Railroaded at work

[Babzuptown]

I accepted a job on a PCU. The requirements were simply, willing to train Med Surg RN w/expereince. I have my ACLS and passed their telemetry exam, not just a simple version either, with 96.6%. I further had to take a Critical Care class and pass with 81%. Which is did with exactly 81%.

I have a BSN from Oregon Health and Sciences University. I am a caring and thoughtful RN/person.

I struggled at first in this new hospital learning a new charting system (DOS) and free text. I was used to using Horizons Clinical, a click the box type of program used the the Povidence Health systems. I was also used to using a Pyxis and a scanner to administer medications. The new hospital uses the old, pull the med out of the drawer and do your 5 checks of administration and sign off in the book.

So, it was overwhelming for me at 47 to go into a new unit and learn so much of everything. New skills, higher acuity, where is everything, what to chart...med book.

I still look like I'm in my 30s. Its good and bad . It probably helped in getting the job but I think it is a detriment, in a way, on the floor. I have a 47 year old's confidence and give off an aire of self-acceptance. I seems that you have to grovel and eat sh** from some of the nurses in order to fit it. One of my preceptors was arguing that if a QRS comples is >.10, this indicates a conduction block. I tried to tactfully get her to rethink this, "I've always been told it is >.12" or something like that. It was just one thing that got me off on a bad foot with this particular preceptor. I had approached her three times that shift to report my guy had'nt peed since having his foley removed. The first time was just after taking report that he would be coming to our floor. I was told the foley had been removed and I asked "has he peed yet." I was told no. After I got off the phone, I went to her and told her about the guy including "and he hasn't peed yet." The second time I went to her to inform...not yet, she responded, "It's still early" The shift was busy. At change of shift (I'd had him about 5 hours at this point) I told her he still hadn't peed, we instructed the aid to obtain a bladder scan. The oncoming RN was not happy with us at report. The next day this preceptor confronted me at the start of shift and accused me right on the floor of never having given her a heads up about this. I was speechless but did not intend to argue on the floor. I just acknowledged the concern and apologized in an effort to get along/fit in. I was later that week called into the Manager's office and accused of being misleading in regard to my experience in my interview. I was told "We are ready to part ways with you."

I am a single mom and had invested quite an effort into this job or I would have probably left at that time. But I stuck it out. It got better for a while. Then when I made the transition to nights, my position was a night position, my personal hell began. I was assigned a very pleasant appearing RN, an older woman who also looks suprisingly younger. She is newly divorced and I only mention this because she is probably one of the most miserable people I have ever encountered in my life. When I enthusiastically told her, "I want to do well. It is my hope that a year from now, I will be cross-trained into the ICU," her response was..."Good Luck! I've been here for years and they've never cross trained me." This was said in the most sour tone. And while she looks younger, she has the mannerisms and coloquialisms of a much older person. In a conversational/sarcastic tone stated that the 24 hour check of orders which had already been performed and resulted seemed to me "busy work". I never said I wouldn't do it. Her response was, "You'll do it and put it away, or you'll be done with and put away." Again, speechless. I just don't know people who think like this let alone say it aloud. Oh, did I mention, I'm a city girl and this is a rural community. This nurse has worked here for 20 years. It is her first and only nursing job. So, she never appreciated my coming from outside, new system and all. Most who start new to this unit are nursing school grads who have cut their teeth here. And so, entirely different learning curve.

Its gotten unbearable. The click this woman belongs to has it out for me. All I can say is I've been nice. So nice, in fact, that the manager mentioned specifically, "Everyone says you're real nice, it's just that you can't seem to do the job. Oye....let me tell you. The reports she gets are skewed. They will say, "she failed to manage 5 patients." and leave out the details, like: I was working with three, one of whom was a 3:1 when asked to admit a forth. Then, having a 5th forced on me when I had already refused stating it was unsafe because my 3:1 was so terribly busy. This same night, having the Charge request of my preceptor to report unsafe staffing on the way to meet with my managers. And still my preceptor having the audacity to simply report, "unable to manage 5 patients."

The last night I worked, Wednesday, I was given 5 patients. Everyone else had 3, maybe 4. Part of my correction plan for not being able to manage 5 was to "take 5 patients every night". So, I started with 5 and handed off my easiest patient at 2300 because even my evil preceptor acknowledged it was unsafe. She has further forbid me from delegating tasks. I am expected to do EVERYTHING. And she stated she was told by management not to help me. So, I had a poor quality of sleep that day. I was given a young male aid who was more interested in the basketball game in the breakroom than in being on the floor. He failed to report critical VS to me. And at the end of the shift, I realized I had neglected to turn an elderly and frail woman more often than I should have. She was Alert and Oriented and I would have expected her to say something about having stool incontinence sooner in the shift, but she didn't say anything and I didn't think to just peek in until about 6 am. I asked my preceptor to come in the room to assist me as the woman was not able to help. My preceptor came in with my aid and took over my patient. She told me to go and pass my morning meds and she and the aid would clean my patient up.

During report, I was recommending to the on-coming nurse, "we might want to order an air mattress" for this patient. My preceptor was standing next to me at this point and added, "she has a red mark over her coccyx". The on-coming nurse was the same who had accused me of never reporting to her about the man who didn't pee after having his foley removed. That evening as I was preparing to go into work, I got a call from my manager telling me I'd been suspended and the were performing an investigation. I am to report to work on Tuesday. I expect to be fired.

