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RN fired from ICU and not offered transfer to another floor.

Nurses   (1,987 Views | 33 Replies)
by HansRN HansRN (New) New Nurse

HansRN has 5 years experience .

123 Profile Views; 13 Posts

Hello everyone,

I really need some advice here as I'm in new territory! I was just fired from the ICU after 5 months and it has really devastated me! I went from a tele/observation unit to a cardiac ICU at a different hospital. I fully admit that it was a big jump from what I was used to but I realty felt that I could do it. I had a pretty rough orientation in that I had very high acuity patients right off the bat. My 2nd or 3rd week in I was dealing with a very sick patient that needed CRRT. Before transferring to the unit, I didn't even know what that was. My preceptor said I wasn't ready for it yet but she then changed her mind and had me run it. It was awful and I had tears in my eyes all night plus a headache. I then realized that maybe I had gotten in over my head but then I thought no, I can do this. As I was meeting with my manager and clinician for the first time they expressed concern to me that I was missing alarms and I had missed titrating an insulin drip and got a written warning for it, not even a verbal at first. That was the first I heard of any of this as my preceptor never came to me and talked to me about it and said hey you really need to work on this or that and see if I improved she just went straight to our manager. And after that meeting I was hyperaware of alarms and was telling the other nurses on the unit about their patients! I also didn't miss a beat with titrating insulin but noticed that a seasoned nurse was only getting 2 hr blood sugars after I got report from her and it was suppressed to be every hour....I should have told my manager but didn't. I know better now, record everything and report everything! I also had an incident after orientation on a post-op patient that was to be receiving fluids but I didn't see the order as the computer system was still new to me. Another where pts sats I was told were low and that I needed prompted to check the patient which was not true. The sats for the pt were 88 and above which was acceptable for her and I noticed at the same time the other nurse noticed when she did actually drop and I went right over to the pt. The pts PaO2 in the morning was 50, I know not good! I was told the pt had altered mental status but she was not like that for me, she answered all questions and was sleeping for at least 4 hours thru the night. I'm really not sure how that happened?

These were the main reasons I was let go. They didn't feel it was a good fit yet also said I was good with the patients and their families and that I was a good nurse and person but I wasn't offered to transfer to a med/surg floor? I took a bonus so this really screws me over not to mention now I have to put on my applications that I was fired and give reasons why to who I interview with! This is awful and I'm completely embarassed and devastated. I keep running everything through my head over and over!

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4 Followers; 37,642 Posts; 102,726 Profile Views

From your post, I sense a reluctance to work with you on their part. At some point early on, it was decided that you were not what they were looking for, so the effort was made to find your errors and omissions, in order to justify letting you go. Agree with your observation that you should have reported the errors of others. Same type of thing happened to me in nursing school (ironically in the ICU). Precepting nurse made an error which I caught. I highly suspect that she reported that it was my error instead. My clinical instructor said that I should have documented what happened.

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HansRN has 5 years experience.

13 Posts; 123 Profile Views

I kind of felt that they had decided early on as you said. I saw other nurses not catch alarms and need prompting. Drips that were ended and needed replaced. I felt like any little thing I did was reported to manager. I was also told from the Nurse educator in that meeting that I needed to have a more aggressive attitude and she literally said, "you need to be more, we'll, I'm not going to say the word but you know what I mean." She was referring to a "***." Um, yeah, that's highly inappropriate and unprofessional!

No one ever made me feel very welcome either. I only made one friend the time I was there who was also new to the unit and had the same feelings as me.

I'm sorry you had that experience, especially as a student. I'm sure it put a bad taste in your mouth for nursing!

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hppygr8ful has 18 years experience as a ASN, RN, EMT-I and specializes in Psych, Addictions, Elder Care, L&D.

8 Followers; 3 Articles; 3,050 Posts; 33,991 Profile Views

My question is did they terminate you with these reason in writing or was it more of a "At will" type termination. It makes a difference because with at will terminations you can put prefer to discus in person and if interviewed simply say something like My employer and I came to the conclusion that it was not a good fit. IF you are stepping back to a med surge position you can even say that you felt a bit over your head in ICU and you are returning to a care environment where you feel more comfortable. While an employer can legally say anything about your work that is truthful most will stick to verifying dates of employment. So keep your head high and don't give up. You will find the right job for you.

Hppy

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Hoosier_RN has 20 years experience as a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

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Depending on where you are located, they may not have moved you to another dept, because currently, many hospitals have nurses on furlough because of a huge slowdown. It may not even be about you in the big picture, don't sweat it from that perspective

Edited by Hoosier_RN

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HansRN has 5 years experience.

13 Posts; 123 Profile Views

My question is did they terminate you with these reason in writing or was it more of a "At will" type termination. It makes a difference because with at will terminations you can put prefer to discus in person and if interviewed simply say something like My employer and I came to the conclusion that it was not a good fit. IF you are stepping back to a med surge position you can even say that you felt a bit over your head in ICU and you are returning to a care environment where you feel more comfortable. While an employer can legally say anything about your work that is truthful most will stick to verifying dates of employment. So keep your head high and don't give up. You will find the right job for you.

