worker. It really does happen

[Vito Andolini]

Great article. One thing, though - if, for example, the Instrutor says "You lack critical thinking skills", that is not enough. She needds to define "critical thinking skills" and tell how to get them and why they are needed. It's easy to critique and criticize but so many are not good at helpng a student (or employee) take the next step.

And, of course, some students or workers won't do their share, either.

[talaxandra]

Well, I know Ruby is a h*ll of a preceptor, because she keeps returning here again and again, patiently explaining what the intent of the original post was despite the fact that this sucker is 40 pages long!! :wink2:

:yeahthat:

I appreciate that some members here have had back experience with poor preceptorship, or have been labelled as being inadequate or sub-par and feel (rightly or wrongly) that this was inaccurate and unfair. I agree that bullying and horizontal violence are real and significant issues in all work places, including nursing.

However, there are individuals who are incompetent, resistant to guidance, and unable or unwilling to recognise their inadequacies. There's an amazing paper about this phenomenon, if anyone's interested. I found after reading it that I was a little less frustrated when dealing with these staff members, both with them and with my inability to effect change, because:

people who are unskilled in these domains suffer a dual burden: Not only do these people reach erroneous conclusions and make unfortunate choices, but their incompetence robs them of the metacognitive ability to realize it.

Key findings included that this group of people are less able than most to recognise competence in others (and therefore effectively compare their level of proficiency). It's a fascinating article, with a very amusing concluding paragraph.

[PeachPie]

@ talaxandra: Wow, great article. Man, I see that as the whole self esteem movement showing its ugly consequences. Those kind of people annoy me to no end, or scare me to no end in the clinical settings. It's so annoying that these people's knowledge is inversely proportional to what they think they know. Delusions of grandeur are too grandiose for these people. They have delusions of adequacy. I had a hard teen life, but in the end I'm glad that I endured it at that age and not at an age where I had so much more at stake.

[Ruby Vee, BSN]

:yeahthat:

however, there are individuals who are incompetent, resistant to guidance, and unable or unwilling to recognise their inadequacies. there's an amazing paper about this phenomenon, if anyone's interested. i found after reading it that i was a little less frustrated when dealing with these staff members, both with them and with my inability to effect change, because: key findings included that this group of people are less able than most to recognise competence in others (and therefore effectively compare their level of proficiency). it's a fascinating article, with a very amusing concluding paragraph.

the article was wonderful and explained many things for me.

how, for example, does the laziest nurse on the unit consistently get chosen "employee of the month?"

because she's social and people, failing to recognize competence because they themselves lack it, vote instead for the person they like the most.

why is it the most incompetent cardiologist always has the biggest ego? the study answers that question perfectly. i could go on, but i'm just competent enough to realize i ought to be caring for my patient.

[Guest343211]

how many "second chances" should one person get? if they aren't catching on after six months, is it time to let them go? if they've had multiple second chances with multiple preceptors, perhaps we can assume that the new grad is at least partially to blame. if multiple preceptors with multiple teaching styles haven't helped, i'm thinking it's the new grad and not the preceptors, as was the case for sal.

wow and yes this underscores my point from either side then! why? because the basis for decisions needs to be as truly measureable and objective as possible. . .end of story.

truly objective measures and consistent objective and non-capricious standards--well applying this is the safest bet either way. for if the preceptee is truly incapable or resistant to learning and adjusting to the standards of practice--and that can be objectively mapped out, consistently over time, then letting the person go is more than justified and there is a sense of "balance in the universe" so to speak, in that in the unit or area, there is a general understanding that consistent, non-capricious, objective standards are established and maintained regardless for everyone. this builds teamwork and sense of ownership, community, and cohesion within the group. lack of consistently applied objective standards and measures does the exact opposite. it undermines teamwork, unity, and a healthy work environment. but there is ownership and a sense of peace in knowing that the standards are applied consistently and objectively for everyone across the board, period. the issue of "do we like him or her?" is not the issue, and indeed it really shouldn't be--even in this culture of having everyone "fit" a particular mold in order to continue working in a particular unit. the idea of "fit" has been taken too far and destroys a real sense of unity in diversity and freedom within a group.