I feel terrible about the little lady. I also feel I was set up to fail and am now being kicked for doing just that. I am also very fearful about losing my license should this little lady go on to develop an ulcer on her bottom.

Does anyone have any such experience. I accept my responsibility here. I would hope for the best in terms of, the little lady's interventions came in time to save her bottom. If not fired I will resign. And I would seek another job in another capacity. I think I'm burned out of floor nursing for now.

Please feedback and this is a shortened version of the nasty encounters I've endured in this hospital. Don't know why I can't get accepted by the majority of nurses. I'm an idealist and I know most nursing personalities are "guardians" (if you are familiar with those terms). I can't stand petty, grumpy, negative focused people and maybe they sense that in me even though I smile and try to get along. I am a little stand-offish by nature. I don't drink and so have declined a couple of invitations to "go out." A lot of the nurses drink because they talk about it. I don't drink coffee either and that makes me stand out because the night shift all share in various coffees. I'm not unpolite about it. I'm LDS and I've shared that. And I have overheard a few unkind stories about missionaries at the door from my preceptor. She talked openly in front of me, knowing I'm LDS, about pulling her dog back from going out to be friendly to the boys who showed up at her door and shutting the door in their faces (boys who are far from home, 19-21 y.o.). I've heard another nurse make negative comments about mormons. Again, I've been open about being LDS only because of the coffee thing, having offered that in declining someone's offer for coffee.

Again, very fearful for my license. Any feedback that would be helpful is appreciated.

[NC Girl BSN]

I think at this point, there is nothing that you can do to improve the situation. They will probably fire you so I would be looking for a new job ASAP. Sorry you had a bad expereince. I am a new grad and in my 4th week of precepting and you story is one that I fear the most. Good Luck to you. Changing your environment will give you a new start.

[chenoaspirit, ASN, RN]

It sounds like you were placed into a bad situation. Why were you not allowed to delegate? I mean, if you had 5 patients, how did they expect you to do total care with no help at all from an assistant. I agree, I would look for another job asap.

[caliotter3]

Sorry to hear things are not working out. Look at your behavior when others try to include you. You can go along without standing out. Lots of people don't drink coffee. It upsets the stomach for some. You don't have to discuss your religious beliefs and probably should not. Try to make the smallest effort, then no one can accuse you of being standoffish.

[Babzuptown]

Sorry to hear things are not working out. Look at your behavior when others try to include you. You can go along without standing out. Lots of people don't drink coffee. It upsets the stomach for some. You don't have to discuss your religious beliefs and probably should not. Try to make the smallest effort, then no one can accuse you of being standoffish.

I brought in nice snacks every night and set them out for everyone. I sympathized when someone was having a rough night. I jumped into help. I am standoffish when it comes to clique stuff. I just started getting picked apart at work. I remember, conversationally mentioning that I loved Nancy Grace. She is such a crusader for victims. They had real (mean spirited) fun with that. "How can you stand listening to her voice?" I was like, "What?"

I just don't know how to fit in with women.

Yeah, if they fire me, great. If not, I'm resigning. Any thoughts on the license part?

[RN1982]

I think you should have a meeting with your manager to tell her how you feel you are doing. Tell her/him your frustration. Say that other nurses get 3-4 patients not 5 like you do and say that having 5 patients of higher acuity is unsafe for you and for any nurse on the floor. Say that it would be easier on you if you could take 3-4 patients a shift and learn how to prioritize and organize your shift before moving up to 5 patients. I would also mention that negative comments about your religion are being made in front of you and that you will not tolerate it as it is making a hostile workplace. Lastly, just look for another job because this unit is not for you. It's sad that instead of encouraging you and helping you grow, they make nasty, snide remarks.

[NC Girl BSN]

I doubt they will take your license. The pressure sore thing is a group effort. The Techs are just as responsible. Also you were technically still being precepted even though she did not help. The whole situation sucks now that I think about it.

[RN1982]

Just re-read your post. If you are expecting to be fired, then resign now. Don't go back and continue to work there and put you and your license at risk.

[caliotter3]

Just re-read your post. If you are expecting to be fired, then resign now. Don't go back and continue to work there and put you and your license at risk.

Yes, beat them to the punch. Better to have resigned, than to explain to prospective employers why you were fired.

[Babzuptown]

Thank you NC Girl RN and TurnLeftSide.

Yes it does suck. And I fully expect to be scapegoated with the bed sore, if it is a bed sore. I pray it is not. And I will sit with the managers on Tuesday to hear them tell me what an incompetent nurse I am. I've already prepared a written response. And if they don't fire me, I'm resigning. It encourages me to know that at least one other RN sees the group responsibility here.

[caliotter3]

Why are you looking for group responsibility? Your meeting with your supervisors will be about you.

[Babzuptown]

I will post here after Tuesday what has come of this. As a writer, this is such a classic scenerio of being set up for failure and such a danger for this profession. I sure wish there was something we could do to really make this stop. I posted somewhere else that I am considering walking coast to coast in protest of nurses feeding on eachother. Maybe this could/should be done. Maybe I could ask nurses to join me as I march through their states! See, I truly am the idealist!