Hppy

I wish it were the latter but it was in writing. Thank you for your advice!

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HansRN has 5 years experience.

13 Posts; 123 Profile Views

@ Hoosier,

I didn't think of that. I certainly hope you are right!

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KatieMI has 6 years experience as a BSN, MSN, RN and specializes in ICU, LTACH, Internal Medicine.

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You can always tell on interview that "the position was not a good fit for me" and stop at that. Everybody in medical world knows how things are run in some places, so if your license is otherwise clear, this explanation is more than enough.

You might do nothing wrong that breathing 0.04357658 times/min more than "we always do here". Or someone did not like the way you look around. Or something else along the line. I was terminated under pretty much the same circumstances because someone once said that my accent presents "important safety and security issue". In other words, you just hit bad guys and even worse run unit (to throw an orientee RN with no previous ICU experience into CRRT head first and alone and let it all be figured out as things are going on is a REALLY fantastic idea 😬🤬 Next time, I think they may directly proceed to LVAD or even ECMO with new RN grad so to enjoy the show fully).

Unless there are something really outrageous happen, employers will communicate only dates of employment and personal verification. They know they can be sued (and most likely lose) for every word and breathe on top of it, so they keep silent. This is the reason why even medical professionals caught red-handed stealing drugs and terminated and reported to Boards then and there find new jobs rather quickly and only run into trouble when the Boards process the report - which can take months.

Wishing you good luck to find another job soon and forget about this nightmare.

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HansRN has 5 years experience.

13 Posts; 123 Profile Views

@ Katie

I see what you're saying. It was a very "clicky" unit and I did not feel like I fit in. And I hope you're right about the employers only giving dates and personal verification!

Thank you for advice! I hope this all passes soon too. As the days go on things are getting better! It really helps that I can express myself here and that you all understand the nursing world!

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1,247 Posts; 8,153 Profile Views

All the things you mention are concerning. And the fact that after you were told about not answering alarms and beeps you started reminding other nurses, did not bode well for you. As a newbie, you focus on yourself.

I must not understand how your insulin gtts work. Do you not set your VTBI for the amount the computer tells you to? Like if the rate was 7.3 for one hours would you not set your VTBI for 7.3 so you would know when the next check was due? How does one check every 2 hours?

And what do you mean the sats for this woman we’re normal in the 80s? Did you have an order stating to keep O2>88%? What did your orders say?

When something is brought up to you that you are doing wrong, it is not your job to keep tabs on others. Fix what you are missing. My concern here is that you really aren’t taking responsibility because others are doing it.

ICU needs new people who are open and willing to learn and to accept their mistakes and work to fix it.

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Hoosier_RN has 20 years experience as a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

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3 hours ago, HansRN said:

@ Katie

I see what you're saying. It was a very "clicky" unit and I did not feel like I fit in. And I hope you're right about the employers only giving dates and personal verification!

Thank you for advice! I hope this all passes soon too. As the days go on things are getting better! It really helps that I can express myself here and that you all understand the nursing world!

Actually, an employer can, and will say anything that they wish, as long as it's true and provable. Example-you've interviewed for a new job and they are calling for a reference. They can say, HansRN had an attendance issue. There were 10 days missed in a 180 day period. As long as they can prove that you missed, no issue. They cannot say that you have a drinking problem or suspect drug issue or threatened violence against coworkers if there is no documentation to support the comments. I do some calls in my area, as I've developed many relationships over the years, and can get the "unofficial skinny" on prospective employees. In truth, many do this, whether they admit it or not. Also, nursing is a small world, so make sure that you keep a positive attitude and build the absolute best reputation you can.

The poster that said to worry about your own patients is correct. When people run to me to tattle, it says more about them than the person that they are tattling on! As far as telling coworkers, try the "Sue, I see that you're busy with the new orders on 302. 304 is alarming, would you like me to get it?" Believe me, the old adage that you get more flies with honey is absolutely true. Good luck going forward!

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LibraNurse27 has 7 years experience as a BSN, RN and specializes in Community Health, Med/Surg, ICU Stepdown.

1 Follower; 293 Posts; 3,417 Profile Views

I'm sorry for your bad experience, sounds really stressful and seems like you were not in a supportive environment. I have been on allnurses more than usual lately due to the quarantine! I've seen multiple threads about new grads quitting ICU, being terminated from ICU or feeling stressed out in ICU. Has anyone had a good experience as a new grad in ICU? Does anyone think new grads should not be hired into ICU? I don't really have an opinion, just curious.

Personally I'm glad I started in Med/Surg and clinic. I got to practice skills in a less intense/urgent environment. I got to learn the hospital routine without running from one crashing pt to another, and I did learn about codes/emergencies but not on a daily basis. I do know one new grad in our ICU who is doing well, but we have a supportive team and it's a small ICU that sometimes has half ICU pts and half overflow from PCU and floor. Any opinions? Once again sorry to the OP for what you experienced and I hope you find a unit you enjoy and feel welcomed on!

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