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!
if an employee is given a choice to test for narks or resign immediately, it clearly means that he got a target on the back. If only one person and not a whole shift asked to test, some other explanation can hardly be expected. Even if result is negative, he will be under microscope. A reasonable person very much might want to just resign, guilty or not.
And if he is not guilty and after this he somehow finds out that he was denied jobs because his former boss telling about "suspicions", it is named "slander" with all four elements. Whoever does it can, and very likely be, sued in person for all incurred damages and then quite a bit. This is after the fact that doing it behind someone's back is not quite professional, even if it is done "just out of concerns for my patients".
This is why so many industries moved to "no references" policies a decade ago. Medicine and nursing in particular are way behind of everybody else in this sense, as usual.
You may count yourself lucky that the story ended the way it did. For one of my former NMs the very similar story (except she was "just sharing" her "concerns" about my legal status) ended up as being grilled alive in Boards.
I've tested on request, twice in my career, and thought nothing of it, surely not even a target on me. I guess I live by the adage that if you've done nothing wrong, then you have nothing to sweat over. Just my personal philosophy, and it's served me well so far.
I will say, most bosses who share private info, don't run out and tell that. As far as your legal status, or anyone else's for that matter, it's easy enough to verify. Sometimes red flags are out there, very easy to see, sometimes they are hidden and need a discerning eye to find. Have a blessed day
You weren't ready for the pace and you need more skills to be able to function properly in that environment. You also need support which they clearly didn't want to give you . You can get there in time. Try ICU step down again. I do wonder if this is what they will be doing to nurses that aren't a "good fit", considering that on some units, they don't need (want) the staff due to the hospital losing money because of Covid. Basically the hospital is downsizing and nurses are struggling to get work on other
It is not defeat or going backwards to go back to your old unit. If you were comfortable there and supported, then go for it! I do know COVID is definitely tying up job transfers for now but it won’t last forever. Honestly, sometimes a new job just doesn’t work out and it makes you realize that the grass isn’t always greener. I wish you the best in whatever you choose to do.
You weren't ready for the pace and you need more skills to be able to function properly in that environment. You also need support which they clearly didn't want to give you . You can get there in time. Try ICU step down again. I do wonder if this is what they will be doing to nurses that aren't a "good fit", considering that on some units, they don't need (want) the staff due to the hospital losing money because of Covid. Basically the hospital is downsizing and nurses are struggling to get work on other
units/hospitals so there is competition.
I think you're right. Thinking back I do think maybe a step down unit would have been better to go to first to get some of the skills. I also look back and realize that I should have asked for a different preceptor. Lessons learned!
And I agree that some of this is probably happening because of COVID especially in areas where they have to take precautions but aren't getting covid patients which was that hospital. They made MICU a Covid unit but only had 3 patients who had it. So those nurses had to be sent elsewhere in the hospital. They also made PACU an extension of ICU, more like a step down unit and again those nurses had to go to other units as well. It's definitely a strange a difficult time right now for everyone! I'm trying to think of the positive in all of this and just look forward! Thank you for your advice.
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!
Thank you!
And to respond to your questions. I don't think new grads should go into an ICU. I think they need to develop skills first. Whenever a new grad got pulled to my old tele unit they were overwhelmed and didn't do well with time management. That's one thing I feel like I did well in the unit.
Although you will have others say that hiring new grads is good because then they can be easily molded to ICU because that's all they know.
I totally feel bad for you!! It sucks and I’ve been there! I was personally fired from ICU because of my attendance. They had a 4 day a yr policy, and one yr I exceeded that, like other nurses but I was the only one fired. And boy, I didn’t see that coming!! I mean, I thought... I must be a real piece of *** cuz you never hear of nurses getting fired! I think I cried the first month. Totally embarrassed, ashamed, and very pissed off. That was oct 3, 2013, and I haven’t been back to work. For many reasons I guess, and hubby said just stay home, so I did. Now,I’m trying to go back to work and I’m having all kinds of issues since I don’t have the recent hospital experience! So if you do stay home awhile, it seems like 3 years is the fine line. More than 3 years and it’s a struggle to get hired anywhere. But good luck to you! And trust me, all those things you said happened that got you fired were all things we’ve all experienced at one time or another! It sounds like they were out to get you, unfortunately....