again i say over and over. the issue is not whether or not someone says so and so is a clinical buffoon!

the issue for nursing is a commitment to objective standards that are developed, maintained, and consistently applied across the board--period. i think this should be demonstrated in order to meet and maintain magnet status or even other types of accreditation.

i submit again that this is one of the huge differences between medicine and nursing. medicine expects objective analysis and dedicated support of the new docs--knowing they have soooo much to learn.

nursing, professionally speaking, imho hasn't learned this across the board. i have happily seen it applied in some places that i've been privileged to wrok, but overall, no--not across the board.

what we see across the board is capriciousness in evaluation and "mentoring" and "precepting."

until nursing across the board accepts and embraces this objective measures professional model, these games will continue.

some people that are not indeed meeting the standards by objective analysis will stay because they are more liked of "fit" for trivial reasons, whilst other nurses that have amazing potential will be harshly eliminated for capricious reasons.

if the unit and the system in place is truly operating in good faith and professional standards of consistently applied objective measure on a regular basis are in place, those that are cut out from the particular unit will be justly eliminated from positions--at least until they get perhaps a more generalized understanding of nursing practice--and those that are basically very competent but are nervous or simply in learning mode will get what they must, and it will be objectively evaluated as such--and the silly capricious analyses will go the way of the pipes--where such things belong.

also, one has to accept this professional understanding. those precepting really and truly have to want to see the preceptee succeed--and they have to be open to seeing all perspectives and to consistently employee objective measures of analysis and feedback--and the managers, administration, and educational people have to help ensure that that is indeed in place.

the problem is that many in units and even from an administrative standpoint are smart enough to know that employing consistent, objective standards and measures of analysis are the right way to go, but doing so will take away their ability to in fact be capricious if they or others want. and well, with at-will -employment in place, capriciousness is pretty much ok. i am wondering when some folks with dedicated pro bono lawyers or perhaps the funds will hold these places accountable for lack of functioning not only in good faith, but by way of the highest professional standards and ethics.

capricious decisions should not be to prevalent within nursing. we avoid this by establishing and maintaining objective standards and consistently applying them across the board, period. and the capricous mentalities especially should not be in the professional mode of practice for nursing.

thanks

[IHeartPeds87]

Okay, granted I haven't read this entire tread. Going off the original OP's post, however, I have a few comments:

I agree that new grads don't always "know it all" but do we have to fire everyone who is having difficulty adjusting to a new job? Especially with nursing there is a steep learning curve.....mentoring might be a better answer than giving them the boot!!

[highlandlass1592, BSN, RN]

There's a difference between those who are "having difficulty adjusting to a new job" and those who aren't willing to honestly reflect upon their learning experiences, who blame everyone else but themselves for their mistakes. Those who aren't willing to learn, assume the world is out to get them. THESE are the people Ruby are referring to. Some people can be mentored to death and they still aren't going to cut it. It's about accepting personal responsibility for your learning and nursing career.

[sunnycalifRN]

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.

ruby,

thanks for your original post and for sticking with this thread. to your original point, i, too, have seen the "just don't get it" type of new grads and understand the anguish that you're describing. i think that most of us want to see our new grad colleagues succeed and will help them as much as possible. in our icu, those that aren't cutting it, are allowed to transfer to med-surg.

[sunnycalifRN]

i submit again that this is one of the huge differences between medicine and nursing. medicine expects objective analysis and dedicated support of the new docs--knowing they have soooo much to learn.

nursing, professionally speaking, imho hasn't learned this across the board. i have happily seen it applied in some places that i've been privileged to wrok, but overall, no--not across the board.

you're making good points. i'm curious, though, how do you see medicine doing this objective analysis of performance? the board exams? how docs respond to didactic teaching rounds? how docs perform under stress? how docs solve complex clinical problems?

with the exception of written exams, the evaluation of performance involves peers, and that means that subjectivity may rear its ugly head.

i know that nursing has its nclex exam, various certification exams, and individual nursing units may employ their own tests. what objective analytical tool are you suggesting?