I totally feel bad for you!! It sucks and I’ve been there! I was personally fired from ICU because of my attendance. They had a 4 day a yr policy, and one yr I exceeded that, like other nurses but I was the only one fired. And boy, I didn’t see that coming!! I mean, I thought... I must be a real piece of *** cuz you never hear of nurses getting fired! I think I cried the first month. Totally embarrassed, ashamed, and very pissed off. That was oct 3, 2013, and I haven’t been back to work. For many reasons I guess, and hubby said just stay home, so I did. Now,I’m trying to go back to work and I’m having all kinds of issues since I don’t have the recent hospital experience! So if you do stay home awhile, it seems like 3 years is the fine line. More than 3 years and it’s a struggle to get hired anywhere. But good luck to you! And trust me, all those things you said happened that got you fired were all things we’ve all experienced at one time or another! It sounds like they were out to get you, unfortunately....
I'm so sorry you went through that! It really does suck, doesn't it! But I'm doing better than I thought. I actually just talked with a friend who worked the same unit years ago and had similar experience. Makes me realize I'm not the only one this has happened to and it seems to be a trend of theirs.
I wish I had the opportunity to stay home but I don't. Good luck to you and your job search!
That’s an odd way to do an insulin gtt. So, are you saying the night shift nurse had all her blood sugars greater than 350 and was still checking every two hours?
And my point about the sat was, what was your order? No what they had been in the past, what was your order for? Was the order to keep it greater than 90, 92%? Yesterday, one patient had an order to keep greater than 90, the other greater than 94. You have to know and understand your orders. Nursing is not about what the previous shift did, it’s about what the patient is doing now with what your orders are.
I'm not sure why that's an odd way to do an insulin gtt? although it is the only way I learned on the unit. What do you do? And yes the blood sugars for the previous nurse were high therefore she should have checked blood sugars every hour, instead she only checked every two hours.
And yes, the order was for the pts sats to be 88 and above.
And I agree to some extent that nursing is about what is happening right now but you do have to factor in what happened on the previous shift! You need to know if something serious happened. And it's not just about the orders. You have to look at your patient and see what the patient is doing, that's why they call it critical thinking. We use those skills to make calls and judgements and notify the Doctor that may change the orders that we currently have.
I'm not sure why that's an odd way to do an insulin gtt? although it is the only way I learned on the unit. What do you do? And yes the blood sugars for the previous nurse were high therefore she should have checked blood sugars every hour, instead she only checked every two hours.
And yes, the order was for the pts sats to be 88 and above.
And I agree to some extent that nursing is about what is happening right now but you do have to factor in what happened on the previous shift! You need to know if something serious happened. And it's not just about the orders. You have to look at your patient and see what the patient is doing, that's why they call it critical thinking. We use those skills to make calls and judgements and notify the Doctor that may change the orders that we currently have.
So there was a patient on an insulin gtt with blood sugars still above 350 the entire previous shift? That’s an incident report to me. Where I’m at, you check sugar, put it in the computer, and the computer tells you the rate to run it and for how long. There should never be sugars consistently above 350 when a patient is on a gtt. That requires a call to a physician.
If the patient is maintaining their sat according to the order then you are covered and there is nothing to do.
Was there possibly some communication errors between you and other nurses? I will reiterate, you telling other nurses about their beeps did you in. I just go and get the beeps. I may say something to charge of a particular nurse refuses to get their beeps. Or I may off handedly say, hey I turned your pump off or I added volume, but I’m always helping as a team player. I also always make my orientees get their own beeps as it trains them to listen for pumps and vents. I don’t need trained on that.
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?
This screams silent hypoxia R/T Covid-19. Some people have shown no symptoms other than a crazy low O2 sat & pneumonia on CXR
Sorry this happened to you. I'm not a nurse yet but I aspire to work in a cardiac stepdown unit (the same one where I had my most recent rotation) a year from now (or maybe this Summer as a tech). I wish the best to you!
Hoosier_RN, MSN
3,968 Posts
I've tested on request, twice in my career, and thought nothing of it, surely not even a target on me. I guess I live by the adage that if you've done nothing wrong, then you have nothing to sweat over. Just my personal philosophy, and it's served me well so far.
I will say, most bosses who share private info, don't run out and tell that. As far as your legal status, or anyone else's for that matter, it's easy enough to verify. Sometimes red flags are out there, very easy to see, sometimes they are hidden and need a discerning eye to find. Have a blessed day